Trots att vi vet att problematiskt spelbeteende ofta utvecklas ofta i yngre vuxenålder, saknas kunskap om faktorer som i åldersgruppen predicerar spelproblem och spelberoende.

This observational study sought to improve our understanding of factors that contribute to risky sexual behavior among women seeking treatment for alcohol and other substance use disorders. Women were recruited at the start of outpatient (n=236) or inpatient (n=166) treatment. At intake, a Timeline Follow-back interview was used to obtain retrospective reports of daily drinking, drug use, and sexual behavior for a 90-day pre-treatment baseline period. Additional interview and questionnaire measures also were obtained. Measures were re- administered at four 90-day follow-up interviews. Among women who reported sex with a primary partner during baseline (n=261), 15% reported consistent condom use for all events with this partner, whereas 80% reported no condom use with this partner. Among women who reported sex with a non-primary partner (n=159; doesn’t include commercial sex trading), 26% reported consistent condom use and 45% reported no condom use with such partners. Significant correlates of non-use of condoms included negative beliefs and attitudes and low self-efficacy regarding condom use and AIDS prevention, as well as psychological distress, sexual impulsiveness and sensation seeking, history of severe assault by a male partner, and (with primary partners) negative partner attitudes toward condom use. Some of these correlates also predicted unprotected sex with a primary partner during the first 90 days after treatment entry, after controlling for baseline. However, unsafe sex with a non-primary partner during follow-up was most notably associated with follow-up levels of substance use, i.e., more drinks per drinking day and greater frequency of alcohol, marijuana, and cocaine use. In sum, preliminary analyses of baseline and follow-up data indicate a high prevalence of unprotected sex in this population. Identification of factors related to baseline and follow-up levels of risky behavior may suggest targets for future intervention development.

The objective of this research was to study whether automated telephony could be used in paroled offenders to perform daily assessment of variables associated with recidivismin crime, and whether there are grounds for studying the effects of a brief intervention based on these assessments during 30 days following probation. The design included a randomized controlled trial using automated daily assessments and feedback interventions based on Interactive Voice Response (IVR). Participants included paroled offenders (N = 108) during their first 30 days after leaving prison. All subjects were called daily and answered assessment questions. Based on the content of their daily assessments, the subjects in the intervention group received immediate feedback and a recommendation by IVR, and their probation officers also received a daily report by email. Main outcomemeasures (assessed daily) included Stress (Arnetz and Hasson Stress Questionnaire and a revised version of Daily Assessment of Daily Experience), Mood (SCL-8D measuring depression and anxiety), and Use and Urge to Use Alcohol and Drugs (revised version of the Alcohol Urge Questionnaire). Participants were also asked to rate the severity of their most stressful event that day. The outcome variables were analyzed using linear mixed models, presented as group differences between means, 95%CI. Results indicated that the intervention group showed greater improvement than the control group in stress (9.6, 0.5; 18.7, p = 0.038), depression/anxiety (4.6, 0.2; 9.0, p = 0.042), alcohol use (0.8, 0.1; 1.4, p = 0.031), drug use (1.0, 0.5; 1.6, p = 0.000), and in the severity of themost stressful daily event (1.9, 1.1; 2.7, p = 0.000). There were no differences between the groups in the Stress scale and in craving for alcohol and drugs. Overall, the research suggests that in paroled offenders, automated telephony is an effective technology thatmay be used to follow up and to give interventions, resulting in reduced stress and drug use.

This randomized trial evaluates whether automated telephony could be used to perform daily assessments in paroled offenders (N = 108) during their first 30 days after leaving prison. All subjects were called daily and answered assessment questions. Based on the content of their daily assessments, subjects in the intervention group received immediate feedback and a recommendation by automated telephony, and their probation officers also received a daily report by email. The outcome variables were analyzed using linear mixed models. The intervention group showed greater improvement than the control group in the summary scores (M = 9.6, 95% confidence interval [CI] = [0.5, 18.7], p = .038), in mental symptoms (M = 4.6, CI = [0.2, 9.0], p = .042), in alcohol drinking (M = 0.8, CI = [0.1, 1.4], p = .031), in drug use (M = 1.0, CI = [0.5, 1.6], p = .000), and in most stressful daily event (M = 1.9, CI = [1.1, 2.7], p = .000). In conclusion, automated telephony may be used to follow up and to give interventions, resulting in reduced stress and drug use, in paroled offenders.

Med hänvisning till CANs skolundersökningar kan det konstateras att användande av narkotika och cannabis generellt har ökat från 1989 till 2013. Denna ökning gäller alla regioner i Sverige och oavsett var i landet man bor så följs upp- och nedgångar i drogvanorna i stor del åt. Under åren 2012–2014 användes mest cannabis i Stockholm och Malmö och minst i Glesbygden. Det förelåg inte skillnader mellan cannabisanvändande och betyg eller föräldrarnas utbildningsnivå. Resultat från den europeiska ESPAD-skolstudien visade en ökning av cannabisanvändande fram till 2003 med något lägre nivåer 2007 och 2011. Cannabisanvändandet i Sverige var lägre eller mycket lägre än i de flesta andra länder. När det gäller primärprevention av cannabisanvändande har en nyligen publicerad systematisk litteraturgenomgång av tillgänglig forskning dragit slutsatsen att många men inte alla studier har signifikant positiva effekter, men att effektstorlekarna är i regel små eller triviala. Högst effektstorlek återfinns i generella multimodala program riktade till gruppen 10–13 år, som inte leds av ungdomarnas ordinarie lärare, och som innehåller högst 10 sessioner samt en s k boostersession för att förstärka effekten. För behandling av missbruk eller beroende av cannabis rekommenderar Socialstyrelsen att hälso- och sjukvården samt socialtjänsten ska erbjuda kognitiv beteendeterapi (KBT) eller återfallsprevention med tillägg av motiverande samtal eller Motivational Enhancement Therapy (MET) som är en särskild kombination av bedömning, återkoppling och motivationshöjande samtal. När det gäller den legalisering av cannabis som genomförts i USA sammanfattas dels ett kritiskt ställningstagande inklusive därpå nödvändiga rekommendationer som har publicerats av American Academy of Pediatrics (AAP) och som är den ledande vetenskapliga organisationen för barnläkare i USA. Avslutningsvis presenteras en nyligen presenterad analys från en svensk-amerikansk studie som studerat effekter av legalisering av cannabis i delstaten Washington och som visar att tillgängligheten inte har förändrats men att det finns en tendens (p=0,08) till ökad konsumtion av cannabis till följd av legaliseringen samt att pojkar anser att kontinuerligt användande av cannabis till följd av legaliseringen innebär mindre risk.

Med hänvisning till CANs skolundersökningar kan det konstateras att användande av narkotika och cannabis generellt har ökat från 1989 till 2013. Denna ökning gäller alla regioner i Sverige och oavsett var i landet man bor så följs upp- och nedgångar i drogvanorna i stor del åt. Under åren 2012–2014 användes mest cannabis i Stockholm och Malmö och minst i Glesbygden. Det förelåg inte skillnader mellan cannabisanvändande och betyg eller föräldrarnas utbildningsnivå. Resultat från den europeiska ESPAD-skolstudien visade en ökning av cannabisanvändande fram till 2003 med något lägre nivåer 2007 och 2011. Cannabisanvändandet i Sverige var lägre eller mycket lägre än i de flesta andra länder. När det gäller primärprevention av cannabisanvändande har en nyligen publicerad systematisk litteraturgenomgång av tillgänglig forskning dragit slutsatsen att många men inte alla studier har signifikant positiva effekter, men att effektstorlekarna är i regel små eller triviala. Högst effektstorlek återfinns i generella multimodala program riktade till gruppen 10–13 år, som inte leds av ungdomarnas ordinarie lärare, och som innehåller högst 10 sessioner samt en s k boostersession för att förstärka effekten. För behandling av missbruk eller beroende av cannabis rekommenderar Socialstyrelsen att hälso- och sjukvården samt socialtjänsten ska erbjuda kognitiv beteendeterapi (KBT) eller återfallsprevention med tillägg av motiverande samtal eller Motivational Enhancement Therapy (MET) som är en särskild kombination av bedömning, återkoppling och motivationshöjande samtal. När det gäller den legalisering av cannabis som genomförts i USA sammanfattas dels ett kritiskt ställningstagande inklusive därpå nödvändiga rekommendationer som har publicerats av American Academy of Pediatrics (AAP) och som är den ledande vetenskapliga organisationen för barnläkare i USA. Avslutningsvis presenteras en nyligen presenterad analys från en svensk-amerikansk studie som studerat effekter av legalisering av cannabis i delstaten Washington och som visar att tillgängligheten inte har förändrats men att det finns en tendens (p=0,08) till ökad konsumtion av cannabis till följd av legaliseringen samt att pojkar anser att kontinuerligt användande av cannabis till följd av legaliseringen innebär mindre risk.

The present study includes baseline data from 2867 students (77.8% from Sweden, 22.2% from US) and evaluates the relationships among self-reported disabilities, alcohol use, other substance use, and psychosocial adjustment. There were 114 (4.6%) ‘‘hard-of-hearing’’ (HH) students, 129 (5.2%) reported visual disabilities, 33 (1.3%) reported motor disabilities, 223 (9.0%) reported a reading/writing disability, and 97 (3.6%) reported they had ‘‘other’’ disabilities. Of these, 70 (14.1%) reported more than one disability. Presence of a disability was significantly higher among Sweden students (2 (1)=19.93, p< 0.001), with 19.1% of Sweden students and 11.5% of US students reporting at least one disability. Reporting any type of disability was associated with significantly greater alcohol use frequency, intensity, and related problems (all p < 0.02), significantly more mental health symptoms and conduct problems (p < 0.005), and significantly greater likelihood of illicit and prescription drug use (all p < 0.001). With respect to specific disabilities, individuals with motor disabilities reported the highest levels of alcohol use and mental health symptoms, whereas individuals who reported ‘‘other’’ disabilities had higher rates of illicit drug use and conduct problems. Further, there was a significantly positive correlation between the number of disabilities and intensity of alcohol use, mental health symptoms, conduct problems, illicit and prescription drug use, and alcohol related problems (all p < 0.001). The association between conduct problems and disability (any disability and number of disabilities) was moderated by country of origin, gender, and drinking for coping reasons on the Drinking Motives Questionnaire. Participants in Sweden, males, and those who drank for coping reasons were more likely to report a relationship between disability and conduct problems (p < 0.001). Participants who drank for coping reasons were also more likely to report a relationship between disability and alcohol related problems (p=0.001). These findings indicate students with disabilities are an important risk group for preventive interventions for alcohol, substance, and mental health problems, and may benefit from interventions which target healthy coping skills. This research was supported by NIAAA # 5R01AA018276 awarded to Drs. Larimer & Berglund

Aims: Perceived risk is related to use of cannabis, alcohol, and tobacco among youth. Sweden and US have different policies and customs related to these substances thatmay influence both risk perception and behavior regarding use of these substances. Differences in perceived risk of cannabis, cigarettes, chewing tobacco and alcohol in Sweden and the US have been reported but no direct systematic comparison has been performed. Design and setting: The ATLAS Project is a long-term longitudinal study comparing the development of substance use from high school to the young adult life period (18–23 years) in the US and Sweden. Participants: Baseline data for 3352 17–19 year-old high school students (65%from Sweden, 56% women, mean age 17.8, 35%from US 58%women,mean age 17.6). Measurements: Surveys of perceived risk items, ever use of cannabis, cigarettes and alcohol, as well as conduct problems, mental health symptoms, and impulsivity. Findings: The largest differences between the countries were found for the risk of cannabis use. Swedish participants reported much higher perceived risk both for continuous and occasional use than US students. For cigarettes, chewing tobacco and alcohol students from the US reported higher risk perception than the Swedish students did. Females reported higher perceived risk for all substances than male students.Conduct problems were associated with less perceived risk in all examples and impulsivity in cannabis and alcohol issues. Increasedmental health symptoms were associated with increased perceived risk for alcohol. Those who have used the specific drug reported lower levels of risk for that drug butmostly not for other drugs. Conclusions: Perceived risk for cannabis was higher in Swedish students than in US students while cigarette smoking, chewing tobacco and alcohol use were perceived as more risky in the US. One possibility could be that Sweden has much tougher drug laws than the US while less stringent alcohol and tobacco laws.

Background. To study effects of ever used cigarettes or cannabis on amount and consequences of alcohol drinking. The ATLAS Project is a long-term longitudinal study comparing the development of substance use from high school to the young adult life period (18-23 years) in the US and Sweden. Methods. Baseline data for 3352 17-19 year-old students (65% from Sweden, 35% from US). Measurements: Questionnaire AUDIT-C, Rutgers Alcohol Problem Index, RAPI, ever use of marijuana, cigarettes and alcohol, onset of alcohol drinking, Conduct problems, SCL-8, Impulsivity. Results. The patterns of ever use differed distinctly between the two countries. In US 35% had never used alcohol, 17% had used alcohol and cannabis, 4% alcohol and cigarettes and 22% alcohol, cannabis and cigarettes. Corresponding figures in Sweden were 7%, 1%, 48% and 17%, respectively. Sweden had higher scores on AUDIT C and RAPI than US in the first three groups. In hierarchical multiple regression analyses on AUDIT C early drinking onset, conduct problems and impulsivity had about the same positive effects. Sweden, ever use of cigarettes and marijuana were all significantly related. Marijuana influenced less in Sweden than in the US. In hierarchical multiple regression analyses on RAPI conduct problems had a very strong effect. Sweden, cigarettes and marijuana were all significantly related. Cigarettes influenced less on consequences of drinking in Sweden than in the US. Conclusions. Sweden and the US differed in important aspects on modulating effects of cannabis and cigarettes on alcohol drinking. Supported by a grant from NIAAA/NIH for Larimer/Berglund.

Objective Adolescent alcohol use predicts a myriad of negative mental and physical health outcomes including fatality (Midanik, 2004). Research in parental influence on alcohol consumption finds parental monitoring (PM), or knowing where/whom your child is with, is associated with lower levels of alcohol use in adolescents (e.g., Arria et al., 2008). As PM interventions have had only limited success (Koutakis, Stattin, & Kerr, 2008), investigating moderating factors of PM is of importance. Country may serve as one such moderator (Calafat, Garcia, Juan, Becoña, & Fernández-Hermida, 2014). Thus, the purpose of the present report is to assess the relationship between PM and alcohol use in the US and Sweden. Method High school seniors from the US (n = 1181, 42.3% Male) and Sweden (n = 2171, 44.1% Male) completed assessments of total drinks consumed in a typical week, problematic alcohol use, and perceived PM. Results Generalized linear mixed modeling (GLM, Cohen, Cohen, West, & Aiken, 2013; Hilbe, 2011) was used to examine whether country moderated the relationship between PM and alcohol use. Results revealed main effects of country and PM and a significant interaction between country and PM in predicting total drinks per week and PM in predicting problematic alcohol use (p < 0.001). Conclusions While PM is related to lower quantity of alcohol consumed and problematic alcohol use, greater PM appears to be more strongly related to fewer drinks per week and less problematic alcohol use in the US, as compared to Sweden.

The transition fromadolescence to emerging adulthood is a period of increased risk for heavy drinking behavior. Prior research has found that college students drink more and experience more consequences than their non-college counterparts. However, sparse research has examined whether students who are college- versus work-bound show differences in drinking and related consequences in high school (HS) as well. In addition, little research has explored whether alcohol expectancies also change over time as a function of selection into college versus non-college environments. The current study examined whether alcohol-related expectancies, consequences, and drinking changed over the course of a year as a function of whether participants transitioned into a four-year university (UNI), community college/trade school (CC), or workforce setting (WF). Participants (N=848) were HS seniors (mean age=17.5 years; 37%male, 73%Caucasian) taking part in a larger study examining alcohol use trajectories.Measures included alcohol expectancies (CEOA), drinking (DDQ), and alcohol-related problems (RAPI) assessed during their senior year and one year later. Repeatedmeasures ANOVAs revealed significant main effects for time, indicating increases in drinks per week F(1, 807)=19.18, p>0.001 and alcohol-related problems F(1, 808)=8.78, p>0.01 and a decrease in alcohol expectancies F(1, 808)=14.35, p>0.001 from baseline to 12 month follow-up. Results also found a main effect for group, indicating UNI students held higher expectancies F(2, 808)=8.15, p>0.001 and drank more F(2, 807)=6.26, p>0.01 than other participants. A significant time9group interaction showed that whereas UNI-bound students drank less thanWF-bound students in HS, the roles reversed one year later with UNI students drinking more thanWF students F (2, 807)=27.56, p>0.001. Similarly, WF-bound students had more alcohol-related problems in HS followed by CC-bound students and UNI-bound students, but one year later the order reversed with UNI students exhibiting the most alcohol-related problems F(2, 807)=5.21, p>0.01. Results indicate that whereas UNI-bound seniors exhibit the highest expectancies, drink less, and experience fewer problems during HS, upon entry into UNI, they experience more problems and out-drink their CC andWF counterparts. These results highlight the importance of prevention strategies, including an expectancy challenge component, especially for UNI-bound HS seniors.

Literature indicates that high school students experience numerous negative consequences related to drinking (Miller, Naimi, Brewer, & Jones, 2007). It is therefore important to understand determinants of drinking behaviors in this population, such as injunctive norms (i.e., perception of self and/or others’ approval of a specific behavior; Cialdini et al., 1990). A recent study among college students documented a discrepancy between personal attitudes about alcohol-related consequences and perceived attitudes of peers, with students perceiving peers to be more approving of alcohol-related consequences than themselves, which predicted higher rates of alcohol use (DeMartini, Carey, Lao, & Luciano, 2011). To our knowledge, this has not been studied among high school students. Thus, the purpose of the current study is to evaluate the predictive role of perceived differences in injunctive norms between self and peers for alcohol-related consequences among high school seniors. The sample included 3,352 students in the US (n = 1181, 57.7%female) and Sweden (n = 2171, 55.9% female), participating in an international longitudinal study about alcohol use trajectories. Measures included injunctive norms for self and friends for alcohol-related consequences (i.e., 7 items adapted from the RAPI; White & Labouvie, 1989), alcohol-related consequences (RAPI; White & Labouvie, 1989), and alcohol use (DDQ; Collins, Parks, & Marlatt, 1985). Paired samples t-tests were used to compare mean injunctive norms for self (M = 1.78), and friends (M = 2.02). There was a significant difference in perceived attitudes between self and friends (t (3173) = -17.76, p < .001) such that injunctive norms for self were lower than for friends. Next, regression analyses evaluated the discrepancy in injunctive norms for self and friends and its relation to alcohol outcomes. Differences between self and friends were computed by subtracting self from friends (F-S). F-S significantly predicted total drinks per week (b = .11, F (1, 3059) = 40.27, p < .001), average drinks per drinking occasion (b = .08, F (1, 3059) = 17.37, p < .001), and negative consequences (b = .21, F (1, 3113) = 143.09, p < .001). These results provide additional support of the importance of injunctive norms of alcohol-related consequences in young adults and have implications for prevention programs tailored to high school students. This research was supported by NIAAA #U01 AA018276 awarded to Drs. Larimer & Berglund.

Alcohol use is common among United States and Swedish high school students and is related to negative consequences. Whereas drinking intentions are associated with future drinking behaviors, the use of protective behavioral strategies (PBS) is associated with decreased alcohol-related harm among young adults. The interactive effect of PBS and drinking intentions in predicting alcohol outcomes has not been examined. Further, because most PBS studies have been conducted among U.S. college students, PBS research among other populations is needed. The aims of this study were to evaluate longitudinally (a) the relationships between drinking intentions, PBS and alcohol outcomes, and (b) the moderating roles of drinking intentions and country in these relationships among United States and Swedish high school drinkers. Data were collected at baseline, 6- and 12-month follow-ups on 901 Swedish and 288 U.S. high school drinkers. Drinking intentions were associated with more alcohol use and consequences, and use of certain PBS was related to fewer alcohol-related consequences over time. Additionally, the negative prospective relationship between use of PBS and alcohol use, but not alcohol-related consequences, was moderated by intentions, such that the relationship was stronger among participants endorsing high drinking intentions. Country did not moderate these relationships. These results provide initial support for the generalizability of PBS college research to United States and Swedish high school students and suggest that interventions targeting the use of PBS may be most effective among high school drinkers endorsing high drinking intentions.

Denna rapport är en halvtidsdokumentation av den storstadssatsning som mellan 2012 och 2014 genomförs i Stockholm, Göteborg och Malmö med syfte att minska användande av cannabis hos unga. Författarna till rapporten är medlemmar av den övergripande forskargrupp som utsetts av de tre medverkande storstäderna för att följa, dokumentera och utvärdera projektet som helhet. Den övergripande forskargruppen kommer att presentera sin slutrapport sommaren/hösten 2014. Halvtidsdokumentationen avser perioden från januari 2012 till september 2013 och har tillkommit på initiativ av den övergripande forskargruppen för att dokumentera storstadssatsningens förlopp samt för att skapa ett underlag som kan användas såväl under den återstående projekttiden, som vid slutrapportering av hela storstadssatsningen. Rapporten presenterades på ett seminarium med de tre medverkande städerna i Malmö den 3 februari 2014. Rapporten publiceras av Malmö Högskola efter överenskommelse med medverkande städer för att möjliggöra citering av rapportens innehåll vid kommande slutrapport samt för att göra dess innehåll tillgängligt för andra intressenter.

Young adult drinkers engage in a range of drinking patterns from abstaining to heavy drinking in both the United States and Sweden. Heavy drinking during young adulthood in both countries is associated with a variety of negative consequences. Personalized feedback interventions have been identified as effective prevention strategies to prevent or reduce heavy drinking in the United States. This study examined transitions in drinking profiles and compared the efficacy of a personalized feedback intervention for 3965 young adults in the United States (1,735) and Sweden (2230) during their transition out of high school. Using goodness-of-fit criteria, results indicated that three drinking profiles exist among young adults transitioning out of high school: very low drinkers/abstainers, moderate to heavy drinkers, and very heavy drinkers. Latent Markov models revealed a moderating effect of country on personalized feedback intervention such that intervention condition participants in the United States were more likely to belong to the light drinker/abstainer or moderate to heavy profile relative to the very heavy drinking profile at 6-month follow-up. There was no significant effect of personalized feedback intervention in Sweden. Future research could investigate the impact of when personalized feedback interventions are administered and could examine if personalized feedback interventions should be more intentionally culturally adapted in order to be more effective.

A key developmental period for alcohol misuse is emerging adulthood (roughly ages 18–25). Personalized Feedback Interventions (PFI) are effective in reducing alcohol-related harmin college populations, however little research has evaluated PFIs given during high school.Moreover, cultural differences influence both alcohol misuse and response to interventions. The purpose of this study is to evaluate the efficacy of a web-based PFI given to high school seniors (ages 17-19) in the USA and Sweden. 1181 participants (42.3%male; 28.3%risky drinkers based on AUDIT-C) in the USA and 2171 in Sweden (44.1%male; 52.3% risky drinkers based on AUDIT-C) were assessed during their high school senior year. Approximately 1/3 were randomized to receive PFI. Approximately 1 week after viewing the PFI, participants were asked to complete a post-feedback satisfaction survey (3 subscales: information motivated change, shared information with friends, information was educational), and their “stage” on the readiness to change scale. Results showed 1) information motivated change subscale was associated with increases in contemplation and action stages of change and decreases in precontemplation; Swedish participants and those with higher AUDIT-C scores had lower scores; (2) USA sample was less likely to share information with friends; those with higher AUDIT-C scores were more likely to share information with friends; and (3) those with higher AUDIT-C scores were less likely to find information educational. Participants completed 6- and 12- month follow up surveys. After controlling for key baseline variables and using appropriate distributions for analyses, 6 month outcomes from 2236 participants (852 in USA; 1384 in Sweden; 731 received PFI), found those who received PFI drank significantly less alcohol per occasion (typical and peak), had lower blood alcohol concentration (typical and peak) and drank on fewer occasions than those who did not receive the PFI (effect size range: d = .12 to d = .22). There were no significant effects of PFI on alcohol-related problems or readiness to change and no significant interactions between country of residence and intervention on drinking outcomes. Results suggest web-based PFIs given during senior year of high school are efficacious in reducing alcohol use during transition to adulthood. Twelve-month outcomes and mediators will also be presented. This research was supported by NIAAA # 5R01AA018276 awarded to Drs. Larimer & Berglund.

Positive alcohol expectancies and alcohol use tend to increase from adolescence to young adulthood, yet little is known about the associations between these constructs across cultures. The current study adds to the extant literature by examining the growth trajectories of positive alcohol expectancies and drinking behavior among United States (US) and Swedish participants during a critical period where significant change in these outcomes may be expected to occur. A total of 870 (US, N = 362; Sweden, N = 508) high school seniors completed baseline, 6-month, and 12-month assessments of alcohol expectancies and drinking (i.e., drinks per week). Changes in positive alcohol expectancies and drinking behavior were examined using a parallel process latent growth model. In both samples, higher baseline levels of positive alcohol expectancies were associated with a higher number of drinks consumed per week at baseline. In the US sample, lower baseline levels of positive alcohol expectancies were associated with a greater increase in positive alcohol expectancies at 12-month follow-up, and lower baseline levels of drinks per week were associated with a greater increase in drinks consumed per week at 12-month follow-up. In the Swedish sample, an increase in positive alcohol expectancies over time was associated with an increase in drinks consumed per week over the same period of time. Additional research is needed to examine when and for whom expectancy-based alcohol interventions are most efficacious.

Decreases in alcohol consumptions have been linked to the use of protective behavioral strategies (PBS) a number of times (Arterberry et al., 2014; Kenny et al., 2014; & Braitman et al., 2014). Trait mindfulness has been researched looking for a link in substance use treatment. Promising results have been found (Grow et al., 2015; Vinci et al., 2014) that have led to the creation of treatment modalities such as Mindfulness-Based Relapse Prevention (Bowen, Charla, Marlatt, 2010). The present study investigates the relation between PBS, mindfulness, and negative outcomes due to alcohol consumption. The participants are part of a larger study (N = 3,352) investigating a brief online alcohol use intervention amongWashington state (n = 1,181) and Swedish high school seniors (n = 2,171). Data was collected at a six-month follow-up via an online survey. Participants completed the 15-item Protective Behavioral Strategies Scale that measures PBS with responses ranging from 1-Never to 6-Always (PBSS; Martens et al., 2007); a 12-item trait mindfulness measure with responses ranging from1-Rarely/Not at all to 4-Almost always (Cognitive and AffectiveMindfulness Scale Revised; Feldman et al., 2007); and the Young Adult Alcohol Problem Screening Test (Hurlbut & Sher, 1992), which measures social and personal problems related to drinking. A regression analysis was performed to assess the relationship between the measures. Significant main effects were found for PBS (p < 0.001) and mindfulness (p < 0.01) on negative consequences of alcohol use. However, there was no moderating effect of mindfulness on the relation between PBS and negative effects of alcohol (p = 0.10). Results support past research on the impact of mindfulness on negative effects of alcohol. Results regarding PBS were not consistent with past literature regarding their impact on decreasing negative effects of alcohol. This may be attributed to a relationship between those individuals using PBS and the amount of negative drinking consequences they already experience. There was not enough evidence to suggest amoderating effect ofmindfulness as a factor that would further decrease negative alcohol effects. Future research could investigate whether a treatment designed to increase the effectiveness of PBS through increased mindfulness is a suitable intervention. This research was supported by NIAAA # 5R01AA018276 awarded to Drs. Larimer & Berglund.

Mindfulness-based interventions have become increasingly utilized with individuals with alcohol and substance use disorders (e.g., Bowen et al., 2014); however, the relationship between mindfulness and substance use is complex (Karyadi et al., 2014). Mindfulness is a multifaceted construct and includes factors related to attentional control, present moment focus, and an attitude of non-judgment and acceptance. Thus, the relationship between different mindfulness factors and substance use, and negative consequences related to its use, may differ. In the present study, we examined which specific elements of mindfulness would best predict drinking consequences 6 months later in a sample of American and Swedish adolescents. Additionally, we examined whether adolescents’ nationality would moderate the relationship between mindfulness and drinking consequences. Our sample included Washington St, USA and Swedish adolescents participating in a larger study investigating a brief online intervention for alcohol use (N = 3,352). Participants completed an online survey at 6- and 12-month follow up. At the 6-month follow up, trait-mindfulness wasmeasured using the Cognitive and AffectiveMindfulness Scale-Revised (Feldman et al., 2007). At 12-month follow up, alcohol related negative consequences were measured using the Rutgers Alcohol Problem Index (White & Lobouvie, 1989). Linear regression analysis revealed that mindfulness factors did explain a significant proportion of variance in drinking consequences scores, R2 = 0.02, F(4, 620) = 2.67, p = 0.03. Specifically, the mindfulness factor of attention predicted drinking consequences, such that lower levels of attention predictedmore drinking consequences, b = 0.23, p = 0.02. None of the other mindfulness factors significantly predicted drinking consequences. Adolescents’ nationality did notmoderate the relationship between the mindfulness factors and drinking consequences 6 month later. The present study findings differ from previous findings, which found a relationship between awareness and drinking consequences (Fernandez et al., 2010), although this may be due to differences in how mindfulness factors were conceptualized and assessed. Nationality was not shown to moderate the relationship between mindfulness factors and drinking consequences, suggesting that mindfulness factors may not be culturally bound and may operate consistently across cultures, although examination of additional cultures is needed.

Background: The re-entry process is considered to be a stressful event and stress has been identified as an acute dynamic risk factor for crime and criminal recidivism. This study uses Interactive Voice Response to measure stressful daily events, and severity of those events, in paroled offenders during their first 30 days after leaving prison. As far as we know, this is the first study using automated telephony to monitor daily development of stressful events among paroled offenders. Aim: What kind of stressful daily events have been reported by prisoners on parole during the first 30 days after leaving prison and how severe are they in terms of a) self-reported rating, and b) variables associated with psychosocial dysfunction. Methods: 108 paroled offenders were recruited from the Swedish Prison and Probation Service while still in prison. A computer was programmed to perform one daily telephone assessment for each participant, starting the day after probation and continuing for 30 consecutive days. Measures: All subjects were called daily and asked to make a voice recording, maximum 30 s, about their most stressful daily event, and then rate the severity of this event on a scale ranging from 0 (very severe) to 9 (not at all) (Stone & Neal, 1982). They were also asked to daily report their current use and craving for alcohol and drugs, common indices of stress, and symptoms of anxiety and depression (SCL-8). All questions were rated on a 10-digit scale, ranging from 0 (negative) to 9 (positive). The daily assessment involved totally 21 questions and with the exception of the rating of most stressful event, the remaining 19 questions were summarized to a total scale ranging from 0 (maximum negative) to 171 points (maximum positive). Analysis: Descriptive content analysis was used to examine the data on daily stressful events. Mean values were calculated on the self-reported severity ratings, use and craving for alcohol and drugs, common indices of stress, and symptoms of anxiety and depression (SCL-8). Results: Of a possible 3,240 follow-up contacts during the first 30 days after release on parole, 2,298 (70.9%) recordings were completed. The number of completed recordings for the open-ended question, the most stressful daily event, were 1020 (32.5%), of which 481 (14.8%) contained an stressful event. Of the total of 108 individuals who participated in the follow-ups 76/108 (70.6%) completed at least one recording. The recordings about stressful daily events were categorized and are presented in the table below. Conclusion: This study shows that it is possible to use automated telephony to monitor daily events as well as severity of those events among prisoners on parole. This kind of technology may have implication for parole officers whose work situation is associated with a significant workload and have little time to follow up and intervene on paroled offenders. It may, for example, be used to identify acute challenges related to criminal recidivism that former inmates are facing in the critical period following releas

Few studies have assessed acute dynamic risk repeatedly among paroled offenders to investigate the relationship between changes in acute dynamic risk and recidivism in crime. The present study investigates whether one-month changes in ten stress-related acute dynamic risk factors, collected through automated telephony while the participants were still in prison and over 30 consecutive days following parole, predict one-year criminal recidivism, including its predictive accuracy. The study also investigates whether a brief feedback intervention in conjunction with the daily assessments reduces recidivism compared to an assessment-only control group. Changes in five risk factors were found to be associated with increased risk of criminal recidivism after controlling for the results in prison, the initial value after parole, and the intervention. The predictive accuracy is marginally accurate: Summary score (AUC) = .666; Level of stress (AHSS) = .644; Psychiatric symptoms (SCL-8D) = .641; Anxiety symptoms = .673; Severity of most stressful daily event = .690. No differences in one-year recidivism rates were established between the intervention group and the control group. The study shows that daily assessments can usefully be made of dynamic risk factors in paroled offenders.

Purpose: Alcohol use reaches its peak during young adulthood. The current study examined transitions in drinking status across a one year period in Swedish and American young adults while also examining the association between country of origin, educational status, tobacco use, andmarijuana use on the probabilities of heavy drinking and transitions in heavy drinking over time. Methods: Young adults (N=3342; mean age=17.7 (SD=0.53; 56.6% female) were recruited from Sweden (n=2171) and US (n=1181) schools and assessed prospectively at 6- and 12-months following the baseline assessment. The Daily Drinking Questionnaire was used to assess changes in the quantity and frequency of alcohol use. Educational status, tobacco use, andmarijuana use were also assessed prospectively at 6- and 12-months. Results: Latent Markov models were used to examine changes in alcohol use from baseline to the 12-month follow-up, as well as cross-sectional and cross-lagged associations between heavy drinking and educational status, tobacco use, and marijuana use over time. The “low drinking class” had, on average,