Addict Behav [JOURNAL]
Sun
200 papers
Altered functional diversity in alcohol use disorder: an edge-centric marker linked to neurochemical and transcriptional signatures.
Wang M, Huang Z, Zheng H … +2 more , Dong G, Zeng N
Addict Behav · 2026 Aug · PMID 41932004 · Publisher ↗
BACKGROUND: Alcohol Use Disorder (AUD) is increasingly understood as a disorder of connectomic dysregulation. However, node-centric models fail to capture the brain's overlapping functional architecture. We employed an e...
BACKGROUND: Alcohol Use Disorder (AUD) is increasingly understood as a disorder of connectomic dysregulation. However, node-centric models fail to capture the brain's overlapping functional architecture. We employed an edge-centric framework to quantify functional diversity from overlapping communities and investigated its neurobiological basis in AUD. METHODS: We analyzed resting-state fMRI data from 93 individuals with AUD and 91 matched healthy controls. We quantified nodal functional diversity using normalized entropy derived from overlapping edge communities. In this context, high diversity (entropy approaching 1) reflects flexible, multi-network engagement, while low diversity (entropy approaching 0) reflects functional specialization. A Partial Least Squares Discriminant Analysis (PLS-DA) identified the whole-brain functional diversity pattern maximizing group separation. This pattern was then correlated with normative neurotransmitter receptor and gene expression data. RESULTS: A PLS component significantly separated the groups (p < 0.001). This pattern was defined by decreased functional diversity in the nucleus accumbens and globus pallidus, and increased functional generalization in the insula and inferior frontal gyrus. This AUD-related pattern was negatively predicted by D1 and NMDA receptor distributions and positively by the 5-HTT transporter. Spatially, this pattern correlated with genes enriched for "synapse structure" and "cellular responses to stress". CONCLUSION: Our edge-centric approach identified a bidirectional reorganization of functional diversity in AUD. This pattern, reflecting a specialized striatum and generalized insula, is spatially anchored to core dopaminergic/glutamatergic receptor maps and genetic pathways for synaptic plasticity and cellular stress, highlighting functional diversity as a novel, multilevel biomarker for AUD.
Anxiety sensitivity dimensions and the alcohol hangover experience: Longitudinal associations with hangover-related anxiety and depression.
Fujiwara S, Sherry SB, Rostampour R … +5 more , Kim AJ, Kruisselbrink LD, Lambe LJ, Watt MC, Stewart SH
Addict Behav · 2026 Aug · PMID 41930802 · Publisher ↗
Anxiety sensitivity (AS), the fear of anxiety-related sensations and emotions, is linked to alcohol use and related problems, yet its relationship to alcohol hangover experiences remains unstudied. Because hangover sympt...
Anxiety sensitivity (AS), the fear of anxiety-related sensations and emotions, is linked to alcohol use and related problems, yet its relationship to alcohol hangover experiences remains unstudied. Because hangover symptoms, like nausea and sweating, resemble anxiety-related sensations, we theorized that levels of AS would influence hangover-related experiences. We examined the relations of AS dimensions (i.e., AS physical, cognitive, and social concerns) with hangover-related experience outcomes (i.e., hangover-related anxiety and hangover-related depression). N = 334 emerging adult drinkers (aged 19-29) from three eastern Canadian universities who had experienced a hangover in the last two weeks completed self-report surveys at two time-points separated by one month. We hypothesized higher AS physical, cognitive, and social concerns at baseline would predict greater hangover-related anxiety at one-month follow-up, and only higher AS cognitive concerns at baseline would predict greater hangover-related depression at follow-up. We expected these results to hold while controlling baseline levels of the hangover outcome in question and other important covariates. Results revealed baseline AS cognitive concerns were the only AS dimension predicting hangover-related anxiety at follow-up beyond covariates. None of the baseline AS dimensions predicted hangover-related depression at follow-up beyond covariates. Results help us to identify who is at most risk of adverse hangover-related anxiety experiences and potentially prevent these aversive hangover experiences and associated future alcohol problems in hangover-sensitive drinkers by targeting higher AS cognitive concerns in intervention.
Experiences of opioid-related stigma among sexual assault survivors who use opioids in the community.
Bhuptani PH, Mayer ED, Sharma A … +5 more , Ho D, Srinagesh A, Adams-Clark A, Orchowski LM, Weiss NH
Addict Behav · 2026 Aug · PMID 41921389 · Publisher ↗
Opioid use is highly stigmatized, yet little is known about how stigma is experienced by community participants who are actively using opioids. Method This qualitative study explored opioid-related stigma among adults wh...
Opioid use is highly stigmatized, yet little is known about how stigma is experienced by community participants who are actively using opioids. Method This qualitative study explored opioid-related stigma among adults who use opioids (N = 17) and have experienced sexual violence, recruited through community outreach and local partnerships. Semi-structured interviews examined experiences of structural, interpersonal, and internalized stigma, and transcripts were analyzed using thematic analysis. Results Five themes emerged regarding opioid use and stigma: (1) pervasive judgment and rejection from family, friends, and colleagues, (2) stigmatizing encounters within healthcare and treatment systems, (3) internalized stigma and cycles of shame, (4) structural barriers that reinforce marginalization, and (5) strategies to resist and counter stigma. Conclusion Findings highlight the multifaceted nature of opioid-related stigma and its role in shaping opioid use, treatment engagement, and recovery trajectories. By centering the voices of individuals actively using non-medical opioids this study underscores the need for stigma reduction interventions that integrate harm reduction, trauma-informed care, and structural reforms.
Longitudinal associations among posttraumatic stress symptoms, intolerance of uncertainty and internet gaming disorder symptoms among disaster-exposed adolescents.
Yuan GF, Fung HW, Wong MY … +2 more , Shi W, Ding X
Addict Behav · 2026 Aug · PMID 41921388 · Publisher ↗
Disaster-exposed adolescents face elevated risks for developing posttraumatic stress symptoms (PTSS) and maladaptive coping behaviors, including internet gaming disorder (IGD). However, the longitudinal mechanisms underl...
Disaster-exposed adolescents face elevated risks for developing posttraumatic stress symptoms (PTSS) and maladaptive coping behaviors, including internet gaming disorder (IGD). However, the longitudinal mechanisms underlying these relationships remain unclear, particularly the role of intolerance of uncertainty (IU) as a potential transdiagnostic vulnerability factor. This longitudinal study examined 403 disaster-exposed adolescents (M = 13.33, SD = 0.52; 49.6% girls) across three waves. PTSS, IU, and IGD symptoms were assessed at three time points, with a six-month interval between each assessment. We employed latent variable cross-lagged panel models to examine the temporal directionality of these relationships and tested a complete longitudinal mediation model. Cross-lagged analyses indicated that PTSS consistently predicted subsequent increases in IGD symptoms over time, but not vice versa. The longitudinal mediation model revealed two significant indirect pathways: (1) early PTSS predicted later IGD symptoms through the mediating effect of increased IU, and (2) early IU predicted later IGD symptoms through the mediating effect of increased PTSS. Our findings reveal complex longitudinal pathways linking trauma-related distress, cognitive vulnerability, and problematic gaming. Intolerance of uncertainty emerges as a key mechanism that both results from trauma and contributes to the development of IGD. These results underscore the importance of screening for and treating IU in trauma-informed interventions for disaster-exposed adolescents to prevent the onset or exacerbation of secondary complications like IGD.
Gender-related differences in structural pathways involving alcohol-related aggressive behaviors, family conflicts, and Cluster B personality disorders in substance use treatment: engagement, discharge, and readmissions.
Dacosta-Sánchez D, González Ponce BM, Mancheño-Velasco C … +2 more , Narváez-Camargo M, Lozano ÓM
Addict Behav · 2026 Aug · PMID 41916201 · Publisher ↗
BACKGROUND: Gender-informed addiction care needs evidence on whether alcohol-related aggressive behaviors, family conflict and Cluster B pathology influence treatment differently for men and women. OBJECTIVE: To test gen...
BACKGROUND: Gender-informed addiction care needs evidence on whether alcohol-related aggressive behaviors, family conflict and Cluster B pathology influence treatment differently for men and women. OBJECTIVE: To test gender-specific structural pathways associating years of problematic alcohol use, alcohol-related aggressive behaviors, partner conflict, child conflict and Cluster B diagnosis with appointment adherence, retention, therapeutic discharge and readmissions. METHOD: Retrospective electronic health record study in Andalusia's public addiction treatment network (N = 4844 entrants, 2015-2021; 25.5% women). Multigroup structural modelling tested within-gender associations and gender differences in pathways to outcomes. RESULTS: Child conflict was more prevalent in women than men (31.7% vs 15.9%; V = 0.17; p < 0.001) and was associated with higher readmissions in women (β = 0.101; p = 0.001) but not men (β = -0.029; p = 0.126); partner conflict was associated with fewer readmissions in men (β = -0.041; p = 0.019). In men, alcohol-related aggressive behaviors were associated with lower appointment adherence (β = -0.059; p = 0.001). Cluster B diagnosis was associated with lower therapeutic discharge (men: β = -0.063; p = 0.017; women: β = -0.138; p = 0.005) and higher readmissions (men: β = 0.062; women: β = 0.095; both p < 0.001). Retention was associated with higher discharge and fewer readmissions in both genders (all p < 0.001). Meaningful gender-specific structural differences emerged only in the pathway associating child conflict to readmissions. DISCUSSION AND CONCLUSION: These pathways highlight child conflict as a gender-specific readmission risk marker for women and support family-focused, gender-informed interventions that strengthen adherence and retention.
Late adolescent nonmedical prescription stimulant sources and links to young adult nonmedical stimulant use and sources.
Schepis TS, McCabe SE, West BT … +3 more , Ford JA, Jardine J, Veliz PT
Addict Behav · 2026 Aug · PMID 41916200 · Full text
INTRODUCTION: Specific sources for nonmedical prescription stimulant use (NMPSU) are linked to different rates of concurrent substance use (e.g., cannabis use) in adolescents and young adults. This study investigates whe...
INTRODUCTION: Specific sources for nonmedical prescription stimulant use (NMPSU) are linked to different rates of concurrent substance use (e.g., cannabis use) in adolescents and young adults. This study investigates whether NMPSU sources at age 17-18 (baseline) are linked to greater odds of NMPSU over young adulthood (19-30 years) and whether sources are consistent across development. METHODS: Data were from the 2007-2020 longitudinal Monitoring the Future panel study, with 1244 observations from 876 unique participants with any past-year NMPSU source data. NMPSU sources included given for free, theft, purchases, from one's own prescription, or other sources. Multiple source use was also captured. Analyses estimated NMPSU sources by age group (17-18 vs. 19-30) and NMPSU and source use at ages 19-30 based on NMPSU sources at ages 17-18. RESULTS: When compared to older adolescents, young adults were more likely to obtain stimulant medication from peers or family for free (adjusted odds ratio [aOR] = 1.58, 95% confidence interval (95% CI) = 1.10, 2.28), while NMPSU from one's own prescription (aOR = 0.39, 95% CI = 0.23, 0.65) and other source use (aOR = 0.38, 95% CI = 0.21, 0.69) were less common. Sources at ages 17-18 did not predict prevalence of past-year NMPSU at ages 19-30; similarly, sources were not consistent across the study period. CONCLUSIONS: NMPSU sources in late adolescence were not related to NMPSU in young adulthood, and sources were not consistent. Stimulant medication sources may be a better indicator of current risky behavior than of longer-term substance use.
Variability in drinking quantities related to impaired control and pharmacological criteria for lifetime alcohol use disorder.
Gruenewald PJ, Caetano R, Mair C
Addict Behav · 2026 Aug · PMID 41904834 · Full text
BACKGROUND: Greater variability in the amounts of alcohol consumed across drinking occasions is related to heavier drinking and greater numbers of alcohol related problems. While it is known that greater variability is a...
BACKGROUND: Greater variability in the amounts of alcohol consumed across drinking occasions is related to heavier drinking and greater numbers of alcohol related problems. While it is known that greater variability is associated with measures of drinking patterns (quantities, frequencies and volumes), drinkers who report more symptoms of impaired control and pharmacological criteria related to lifetime alcohol use disorder (AUD) may also exhibit greater variability and drinking risks. METHODS: A web-based survey of 2044 "regular" drinkers reporting use at least twice a month over the previous year assessed sociodemographic, cognitive social characteristics, drinking patterns, and symptoms of lifetime AUD. The mean, variance and coefficient of variation, cv, of the distribution of drinking quantities were calculated for drinkers who consumed on 10 or more occasions. Estimated values of cv were related to model covariates and, specifically, symptoms of impaired control (e.g., inability to stop drinking) and pharmacological criteria (i.e., tolerance, withdrawal and craving) related to lifetime AUD using zero censored Tobit regression models. RESULTS: The average cv for these drinkers was 0.482 and cv was related to average drinking quantities (Wald X = 33.98, df = 6, p < 0.001), frequencies and volumes (Wald X = 6.16, df = 3, p < 0.001), social drinking motives (Wald X = 3.75, df = 3, p = 0.011), numbers of pharmacological criteria related to lifetime AUD (Wald X = 4.89, df = 1, p = 0.0272) but not reports of impaired control (Wald Χ = 0.26, p = 0.6135). CONCLUSIONS: Pharmacological symptom criteria related to lifetime AUD are related to greater cv and expose regular drinkers to much greater risks for heavier drinking and problems.
Examining in the moment patterns of tobacco and cannabis co-use prior to a tobacco quit attempt.
Wedel AV, Walters K, Baker N … +3 more , Dowd AN, Tomko RL, McClure EA
Addict Behav · 2026 Aug · PMID 41904833 · Publisher ↗
OBJECTIVE: Cannabis use is common among those who use tobacco, yet much remains unknown about daily variation in patterns of co-use and their associations with tobacco and cannabis consumption. This multimethod study use...
OBJECTIVE: Cannabis use is common among those who use tobacco, yet much remains unknown about daily variation in patterns of co-use and their associations with tobacco and cannabis consumption. This multimethod study used daily diaries and a 7-day burst of ecological momentary assessment (EMA) to (a) examine baseline patterns of cannabis, tobacco, and co-use among daily tobacco users who co-use cannabis, and (b) examine daily and momentary associations of these patterns with cigarette and cannabis consumption prior to a tobacco quit attempt. METHODS: Daily diaries were collected from 110 participants that smoked cigarettes daily (M = 32.23 [SD = 5.63], 42% female) for 7 days prior to initiating tobacco treatment. A subsample of these participants (n = 32) also completed up to 4 EMA sessions per day for 7 days preceding treatment initiation. Multilevel models were used to test direct relationships of use type (tobacco-only, cannabis-only, sequential co-use, co-administration) with daily cigarette and cannabis consumption within-person. RESULTS: Participants reported co-using tobacco and cannabis on 76% of days and 21% of sessions, with more co-use occurring sequentially than via co-administration. Day-to-day, participants reported smoking more cigarettes, but not more cannabis, on days with co-use. Moment-to-moment, compared to single-substance sessions, sequential co-use was associated with greater cigarette and cannabis consumption, while co-administration was associated with greater cannabis use but fewer cigarettes. CONCLUSIONS: Both sequential co-use and co-administration are linked to changes in tobacco and cannabis use, with sequential co-use associated with greater consumption of both substances. Sequential co-use patterns may be particularly relevant targets for future intervention research.
A qualitative insight into the experience of slamming: A focus group study in western France.
Corre C, Bourdon M, Caillon J … +3 more , Victorri-Vigneau C, Grall-Bronnec M, Schreck B
Addict Behav · 2026 Aug · PMID 41904832 · Publisher ↗
BACKGROUND: Slamming refers to the injection of psychoactive substances in a sexual context and has been developing in Europe since the late 2000s. It typically involves the use of psychostimulants such as cathinones, co...
BACKGROUND: Slamming refers to the injection of psychoactive substances in a sexual context and has been developing in Europe since the late 2000s. It typically involves the use of psychostimulants such as cathinones, cocaine, or methamphetamine. The experience of individuals in slamming has rarely been studied through group interviews. This study aimed to describe the experience of slamming from the users' perspectives through focus groups. METHODS: Four focus groups were conducted. Groups included 3-5 participants, for a total of 16 individuals recruited via healthcare centres, community-based centres, bars, gay saunas and social media platforms. A reflexive thematic analysis was carried out following Braun and Clarke's iterative process, allowing for a rich description of the dynamics associated with slamming. RESULTS: Four themes were generated: an addictive process, the experience of sexuality, the social dimension of slamming, and emotional intensity. Together, these themes highlight how slamming is motivated by the pursuit of pleasure and social connection, while also functioning as a coping strategy for emotional distress and being associated with intense bodily sensations and addiction-related dynamics. CONCLUSION: This study highlights the complex psychosocial dimensions of slamming and underscores the need for comprehensive care integrating addiction treatment and psychiatric support, as well as the importance of community-based approaches.
"Men should watch football games instead of soap operas": Masculine role norm endorsement as a population-level construct associated with harmful gambling.
Newall P, Weiss-Cohen L, Russell AMT … +1 more , Cassino D
Addict Behav · 2026 Aug · PMID 41904831 · Publisher ↗
Men experience an increased risk of harmful gambling. As with other determinants of gambling harms, this can be due to a combination of biological, psychological, and social factors, such as the construct of masculinity,...
Men experience an increased risk of harmful gambling. As with other determinants of gambling harms, this can be due to a combination of biological, psychological, and social factors, such as the construct of masculinity, which cuts across these factors. Here we focus on a facet of gender ideology, the endorsement of masculine role norms about how men should behave (as measured by the five-item MRNI-VB scale; e.g., "Men should watch football games instead of soap operas"). These role norms can be endorsed by anyone, and are therefore distinct from gender identity. We conducted a cross-sectional online study (data retained for 4193 participants reporting past 12-month gambling engagement), exploring associations between masculine role norm endorsement and harmful gambling among men (n = 2070), and among women-and-others (n = 2123). Masculine role norm endorsement as measured by the MRNI-VB scale consistently predicted higher levels of gambling harm (as measured by the Problem Gambling Severity Index), across three models containing from zero to 11 other distal predictors of harmful gambling (e.g., race/ethnicity, impulsivity, social support). Identifying as a man did not significantly improve model fit, and there were no significant interactions between masculine role norm endorsement and identifying as a man. Men and women-and-others with higher rates of masculine role norm endorsement were therefore equally likely to experience higher rates of gambling harm. This points toward gender ideology as a novel population-level risk factor for harmful gambling, that may have been missed by previous research's focus on gender identity.
Trends in cannabis use and cannabis use disorder among parents in the U.S., 2012-2024.
Dontha M, Chitty TC, Waddell JT … +3 more , Kemp EC, Patel H, Pelham WE
Addict Behav · 2026 Aug · PMID 41904830 · Full text
OBJECTIVE: Determine the prevalence and trends in cannabis use among U.S. parents of children < 18 years old. Cannabis use increasing among parents could be important because cannabis has been linked to parenting quality...
OBJECTIVE: Determine the prevalence and trends in cannabis use among U.S. parents of children < 18 years old. Cannabis use increasing among parents could be important because cannabis has been linked to parenting quality in cross-sectional studies. METHOD: Analyzed 2012-2024 data from the National Survey on Drug Use and Health (NSDUH) (N = 481,858), an annual survey of U.S. residents aged ≥ 12 years old. We estimated the prevalence of cannabis use outcomes in parents vs. non-parents and tested whether trends in cannabis use outcomes differed among parents (N = 169,926) vs. non-parents (N = 311,932). RESULTS: In 2024, 8.0% of parents living with children used cannabis on the majority of days, 5.2% of parents used cannabis daily, and 6.7% of parents met DSM-5 criteria for CUD. Since 2012, daily cannabis use has increased a nearly identical amount in parents vs. non-parents. Four times as many parents used cannabis daily in 2024 vs. in 2012. The rate of CUD among parents has increased 1.5x since 2020 (when first measured). Significant increases have occurred in parents of almost all sociodemographic groups. CONCLUSIONS: Daily cannabis use among parents went from quite rare in 2012 (1 in 80) to fairly common in 2024 (1 in 19). Back-of-the-envelope calculations suggest ≥ 5.9 million children in the U.S. now live with a parent who uses cannabis on the majority of days. Determining how cannabis use affects parenting and offspring has thus become an important public health question.
Understanding positive heavy drinking attitudes: daily variability and their role in intervention-related changes in alcohol use.
DiBello AM, Merrill JE, Carey KB … +1 more , Miller MB
Addict Behav · 2026 Aug · PMID 41904829 · Publisher ↗
PURPOSE: Alcohol use and its related harms remain highly prevalent among young adults, with heavy drinking and alcohol-induced blackouts posing significant public health risks. This study had two goals: first, we examine...
PURPOSE: Alcohol use and its related harms remain highly prevalent among young adults, with heavy drinking and alcohol-induced blackouts posing significant public health risks. This study had two goals: first, we examined attitudes toward heavy drinking as both stable (between-person) and dynamic (within-person) predictors of alcohol use and consequences among heavy-drinking young adults. Furthermore, we explored changes in attitudes toward heavy drinking as a mediator of intervention efficacy. METHOD: The data for the current work come from a larger randomized controlled trial where participants in the intervention condition completed 30 days of daily surveys assessing attitudes toward heavy drinking and drinking outcomes. Generalized linear mixed models were used to test within- and between-person associations between daily attitudes and odds of drinking on a given day, same-day drinking quantity, high-intensity drinking (HID), alcohol-related consequences, and blackout. Exploratory mediation analyses leveraged data from all participants in the full trial collected at baseline, post-intervention, and 3-month follow-up and tested whether changes in attitudes mediated intervention effects on HID. RESULTS: Results indicated that individuals with more favorable attitudes toward heavy drinking consumed more drinks per day on average. Within-person fluctuations were especially influential: on days when participants held more favorable attitudes than usual, they reported greater odds of drinking (vs. not), significantly higher drinking quantity, and greater odds of HID (vs. not), alcohol-related consequences (vs. not), and blackout (vs. not). In exploratory analyses, the digital health intervention (the "Drinking Dashboard") reduced favorable attitudes toward heavy drinking, which in turn mediated reductions in HID. CONCLUSIONS: Findings demonstrate that attitudes toward heavy drinking are both dynamic and modifiable. Day-to-day variability in attitudes predicted same-day risky drinking behaviors, and changes in attitudes served as a mechanism of intervention efficacy. These results highlight attitudes as both a proximal risk factor and a key target for digital interventions aimed at reducing alcohol-related harm among young adults.
Walking away from alcohol urges: A preliminary test of the efficacy of moderate-intensity exercise for reducing alcohol craving in heavy social drinkers.
Gavigan L, Prapavessis H, Chavarria J
Addict Behav · 2026 Aug · PMID 41904828 · Publisher ↗
BACKGROUND: Exercise may be a feasible strategy to help control alcohol consumption, yet its impact on alcohol craving and drinking behavior in community samples of heavy social drinkers remains unclear. This preliminary...
BACKGROUND: Exercise may be a feasible strategy to help control alcohol consumption, yet its impact on alcohol craving and drinking behavior in community samples of heavy social drinkers remains unclear. This preliminary study tested whether a single, 20-minute bout of moderate-intensity exercise reduces in-the-moment alcohol craving, wanting, and consumption compared to a colouring distraction. METHODS: Sixty-eight heavy social drinkers (ages 19-65) were randomized to 20 minutes of treadmill walking or colouring following consumption of an alcohol prime beverage designed to elicit craving. Alcohol craving (Alcohol Urge Questionnaire), wanting (Drug Effects Questionnaire), and affect (Positive Affect Negative Affect Scale) were assessed at post-prime, mid-activity, and post-activity time points. An ad libitum beverage task (proportion of alcohol placebo vs. water consumed) assessed alcohol consumption. Bayesian multilevel and zero-one-inflated beta models tested study hypotheses, with Bayes factors (BF) quantifying evidence strength. RESULTS: There was strong evidence that exercise reduced craving and wanting from post-prime to mid-activity to a greater extent than colouring (BF > 18, posterior probabilities > 95%). By post-activity, both conditions showed within-group decreases, but between-group differences were minimal. During the beverage task, exercise condition participants consumed less alcohol placebo than water (BF = 13.0), with weaker evidence for a similar association in the colouring group. Affect changes were equivalent across conditions. CONCLUSIONS: A single, moderate-intensity exercise session reduced alcohol craving and wanting during exercise and was associated with less placebo consumption than water. Exercise may offer a tolerable, low-cost strategy to reduce alcohol urges in heavy social drinkers.
Religion, morals, and pornography: risk or resource? A U.S. census-matched study.
Engelhardt R, Desbuleux JFM, Maes J … +3 more , Grubbs JB, Bőthe B, Kraus SW
Addict Behav · 2026 Jul · PMID 41895073 · Publisher ↗
Pornography use is common in the United States, and a subset of individuals develop problematic pornography use (PPU). Previous research often excluded abstainers, leading to potentially biased conclusions on the overall...
Pornography use is common in the United States, and a subset of individuals develop problematic pornography use (PPU). Previous research often excluded abstainers, leading to potentially biased conclusions on the overall role of religion and moral beliefs in pornography research. This study tested whether religious identification and moral disapproval of pornography function as risk factors for PPU or resources for well-being when the full population is considered. We analyzed data from a census-matched sample of U.S. adults (n = 2,806), using correlations, group comparisons, and hierarchical regressions to examine associations of religious identification and moral disapproval of pornography with sexual, romantic, and general life satisfaction, and suicidality. When including pornography-abstainers in analyses, moral disapproval and Judeo-Christian religious identification were unassociated with PPU, but linked to higher sexual, romantic, and general life satisfaction, and less suicidality. In contrast, PPU and pornography frequency were linked to lower satisfaction and more suicidality. Expanding analyses on the general population reframes the role of religion and morality in pornography research. Findings suggest that religion and moral disapproval may serve as protective resources for well-being and mental health. Further studies are needed to clarify the underlying mechanisms.
New versus continued e-cigarette use and cigarette reuptake among US adults who formerly smoked cigarettes.
Ozga JE, Jensen JK, Chen-Sankey J … +2 more , Pérez A, Stanton CA
Addict Behav · 2026 Jul · PMID 41880794 · Full text
BACKGROUND: E-cigarette use has been associated with cigarette reuptake after a period of abstinence from cigarette smoking. This study examined how e-cigarette patterns across time (e.g., new versus continued use) contr...
BACKGROUND: E-cigarette use has been associated with cigarette reuptake after a period of abstinence from cigarette smoking. This study examined how e-cigarette patterns across time (e.g., new versus continued use) contribute to cigarette reuptake among U.S. adults. METHODS: Adults (N = 4,511) declaring former cigarette smoking at Wave (W) 6 (2021) of the Population Assessment of Tobacco and Health Study were included. Multivariable logistic regressions examined associations between W6 past 30-day (P30D) e-cigarette use, W7 (2022-2023) P30D e-cigarette use, and W7 P30D cigarette reuptake, as well as the interaction between W6 and W7 P30D e-cigarette use on W7 P30D cigarette reuptake. RESULTS: Among adults with former cigarette smoking at W6, 11.4% had P30D cigarette reuptake at W7. P30D cigarette reuptake was lowest among those who did not use e-cigarettes at both waves (4.9%) compared to respondents with e-cigarette use at one or both waves (range 16.4-34.5%). Adults with new e-cigarette use at W7 (i.e., no W6 e-cigarette use) had higher odds of P30D cigarette reuptake (AOR = 3.68; 95% CI = 2.34, 5.79) compared to those with no e-cigarette use at either wave. No significant difference was found between adults with e-cigarette use at both waves and no e-cigarette use at either wave on P30D cigarette reuptake. CONCLUSIONS: P30D cigarette reuptake was lowest among those who did not use e-cigarettes at all. Initiating e-cigarette use was associated with P30D cigarette reuptake whereas continued e-cigarette use over 1-2 years was not. Relapse prevention programs for those who have quit smoking may be enhanced by research that builds on these findings.
Anxiety modulates the relationship between right inferior parietal lobule structure and problematic smartphone use: a test of the I-PACE model.
Wang ZL, Wang YL, Zhang YL … +4 more , Zhu J, Zhou J, Li CC, Hu Q
Addict Behav · 2026 Jul · PMID 41871476 · Publisher ↗
BACKGROUND: Problematic smartphone use (PSU) has been increasingly recognized as a behavioral addiction associated with heightened anxiety. According to the Interaction of Person-Affect-Cognition-Execution (I-PACE) model...
BACKGROUND: Problematic smartphone use (PSU) has been increasingly recognized as a behavioral addiction associated with heightened anxiety. According to the Interaction of Person-Affect-Cognition-Execution (I-PACE) model, affective factors such as anxiety may interact with individual neurobiological characteristics to facilitate and maintain problematic behaviors. However, the neurostructural mechanisms underlying the relationship between anxiety and PSU remain insufficiently understood. METHODS: The Smartphone Application-Based Addiction Scale (SABAS) and the Generalized Anxiety Disorder-7 (GAD-7) were used to assess smartphone use severity and anxiety levels in the problematic smartphone use group and the healthy control group. Group differences in anxiety levels were first examined, followed by correlational analyses. Structural magnetic resonance imaging (sMRI) data were acquired, and voxel-based morphometry (VBM) was applied to identify brain regions associated with anxiety and problematic smartphone use. Within the problematic smartphone use group, moderation analyses were further conducted to examine whether anxiety moderated the relationship between gray matter volume in the identified regions and the severity of problematic smartphone use. RESULTS: Individuals with problematic smartphone use exhibited significantly higher anxiety levels than healthy controls. Structural imaging analyses revealed three brain regions significantly associated with anxiety. Notably, within the PSU group, anxiety significantly moderated the relationship between gray matter volume of the right inferior parietal lobule (IPL) and problematic smartphone use severity. Specifically, alterations in the right IPL were more strongly associated with PSU under lower levels of anxiety. CONCLUSIONS: These findings suggest that anxiety plays a critical modulatory role in the association between neurostructural alterations in the right inferior parietal lobule and problematic smartphone use. Consistent with the I-PACE model, affective vulnerability and brain structure jointly contribute to the development and maintenance of PSU. The right IPL may represent a key neural substrate linking anxiety-related cognitive control and attentional processes to maladaptive smartphone use behaviors.
Shifting perceptions of e-cigarette risk: A secondary analysis from a nationwide, randomized controlled clinical trial of e-cigarettes among smokers.
Barros EM, Ferreira AC, Neelon B … +3 more , Ravenel IE, Carpenter MJ, Smith TT
Addict Behav · 2026 Jul · PMID 41865464 · Full text
INTRODUCTION: The Food and Drug Administration (FDA) acknowledges there is a continuum of risk for tobacco products, and that e-cigarettes are generally less harmful than combustible cigarettes. However, most US adults p...
INTRODUCTION: The Food and Drug Administration (FDA) acknowledges there is a continuum of risk for tobacco products, and that e-cigarettes are generally less harmful than combustible cigarettes. However, most US adults perceive e-cigarettes as more harmful than cigarettes, and negative perceptions have increased over time. Media coverage surrounding e-cigarette or vaping product use-associated lung injury (EVALI) may have played a role in the changing relative harm perceptions about e-cigarettes and other tobacco products. The goal of the present study was to compare relative risk perceptions for cigarettes and e-cigarettes before, during, and after EVALI. METHODS: The present paper is a secondary data analysis from a US RCT conducted from May 2018 to March of 2022. Participants self-reported demographic information and perceptions of risk for both cigarettes and e-cigarettes at baseline. Changes in relative risk before, during, and after the EVALI outbreak, were compared using a piecewise constant model. RESULTS: Relative risk perceptions of e-cigarettes were significantly greater during (p < 0.001) and after EVALI (p < 0.001) compared to before the onset of EVALI. The differences in risk perceptions between cohorts of participants differed by race (p = 0.014), in that there was a significant increase in perceived risk of harm of e-cigarettes (relative risk perceptions) during and after EVALI compared to before EVALI for non-white participants (p < 0.001, p < 0.001). CONCLUSIONS: Onset of EVALI may have impacted relative risk perceptions of e-cigarettes compared to cigarettes. Non-white smokers were more likely to experience increased perceived risk of harm of e-cigarettes (relative risk perceptions). There is a need to continue monitoring risk perceptions among smokers, as negative relative risk perceptions may hinder switching from cigarettes to e-cigarettes.
Determinants of gaming disorder among aspiring professional esports players: a prospective study.
Laberge F, Dufour M, Goyette M … +3 more , Morvannou A, Berrigan F, Bonneville-Roussy A
Addict Behav · 2026 Jul · PMID 41865463 · Publisher ↗
INTRODUCTION: Esports, the competitive practice of video gaming within an organized framework, has rapidly expanded, encouraging people to seek opportunities in esports teams. Numerous competitions are emerging, some off...
INTRODUCTION: Esports, the competitive practice of video gaming within an organized framework, has rapidly expanded, encouraging people to seek opportunities in esports teams. Numerous competitions are emerging, some offering substantial prize pools. While esports can be pursued as a leisure activity, some individuals have become professionals, and others aspire to turn it into a career. As more youth pursue esports as a potential career, concerns have emerged regarding the risk of developing gaming disorder (GD) due to excessive gaming. Despite growing interest, little is known about youth aspiring to professional esports careers, particularly regarding the influence of esports career intentions in the short-term development of GD. METHODS: This longitudinal study aims to compare one-year changes in GD between 111 esports players intending to become professionals and 108 esports players without this intention. The association between group membership and GD, as well as its evolution over time, is further assessed after controlling for relevant covariates. A repeated-measures ANOVA followed by an ANCOVA including 8 covariates (gaming habits and psychological factors) were conducted. RESULTS: GD showed a similar decrease over one year in both groups. Group membership did not emerge as a significant predictor of changes in GD over time, whereas negative consequences and life satisfaction were associated with GD trajectories. Furthermore, group differences in GD did not remain significant after controlling for gaming time, negative consequences, and escape motive. CONCLUSION: GD prevention efforts may benefit from placing greater emphasis on gaming habits and psychological factors rather than on professionalization intentions alone.
Drug positivity, co-detection patterns, and demographic predictors in patients seeking substance use disorder treatment, United States, 2023.
Park J, Niles JK, Goldberger BA … +5 more , Orellana RC, Casey Lyons B, Lee SH, Baldwin GT, Park S
Addict Behav · 2026 Jul · PMID 41864144 · Full text
OBJECTIVE: To examine drug positivity, co-detection patterns, and demographic associations across 14 drug categories in patients seeking substance use disorder (SUD) treatment. METHODS: This cross-sectional study analyze...
OBJECTIVE: To examine drug positivity, co-detection patterns, and demographic associations across 14 drug categories in patients seeking substance use disorder (SUD) treatment. METHODS: This cross-sectional study analyzed 2023 urine drug testing data from Quest Diagnostics. Included were patients aged ≥ 15 years with a valid first urine drug test result ordered by SUD treatment providers. Tests screened for 14 drug categories, including fentanyl, heroin (6-acetylmorphine only), prescription opioids, stimulants, benzodiazepines, and others. Outcomes included drug positivity, paired drug co-detection, and associations with age, sex, insurance type, and geographic region using multivariable logistic regression. RESULTS: Among 99,224 patients, most were aged 35 - 54 years (46.9%), male (62.6%), on Medicaid (48.2%) or private insurance (46.5%), and resided in the Northeast (56.3%). Buprenorphine (24.5%) and fentanyl (17.5%) had the highest positivity rates, with fentanyl frequently co-detected with other substances. Patients aged ≥ 25 years had higher odds of drug positivity (adjusted odds ratio [AOR] range: 1.3 - 9.8), except for fentanyl, methamphetamine, and amphetamine. Males had higher odds of fentanyl (AOR, 1.1) and cocaine (AOR, 1.1) positivity but lower odds for most other drugs. Medicaid beneficiaries had increased odds for multiple substances, including methadone (AOR, 3.4) and buprenorphine (AOR, 1.7), versus those with private insurance. Regional variation was notable, with higher odds for buprenorphine in the Midwest and South, but lower odds for methadone compared to the Northeast. CONCLUSIONS: This study highlights variations in substance presence and co-detection across 14 drug categories in SUD treatment patients, underscoring the need for tailored prevention and treatment strategies.
Stimulant use predicts high-risk substance use behaviors during medication treatment for opioid use disorder.
Marino EN, Bone C, Perez MC … +2 more , Robles RC, Potter JS
Addict Behav · 2026 Jul · PMID 41861768 · Publisher ↗
BACKGROUND: The fourth wave of the overdose epidemic has been characterized by co-utilization of opioids and stimulants. This combined use is associated with high-risk behaviors, including heroin and intravenous drug use...
BACKGROUND: The fourth wave of the overdose epidemic has been characterized by co-utilization of opioids and stimulants. This combined use is associated with high-risk behaviors, including heroin and intravenous drug use. Because research in real-world settings is limited, the objective of this study was to examine the impact of stimulant use before and during treatment for opioid use disorder on high-risk behaviors (intravenous opioid or stimulant use, heroin use). METHOD: The current study included patients who initiated either methadone or buprenorphine from a statewide network of providers in Texas from May 20, 2020 to August 31, 2024. They were all uninsured/underinsured and living below the federal poverty line. We utilized two logistic regressions to examine whether stimulant use before or during treatment predicted heroin use or intravenous stimulant or opioid use. RESULTS: In total, 2848 patients were included in this study (M = 42.5 [SD = 12.2], 41.5% female, 82.2% White, and 33.6% Hispanic/Latino). Patterns of substance use at treatment initiation and during treatment, respectively, included: stimulant use (17.1% and 11.3%), intravenous stimulant or opioid use (39.0% and 36.6%), and heroin use (33.6% and 24.6%). Analyses showed that stimulant use during treatment predicted heroin use during treatment, and stimulant use both before and during treatment predicted intravenous use during treatment. CONCLUSIONS: Separately analyzing stimulant use at treatment initiation and during treatment indicated a time-specific association between stimulant use and high-risk behaviors. Addressing stimulant use concurrent with opioid use will help reduce high-risk behaviors and may improve the prognosis of those using opioids and stimulants.
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