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OBJECTIVE: This study tested three conceptual explanatory models that have been theorized to account for the linkages between religious/spiritual (R/S) struggles and psychological distress: the primary model (i.e., R/S struggles lead to psychological distress), the secondary model (i.e., psychological distress leads to R/S struggles), and the complex model (i.e., R/S struggles and psychological distress reciprocally exacerbate each other). METHODS: Using prospective data from a sample of US adults living with chronic health conditions (n = 302), we performed a cross-lagged panel analysis with three timepoints to test for evidence of potential causal relations between R/S struggles and psychological distress. RESULTS: Consistent with the complex conceptual model of R/S struggles, we found evidence of positive reciprocal associations between R/S struggles and psychological distress. CONCLUSION: The findings highlight the importance of attending to the dynamic interplay between R/S struggles and psychological distress when working with adults who have chronic health conditions.

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Suffering has been a topic of considerable discussion in the fields of medicine and palliative care, yet few studies have reported causal evidence linking the experience of suffering to health and well-being. In this three-wave prospective cohort study, we explore the potential psychological implications of suffering during the COVID-19 pandemic by examining relations among suffering, mental health, and psychological well-being in a sample of U.S. adults living with chronic health conditions. We analyzed data from n = 184 participants who completed assessments one month before the SARS-CoV-2 outbreak was declared a pandemic by the World Health Organization (February 2020) and then two months (April 2020) and four months later (May/June 2020). Analyses controlled for a range of factors, including sociodemographic characteristics, physical health, religious/spiritual factors, psychological characteristics, and prior values of the predictor and each of the outcomes assessed one month before the COVID-19 pandemic. Results of the primary analysis indicated that greater overall suffering assessed one month into the COVID-19 pandemic was associated with lower psychological well-being (ß = -.17, 95% CI: -.29, -.05) and higher levels of anxiety (ß = .27, 95% CI: .13, .41) and depression (ß = .16, 95% CI: .03, .29) two months later. In a secondary analysis that explored anxiety, depression, and psychological well-being as candidate antecedents of suffering, depression assessed one month into the COVID-19 pandemic was most strongly associated with worse overall suffering two months later. We highlight the implications of the findings for high-risk populations who are suffering amidst the challenges of the COVID-19 pandemic. Potential benefits of both integrating assessments of suffering into screening procedures and addressing experiences of suffering in mental health service settings are discussed.

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BACKGROUND: Alcohol hangovers have been found to be a common and costly consequence of alcohol misuse. However, there is only limited psychometric support for instruments to accurately measure hangovers beyond the college-age years. This study investigated the psychometric properties of the Hangover Symptom Scale (HSS) and the Hangover Symptom Scale-Short Form (HSS-5) including the internal consistency, convergent and discriminant validity, construct validity, and the measurement invariance of these scales between light and heavy drinkers, individuals with a positive and negative family history of alcohol use disorder (AUD), and men and women in a post-college-aged sample. The association of the HSS and HSS-5 with alcohol use problems was also tested. METHODS: Participants were 294 nonalcoholic light and heavy social drinkers (age range 21 to 35 years; 57.8% male) enrolled in the Chicago Social Drinking Project. They completed the HSS as part of a take-home packet completed outside of the laboratory. The psychometric properties of the HSS and HSS-5 were tested. RESULTS: Stronger psychometric support was found for the HSS-5 relative to the full HSS. While both measures demonstrated strong internal consistency reliability, convergent and discriminant validity, and an association with alcohol use problems, only the HSS-5 showed construct validity as determined by confirmatory factor analysis. Further, only the HSS-5 showed measurement invariance between men and women, light and heavy drinkers, and individuals with a positive and negative family history of AUD. CONCLUSIONS: This was the first study to examine the psychometric properties of the HSS and HSS-5 in a post-college-aged sample and the first to investigate the measurement invariance of these measures as a function of sex, drinking history, and family history of AUD. This study supports the use of the HSS-5 as a reliable and valid brief measure of frequency of hangover symptoms.

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BACKGROUND: Laboratory alcohol challenges are the "gold standard" for obtaining accurate measurements of subjective alcohol stimulation, sedation, and reward. However, these approaches are time and resource intensive. This study examined the extent to which self-reported anticipated alcohol stimulation, sedation, and reward corresponded with those same responses measured with the Biphasic Alcohol Effects Scale (BAES), Brief-BAES (B-BAES), and Drug Effects Questionnaire (DEQ) during a controlled laboratory alcohol challenge. METHODS: Participants were 106 light-to-heavy social drinkers (58.5% male; mean ± SD age = 35.8 ± 3.2 years) who completed the Anticipated BAES and DEQ, as well as laboratory-derived versions of these scales 30 and 60 minutes after consuming placebo and 0.8 g/kg alcohol on separate days as part of laboratory sessions in the Chicago Social Drinking Project. RESULTS: Anticipated BAES/B-BAES and Anticipated DEQ alcohol effects were strong predictors of their corresponding laboratory-derived responses during both the rising limb and at peak breath alcohol concentrations. Effects were significant even when accounting for age, sex, past-month heavy drinking frequency, and laboratory session order (placebo or alcohol first). CONCLUSIONS: This study provides strong preliminary support for measuring anticipated alcohol effects with the Anticipated BAES/B-BAES and Anticipated DEQ as a proxy of subjective responses experienced during a controlled laboratory alcohol challenge. The findings lend support for these measures as viable alternatives to other anticipatory scales when laboratory-derived alcohol response measurement is not feasible.

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AIMS: To compare subjective responses to alcohol among Han Chinese and Caucasian American males. DESIGN: Double-blinded, placebo-controlled human laboratory design. Participants completed three randomized experimental sessions with high and low alcohol and placebo beverages. SETTING: Chinese participants were examined at Xinjiang Medical University, China. Caucasian participants were examined at the University of Chicago, USA. PARTICIPANTS: Seventy Han Chinese (35 heavy/35 light drinkers) and 75 Caucasian Americans (43 heavy/32 light drinkers). MEASUREMENTS: Breath alcohol concentration (BrAC) and the 'stimulation' and 'sedation' subscales of the Biphasic Alcohol Effects Scale were assessed at pre-drink baseline and four time-points after beverage consumption. The 'like' and 'want' subscales of the Drug Effects Questionnaire were also assessed at the post-drink assessments. FINDINGS: Comparisons with light drinkers showed that high- and low-dose alcohol produced decreases in stimulation, liking and wanting in Chinese versus Caucasians (P < 0.05), and dose-dependent increases in sedation in both groups (P < 0.001). Among heavy drinkers, high-dose alcohol produced higher stimulation (P < 0.001) but with concomitant higher sedation for both doses (P < 0.05) for Chinese versus Caucasians. Alcohol also demonstrated significantly lower liking (P < 0.001) in Chinese versus Caucasian heavy drinkers for both doses. Interestingly, both groups showed dose-dependent increases in wanting relative to placebo (P < 0.05), but the magnitude of the increase was lower in Chinese drinkers. CONCLUSIONS: Stimulating effects of alcohol are predominant in Chinese male binge drinkers, as has been found in Caucasians, but with less hedonic and motivational reward, potentially explaining some of the lower risk for alcohol disorders in Asian subgroups.

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BACKGROUND: The Biphasic Alcohol Effects Scale (BAES) is a reliable and valid 14-item measure of alcohol's acute stimulant and sedative effects, but its length may preclude use in research paradigms with time constraints on assessment. Here, we report further psychometric support for the 6-item Brief BAES (B-BAES) originally developed by our group in 2009. METHODS: Two studies are included: the first study tested the B-BAES in an independent sample of young adult heavy social drinkers administered 0.8 g/kg alcohol in a laboratory challenge study (N = 104) to confirm the reliability and validity of the 6-item B-BAES. The second study compared the predictive validity of the B-BAES versus the BAES in a separate sample of 104 heavy drinkers who took part in a prospective laboratory alcohol challenge and follow-up study of drinking behaviors. RESULTS: An item analysis demonstrated strong support across several intervals on the breath alcohol curve for the same 6 B-BAES items (energized, excited, up, sedated, slow thoughts, sluggish). Confirmatory factor analysis with the B-BAES demonstrated strong support for the same underlying structure as with the full BAES, and tests of internal consistency reliability were very strong to excellent. B-BAES subscale scores correlated highly with corresponding scores of the BAES and predicted binge-drinking frequency during a 2-year follow-up. CONCLUSIONS: These results provide strong psychometric support to confirm use of the B-BAES in studies assessing alcohol's stimulant and sedative properties. The B-BAES may be a useful new tool to enhance the scope of future research assessing alcohol's biphasic effects, particularly in paradigms when time and concise measurement are priorities.

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RATIONALE: The Drug Effects Questionnaire (DEQ) is widely used in studies of acute subjective response (SR) to a variety of substances, but the format of the DEQ varies widely across studies, and details of its psychometric properties are lacking. Thus, the field would benefit from demonstrating the reliability and validity of the DEQ for use across multiple substances. OBJECTIVE: The current study evaluated the psychometric properties of several variations of DEQ items, which assessed the extent to which participants (1) feel any substance effect(s), (2) feel high, (3) like the effects, (4) dislike the effects, and (5) want more of the substance using 100-mm visual analog scales. METHODS: DEQ data from three placebo-controlled studies were analyzed to examine SR to amphetamine, nicotine, and alcohol. We evaluated the internal structure of the DEQ for use with each substance as well as relationships between scale items, measures of similar constructs, and substance-related behaviors. RESULTS: Results provided preliminary psychometric support for items assessing each DEQ construct (feel, high, dislike, like, and more). CONCLUSIONS: Based on the study results, we identify several common limitations of extant variants of the DEQ and recommend an improved version of the measure. The simplicity and brevity of the DEQ combined with its promising psychometric properties support its use in future SR research across a variety of substances.

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BACKGROUND: The meta-analysis by Quinn and Fromme (2011) is reviewed and integrated into the larger field. Guidelines for future research are presented. RESULTS: With results of the meta-analysis along with those of a recent comprehensive prospective study by our group (King et al., 2011), there is a call to the field to specify terms and integrate theoretical frameworks to advance our knowledge and improve comparisons across trials. CONCLUSIONS: The meta-analysis is both timely and thorough and will provide clinical researchers with important information to move the field forward.

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BACKGROUND: The utility of one of the most widely used subjective alcohol assessment tools, the Biphasic Alcohol Effects Scale (BAES) has been somewhat limited based on lack of psychometric studies in large and diverse samples, a range of alcohol doses, the length of the measure, and the original instructional set which precluded baseline measurement and disclosed to subjects that they received alcohol. METHODS: The current study investigated the factor structure of the BAES with a modified instructional set at pre-drink baseline and after consumption of various doses of alcohol, in a sample of 190 men and women, heavy and light social drinkers. This study tested the psychometric properties of a brief version of the BAES (Brief-BAES or B-BAES). RESULTS: Results demonstrated robust support of the stimulant and sedative constructs across all conditions, and demonstrated strong psychometric support for the 6-item B-BAES. DISCUSSION: This is the first comprehensive study to expand the utility of the BAES by instructional set, baseline measurement, at various alcohol doses, and by drinking history and sex. In addition, the introduction of the B-BAES may further increase the utility of this scale, particularly in paradigms with repeated measurement or time constraints.

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