Medicine and Health Sciences Commons^™

Assessment Of Simultaneous Alcohol And Cannabis Use And Its Related Consequences And Cognitions In College Students: A Narrative Review, Jennifer L. Shipley, Abby L. Braitman

Psychology Faculty Publications

As rates of students using cannabis continue to rise, simultaneous use of alcohol and cannabis (such that their effects overlap; commonly referred to as simultaneous alcohol and marijuana [SAM] use) is prevalent among college students who use both substances. Although research focusing on SAM use and related cognitions and consequences continues to grow, there are no common established measures, as approaches vary across studies. This narrative review identifies current methods for assessing SAM use and measures of SAM-related consequences and cognitions (motives and expectancies) among college students, evaluates how they were developed, identifies gaps in the literature, and provides recommendations …

Neural Systems Underlying Rdoc Social Constructs: An Activation Likelihood Estimation Meta-Analysis, Rosario Pintos Lobo, Katherine L. Bottenhorn, Michael C. Riedel, Afra I. Toma, Megan M. Hare, Donisha D. Smith, Alexandra C. Moor, Isis K. Cowan, Javier A. Valdes, Jessica E. Bartley, Taylor Salo, Emily R. Boeving, Brianna Pankey, Matthew T. Sutherland, Erica D. Musser, Angela R. Laird

Psychology Faculty Publications

Neuroscientists have sought to identify the underlying neural systems supporting social processing that allow interaction and communication, forming social relationships, and navigating the social world. Through the use of NIMH’s Research Domain Criteria (RDoC) framework, we evaluated consensus among studies that examined brain activity during social tasks to elucidate regions comprising the “social brain”. We examined convergence across tasks corresponding to the four RDoC social constructs, including Affiliation and Attachment, Social Communication, Perception and Understanding of Self, and Perception and Understanding of Others. We performed a series of coordinate-based meta-analyses using the activation likelihood estimate (ALE) method. Meta-analysis was performed …

Ptsd And Alcohol Use Disorders Predict The Pace Of Cellular Aging, Sage E. Hawn, Xiang Zhao, Mark W. Miller, Sara Wallander, Christine Govan, Anjanette Stone, Steven A. Schichman, Mark W. Logue, Erika J. Wolf

Psychology Faculty Publications

Advanced epigenetic age is associated with psychopathology and may help to explain the link between psychopathology and physical health morbidity and mortality. Using a longitudinal sample of 171 trauma-exposed Veterans, we modeled the rate of change in epigenetic age across two time points (averaging 5.58 years apart) using two epigenetic age algorithms (GrimAge and Horvath) and tested associations with posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and depression. Results showed that PTSD (β = .199) and AUD (β = .186) were associated with a quickened pace of epigenetic aging over time (ps < .021). Results replicate and extend prior work and offer foundational support for identifying interventions that slow the pace of biological aging among those with psychopathology.

Criterion Validity Of Protective Behavioral Strategies For Alcohol Consumption Among College Students, Abby L. Braitman, Amy Stamates, Melissa Colangelo, Sarah J. Ehlke, Jordan Ortman, Kristin E. Heron, Kate B. Carey

Psychology Faculty Publications

Background: Protective behavioral strategies (PBS), or behaviors used to reduce harm associated with alcohol use, are often associated with lower levels of alcohol consumption, lower engagement in high-risk drinking behaviors, and fewer alcohol-related consequences. Although the majority of studies have found significant associations between higher PBS use and lower consumption or consequences, some studies have found nonsignificant or even positive associations. One explanatory hypothesis is that the mixed findings are due to differential content in PBS measures. Objectives: The current study examined the criterion validity of two widely-used PBS measures, the PBSS and the SQ. In a multi-institution online …

Changes In Mental Health As A Predictor Of Cannabis Coping Motives And Consequences: Examining The Impact Of Covid-19 Among College Students, Rebecca Dunaief, Adrian Jorge Bravo, James Henson

Psychology Faculty Publications

Objective: Cannabis use is common among college students and many students use cannabis to cope with negative affect. The COVID-19 pandemic was a particularly stressful time for college students. Subsequently, the present study compared college students who reported increases in anxiety/depression symptoms since COVID-19 stay at home orders to those who reported no change in anxiety/depression symptoms on cannabis coping motives, use frequency, and negative consequences. Specifically, we examined whether self-reported changes (i.e., group that indicated increases) in poor mental health during COVID-19 were associated with problematic cannabis use via higher cannabis coping motives. Method: College students (analytic n = …

Genetic Associations Between Alcohol Phenotypes And Life Satisfaction: A Genomic Structural Equation Modeling Approach, Kaitlin E. Bountress, Shannon E. Cusack, Sage E. Hawn, Andrew Grotzinger, Daniel Bustamante, Robert M. Kirkpatrick, Howard J. Edenberg, Ananda B. Amstadter

Psychology Faculty Publications

Alcohol use (i.e., quantity, frequency) and alcohol use disorder (AUD) are common, associated with adverse outcomes, and genetically-influenced. Genome-wide association studies (GWAS) identified genetic loci associated with both. AUD is positively genetically associated with psychopathology, while alcohol use (e.g., drinks per week) is negatively associated or NS related to psychopathology. We wanted to test if these genetic associations extended to life satisfaction, as there is an interest in understanding the associations between psychopathology-related traits and constructs that are not just the absence of psychopathology, but positive outcomes (e.g., well-being variables). Thus, we used Genomic Structural Equation Modeling (gSEM) to analyze …

Can Implicit Measures Augment Suicide Detection In Youth? The Feasibility And Acceptability Of The Death Implicit Association Test Among Pediatric Medical Impatients, Annabelle M. Mournet, Daniel S. Powell, Elizabeth C. Lanzillo, Sandra Mcbee-Strayer, Emory Bergdoll, Catherine R. Glenn, Alexander Millner, Maryland Pao, Matthew K. Nock, Lisa M. Horowitz, Jeffrey A. Bridge

Psychology Faculty Publications

Background: Medically ill youth are at increased suicide risk, necessitating early detection. This study aimed to assess the feasibility of administering the Death Implicit Association Test (Death IAT) to pediatric medical inpatients. Methods: Participants completed measures including the Ask Suicide-Screening Questions (ASQ) and the Death IAT. Results: Over 90% of participants found the Death IAT to be acceptable and more than 75% of participants were comfortable completing the task. There was a small, but statistically significant, improvement from pre-survey to post-survey reports of mood (t(174) = 3.02, p = 0.003, d = 0.15). Participants who endorsed a past suicide attempt …

Impact Of A Reduced Nicotine Standard On Young Adult Appeal For Menthol And Non-Menthol Cigarettes, Amy M. Cohn, Rachel Cassidy, Rachel Denlinger-Apte, Eric Donny, Andrea C. Villanti, Dorothy Hatsukami, Delaney Dunn, Riley Wyatt, Taylor Niznik, Tamar Cohen-Davidyan, Michael Smith, Sarah J. Ehlke

Psychology Faculty Publications

Introduction The Food and Drug Administration (FDA) announced its intention to reduce the nicotine content in cigarettes as a strategy to promote cessation and reduce smoking-related harm. A low nicotine product standard will apply to all cigarettes on the market, including menthol cigarettes. In December 2021, the FDA approved a modified risk tobacco product application for menthol and non-menthol flavoured very low nicotine cigarettes (VLNC) from the 22nd Century Group. Notably, experimentation with menthol cigarettes is linked to smoking progression, as well as greater nicotine dependence relative to non-menthol cigarette use. If menthol VLNCs are perceived as more appealing than …

Examining Emailed Feedback As Boosters After A College Drinking Intervention Among Fraternities And Sororities: Rationale And Protocol For A Remote Controlled Trial (Project Greek), Abby L. Braitman, Jennifer L. Shipley, Megan Strowger, Rachel Ayala Guzman, Alina Whiteside, Adrian J. Bravo, Kate B. Carey

Psychology Faculty Publications

BACKGROUND: College students involved in Greek life (ie, members of fraternities and sororities) tend to engage in more high-risk alcohol use and experience more negative consequences than those not involved in Greek life. Web-based alcohol interventions, such as Alcohol eCHECKUP TO GO, have been successful in reducing alcohol use and consequences among the general college student population, but interventions targeting alcohol reduction among those involved in Greek life have had limited success. Booster emails including personalized feedback regarding descriptive norms and protective behavioral strategies have shown potential in increasing the effectiveness of web-based interventions among college drinkers. Studies are needed …

Associations Between Body Dissatisfaction And Relationship Functioning Among Same-Sex Female Couples: An Actor-Partner Interdependence Model, Cassidy M. Sandoval, Kelly A. Romano, Kristin E. Heron, Charlotte A. Dawson, Tiphanie G. Sutton, Barbara A. Winstead, Robin J. Lewis

Psychology Faculty Publications

Nearly all past research about body dissatisfaction and romantic relationship factors is among heterosexual couples; little is known about these associations in sexual minority couples. The present study aimed to fill gaps in the current literature by using actor-partner interdependence models (APIMs) to examine dyadic patterns of association between body dissatisfaction and different aspects of relationship functioning among same-sex female couples. Participants were 163 same-sex female romantic dyads (326 women) between the ages of 18-35 years who completed measures of body dissatisfaction and relationship factors. Results from significance testing of actor and partner effects indicated higher levels of women's own …

Minority Stress And Alcohol Use In Sexual Minority Women's Daily Lives, Robin J. Lewis, Kelly A. Romano, Sarah J. Ehlke, Cathy Lau-Barraco, Cassidy M. Sandoval, Douglas J. Glenn, Kristin E. Heron

Psychology Faculty Publications

No abstract provided.

Maternal Depression Trajectories And Child Bmi In A Multi-Ethnic Sample: A Latent Growth Modeling Analysis, Charlotte V. Farewell, Ryley Donohoe, Zaneta Thayer, James Paulson, Jacinda Nicklas, Caroline Walker, Karen Waldie, Jenn A. Leiferman

Psychology Faculty Publications

Background

Perinatal (antenatal and postpartum) depression impacts approximately 12% of mothers. Perinatal depression can impact everyday functioning for mothers, and the relationship with, and development of, their children. The purpose of this study was to investigate depression trajectories from the antenatal period through 54-months postpartum and associations with child body mass index at 54-months postpartum.

Methods

This study applied latent growth modeling to the Growing Up in New Zealand study, which is a longitudinal pregnancy cohort study that provides nationally representative-level data, to investigate associations between depression at three time points (antenatal, 9-months postpartum, 54-months postpartum) and child body mass …

Preferences In Information Processing, Marginalized Identity, And Non-Monogamy: Understanding Factors In Suicide-Related Behavior Among Members Of The Alternative Sexuality Community, Robert J. Cramer, Jennifer Langhinrichsen-Rohling, Andrea R. Kaniuka, Corrine N. Wilsey, Annelise Mennicke, Susan Wright, Erika Montanaro, Jessamyn Bowling, Kristin E. Heron

Psychology Faculty Publications

Suicide-related behavior (SRB) is a mental health disparity experienced by the alternative sexuality community. We assessed mental health, relationship orientation, marginalized identities (i.e., sexual orientation minority, gender minority, racial minority, ethnic minority, and lower education), and preferences in information processing (PIP) as factors differentiating lifetime SRB groups. An online cross-sectional survey study was conducted in 2018. Members of the National Coalition for Sexual Freedom (NCSF; n = 334) took part. Bivariate analyses identified the following SRB risk factors: female and transgender/gender non-binary identity, sexual orientation minority identity, lower education, suicide attempt/death exposure, Need for Affect (NFA) Avoidance, depression, and anxiety. …

A Daily Diary Study Of Drinking And Nondrinking Days In Nonstudent Alcohol Users, Cathy Lau-Barraco, Ashley N. Linden-Carmichael

Psychology Faculty Publications

Background: Emerging adults with lower educational attainment are at higher long-term risk for problematic drinking and alcohol use disorders. Efforts to gain a more in-depth understanding of the drinking habits of nonstudent emerging adults are critical to reduce disparities and to shed light on targets of intervention for this vulnerable group.

Objectives: The current investigation aimed to: (1) provide a description of the daily drinking habits of nonstudent emerging adult drinkers using a 14-day diary method, and (2) examine nondrinking days by assessing their reasons for not drinking as well as strategies used to avoid drinking.

Methods: Participants were 27 …

Utilization, Receptivity And Reactivity To Interactive Voice Response Daily Monitoring In Risky Drinking Smokers Who Are Motivated To Quit, Amy M. Cohn, Hoda Elmasry, Sarah J. Ehlke

Psychology Faculty Publications

INTRODUCTION Interactive Voice Response (IVR) technology has become an increasingly popular and valid method for collecting Ecological Momentary Assessment (EMA) data on a variety of health-risk behaviors, including daily alcohol use and cigarette smoking, and for stimulating behavior change. However, very little research has evaluated the parameters of IVR compliance and reactivity in respondents who may have greater problem severity than samples previously examined in published IVR studies. This study examined the prevalence and correlates of use, receptivity and reactivity to IVR monitoring in 77 untreated risky drinking smokers who were motivated to quit within the next 6 months.

METHODS …

Sexual Coercion, Drinking To Cope Motives, And Alcohol-Related Consequences Among Self-Identified Bisexual Women, Michelle L. Kelly, Sarah J. Ehlke, Robin J. Lewis, Abby L. Braitman, Wendy Bostwick, Kristin E. Heron, Cathy Lau-Barraco

Psychology Faculty Publications

Background: Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. Objectives: The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. Methods: Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who …

Drinking To Cope With Depressive Symptoms And Ruminative Thinking: A Multiple Mediation Model Among College Students, Adrian J. Bravo, Matthew R. Pearson, James M. Henson

Psychology Faculty Publications

Background: Understanding the potential psychosocial mechanisms that explain (i.e., mediate) the associations between depressive symptoms and alcohol-related problems can improve interventions targeting college students.

Objectives: The current research examined four distinct facets of rumination (e.g., problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and drinking to cope motives as potential explanatory mechanisms by which depressive symptoms are associated with increased alcohol-related problems.

Method: Participants were undergraduate students from a large, southeastern university in the United States that consumed at least one drink per typical week in the previous month (n = 403). The majority of participants were female ( …

Protective Behavioral Strategies As A Context-Specific Mediator: A Multilevel Examination Of Within- And Between-Person Associations Of Daily Drinking, Abby L. Braitman, Ashley N. Linden-Carmichael, James M. Henson

Psychology Faculty Publications

Research indicates that a drinker’s environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one’s drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different …

Self-Reported Pain In Male And Female Iraq/Afghanistan-Era Veterans: Associations With Psychiatric Symptoms And Functioning, Jennifer C. Naylor, H. Ryan Wagner, Mira Brancu, Megan Shepherd-Banigan, Eric Elbogen, Michelle Kelley, Teresa Fecteau, Karen Goldstein, Nathan A. Kimbrel, Christine E. Marx

Psychology Faculty Publications

Objective. To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans.

Design. Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite study of postdeployment mental health.

Setting. Veterans were enrolled at one of four participating VA sites.

Subjects. Two thousand five hundred eighty-seven male and 662 female Iraq/Afghanistan-era veterans.

Methods. Nonparametric Wilcoxon rank tests examined differences in pain scores between male and female veterans. Chi-square tests assessed differences between male and female veterans in the proportion of respondents endorsing moderate to high levels of pain vs no pain. Multilevel …

Alcohol Use Variability In A Community-Based Sample Of Nonstudent Emerging Adult Heavy Drinkers, Cathy Lau-Barraco, Abbly L. Braitman, Amy L. Stamates, Ashley N. Linden-Carmichael

Psychology Faculty Publications

BACKGROUND: While nonstudent emerging adults are at elevated risk for experiencing alcohol-related problems, there remains a paucity of research devoted specifically to addressing drinking in this group.

OBJECTIVES: The present study sought to offer unique insights into nonstudent drinking by examining drinking variability across 30 days using a retrospective diary method. Specific aims were to: (1) compare within- and between-person variability in alcohol use across 30 days, and (2) determine the extent to which central social-cognitive between-person factors (i.e., social expectancies, perceived drinking norms, social drinking motivations) predict between-person alcohol use as well as within-person variability in drinking.

METHODS: Participants …

Depressive Symptoms And Alcohol-Related Problems Among College Students: A Moderated-Mediated Model Of Mindfulness And Drinking To Cope, Adrian J. Bravo, Matthew R. Pearson, Leah E. Stevens, James M. Henson

Psychology Faculty Publications

Objective: In college student samples, the association between depressive symptoms and alcohol-related problems has been found to be mediated by drinking-to-cope motives. Mindfulness-based interventions suggest that mindfulness may attenuate the conditioned response of using substances in response to negative emotional states, and trait mindfulness has been shown to be a protective factor associated with experiencing fewer alcohol-related problems. In the present study, we examined trait mindfulness as a moderator of the indirect associations of depressive symptoms on alcohol-related problems via drinking-to-cope motives. Method: Participants were undergraduate students at a large, southeastern university in the United States who drank at least …

Behavioral Couples Treatment For Substance Use Disorder: Secondary Effects On The Reduction Of Risk For Child Abuse, Michelle L. Kelley, Adrian J. Bravo, Abby L. Braitman, Adrienne K. Lawless, Hannah R. Lawrence

Psychology Faculty Publications

Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6 month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For …

Initiation And Retention In Couples Outpatient Treatment For Parents With Drug And Alcohol Use Disorders, Abbly L. Braitman, Michelle L. Kelley

Psychology Faculty Publications

The focus of the current study was to identity mental health, relationship factors, substance use related problems, and individual factors as predictors of couples-based substance abuse treatment initiation and attendance. Heterosexual couples with children that met study criteria were invited to attend 12 sessions of outpatient behavioral couples therapy. Men were more likely to initiate treatment if they had a higher income, had greater relationship satisfaction, were initiating treatment for alcohol use disorder only, were younger when they first suspected a problem, and had higher depression but lower hostility or phobic anxiety. Men attended more treatment sessions if they reported …

A Preliminary Investigation Of Caffeinated Alcohol Use During Spring Break, Ashley N. Linden-Carmichael, Cathy Lau-Barraco

Psychology Faculty Publications

Background: Caffeinated alcoholic beverages (e.g., Red Bull and vodka) are popular but associated with negative consequences. CABs may be particularly popular during Spring Break, a potentially risky social event.

Objectives: We aimed to identify the prevalence of Spring Break caffeinated alcohol use, determine how caffeinated alcohol use Spring Break drinking habits differ from usual, and examine the association between Spring Break caffeinated alcohol use and alcohol-related problems.

Methods: Data were collected from 95 college students during March of 2013 and 2014. Students completed questionnaires of their alcohol and caffeinated alcohol use before and during Spring Break and Spring Break alcohol-related …

The Course And Interrelationship Of Maternal And Paternal Perinatal Depression, James F. Paulson, Sharnail D. Bazemore, Janice H. Goodman, Jenn A. Leiferman

Psychology Faculty Publications

The aims of the study were to describe course of depression in both mothers and fathers from the third trimester of pregnancy through 6 months postpartum and to examine the relationship between maternal and paternal depression. Hypotheses were as follows: (a) Depressive symptoms would be correlated between parents and (b) earlier depressive symptoms in one parent would predict later increases in depression in the other. Eighty cohabitating primiparous couples were recruited from prenatal OBGYN visits and community agencies and enrolled during pregnancy, between 28-week gestation and delivery. Participants completed measures of depression on four occasions: baseline and 1, 3, and …

Personalized Boosters For A Computerized Intervention Targeting College Drinking: The Influence Of Protective Behavioral Strategies, Abby L. Braitman, James M. Henson

Psychology Faculty Publications

Objective: Computerized interventions are cost-effective and can quickly deliver individual feedback to many students. However, in-person interventions are more efficacious. The current study sought to improve the efficacy of a popular online intervention via e-mailed boosters with personalized feedback.

Participants: Participants were 213 student drinkers at a southeastern public university, ages 18-24. Methods: Students were randomized into (1) intervention only, or (2) intervention plus booster. Alcohol consumption and related problems were assessed at baseline, 2weeks post, and 4weeks post.

Results: Boosters yielded reductions in drinking, but not alcohol-related problems. Boosters were associated with significant reductions for drinking frequency, heavy drinking …

Alcohol Expectancies Mediate The Relationship Between Age Of First Intoxication And Drinking Outcomes In College Binge Drinkers, Amy L. Stamates, Cathy Lau-Barraco, Ashley Linden-Carmichael

Psychology Faculty Publications

Background: While prior research has shown that age of first intoxication (AI) is associated with negative alcohol outcomes, limited research has examined factors accounting for this relationship. Alcohol expectancies, or beliefs about the effects of alcohol, may explain such associations as both positive and negative expectancies have been shown to be key predictors of drinking outcomes.

Objective: The present study examined expectancies as mediators between early AI and alcohol-related outcomes.

Method: Data collection occurred in 2012 and 2013. Participants were college students (N = 562, 65.8% women) who completed an online survey including measures of alcohol use history, alcohol expectancies, …

Early Adverse Experiences And Health: The Transition To College, Kelly B. Filipkowski, Kristin E. Heron, Joshua M. Smyth

Psychology Faculty Publications

Objective: This study cross-sectionally and prospectively examined the impact of adversity experienced prior to college on the health and well-being of students adjusting to their first college semester. Methods: Two-hundred sixteen (216) first-year students completed measures of adverse life experiences, perceived stress, physical symptoms, and health-related behaviors during the first 2 weeks of college entry and again at the end of the first semester. Results: Reported adversity prior to college predicted greater perceived stress and physical symptoms at college entry and an increase in physical symptoms over the semester; perceived stress mediated the prospective changes. Early adversity …

A Latent Profile Analysis Of Drinking Patterns Among Nonstudent Emerging Adults, Cathy Lau-Barraco, Abby L. Braitman, Amy L. Stamates, Ashley N. Linden-Carmichael

Psychology Faculty Publications

Research indicates that nonstudent emerging adults, as compared to their college-attending peers, are at higher risk for experiencing alcohol-related problems, including alcohol use disorders. The present study sought to extend the limited research on nonstudent drinking by (1) identifying sub-groups of nonstudent drinkers based on their drinking patterns and (2) determining the extent to which social-cognitive between-person factors related to drinking (i.e., social expectancies, perceived drinking norms, social drinking motivations) distinguish these sub-groups. Participants were 195 (65.1% men) nonstudent emerging adult heavy episodic drinkers recruited from the community. Mean age was 21.88 (SD = 2.08) years and 45.4% were unemployed. …

Molly Users Versus Non-Users In A Sample Of College Alcohol Drinkers: Differences In Substance-Related Harms And Sensation Seeking, Ashley N. Linden-Carmichael, Amy L. Stamates, Brynn E. Sheehan, Cathy Lau-Barraco

Psychology Faculty Publications

Background: Molly is one form of MDMA (3,4-methylenedioxymethamphetamine) that is touted to be more pure and potentially less harmful than other forms, such as ecstasy. Media reports and case studies suggest that this drug is popular among college students and is related to adverse health problems. The current study sought to address the knowledge gaps about Molly by examining whether users differ in substance use outcomes and sensation seeking than nonusers. Specifically, this study tested whether Molly users engaged in heavier use of other substances and experienced more substance-related harms in general than nonusers. Further, the current study investigated whether …