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75 Examining the Role of Executive Functions on the Intention-Behavior Gap of Alcohol Harm Reduction Strategy Use
- Becky K Gius, Robert Schlauch
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 277-278
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- Article
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Objective:
The Temporal Self-Regulation Theory (Hall and Fong, 2007) proposes that initiation and maintenance of effortful health behaviors relies on executive functions (EF: cognitive abilities associated with goal-directed behavior). Alcohol harm reduction strategies are health behaviors that aim to minimize the likelihood or severity of consequences associated with alcohol use. Some drinkers have the intention to drink safely but lack the ability to effectively initiate and execute the harm reduction behaviors. Executive functions may be one mechanism that helps explain the gap between safe drinking intentions and behavior. Specific components of EF may be differentially associated with alcohol harm reduction strategy use; working memory and set-shifting may be especially important in planning and following through with alcohol harm reduction strategies, and individuals with greater working memory capacity and set-shifting abilities may be more successful in implementing strategies that require preplanning and have a focus on altering typical the manner of drinking (e.g., not mixing types of alcohol). Inhibition may be important for resisting temptations that are inconsistent with safe drinking goals, and those with stronger inhibitory control may be more likely to follow through with strategies that require withholding responses despite desire to engage in the behavior, such as stopping or limiting drinking (e.g., not exceeding a predetermined number of drinks).
Participants and Methods:Using ecological momentary assessment, the current study explored the extent to which an intention-behavior gap in harm reduction strategy use exists among college student drinkers (n=77), and investigated how potential individual differences in EF (i.e., working memory, set-shifting, and inhibition) were associated with translating intentions of drinking safely into action. Daily monitoring assessments contained brief measures of intention to use harm reduction strategies, actual strategy use, and alcohol-related behaviors, and were assessed daily for twenty-one days.
Results:Multilevel model analyses revealed that although intention to use strategies predicted actual strategy use, measures of EF did not significantly moderate the relationship. Exploratory analyses indicated that set-shifting significantly moderated the intention-behavior gap for a subset of harm reduction strategies that relies more heavily on modifying behavior during a drinking event. Set-shifting did not significantly moderate the intention-behavior gap for a subset of strategies that relies more heavily on pre-planning before the drinking event.
Conclusions:Findings from the current study suggests that those who plan to use strategies typically follow through regardless of individual differences in EF. Efforts to increase intention to drink safely can be incorporated into existing alcohol prevention and intervention programs, which would likely lead to increased use of harm reduction strategies and decreased alcohol-related consequences.
42 Associations Between Mild Traumatic Brain Injury, Executive Function, and Criminal Justice Involvement among Veterans and Service Members: a LIMBIC-CENC study
- Becky K Gius, Lauren F. Fournier, Tea Reljic, Terri K. Pogoda, John D. Corrigan, Maya Troyanskaya, Cooper B. Hodges, Shannon R Miles, Amanda Garcia
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 148-150
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- Article
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- You have access Access
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Objective:
To examine relationships between history of mild traumatic brain injury (mTBI), neuropsychological measures of executive function, and lifetime history of criminal justice (CJ) involvement among combat-exposed Veterans and Service Members (V/SM).
Participants and Methods:Participants were combat-exposed V/SM who completed a baseline assessment for the multicenter Long-term Impact of Military-Relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium study (N=1,341) and had adequate engagement/symptom reporting on measures of performance and symptom validity (i.e., Medical Symptom Validity Test and Mild Brain Injury Atypical Symptoms Scale). Neuropsychological battery included the Trail Making Test (A and B), Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span subtest, and the National Institute of Health (NIH) Toolbox Flanker subtest. Lifetime history of brain injury, criminal justice involvement, and demographics were collected. Participants were 87% male, 72% white, with a mean age of 40 years (SD=9.67). Eighty-one percent had at least some college education. Nineteen percent were active duty. Eighty percent of Veterans and 86% of Service Members reported a history of >1 mTBI, and of these 31% and 47% respectively experienced 3+ mTBIs.
Results:Three groups were composed based on level of involvement with the CJ system: 1.) No history of arrests or incarcerations (3+ mTBIs: 64%), 2.) A lifetime history of arrest but no felony incarceration (3+ mTBIs: 34%), and 3.) A lifetime history of felony incarceration (3+ mTBIs: 2%). Ordinal regression analyses revealed that performance on a working memory task (Digit Span; b= 0.024, p= .041; OR= 1.024) was significantly associated with increased CJ involvement after adjusting for age, education, service status, and mTBIs. Performance on measures of processing speed (Trails A), set-shifting (Trails B), and inhibition (Flanker) were not significantly associated with CJ involvement. Number of mTBIs was significantly and positively associated with level of CJ involvement in all four models; Digit Span (p= .016), Trails A (p= .016), Trails B (p= .020), and Flanker (p= .008).
Conclusions:Performance on most measures of executive functioning was not significantly associated with CJ involvement in this large, representative sample of V/SM who served in combat. Although performance on a working memory task was significantly associated with CJ involvement, the size of the effect was small and the association was in the opposite direction as expected. Number of mTBIs was significantly associated with level of CJ involvement, indicating that sustaining multiple mTBI may be linked to greater risk of CJ involvement. These findings suggest that social and psychological factors beyond executive dysfunction may better explain the relationship between history mTBIs and CJ involvement. Some aspects of military service and veteran status, such as interdisciplinary treatment for brain injury and physical, mental, and psychosocial health needs, may be protective against previously identified risk factors for arrest (e.g., deficits in executive functioning). Contextualizing mTBI within the larger behavioral health profile of V/SM, with emphasis placed on intervention for related co-morbidities, may reduce the impact of previous arrest on wellbeing and/or reduce the risk of future CJ involvement.