Cue Exposure Therapy (CET) is a behavioristic psychological approach to treating substance use disorders (SUD). Prior systematic reviews have found CET to be ineffective when targeting SUDs. The effect of this approach on alcohol use disorders (AUD) seems more promising at trial level but has yet to be systematically reviewed and quantitatively analyzed. Therefore, we aimed to examine the effectiveness of CET targeting AUD compared to active control conditions in a meta-analytic review. Following a systematic search of the literature, a total of seven controlled trials were identified. CET showed no to small additional effects on drinking intensity and drinking frequency, a small additional effect on total drinking score and a moderate additional effect on latency to relapse. Stratification and analysis of a-priori defined trial covariates revealed that CET may have an increased effect in the longer term, and that CET combined with urge-specific coping skills may be the better option for treating AUD than conventional CET. Also, CET may prove less effective when comparing it to cognitive behaviour therapy as opposed to other active control conditions. The overall quality of evidence was graded low due to high risk of bias, inconsistency, imprecision and suspected publication bias. Sounder methodological trials are needed to derive a firm conclusion about the effectiveness of CET for treating AUD.

Background and aim No large‐scale, longitudinal clinical study has examined whether patients with different types of eating disorders (ED) have an increased risk of a subsequent alcohol use disorder (AUD). This study aimed to assess the ongoing risk of receiving a diagnosis of AUD following a first‐time diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), or unspecified ED (USED). Design Retrospective cohort study. Setting Danish nationwide registries, January 1994 to December 2018. Participants A total of 20 759 ED patients and 83 036 controls were followed from the date of first ED diagnosis (index date) until the date of first AUD diagnosis, death, emigration, or the end of the study. Controls were selected in a 1:4 ratio and matched on month and year of birth, gender and ethnicity. Measurements We obtained data on ED (AN, BN, USED; exposure) and AUD (abuse/dependence; outcome) diagnoses as well as sociodemographics and other psychiatric diagnoses. Time to AUD was generated from the index date. Risk of AUD after the index date was assessed among those without a prior AUD diagnosis while adjusting for sociodemographics and prior psychiatric diagnoses. Findings Compared with controls, an increased relative risk of AUD after the index date was observed in AN patients throughout the study lasting 15 + years (adjusted hazard ratios [HRs] ranging from 2.49 [99% CI = 1.46, 4.25] to 6.83 [2.84, 16.41]), in BN patients during the first year of follow‐up and from 2 years onward (2.72 [1.66, 4.44] to 17.44 [6.01, 50.63]), and in USED patients during the first year and 2–15 years of follow‐up (2.52 [1.54, 4.14] to 14.17 [5.86, 34.27]). In all three groups, estimates were highest during the first year, particularly among BN patients. Conclusions Patients with anorexia nervosa, bulimia nervosa, or unspecified eating disorders appear to have an increased ongoing risk of receiving a diagnosis of alcohol use disorder following their first eating disorder diagnosis compared with controls.

BackgroundType 2 diabetes (T2D) is on the rise among young adults (aged 20–39 years). A challenge for health risk communication is that young adults may not be aware or lack acknowledgement of their personal risk of developing T2D. To date, no knowledge is available on potential relationships between personality traits and T2D risk perception in this target group. This cross-sectional study aimed to investigate direct and indirect (mediated via health-related behaviours and body mass index) associations between the Five-Factor Model personality traits and T2D risk perception among university students in Denmark.MethodsParticipants included 1205 students (80% females; mean age = 25) from five major universities. All variables were assessed by means of self-report in an online questionnaire. Health-related behaviours included physical activity, sweets consumption and prior T2D screening. Covariates included socio-demographic factors and family history of T2D.ResultsA hierarchical multiple regression analysis revealed that higher levels of conscientiousness and emotional stability were directly negatively associated with T2D risk perception after controlling for covariates, health-related behaviours, and body mass index. Binary logistic regression analyses showed several significant associations between personality traits and health-related behaviours as well as body mass index. Sobel tests indicated that both physical activity and body mass index partially mediated the association between conscientiousness and T2D risk perception. The association between extraversion and T2D risk perception was fully mediated by PA.ConclusionsWe present novel evidence suggesting that personality traits, health-related behaviours and body mass index are associated with T2D risk perception among young adults. Thus, it may be beneficial to tailor health risk communications targeting T2D to match recipients’ personality characteristics instead of using the one size fits all approach.

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