Research highlight: Emily Grekin
Research highlight: Emily Grekin
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 20.2 million adults in the United States (8.4%) met the criteria for a substance use disorder in the past year. These disorders are extremely harmful, leading to physical and psychological problems, as well as costs of over 700 billion, annually, from health care expenses, crime, and lost work productivity. Despite this, the vast majority of problem substance users are not interested in receiving treatment. For example, the National Survey on Drug Use and Health (NSDUH) estimates that 87.4% of individuals who meet the criteria for an alcohol use disorder neither want nor receive treatment.
Recognition of this gap has led to increased efforts to implement screening and brief intervention for substance use problems in primary care settings. More specifically, there has been a push for medical professionals to proactively screen all patients for substance use problems and to intervene when necessary. While proactive screening is effective, it is difficult to implement due to limitations in time, training, and willingness among health care providers. In an attempt to address this issue, researchers have created computer-delivered interventions (CDIs), or interactive computer programs that assess substance use and then provide feedback and strategies for change. CDIs can be presented briefly, inexpensively, and without the need for training or provider time.
Dr. Grekin’s research focuses on improving the effectiveness of CDIs. In particular, she is interested in whether giving CDIs more ‘human-like’ qualities will make them more effective. She has received funding from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to create a series of CDIs that vary in their degree of human-like qualities. For example, some CDIs involve an animated talking narrator, whereas others require participants to read text from the computer screen. Similarly, in some CDIs, the animated narrator reacts positively to participants (uses their name, makes empathic statements, etc.), whereas in others, the narrator is more neutral. Dr. Grekin and her co-investigators are in the process of testing 32 different versions of CDIs that vary in their level of human-like qualities using a sample of 352 undergraduates.
Another important piece of Dr. Grekin’s research involves racial and ethnic differences in substance use. She has published articles examining relationships between perceived racism and alcohol consequences among both African American and Caucasian college students. She, along with graduate student Dinah Ayna, have also published manuscripts examining the prevalence and predictors of waterpipe use among Arab American and non-Arab American college students. In 2010, she received a grant from the Alcohol Beverage Medical Research Foundation to examine longitudinal predictors of problematic alcohol use among racially diverse college students. This research is particularly important given that (1) there are substantial racial differences in the epidemiology of alcohol use and (2) the vast majority of college student substance use research relies on samples that are over 90% Caucasian.
Finally, Dr. Grekin has a research interest in relationships between substance use and disinhibited personality traits (i.e. traits like impulsivity, sensation-seeking and risk-taking). Her work in this area has revolved around two goals: (1) to examine prospective relationships between disinhibition and substance use using both self-report measures and laboratory tasks and (2) to examine environments in which disinhibition is most likely to lead to substance use. In the context of these goals, she has demonstrated that disinhibited personality traits predict stable, ‘trait-like’ alcohol, drug and tobacco dependence (i.e., latent constructs indicated by time-specific measurements of substance use taken over a two-year period). Additionally, along with her colleagues Anneke Goudriaan and Kenneth Sher, she has found that performance on laboratory measures of impulsive decision-making predicts both concurrent and future alcohol use, even after controlling for the effects of self-reported impulsivity.
Dr. Grekin has also conducted studies examining the degree to which disinhibition interacts with other variables to predict substance use. For example, using data from a longitudinal sample of college students, she found that disinhibition interacted with fraternity/sorority membership to predict alcohol dependence, such that fraternity/sorority members who were also high in disinhibition were at particularly high risk for alcohol dependence. In another study, she found that measures from a behavioral undercontrol composite interacted with alcohol use to predict relationship aggression. A more recent study shows that disinhibition interacts with childhood sexual abuse to predict alcohol-related consequences. Overall, these data (1) suggest that disinhibition exacerbates the impact of previously established substance use risk factors and (2) highlight the need for substance use interventions to assess both temperamental and environmental variables.
Dr. Grekin is extremely fortunate to work with a talented group of graduate students, post-doctoral and faculty collaborators. She is looking forward to continuing her research on predictors of and interventions for problematic substance use.