Alisa A. Padon

Ventromedial frontal lobe plays a critical role in facial emotion recognition

The ventromedial prefrontal cortex has been implicated in a variety of emotion processes. However, findings regarding the role of this region specifically in emotion recognition have been mixed. We used a sensitive facial emotion recognition task to compare the emotion recognition performance of 7 subjects with lesions confined to ventromedial prefrontal regions, 8 subjects with lesions elsewhere in prefrontal cortex, and 16 healthy control subjects. We found that emotion recognition was impaired following ventromedial, but not dorsal or lateral, prefrontal damage. This impairment appeared to be quite general, with lower overall ratings or more confusion between all six emotions examined. We also explored the relationship between emotion recognition performance and the ability of the same patients to experience transient happiness and sadness during a laboratory mood induction. We found some support for a relationship between sadness recognition and experience. Taken together, our results indicate that the ventromedial frontal lobe plays a crucial role in facial emotion recognition, and suggest that this deficit may be related to the subjective experience of emotion.

Brand‐Specific Consumption of Alcohol Among Underage Youth in the United States

BACKGROUND Little is known about brand-specific alcohol consumption among underage youth, as existing information is collected at the level of alcoholic beverage type. This study identifies the alcohol brands consumed by a nationally representative sample of underage youth in the United States. METHODS We obtained a national sample of 1,032 underage youth, aged 13 to 20, using a pre-recruited Internet panel maintained by Knowledge Networks. Youth aged 18 to 20 were recruited directly from the panel via email invitation. Teens aged 13 to 17 were identified by asking adult panelists to identify a member of their household. The survey assessed the past 30-day consumption of 898 brands of alcohol among 16 alcoholic beverage types, including the frequency and amount of each brand consumed in the past 30 days. Market share for a given brand was calculated by dividing the total number of drinks for that brand in the past 30 days across the entire sample by the total number of drinks for all identified brands. RESULTS The alcohol brands with highest prevalence of past 30-day consumption were Bud Light (27.9%, 95% confidence interval [CI] 23.3 to 32.4%), Smirnoff malt beverages (17.0%, 95% CI 12.9 to 21.1%), and Budweiser (14.6%, 95% CI 11.0 to 18.3%). Brand market share was concentrated in a relatively small number of brands, with the top 25 brands accounting for nearly half of all market shares. CONCLUSIONS Underage youth alcohol consumption, although spread out over several alcoholic beverage types, is concentrated among a relatively small number of alcohol brands. This finding has important implications for alcohol research, practice, and policy.

Contrasting roles for lateral and ventromedial prefrontal cortex in transient and dispositional affective experience

Prefrontal cortex (PFC) has been implicated in the experience and regulation of emotional states. Emotional experience is a complex construct, encompassing a range of more specific processes. This exploratory study aimed to delineate which (if any) aspects of emotional experience rely critically on either the ventromedial frontal (VMF) or lateral frontal (LF) lobes. The affective experience of individuals with damage to these regions was surveyed in detail using several measures and compared with that of control participants. Dependent measures included subjective and observer ratings of both dispositional affect and transient responses to laboratory mood inductions. VMF damage was associated with greater negative dispositional affect relative to controls and to individuals with LF damage; however, transient responses to emotional stimuli were largely normal. In contrast, LF damage was associated with an exaggerated subjective reactivity to sad emotional stimuli relative to control participants, but normal dispositional affect. Interestingly, neither form of PFC damage affected spontaneous emotion recovery following the mood inductions. These findings suggest a role for VMF in modulating dispositional negative affect; in contrast, LF areas appear to be critical in regulating transient emotional responses while emotional stimuli are present. This study also illustrates the dissociability of different aspects of emotional experience in patients with focal brain injury.

Self-reported youth and adult exposure to alcohol marketing in traditional and digital media: results of a pilot survey.

BACKGROUND Alcohol marketing is known to be a significant risk factor for underage drinking. However, little is known about youth and adult exposure to alcohol advertising in digital and social media. This study piloted a comparative assessment of youth and adult recall of exposure to online marketing of alcohol. METHODS From September to October 2013, a pilot survey of past 30-day exposure to alcohol advertising and promotional content in traditional and digital media was administered to a national sample of 1,192 youth (ages 13 to 20) and 1,124 adults (ages ≥21) using a prerecruited Internet panel maintained by GfK Custom Research. The weighted proportions of youth and adults who reported this exposure were compared by media type and by advertising and promotional content. RESULTS Youth were more likely than adults to recall exposure to alcohol advertising on television (69.2% vs. 61.9%), radio (24.8% vs. 16.7%), billboards (54.8% vs. 35.4%), and the Internet (29.7% vs. 16.8%), but less likely to recall seeing advertising in magazines (35.7% vs. 36.4%). Youth were also more likely to recall seeing advertisements and pictures on the Internet of celebrities using alcohol (36.1% vs. 20.8%) or wearing clothing promoting alcohol (27.7% vs. 15.9%), and actively respond (i.e., like, share, or post) to alcohol-related content online. CONCLUSIONS Youth report greater exposure to alcohol advertising and promotional content than adults in most media, including on the Internet. These findings emphasize the need to assure compliance with voluntary industry standards on the placement of alcohol advertising and the importance of developing better tools for monitoring youth exposure to alcohol marketing, particularly on the Internet.

Assessing youth-appealing content in alcohol advertisements: application of a Content Appealing to Youth (CAY) index

ABSTRACT Underage drinking is a serious public health problem in the United States, and youth exposure to alcohol advertising has been indicated as a possible contributing factor. Although a number of studies have identified advertising content features that youth find appealing, a key limitation of this research is the absence of a broader tool to examine those features, especially those used by alcohol brands that are popular with underage drinkers. We created an index of content elements found in the research literature to be appealing to youth, and then used this index in a content analysis to identify the degree to which youth-appealing content appeared in a sample of alcohol ads that aired on television shows popular among youth. Finally, using bivariate analysis, we tested the relationship between alcohol brands’ use of this content and the popularity of those brands among youth. We found that many of the ads featured youth-appealing content, and that the ads for the alcohol brands most popular among youth had more youth-appealing content than the less popular brands.

Tapping Into Motivations for Drinking Among Youth: Normative Beliefs About Alcohol Use Among Underage Drinkers in the United States

Social norms affect human behavior, and underage drinking is no exception. Using the theory of normative social behavior, this study tested the proposition that the association between perceptions about the prevalence of drinking (descriptive norms) and underage drinking is strengthened when perceived pressures to conform (injunctive norms) and beliefs about the benefits of drinking (outcome expectations) are high. This proposition was tested on a nationally representative sample of underage drinkers ages 13–20 (N = 1,031) in relation to their alcohol consumption, expanding on research with college-age youth. On average, males and females reported drinking 23 and 18 drinks per month, respectively. The main effect of descriptive norms (β = .10, p < .01) on alcohol consumption was modified by interactions with injunctive norms (β = .11, p < .01), benefit to self (β = .12, p < .001), and benefit to others (β = .10, p < .01). Underage drinkers are most vulnerable to excessive drinking if they believe that most others drink, that they themselves are expected to drink, and that drinking confers several benefits. Norms-based interventions to reduce youth alcohol use need to focus on changing not only descriptive norms but also injunctive norms and outcome expectations.

Alcohol brand use of youth-appealing advertising and consumption by youth and adults

Background Youth exposure to alcohol marketing has been shown to be an important contributor to the problem of underage drinking in the U.S. More work is needed on identifying and minimizing content with particular appeal to youth. Design and Methods We tested the association between the youth-appeal of marketing content of televised alcohol advertisements and the brand-specific alcohol consumption of both underage youth and adults. We used existing data from three sources: a brand-specific alcohol consumption survey among underage youth (N=1032), a brand-specific alcohol consumption survey among adults (N ~13,000), and an analysis of content appealing to youth (CAY) in a sample of televised alcohol advertisements (n=96) aired during the youth survey. The association between CAY scores for the 96 alcohol ads and youth (age 13-20) versus adult (age 21+) consumption of those ads’ brands was tested through bivariate and multivariate models. Results Brand CAY scores were (a) positively associated with brand-specific youth consumption after controlling for adult brand consumption; (b) positively associated with a ratio of youth-toadult brand-specific consumption; and (c) not associated with adult brand consumption. Conclusions Alcohol brands with youth-appealing advertising are consumed more often by youth than adults, indicating that these ads may be more persuasive to relatively younger audiences, and that youth are not simply mirroring adult consumption patterns in their choice of brands. Future research should consider the content of alcohol advertising when testing marketing effects on youth drinking, and surveillance efforts might focus on brands popular among youth. Significance for public health Youth are overexposed to alcohol advertising. This contributes to youth having positive expectations of drinking, initiating drinking, and drinking more in quantity and frequency. The alcohol industry’s self-regulatory guidelines stipulate that marketing content cannot be primarily attractive to youth versus adults. But we do not yet have a sound scientific tool to assess what would be primarily attractive to youth. This manuscript uses a new tool, the CAY index, and two large, nationally representative datasets of youth and adult drinking patterns and shows that alcohol brands’ use of such content in their advertisements is not associated with adult brand consumption but is positively associated with youth brand consumption over and above the influence of adult brand preferences. This is critical evidence for supporting revised industry guidelines in order to protect youth from the effect of advertising on underage drinking.

Alcohol Advertising on Social Media: Examining the Content of Popular Alcohol Brands on Instagram

ABSTRACT Background: There is considerable evidence that exposure to alcohol marketing increases the likelihood of adolescents initiating and engaging in alcohol consumption. There is a paucity of research, however, specifically examining industry generated alcohol marketing occurring on social media/networking platforms. Objective: The purpose of this investigation was to analyze the content of promotional advertisements by alcohol brands on Instagram. Methods: For a 30-day period, Instagram profiles of 15 distinct alcohol brands were examined. Pictorial posts/updates from each profile were screen captured and individually documented. Approximately 184 distinct posts constituted our final sample. The Content Appealing to Youth Index was independently employed by two raters to assess each post. For each characteristic, Cohens Kappa measures, and associated 95% confidence intervals, were calculated. Descriptive statistics were performed. Results: Posts increased throughout the week and peaked on Thursday and Friday. The production value of the posts examined was generally high, frequently featuring color, texture, shine, contrast, faces, and action. Character appeals and use of youth-oriented genres were uncommon. Many of the posts used product appeals and physical benefits to consumption. The posts also emphasized the following rewarding appeal characteristics: positive emotional experiences, achievement, individuality, and camaraderie. The most commonly coded risk-related feature was inappropriate use. Conclusions/Importance: This investigation represents an initial attempt to provide insights into the content alcohol brands are including in their promotional materials on social networking sites.

Alcohol Advertising on Twitter—A Topic Model

ABSTRACT Background: Exposure to alcohol-related advertising is consistently linked to adolescent drinking initiation and alcohol-related consequences. Since the advent of social networking sites, the alcohol industry has adapted its advertising efforts and allocated large portions of advertising budgets and efforts on digital and online media. Purpose: This investigation employed a novel, objective content analysis to examine the advertising practices of leading alcohol brands on Twitter. Methods: Latent Dirichlet allocation (LDA) was utilized to examine the entire Twitter post history for 13 alcohol brands. Results: Very distinct, clear themes emerged for each brand. Each brand had a unique approach to marketing that was representative of the brand itself. Insufficient alcohol brand messaging on Twitter focused on moderation (ie, drink responsibly). Discussion: Our analysis of tweets from 2010 to 2017 by 13 distinct alcohol brands echoes previous documenting utilization of content appealing to youth and violation of the alcohol industry’s self-developed marketing code. Translation to Health Education Practice: Public health practitioners and policymakers should utilize these findings and those of previous peer-reviewed studies to advocate for clear externally monitored advertising regulations and guidelines protecting adolescents from alcohol advertising exposure.

Towards a global policy against alcohol marketing to youth: Challenges and recommendations for research

A significant body of work now indicates that adult onset of alcoholism and alcohol-related problems can be traced back to underage drinking.1,2 Despite numerous countries’ efforts to curtail underage drinking, it remains a significant global public health issue,3,4 and alcohol marketing has been identified as one of the primary contributors to this growing problem.5 Among various tools countries can use to curtail underage drinking, an important one is formulating and implementing policies that govern alcohol marketing practices, especially those directed toward children and adolescents. Developing such policies, however, must be based on sound scientific evidence, which could come in at least two forms: demonstration of impact of drinking and a marketing causal vector that links advertising with underage consumption of alcohol. By impact, we mean that the evidence needs to point to the effects of underage drinking. It would show the deleterious effects not only on individuals themselves, but also on their social networks, communities, and society as a whole, thus compelling the need for change. Second, the evidence needs to demonstrate a marketing causal vector, ability to make a causal link between the marketing or advertisement of alcohol, either directly or indirectly, to youth, on the one hand, with subsequent underage consumption of alcohol, on the other. A substantial body of work demonstrates both these aspects.5-8 A number of countries have sound policies in place restricting the direct marketing of alcohol to children and adolescents and/or imposing stringent restrictions on alcohol marketing to which youth are indirectly exposed; a comprehensive list is compiled in the Global Health Observatory data repository.9 Globally, however, much more needs to be done, including in amassing evidence about the effectiveness of such policies in curtailing underage alcohol consumption. Are such policies effective and what challenges must the scientific community face to contribute to that literature? These are some of the questions we raise in this editorial. We frame our discussion around challenges along two pillars: enacting effective marketing policies and evaluating the effectiveness of such policies in curtailing underage advertising exposure.