The Association of Alcohol and Drug Use with Persistence of Violent Offending in Young Adulthood

PURPOSE

This study expanded upon an earlier study, which examined the associations between heavy drinking and persistence of serious violent offending through emerging adulthood (approximate age 25), by examining associations between alcohol, marijuana, and other drug use and disorders and persistence of serious violent offending through young adulthood (approximate age 36).

METHODS

We used official records and self-reported longitudinal data from Black and White men from early adolescence through young adulthood (n = 391). Men were divided into four violence groups: non-violent, desisters, persisters, and very late-onsetters. Multinomial logistic regression analyses controlling for race and incarceration were used to compare these groups in terms of substance use in young adulthood and changes in use from emerging to young adulthood.

RESULTS

Most previous serious violent offenders did not re-offend in young adulthood. Whereas alcohol use did not differ across groups, persisters and desisters, compared to non-violent men, were more likely to use hard drugs, deal drugs, have a lifetime substance use disorder diagnosis and show larger decreases in alcohol and marijuana frequency from emerging to young adulthood. None of these measures differed between persisters and desisters except that persisters reported larger decreases in alcohol and marijuana use frequency.

CONCLUSIONS

The findings demonstrated reductions in serious violent offending during young adulthood and suggested that after adolescence, illicit drug use, compared to alcohol use, may play a more important role in initiation and maintenance of serious violent offending. Future research that examines the interrelations of drug use, drug culture, and violence is warranted.

Chronic adolescent marijuana use as a risk factor for physical and mental health problems in young adult men

Some evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms). However, relatively few longitudinal studies have prospectively examined the long-term physical and mental health consequences associated with chronic adolescent marijuana use. The present study used data from a longitudinal sample of Black and White young men to determine whether different developmental patterns of marijuana use, assessed annually from early adolescence to the mid-20s, were associated with adverse physical (e.g., asthma, high blood pressure) and mental (e.g., psychosis, anxiety disorders) health outcomes in the mid-30s. Analyses also examined whether chronic marijuana use was more strongly associated with later health problems in Black men relative to White men. Findings from latent class growth curve analysis identified 4 distinct subgroups of marijuana users: early onset chronic users, late increasing users, adolescence-limited users, and low/nonusers. Results indicated that the 4 marijuana use trajectory groups were not significantly different in terms of their physical and mental health problems assessed in the mid-30s. The associations between marijuana group membership and later health problems did not vary significantly by race. Findings are discussed in the context of a larger body of work investigating the potential long-term health consequences of early onset chronic marijuana use, as well as the complications inherent in studying the possible link between marijuana use and health effects.

The association between protective behavioral strategies and alcohol-related problems: An examination of race and gender differences among college drinkers

This study examined race and gender differences in use of specific types of protective behavioral strategies (PBS) and the moderating effects of race and gender on the relationship between PBS use and alcohol problems, controlling for alcohol use, among a large sample of Asian, Black, and White college drinkers. There were significant racial and gender differences in the types of PBS used. Moderation analyses indicated that PBS were more protective for women than men against experiencing alcohol-related problems. There were no significant race effects or race-by-gender interaction effects on alcohol problems. Implementing PBS may be beneficial for all college students.

Marijuana motivations across adolescence: impacts on use and consequences

Background. Motivational models for marijuana use have focused on reasons to use marijuana, but rarely consider motives to abstain.

OBJECTIVES

We examined how both adolescent marijuana abstinence motives and use motives contribute to marijuana use and problems at the end of emerging adulthood. Methods. 434 community recruited youth who had not initiated marijuana use at baseline were followed from adolescence (at ages 12, 15, and 18 years) into emerging adulthood (age 25 years). Motives to abstain and to use marijuana, marijuana consumption, and marijuana-related problems were assessed across time. Results. Endorsing more motives to abstain from marijuana across adolescence predicted less marijuana use in emerging adulthood and fewer marijuana-related problems when controlling for past motives to abstain and marijuana-related behavior. Positive reinforcement use motives related to increased marijuana consumption and problems, and negative reinforcement motives predicted problems when controlling for past marijuana use motives and behaviors. Expansion motives during adolescence related to lower marijuana use in emerging adulthood. When considered together, motives to abstain buffered the effect of negative reinforcement motives on outcomes at age 25 for youth endorsing a greater number of abstinence motives. Conclusions/ Implications. Given these findings, inclusion of both motives to use and abstain is warranted within comprehensive models of marijuana use decision making and may provide important markers for prevention and intervention specialists.

Project INTEGRATE: An integrative study of brief alcohol interventions for college students

This article provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed 2 or more times from baseline up to 12 months, with varying assessment schedules across studies. This article describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo (MCMC) algorithms for 2-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single intervention studies.

Differential evaluations of alcohol-related consequences among emerging adults

Personalized feedback interventions (PFIs) to reduce drinking in college students often provide feedback about negative alcohol-related consequences experienced by students to motivate them to drink less. Yet, there is evidence which suggests that not everyone perceives consequences as negative and raises questions regarding the utility of consequence-specific feedback for some individuals. The purpose of the current study was to extend this research to examine salience of consequences among both college and non-college emerging adults, differences in ratings by sex, age, and frequency of experiencing consequences, and the relationship between salience measured in emerging adulthood and drinking patterns in young adulthood. Data were from an accelerated cohort study of males and females (N = 1,308), who were either age 18, 21, or 24 years at the time of consequence evaluation and followed-up 7 years later. Most experienced consequences were rated as at least a little bothersome. Regression analyses indicated that females, older participants, and those who experienced a consequence more often evaluated consequences as more bothersome but there were no differences by college status. Mean ratings of bother did not predict quitting drinking or alcohol problems 7 years later, whereas the number of consequences experienced did. Overall, the results suggest that most consequences are rated similarly by emerging adults regardless of college attendance but that feedback on consequences may be more salient for females and older emerging adults. PFIs may need to differ in the types of feedback they provide depending on demographic characteristics and baseline level of alcohol problems.

Couples' marijuana use is inversely related to their intimate partner violence over the first 9 years of marriage

Research on the association between marijuana use and intimate partner violence (IPV) has generated inconsistent findings, and has been primarily based on cross-sectional data. We examined whether husbands' and wives' marijuana use predicted both husbands' and wives' IPV perpetration over the first 9 years of marriage (Wave 1, n = 634 couples). We also examined moderation by antisocial behavior, the spouse's marijuana use, and whether IPV was reported during the year before marriage. These predictive associations were calculated using a time-lagged multivariate generalized multilevel model, simultaneously estimating predictors of husband and wife IPV. In fully adjusted models, we found that more frequent marijuana use by husbands and wives predicted less frequent IPV perpetration by husbands. Husbands' marijuana use also predicted less frequent IPV perpetration by wives. Moderation analyses demonstrated that couples in which both spouses used marijuana frequently reported the least frequent IPV perpetration. There was a significant positive association between wives' marijuana use and wives' IPV perpetration, but only among wives who had already reported IPV perpetration during the year before marriage. These findings suggest there may be an overall inverse association between marijuana use and IPV perpetration in newly married couples, although use may be associated with greater risk of perpetration among women with a history of IPV perpetration.

When less is more and more is less in brief motivational interventions: characteristics of intervention content and their associations with drinking outcomes

Brief motivational interventions (BMIs) that aim to reduce alcohol use and related problems have been widely implemented in college settings. BMIs share common principles, but vary in specific content. Thus far, the variation in content has not been thoroughly understood in relation to intervention outcomes. The present study addressed this gap by examining variation in breadth of BMI content (i.e., total number of components covered), the extent to which content was personalized to participants, and the interaction between breadth and personalization in relation to treatment outcomes. Data (N = 6,047 participants across 31 separate BMI conditions) came from an integrative data analysis (IDA) study featuring individual-level data from a broad sample of 24 BMI studies of college students. Participants were assessed at baseline and at least 1 follow-up point, conducted up to 12 months postbaseline. Structural equation modeling revealed a significant interaction effect between breadth and personalization of BMI content on alcohol use and related problems at the long-term follow-up (6-12 months) but not at the short-term follow-up (1-3 months). Results indicated that "more is better" for reducing both alcohol use and related problems when BMIs were highly personalized to participants. For less personalized BMIs, coverage of more components was associated with increases in both alcohol use and problems. Findings point to the importance of strategically designing BMIs to maximize their impact on drinking outcomes in college students.

Moderating effects of positive parenting and maternal alcohol use on emerging adults' alcohol use: does living at home matter?

Positive parenting behaviors and parental modeling of alcohol use are consistent predictors of offspring's alcohol use. Recent research extends these findings to emerging adult children and confirms continued parental influence beyond adolescence. This paper examines how maternal warmth and supervision moderate the effects of mother's heavy alcohol use on their offspring's alcohol use among a sample of non-college-attending emerging adults. Three-way interactions were used to examine if these moderating effects differed between emerging adults who lived at home and those with other living arrangements. Separate analyses within gender were used to further examine these associations. Participants were 245 emerging adults between ages 18 and 22 years with no post-secondary education (59% female) who were selected from a national probability-based internet panel. Path analyses indicated that, regardless of living arrangements, male emerging adults who were more likely to witness their mother getting drunk were themselves more likely to engage in risky drinking. However, among female emerging adults, similarity between mothers' and daughters' drunkenness was strongest among participants who resided with their family and also reported low levels of maternal warmth. This study extends previous research by indicating that the effects of maternal modeling of heavy alcohol use on emerging adults' heavy alcohol use depend upon several factors, including the gender of the child and the family context. Implications of the study findings are discussed in terms of expanding the scope of a parent-based intervention (PBI) to all emerging adults, including those who do not attend colleges or universities.

Associations between alcohol use and alcohol-related negative consequences among black and white college men and women

OBJECTIVE

The gender gap in alcohol use has been narrowing among young adults, while race differences in alcohol problems change throughout the life course, with Whites experiencing more problems before middle adulthood and Blacks experiencing more after. Yet, there is a paucity of research on the intricate relationship among gender, race, alcohol use, and alcohol problems in emerging adults. The present study addressed this gap in the literature.

METHOD

The sample included White (n = 14,772) and Black (n = 458) college students from multiple colleges across the United States (59% female; 51% freshmen; Mage = 20 years).

RESULTS

With alcohol use levels adjusted for, women were more likely to report consequences related to damage to self and dependence-like symptoms than men. There were no significant race differences in either the type or the number of alcohol problems. Further, there was no Race × Alcohol Use interaction in relation to alcohol problems. We found a statistically significant interaction between gender and alcohol use in predicting alcohol problems, suggesting that, at higher levels of drinking, the risk for women to experience alcohol problems was significantly greater than that for men.

CONCLUSIONS

The reverse race gap in alcohol use and problems may not surface until young adulthood or may not be relevant for those who attend college. College interventions should help both Black and White students reduce problems associated with drinking and focus on limiting harm among female students.

Treatment outcomes of a combined cognitive behavior therapy and pharmacotherapy for a sample of women with and without substance abuse histories on an acute psychiatric unit: do therapeutic alliance and motivation matter?

BACKGROUND AND OBJECTIVES

Women with comorbid psychiatric and substance abuse problems (PwSA) experience more consequences from their use and typically have the poorest prognosis and outcome, compared to those with psychiatric problems but without substance abuse problems (PwoSA). The present study examined outcomes of a combined intensive inpatient cognitive behavior therapy (CBT) and pharmacotherapy program for women with PwSA and PwoSA.

METHODS

Sample consisted of 117 women on a women-only acute inpatient unit (PwSA = 50, PwoSA = 67).

RESULTS

Women in both groups made significant improvements in psychological functioning. High motivation at admission and therapeutic alliance at discharge were associated with improved psychological functioning at discharge for both groups.

SCIENTIFIC SIGNIFICANCE

Findings provide preliminary support for the efficacy of a combined CBT and pharmacotherapy program for women with psychiatric diagnoses on a women-only acute inpatient unit, and for pre-treatment motivation and therapeutic alliance as important correlates of better treatment outcomes.

Patterns of alcohol use and related consequences in non-college-attending emerging adults

OBJECTIVE

Among emerging adults, those who do not attain postsecondary education are at highest risk for experiencing longterm problems related to alcohol use, including alcohol dependence. The purpose of the current study was to identify latent classes of alcohol users among non-college-attending youth and examine correlates of class membership.

METHOD

Screening criteria were used to select emerging adults between ages 18 and 22 years with no postsecondary education (N = 264) from a prerecruited probability-based Web panel. Latent class analysis (LCA) was used to identify common patterns of alcohol use. Grouping variables and demographic variables were added to the LCA model, and rates of alcohol-related consequences across the LCA classes were compared.

RESULTS

Four classes of drinking patterns were identified: (a) current nondrinkers (34%), (b) weekend light drinkers (38%), (c) weekend risky drinkers (23%), and (d) daily drinkers (5%). Class membership was associated with early onset of alcohol use (age 14 or younger), marital status, employment status, and urban residency (area populated by 50,000 or more people). The number of latent classes did not differ across sex and legal drinking age status, although proportions of subjects within classes varied by age. Weekend risky drinkers were most likely to report sickness and feelings of guilt because of drinking, whereas daily drinkers were most likely to report getting into fights, driving a car after drinking, and missing work.

CONCLUSIONS

Similar to college samples of emerging adults, most of this noncollege sample belonged to latent classes defined by rare or moderate alcohol use. Nevertheless, nearly a quarter of the sample reported high-risk drinking behaviors, and a small number reported drinking alcohol on a daily basis. Both of these classes were at elevated risk for experiencing a number of alcohol-related consequences.

An update of research examining college student alcohol-related consequences: new perspectives and implications for interventions

The objective of this review is to provide an update on existing research examining alcohol-related consequences among college students with relevance for individual-based interventions. While alcohol-related consequences have been a focus of study for several decades, the literature has evolved into an increasingly nuanced understanding of individual and environmental circumstances that contribute to risk of experiencing consequences. A number of risk factors for experiencing alcohol-related consequences have been identified, including belonging to specific student subgroups (e.g., Greek organizations) or drinking during high-risk periods, such as spring break. In addition, the relationship between students' evaluations of both negative and positive consequences and their future drinking behavior has become a focus of research. The current review provides an overview of high-risk student subpopulations, high-risk windows and activities, and college students' subjective evaluations of alcohol-related consequences. Future directions for research are discussed and include determining how students' orientations toward consequences change over time, identifying predictors of membership in high-risk consequence subgroups and refining existing measures of consequences to address evolving research questions.

Effects of childhood maltreatment on violent injuries and premature death during young adulthood among urban high-risk men

OBJECTIVES To assess childhood maltreatment as a risk factor for violent injuries and premature death in young adulthood and whether these associations are mediated by adolescent heavy drinking, hard drug use, hard drug selling, and violent offending. DESIGN Prospective longitudinal study of boys followed from childhood into young adulthood. SETTING Pittsburgh, Pennsylvania. PARTICIPANTS A total of 1009 men from the Pittsburgh Youth Study. MAIN EXPOSURE Childhood maltreatment. MAIN OUTCOME MEASURES Premature deaths between ages 18 and 38 years from the Social Security Death Index and self-reports of violent injuries inflicted by gunshot or knife between ages 18 and 28 years. RESULTS Young men who experienced childhood maltreatment, compared with their counterparts who did not experience it, had a greater risk of violent injuries (relative risk = 1.61; 95% CI, 1.10-2.35) and death (hazard ratio = 2.85; 95% CI, 1.37-5.93) during young adulthood. Adolescent violent offending and hard drug selling explained the association between childhood maltreatment and violent injuries, and violent offending partially accounted for the association between childhood maltreatment and premature death. Although adolescent violent offending predicted both outcomes, maltreated boys still had an increased risk of premature death (hazard ratio = 2.54; 95% CI, 1.21-5.34) after accounting for their adolescent violence. CONCLUSIONS Childhood maltreatment significantly predicts premature death and violent injuries during young adulthood. These associations are partially explained by adolescent involvement in violence and drug dealing. Targeted interventions for maltreated boys to reduce their involvement in adolescent deviant behaviors may help decrease their risks for later serious injuries and premature death.

Motives to drink or not to drink: longitudinal relations among personality, motives, and alcohol use across adolescence and early adulthood

BACKGROUND

Adolescent selective intervention programs for alcohol have focused on the identification of youth at risk as a function of personality and associated alcohol-related cognitions. Research into the role of personality, drinking motivations, and alcohol-related outcomes has generally focused exclusively on motives to drink. We expand on this literature by focusing on both motives to drink and motives not to drink across time from adolescence to early adulthood in a community sample.

METHODS

Using 3 waves of data from 3 cohorts from the Rutgers Health and Human Development Project (n = 1,380; 49.4% women), we modeled the influence of baseline alcohol consumption, disinhibition (DIS), and harm avoidance (ages 15, 18, and 21 years) on drinking motives and motives not to drink 3 years later (ages 18, 21, and 24 years) and alcohol use and drinking-related problems 7 years subsequently (ages 25, 28, and 31 years).

RESULTS

Path analytic models were relatively invariant across cohort. Across cohorts, DIS and baseline alcohol consumption related to later positive reinforcement drinking motives, but less consistency was found for the prediction of negative reinforcement motives to drink. While positive reinforcement motives were associated with greater alcohol consumption and problems 7 years later, negative reinforcement motives were generally associated with problems alone. Positive reinforcement motives for drinking mediated relations between baseline consumption and later consumption. However, results were mixed when considering DIS as a predictor and drinking problems as an outcome. Similarly, personality and baseline consumption related to later motives not to drink and such motives predicted subsequent alcohol-related problems. However, mediation was not generally supported for pathways through motives to abstain.

CONCLUSIONS

The results of this study replicate and extend previous longitudinal findings with youth and add to the growing literature on motivations not to engage in alcohol use.

Educational Paths and Substance Use from Adolescence into Early Adulthood

This study examined how substance use trajectories from ages 15 to 23 in a community sample (N=921) were related to educational pathways. Rates of heavy drinking converged across different paths, but starting college at a 2-year college before transferring to a 4-year college was related to later increase in drinking after high school. Higher future educational attainment was negatively associated with high school marijuana use, but marijuana use increased after high school for individuals who went to 4-year colleges compared to those who did not. Noncollege youth had the highest rates of daily cigarette smoking throughout adolescence and early adulthood, while college dropouts had higher rates of smoking than college students who did not drop out. The findings support the need for universal prevention for early adult heavy drinking, addressing increases in drinking and marijuana use in 4-year colleges, and targeting marijuana use and cigarette smoking interventions at noncollege youth and college dropouts.

Exploring the intersection of neighborhood racial and economic composition and individual race on substance use among male adolescents

This article examines how Blacks and Whites living in neighborhoods with divergent racial and income profiles differed in early onset (by age 14 years) and adolescent lifetime prevalence (by age 18 years) of substance use, with longitudinal data from 473 high-risk boys (58% Black). A latent profile analysis identified four neighborhood classes: Black, lower-income; racially mixed, middle-income; White, middle-income; and White, upper-income. Bivariate analyses showed that Blacks living in racially mixed, middle-income neighborhoods reported the lowest rates of tobacco and marijuana use. Whites living in White, upper-income neighborhoods reported higher substance use prevalence, particularly marijuana. Findings suggest that substance use prevention efforts are critical for Whites in upper-income communities.

Developmental Patterns of Alcohol Use in Relation to Persistence and Desistance of Serious Violent Offending among African American and Caucasian Young Men

This study examined the association of alcohol use with persistence and desistance of serious violent offending among African American and Caucasian young men from adolescence into emerging adulthood. Five violence groups were defined: nonviolent, late-onsetters, desisters, persisters, and one-time offenders. We examined alcohol use trajectories for these groups from ages 12 through 24/25 using a four-piecewise linear growth model (ages 12-14, 14-18, 18-21, and 21-24/25). The persisters and desisters reported the highest levels of drinking at age 13. From ages 14 through 18, however, the late-onsetters showed a higher rate of increase in drinking, compared to the persisters and desisters. Starting from age 18, the desisters' drinking trajectory started to resemble that of the nonviolent group, who showed the highest rate of increase in drinking during emerging adulthood. By age 24/25 the persisters could not be distinguished from the late-onsetters; but were lower than the nonviolent and one-timer groups in terms of their drinking. At age 24/25, the desisters were not significantly different from the other violence groups, although they appeared most similar to the nonviolent and one-timer groups. There was no evidence that the association between drinking and violence differed for African Americans and Caucasians. The findings suggest that yearly changes in alcohol use could provide important clues for preventing violent offending.

Racial differences in trajectories of heavy drinking and regular marijuana use from ages 13 to 24 among African-American and White males

BACKGROUND

Although there are significant differences in prevalence of substance use between African-American and White adolescents, few studies have examined racial differences in developmental patterns of substance use, especially during the important developmental transition from adolescence to young adulthood. This study examines racial differences in trajectories of heavy drinking and regular marijuana use from adolescence into young adulthood.

METHODS

A community-based sample of non-Hispanic African-American (n=276) and non-Hispanic White (n=211) males was analyzed to identify trajectories from ages 13 to 24.

RESULTS

Initial analyses indicated race differences in heavy drinking and regular marijuana use trajectories. African Americans were more likely than Whites to be members of the nonheavy drinkers/nondrinkers group and less likely to be members of the early-onset heavy drinkers group. The former were also more likely than the latter to be members of the late-onset regular marijuana use group. Separate analyses by race indicated differences in heavy drinking for African Americans and Whites. A 2-group model for heavy drinking fit best for African Americans, whereas a 4-group solution fit best for Whites. For regular marijuana use, a similar 4-group solution fit for both races, although group proportions differed.

CONCLUSIONS

Within-race analyses indicated that there were clear race differences in the long-term patterns of alcohol use; regular marijuana use patterns were more similar. Extended follow ups are needed to examine differences and similarities in maturation processes for African-American and White males. For both races, prevention and intervention efforts are necessary into young adulthood.

Risk of marijuana use in male and female college student athletes and nonathletes

OBJECTIVE

A large minority of collegiate athletes report past-year marijuana use even though there is a significant possibility of experiencing negative athlete-specific consequences related to performance, eligibility, and scholarship. The present study examined risk factors that can drive or curb marijuana use in college athletes and nonathletes.

METHOD

Logistic regressions, performed separately for men and for women, assessed the relationship of past-year marijuana use to sensation seeking, negative mood, perceptions of peer marijuana use, motivations for marijuana use, and stress related to body image and academics in athletes (233 men, 156 women) and nonathletes (184 men, 313 women). Risk factors also were compared for male past-year marijuana users who reported using (n = 26) or not using (n = 61) the substance during their competitive season.

RESULTS

For athletes and nonathletes of both genders, being White, being past-year cigarette smokers, having higher sensation-seeking scores, and having exaggerated perceptions of student use norms were associated with past-year marijuana use. Enhancement motivations for use were higher among athletes compared with their same-gender nonathlete peers. In women, but not in men, greater body image stress and lower academic stress were associated with past-year marijuana use. Male athletes who continued using marijuana into their competitive season demonstrated a qualitatively different risk profile compared with athlete past-year users who reported no in-season use, including greater coping motivations for marijuana use.

CONCLUSIONS

This preliminary study suggests that although the overall risk profile of college athletes and nonathletes is similar, athletes appear to be particularly motivated to use marijuana because of its enhancement or pleasurable properties.

Associations between changing developmental contexts and risky sexual behavior in the two years following high school

The present study tested associations between common developmental contexts (relationship involvement, independent living, college attendance, work) and risky sexual behavior (casual sex, inconsistent condom use, high-risk sex) across the 2 years following high school. Data were drawn from the Raising Healthy Children project, and included 801 participants aged 18-21 years. Longitudinal analyses, which controlled for early sexual debut, high school substance use, and high school grades, showed that living with a parent was protective against all three sexual risk behavior outcomes (ORs about 0.70). Being in a romantic relationship was associated with a lower probability of casual sex, but a higher probability of inconsistent condom use. Attending college was associated with a lower probability of high-risk sex (OR = 0.67). Working was not related to the sexual risk behaviors examined. Levels of sexual risk behavior showed little change across the 2 years following high school. Findings from this study suggest that developmental context may affect young adults' engagement in risky sexual behavior. Programs aimed at promoting sexual health and reducing risk behaviors for STIs among young adults should consider targeting those in romantic relationships, those not living with parents, and those not attending college. Further, to develop effective prevention programs for these targeted youth, it is critical that we understand the mechanisms leading to risky sex in these groups.

Romantic relationship status changes and substance use among 18- to 20-year-olds

OBJECTIVE

Changes in romantic relationship status are common in emerging adulthood and may be linked to changes in substance use. This study tested the hypothesis that entry into relationships or transitioning to a more committed status leads to decreases in substance use and that dissolution of relationships or transitioning to a less committed status results in increases in substance use.

METHOD

Data were from a community sample of 939 individuals. Substance use (heavy drinking, marijuana use, and cigarette smoking) and relationship status (single, in a romantic relationship but not cohabiting, cohabiting, or married) were assessed at the beginning and end of three 6-month intervals between the ages of 18 and 20 years. Models were estimated to assess the association between transitions in relationship status and substance use, adjusting for prior levels of use.

RESULTS

There were increases in heavy drinking, marijuana use, and cigarette smoking associated with dissolution of a romantic relationship, as well as increases in marijuana use and cigarette smoking associated with switching partners within a 6-month interval. Mediation analyses found some support for increases in both depressive symptoms and exposure to substance-using peers partially accounting for these associations. Decreases in substance use were not found for individuals entering into a new relationship or transitioning to a more committed relationship status. In fact, cigarette smoking increased among those who went from being single to being in a romantic relationship compared with those whose relationship status did not change.

CONCLUSIONS

Emerging adults who experience dissolution of romantic relationships or quickly move from one relationship to another experience increased substance use. Both depressive symptoms and changes in peer environments may partially account for these changes in use.

Substance use trajectories of black and white young men from adolescence to emerging adulthood: a two-part growth curve analysis

This study examined trajectories of substance use among Black and White young men (N = 983) from adolescence to emerging adulthood using two-part growth curve analysis. Controlling for parental socioeconomic status, Blacks were significantly less likely to use alcohol and hard drugs than Whites at age 17 and drank significantly fewer drinks. The alcohol prevalence gap between Blacks and Whites further increased over time. Blacks in the older cohort had higher growth in the frequency of alcohol use than Whites. Blacks and Whites did not differ in prevalence of marijuana use, although Blacks in the younger cohort reported higher growth in prevalence and higher frequency at age 17. Different prevention approaches may be needed to reduce substance use among Blacks and Whites.

Time-varying associations between conduct problems and alcohol use in adolescent girls: the moderating role of race

OBJECTIVE

The aims of this study were to examine the time-varying developmental associations between conduct problems and early alcohol use in girls between ages 11 and 15 and to test the moderating role of race.

METHOD

The study is based on annual, longitudinal data from oldest cohort in the Pittsburgh Girls Study (n = 566; 56% African American, 44% White). Two models of the association between conduct problems and alcohol use were tested using latent growth curve analyses: conduct-problem-effect (conduct problems predict time-specific variation in alcohol use trajectory) and alcohol-effect (alcohol use predicts time-specific variation in conduct problem trajectory) models.

RESULTS

Girls' conduct problems and alcohol use increased over ages 11-15. Results provided support for a conduct-problem-effect model, although the timing of the associations between conduct problems and alcohol use differed by ethnicity. Among White girls, conduct problems prospectively predicted alcohol use at ages 11-13 but not later, whereas among African American girls, prospective prediction was observed at ages 13-14 but not earlier.

CONCLUSIONS

Study findings indicate developmental differences in the time-varying association of conduct problems and alcohol use during early adolescence for African American and White girls. Ethnic differences in the development of alcohol use warrant further study, and have potential implications for culture-specific early screening and preventive interventions.

Is nonmedical prescription opiate use a unique form of illicit drug use?

Nonmedical prescription opiate (NMPO) use is of great concern because of its high addiction potential, cognitive impairment effects, and other adverse consequences (e.g., hormonal and immune system effects, hyperalgesia and overdose). Due to the combination of drugs used by those who are NMPO users, it is difficult to isolate the negative effects of NMPO use from the effects of other legal and illicit drugs. Based on a stage model of substance use, this study tested whether NMPO use represents a unique form of illicit drug use among emerging adults and whether there are unique consequences of early NMPO use. We used longitudinal data from 912 emerging adults from the Raising Healthy Children study who were interviewed at least annually from the first or second grade through age 21. The findings indicated that almost all NMPO users have also used marijuana and a large majority has also used other drugs, such as cocaine and ecstasy. In addition, more frequent users of NMPOs are also more frequent users of other drugs. Except for violent behavior, NMPO use explained little unique variance in negative outcomes of use (e.g., drug use disorder, mood disorder, nonproductive behavior, poor health, and property crime) beyond that explained by other illicit drug use. Future studies examining the predictors or consequences of NMPO use and nonmedical use of other prescription drugs need to consider use within the context of other drug use.

Associations between heavy drinking and changes in impulsive behavior among adolescent boys

BACKGROUND

Impulsive behavior in humans predicts the onset of drinking during adolescence and alcohol use disorders (AUDs) in adulthood. It is also possible, however, that heavy drinking may increase impulsive behavior by affecting the development of brain areas that support behavioral control or through other associated mechanisms. This study examined whether drinking heavily during adolescence is related to changes in impulsive behavior with a specific focus on how the association differs across individuals, contingent on the developmental course of their impulsiveness.

METHOD

Data came from a sample of boys (N = 503) who were followed annually from approximate age 8 to age 18 and again at approximate age 24/25. Heavy drinking was defined as experiencing a blood alcohol concentration (BAC) level of 0.08% or higher. At each assessment, the parent and child each reported whether the child was impulsive.

RESULTS

First, group-based trajectory analysis was used to identify 4 groups differing in the level and slopes of their trajectories of impulsive behavior from age 9 to age 17: low (13.9%), early adolescence-limited (18.7%), moderate (60.8%), and high (6.6%). These trajectory groups differed in their prevalence of any heavy drinking, peak BACs, and rates of alcohol dependence in adolescence and AUD in early adulthood, with the less impulsive groups being lower on these measures than the more impulsive groups. Heavy drinking was then entered into the model as a time-varying covariate; this measure was lagged so that the results represent change in impulsive behavior the year following heavy drinking. Among boys on the moderate trajectory, those who drank heavily were rated as significantly more impulsive the following year compared to those who did not drink heavily.

CONCLUSIONS

The association between heavy drinking and impulsive behavior may depend on earlier levels of impulsive behavior with those who are moderately impulsive appearing to be at greatest risk for increased impulsive behavior following heavy drinking. Further research is needed to clarify this association.

Effects of Institutional Confinement for Delinquency on Levels of Depression and Anxiety among Male Adolescents

Youth within the juvenile justice system report higher rates of mental illnesses than their peers. This study tested whether institutional confinement increases levels of depression and anxiety among male adolescents. We examined heterogeneous trajectories of depression and anxiety from ages 11 to 14 for 510 male adolescents. Youths who were first placed in custody at age 15 (treatment group) were matched with control boys (no official arrest or reported confinement during adolescence) within each trajectory group using a propensity score matching procedure. Matches were found for 37 pairs for depression and 34 pairs for anxiety. There were no significant differences between the confined and control groups in levels of depression or anxiety at age 16. More research is needed to identify aspects of the juvenile justice system that may positively or negatively affect youth's mental health status.

Psychophysiological reactivity to emotional picture cues two years after college students were mandated for alcohol interventions

This study examined alcohol use behaviors as well as physiological, personality, and motivational measures of arousal in students approximately 2 years after they were mandated to a brief intervention program for violating university policies about on-campus substance use. Students were categorized into serious (medical referrals, n=13) or minor (residence advisor referrals, n=30) infraction groups based on the nature of the incident that led to their being mandated. Self-report measures of arousal, sensation seeking, reasons for drinking, and past 30-day alcohol use were completed. Physiological arousal during exposure to emotional picture cues was assessed by indices of heart rate variability. The minor infraction group reported significantly escalating alcohol use patterns over time and a pattern of less regulated psychophysiological reactivity to external stimuli compared to the serious infraction group. The serious infraction group was higher in sensation seeking and there was some evidence of greater disparity between their physiological and self-reported experiences of emotional arousal in response to picture cues than in the minor group. Thus, the two infraction groups represent different subsets of mandated students, both of whom may be at some risk for using alcohol maladaptively. The findings suggest that intervention strategies that address self-regulation may be beneficial for mandated college students.

Romantic relationships and substance use in early adulthood: an examination of the influences of relationship type, partner substance use, and relationship quality

This study used longitudinal data from 909 young adults to examine associations between substance use and the status and quality of romantic relationships. Heavy alcohol use, marijuana use, and cigarette smoking, as well as relationship status, relationship quality, partner substance use, and other salient life circumstances were assessed at four time points in the two years after high school. Marriage, cohabiting relationships, and noncohabiting dating relationships were associated with reductions in heavy drinking and marijuana use relative to non-dating, after adjusting for adolescent substance use; marriage compared to not dating was associated with reductions in cigarette smoking. For those in romantic relationships, partner substance use moderated the associations between relationship quality and substance use for heavy drinking and for marijuana use, supporting the hypothesis derived from the Social Development Model that the protective effect of stronger social bonds depends on the use patterns of the partner to whom an individual is bonded.

A parallel process model of the development of positive smoking expectancies and smoking behavior during early adolescence in Caucasian and African American girls

This study examined the development of positive smoking expectancies and smoking behavior in an urban cohort of girls followed annually over ages 11-14. Longitudinal data from the oldest cohort of the Pittsburgh Girls Study (N = 566, 56% African American, 44% Caucasian) were used to estimate a parallel process growth model of positive smoking expectancies and smoking behavior. Average level of positive smoking expectancies was relatively stable over ages 11-14, although there was significant variability in initial level and rate of change in positive smoking expectancies. Ethnicity was associated with expectancy intercept and slope, such that African American, relative to Caucasian, girls initially had more positive expectancies, and less rapid change in positive expectancies. Ethnic differences in past year smoking prevalence emerged at age 14, with greater smoking prevalence among Caucasian (17%), compared to African American (8%), girls. Initial level of positive smoking expectancies and initial smoking behavior were positively associated, but positive expectancies did not predict growth in smoking behavior. Depression at age 11 was concurrently and positively associated with both positive expectancies and smoking. Study results suggest the potential utility of culturally tailored smoking prevention efforts, and the potential secondary benefit of depression treatment to prevent smoking among at-risk girls.

Prospective associations among alcohol use-related sexual enhancement expectancies, sex after alcohol use, and casual sex

Higher levels of alcohol use have consistently been related to higher rates of sexual risk taking; however, it is not clear whether this relationship is causal. This study examined the concurrent and predictive associations among alcohol use-related sexual enhancement expectancies, drinking alcohol before engaging in sex, and casual sex during the transition into emerging adulthood and whether these associations differed for men and women. Data came from 590 men and women who were interviewed 3 times at 6-month intervals after high school. Growth curve analyses indicated that alcohol-related sexual enhancement expectancies were related to casual sex indirectly through drinking before sex but did not predict change in either of these behaviors. However, increases in drinking before sex predicted increases in casual sex over time. The findings provide some support for prevention programs that focus on alcohol-related sexual expectancies to reduce sexually transmitted illnesses among emerging adults.

Risk profile of male college athletes who use performance-enhancing substances

OBJECTIVE

There is a general perception that use of performance-enhancing substances (PESs) does not fit the standard profile of substance use. This study sought to determine whether users of PESs report high-risk patterns of alcohol and other drug use and demonstrate risk behaviors associated with problematic substance use.

METHOD

Anonymous self-report questionnaires were administered to a sample of 234 male student athletes. PES users were defined as college athletes who reported past-year use of a broad array of PESs (including stimulants, hormone precursors, and nutritional supplements).

RESULTS

Male athlete PES users (n = 73) compared with nonusers (n = 160) reported more problematic alcohol-use behaviors and more alcohol- and drug-use-related problems. The former compared with the latter was also more likely to report past-year use of tobacco products, marijuana, cocaine, psychedelics, and prescription drugs without a prescription. In addition, PES users demonstrated higher sensation seeking, and greater coping and enhancement motivations for drinking and marijuana use than non-PES users.

CONCLUSIONS

Although banned PESs are not typically viewed as having a high addiction potential, male athletes who use these drugs may be more likely to participate in other problematic substance-use behaviors. Importantly, the male athletes in this study who reported PES use also participated in substance-use behaviors that can have profound negative effects on athletic performance. More research on the use of PESs in college athletes is needed.

An SEM Approach for the Evaluation of Intervention Effects Using Pre-Post-Post Designs

This study analyzes latent change scores using latent curve models (LCMs) for evaluation research with pre-post-post designs. The paper extends a recent article by Willoughby, Vandergrift, Blair, and Granger (2007) on the use of LCMs for studies with pre-post-post designs, and demonstrates that intervention effects can be better tested using different parameterizations of LCMs. This study illustrates how to test the overall mean of a latent variable at the time of research interest, not just at baseline, as well as means of latent change variables between assessments, and introduces how individual differences in the referent outcome (i.e., level-2 random effects) and measurement-specific residuals (i.e., level-1 residuals) can be modeled and interpreted. Two intervention data examples are presented. This LCM approach to change is more advantageous than other methods for its handling of measurement errors and individual differences in response to treatment, avoiding unrealistic assumptions, and being more powerful and flexible.

Transitions into and out of light and intermittent smoking during emerging adulthood

INTRODUCTION

The purpose of this study was to examine transitions in smoking from adolescence into emerging adulthood and to identify factors that might influence these transitions, specifically, movement into and out of light and intermittent smoking.

METHODS

This study used Markov models to examine movement across three stages of smoking (nonsmoking, light and intermittent smoking, and heavy smoking) from adolescence into emerging adulthood. Biannual data were collected from 990 young men and women from the 12th grade until 2 years after high school.

RESULTS

At each timepoint, most youth were nonsmokers. Those who were heavy smokers in 12th grade had a 79% chance of also being heavy smokers 2 years after high school. Between 17% and 21% of participants were light and intermittent smokers at each timepoint, and the likelihood of remaining so at the next timepoint ranged from 56% to 72%. Less than one-half of the 12th-grade light and intermittent smokers were light and intermittent smokers 2 years later, and 3% of the sample were light and intermittent smokers across all assessments. Prevalence and transition rates did not differ by gender. College attendees reported less smoking than nonattendees before and after their transition to college, and attendees compared with nonattendees who smoked were less likely to transition from light and intermittent to heavy smoking and remain heavy smokers. Binge drinking was significantly related to 12th-grade smoking stage and to transitions from nonsmoking to smoking. Overall, few emerging adults maintained light and intermittent smoking consistently over time.

DISCUSSION

Light and intermittent smoking during emerging adulthood may not be the same phenomenon as light and intermittent smoking in adulthood.

Individual and situational factors that influence the efficacy of personalized feedback substance use interventions for mandated college students

Little is known about individual and situational factors that moderate the efficacy of personalized feedback interventions (PFIs). Mandated college students (N = 348) were randomly assigned either to a PFI delivered in the context of a brief motivational interview (BMI; n = 180) or to a written PFI only (WF) condition and were followed up at 4 months and 15 months postintervention. The authors empirically identified heterogeneous subgroups utilizing mixture modeling analysis based on heavy episodic drinking and alcohol-related problems. The 4 identified groups were dichotomized into an improved group (53.4%) and a nonimproved group (46.6%). Logistic regression results indicated that the BMI was no more efficacious than the WF across all mandated students. However, mandated students who experienced a serious incident requiring medical or police attention and those with higher levels of alcohol-related problems at baseline benefited more from the BMI than from the WF. It may be an efficacious and cost-effective approach to provide a written PFI for low-risk mandated students and an enhanced PFI with a BMI for those students who experience a serious incident or have higher baseline alcohol-related problems.

Risk for excessive alcohol use and drinking-related problems in college student athletes

There is compelling evidence that college student athletes engage in frequent episodes of heavy drinking and are prone to negative consequences resulting from such use. This study sought to identify risk and protective factors associated with student-athlete drinking and determine if student-athlete risk factors differed from those of non-athletes. Athletes compared to non-athletes reported more exaggerated perceptions of peer heavy drinking and lower sensation seeking and coping and enhancement motives for drinking, suggesting a risk profile distinct from non-athletes. In the overall sample, higher sensation seeking, overestimation of peer heavy drinking, non-use of protective behaviors while drinking, and higher enhancement and coping drinking motives were associated with greater frequency of heavy episodic drinking and more negative drinking consequences. In athletes compared to non-athletes, sensation seeking was more strongly associated with heavy episodic drinking and drinking to cope was more strongly associated with negative alcohol-related consequences. Overall, the results suggest that already proven brief intervention strategies, with minor adaptations related to the roles of sensation seeking and drinking to cope, may be helpful for student athletes.

Alcohol, tobacco, illicit drugs, and performance enhancers: a comparison of use by college student athletes and nonathletes

OBJECTIVE

The authors compared the prevalence and pattern of substance use in undergraduate student athletes and nonathletes from 2005-2006.

PARTICIPANTS

Authors collected data from male (n = 418) and female (n = 475) student athletes and nonathletes from 2005-2006.

METHODS

The authors administered self-report questionnaires to assess prevalence, quantity, and frequency of alcohol and drug use, and to determine patterns of student athletes' alcohol and drug use during their athletic season versus out of season.

RESULTS

Male student athletes were at high risk for heavy drinking and performance-enhancing drug use. Considerable in-season versus out-of-season substance use fluctuations were identified in male and female student athletes.

CONCLUSIONS

Additional, and possibly alternative, factors are involved in a student athlete's decision-making process regarding drug and alcohol use, which suggests that the development of prevention programs that are specifically designed to meet the unique needs of the college student athlete may be beneficial.

Identifying two potential mechanisms for changes in alcohol use among college-attending and non-college-attending emerging adults

This study tested whether pro-alcohol peer influences and prosocial involvement account for increases in drinking during the transition into emerging adulthood and whether these mechanisms differ depending on college attendance and/or moving away from home. The authors used structural equation modeling of prospective data from 825 young men and women. For 4 groups defined by college and residential status, more drinking in the spring of 12th grade predicted more pro-alcohol peer influences the following fall, and more pro-alcohol peer influences in the fall predicted increases in drinking the following spring. Going to college while living at home was a protective factor against increases in drinking and selection of pro-alcohol peer involvements. Prosocial involvement (measured by involvement in religious activities and volunteer work) was not significantly related to post-high school drinking except among college students living away from home. Prevention efforts should focus on (a) reducing opportunities for heavy drinking for college and noncollege emerging adults as they leave home and (b) increasing prosocial involvement among college students not living at home.

Changes in drinking before a mandated brief intervention with college students

OBJECTIVE

Little is known about the effects of alcohol-related infractions and resulting reprimands for invoking behavioral change among mandated college students. The primary aim of this study was to assess the extent to which students significantly reduce their drinking between the time of an alcohol-related violation and the sanctioned intervention.

METHOD

Data came from 175 (70% male) students mandated to the Rutgers University Alcohol and Other Drug Assistance Program for Students because of infractions of university rules about alcohol and drug use. At intake, students reported on their alcohol consumption for the 30 days before the violation and the 30 days before the intake assessment.

RESULTS

Mandated students significantly reduced peak blood alcohol concentration (BAC) levels, total weekly drinks, and frequency of alcohol use after the violation before any intervention. Those students who had received a legal or medical referral (i.e., a serious infraction) reduced their alcohol consumption (BAC and total drinks) significantly more than those referred by residence hall advisors.

CONCLUSIONS

The alcohol-related violation (including the event itself, getting caught, and/or getting mandated to an intervention) contributes to reductions in alcohol use for mandated college students. The finding that the seriousness of the infraction resulted in greater reductions in alcohol use suggests that the students' cognitive self-appraisal and affective response to the incident may be underlying mechanisms for their changes. Knowing if mandated students have already made significant changes in their drinking before intake would provide counselors with a valuable opportunity to identify and reinforce successful harm reduction strategies and could inform the type or intensity of intervention needed.

Long-Term Effects of Brief Substance Use Interventions for Mandated College Students: Sleeper Effects of an In-Person Personal Feedback Intervention

BACKGROUND

It is known that brief interventions for mandated college students decrease alcohol use and/or related problems in the short term. However, none of the existing studies has followed students' past 6 months. Therefore, we compared the long-term efficacy of 2 brief substance use feedback interventions for mandated college students.

METHODS

We followed up mandated students (N=348) who were randomly assigned to either a brief motivational interview (BMI; n=180) or a written feedback-only (WF; n=168) intervention at 4 months and 15 months postintervention.

RESULTS

Long-term follow-up data revealed that students, at the aggregate level, decreased their peak blood alcohol concentration (BAC) levels, number of drinks per week, and number of alcohol-related problems at 15 months postintervention compared with their baseline levels. With the exception of peak BAC, the observed long-term reduction was mainly due to the positive change among students who received the BMI intervention. Students in the BMI intervention showed significantly lower levels of alcohol-related problems at 15 months than those in the WF intervention. The BMI intervention more effectively reduced within-individual alcohol-related problems during the initial 4 months, and more successfully curbed the subsequent increase in alcohol use frequency and number of drinks per week during the 11 months between the 2 follow-up assessments.

CONCLUSIONS

The results suggest that brief substance use interventions reduce the riskiest type of alcohol use (e.g., peak BAC) among mandated college students over the long term, and that sleeper effects of in-person personal feedback interventions (PFIs) exist. In-person PFIs in the context of a motivational interview may be more efficacious in the long term than written feedback-only interventions for mandated students. Future studies comparing interventions for college students should extend follow-up for longer periods of time.

Stages and sequences of initiation and regular substance use in a longitudinal cohort of black and white male adolescents

OBJECTIVE

This study examined whether developmental sequences and stages of substance-use initiation and regular use differed and, if so, whether they varied for black and white adolescent males.

METHOD

The analyses were based on a cohort of inner-city boys in the Pittsburgh public schools, who had been followed prospectively from ages 7 to 19 across 18 data waves (N = 412).

RESULTS

Blacks were most likely to end initiation of any use and regular use with marijuana, whereas alcohol and tobacco were the most common end stage drugs for whites. Whites were also more likely than blacks to initiate and to become regular users of hard drugs. For both races, the typical developmental sequence for substance-use initiation and regular use was alcohol and/or tobacco, then marijuana, and then hard drugs. However, blacks were more likely to deviate from this sequence than were whites. Participants who initiated any substance use faced a high probability of becoming a regular user of at least one substance.

CONCLUSIONS

There were differences in the sequences and stages of substance-use initiation and regular use by race. Further research is needed to identify the antecedents of escalation to regular use and progression of regular use across substances and to delineate the cultural and environmental factors that affect substance-use progression.

Alcohol Initiation Experiences and Family History of Alcoholism as Predictors of Problem-Drinking Trajectories

OBJECTIVE

The purpose of this study was to identify developmental trajectories of problem drinking from adolescence into young adulthood and to determine if alcohol use initiation experiences and family history of alcoholism, as well as their interactions, would predict trajectory group membership.

METHOD

Five waves of data were collected from respondents who were 12 years old at the time of recruitment to the Rutgers Health and Human Development Project and followed until age 31 (n = 438). A standardized measure of problem drinking (Rutgers Alcohol Problem Index) was used to develop trajectories with growth-mixture modeling. Differences across groups in first- use experience (age of onset, pleasantness of the experience, and feeling intoxicated), a family history of alcoholism, and gender were analyzed with chi-square and analysis of variance tests, and logistic regression analyses were used to estimate the odds of group membership.

RESULTS

Three trajectory groups of drinkers were identified: no or low problem (66.2%), adolescence-limited problem (ALP; 21.6%), and escalating problem (EP; 12.1%) drinkers. Age at drinking onset, feeling drunk during the first alcohol experience, and family history of alcoholism were associated with significantly greater odds of being in a problem trajectory group relative to the no or low problem trajectory. Early experiences did not differentiate the ALP and EP trajectories. None of the interactions was significantly associated with membership in any of the groups.

CONCLUSIONS

The levels and patterns of problem drinking during early to mid-adolescence point to a need for secondary prevention efforts that target problematic users in addition to the current emphasis on primary prevention of alcohol consumption. Prevention-based research may benefit from special focus on the meaning and consequences of self-perception of drunkenness when alcohol is first used.

Evaluating two brief substance-use interventions for mandated college students

OBJECTIVE

This study evaluated two brief personal feedback substance-use interventions for students mandated to the Rutgers University Alcohol and Other Drug Assistance Program for Students (ADAPS): (1) a brief motivational interview (BMI) intervention and (2) a written feedback-only (WF) intervention. A key question addressed by this study was whether there is a need for face-to-face feedback in the context of motivational interviewing to affect changes in substance-use behaviors or whether a written personal feedback profile is enough of an intervention to motivate students to change their substance use.

METHOD

The sample consisted of 222 students who were mandated to ADAPS, were eligible for the study, and completed the 3-month follow-up assessment. Eligible students completed a baseline assessment from which a personal feedback profile was created. They were then randomly assigned to the BMI or WF condition. Students were followed 3 months later.

RESULTS

Students in both interventions reduced their alcohol consumption, prevalence of cigarette and marijuana use, and problems related to alcohol and drug use between baseline and follow-up. There were no differences between the two intervention conditions in terms of any substance-use outcomes.

CONCLUSIONS

The results suggest that, under these circumstances and with these students, assessment and WF students changed similarly to those who had an assessment and WF within the context of a BMI. Given the fact that the former is less costly in terms of time and personnel, written profiles may be found to be a cost-effective means of reducing alcohol and drug use and related problems among low- to moderate-risk mandated college students. More research is needed with mandated students to determine the efficacy of feedback interventions and to isolate the effects of interventions from the effects of being caught and being reprimanded to treatment.

Young girls' expectancies about the effects of alcohol, future intentions and patterns of use

OBJECTIVE

In recent years, rates of alcohol use among young female adolescents have been increasing. Despite such trends, little is known about the precursors of use and intentions to use alcohol among preadolescents. The current prospective study examines the prevalence and correlates of alcohol use, future intentions and alcohol-related expectancies among young girls from ages 8 to 10 years.

METHOD

Alcohol use behaviors and attitudes were assessed annually over a 3-year period in a community sample of 1,161 preadolescent girls. The girls comprised the two oldest cohorts of the ongoing Pittsburgh Girls Study (N = 2,451). Data were collected via separate parent and child interviews conducted in the participants' homes.

RESULTS

The prevalence of alcohol use without parental permission was less than 3% in any given year between ages 8 and 10. Most girls reported sipping only, and there was little continuity of use across assessments. Alcohol-related expectancies were predominantly negative during this period but decreased with age. Positive expectancies, however, increased, particularly among white girls. Early alcohol use was predicted by black race and peer use. Intentions to use alcohol were predicted by low levels of negative expectancies and peer use.

CONCLUSIONS

This study adds to the knowledge of use of alcohol and the development of positive and negative alcohol-related expectancies in girls of elementary school age.

Racial differences in trajectories of cigarette use

This study examined racial differences in developmental trajectories of cigarette smoking from childhood into young adulthood. We used data from the Pittsburgh Youth Study, a prospective, longitudinal study of high-risk males. We developed trajectories of cigarette smoking from age 10 through age 25. Models were estimated separately for African-Americans (N = 562) and Whites (N = 421) because preliminary analyses indicated that there were significant racial differences in onset, levels and patterns of cigarette use. Three trajectory groups emerged for both races: nonsmokers, light/occasional smokers and heavy/regular smokers. Significantly more Whites were in the heavy/regular smoker group and more African-Americans were in the nonsmoker group. White compared to African-American heavy/regular smokers began smoking earlier and reached higher mean quantities of cigarettes per day. In addition, there were racial differences in the timing and rapidity of the development of regular smoking over time. Race remained a significant predictor of cigarette use even after controls for socioeconomic status. Overall, the results indicate that developmental trends in smoking differ by race and that cigarette smoking remains more prevalent and more frequent for White than African-American males, at least through young adulthood.

Longitudinal effects of age at onset and first drinking situations on problem drinking

The purpose of this study was to describe aspects of the first alcohol-use experience, and examine the predictive relations among age of first use, context of alcohol use initiation, and problem drinking with and without controls for psychosocial risk factors. Data were from the Rutgers Health and Human Development Project, a five-wave, prospective study of substance-use behaviors in a community sample. Respondents, who were first interviewed at age 12 (1979-81) and most recently at age 30 or 31 (1999-2000) (N=371), reported on their first drinking experience, and on a range of known risk factors for alcohol abuse. Most alcohol initiation occurred during a family gathering. Regardless of initiation context, youth who drank at an early age were more likely than youth who initiated later to become problem drinkers, although the risk was relatively greater for the youth who first drank outside a family gathering. Based on multivariate logistic regressions, feeling drunk at initiation was the only onset-related variable significantly associated with problem drinking; other significant risks factors included male gender, delinquency, and family history of alcoholism. Because most initiation occurs at a family gathering, alcoholism prevention research may benefit from examining the role that drinking in family contexts could play with regard to socializing young drinkers to less risky drinking behaviors in adulthood. In particular, further research focusing on the subjective effects experienced by youth when they first drink may be merited.

Transformations of covariates for longitudinal data

This paper develops a general approach for dealing with parametric transformations of covariates for longitudinal data, where the responses are modeled marginally and generalized estimating equations (GEEs) are used for estimation of regression parameters. We propose an iterative algorithm for obtaining regression and transformation parameters from estimating equations, utilizing existing software for GEE problems. The algorithmic technique is closely related to that used in the Box-Tidwell transformation in classical linear regression, but we develop it under the GEE setting and for more general transformation functions. We provide supporting theorems for consistency and asymptotic Normality of the estimates. Inference between two nested models is also considered. This methodology is applied to two data sets. One consists of pill dissolution data, the other is taken from the Pittsburgh Youth Study (PYS). The PYS is a prospective longitudinal study of the development of delinquency, substance use, and mental health in male youth. We use the model-based parametric approach to examine the association between alcohol use at an early stage of adolescent development and delinquency over the course of adolescence.

Risk taking as a predictor of adolescent sexual activity and use of contraception

This study tested a risk-taking model of adolescent sexual activity and use of contraception. Longitudinal data were analyzed from a household sample of 1273 unmarried male and female adolescents and young adults. The results indicated that engagement in sexual intercourse and re liability of contraceptive use increased with age throughout adolescence and into young adulthood. Engaging in sexual intercourse among these subjects appeared to reflect a high risk-taking personality profile as de fined by high disinhibition and high impulsivity. Reliable and consistent use of contraception, however, did not appear to relate to this profile. Future research needs to determine other predictors of safe versus unsafe sexual practices.