Solitary Alcohol Use in Teens Is Associated With Drinking in Response to Negative Affect and Predicts Alcohol Problems in Young Adulthood

Adult substance use as a function of growth in peer use across adolescence and young adulthood in the context of ADHD: Findings from the MTA

Peer substance use strongly predicts adolescent and young adult substance use, but its role in ADHD-related risk for substance use, especially in adulthood, is unclear. In a sample with (n = 516) and without (n = 249) childhood ADHD from the Multimodal Treatment Study of ADHD, we compared associations between change over time in peer substance use and personal substance use (alcohol, cigarettes, marijuana, illicit drugs) from age 14-26 by ADHD status. Developmentally typical peer substance use trajectories across adolescence and young adulthood coincided with similar changes in personal use - but less so for those with ADHD histories. Concurrent associations between peer and personal use in adolescence and young adulthood were weaker for those with ADHD histories than without for commonly used substances (alcohol, marijuana). Prospectively, escalating peer use during adolescence forecasted adulthood declines for commonly used substances, yet persistently high substance use at age 25, regardless of ADHD history. In the reverse direction, growth in adolescent substance use predicted developmentally normative young adult declines in peer use - but for the ADHD group, adolescent heavy drinking predicted increases in young adult peer use. Findings suggest that individuals with ADHD may have difficulty emulating their peers' developmentally normative declines in substance use, highlighting the importance of social factors when treating young adults affected by ADHD and substance abuse.

Context matters: Characteristics of solitary versus social cannabis use

INTRODUCTION AND AIMS

Given the increase in cannabis availability and use in North America, identification of risk factors for cannabis use and dependence is paramount. One factor that may be associated with various cannabis-related adverse outcomes is the context in which it is used. This secondary analysis study sought to examine the extent to which the social context of cannabis use is related to patterns of use and associated harms.

DESIGN AND METHODS

One hundred and eighty-eight adult cannabis users were community-recruited in Halifax, Canada. Participants took part in a face-to-face structured interview where they provided information about the social context of their most recent cannabis-using occasion and about their patterns of, and motives for, cannabis use.

RESULTS

Compared to individuals reporting their most recent cannabis-using occasion as social, solitary users (n = 55) were significantly more likely to screen positive for psychosis, endorse more symptoms of cannabis abuse/dependence, report using cannabis to cope, and use cannabis on more days within the previous 30 days. On the other hand, social users were significantly more likely to report using alcohol in addition to cannabis during their most recent cannabis-using occasion (all P < 0.05).

DISCUSSION AND CONCLUSIONS

Results suggest that solitary cannabis use may be associated with specific motives for use and future adverse consequences. Findings from this study serve as a guide for future investigations which could ultimately inform public policy and the development of targeted harm-reduction strategies.

Frequent solitary drinking mediates the associations between negative affect and harmful drinking in emerging adults

INTRODUCTION

Depression and anxiety are highly comorbid conditions that are associated with harmful drinking. Social learning theory proposes that depressed or anxious individuals learn that drinking can reduce negative affect, which makes them susceptible to harmful drinking. Consistent with theory, evidence suggests that negative affect increases risk for harmful drinking. But, less is known about mediators of negative affect-pathways to harmful drinking. Research has demonstrated that solitary drinking is an underlying mechanism of harmful drinking among emerging adults with high levels of negative affect. However, much of this work is cross-sectional. We conducted a longitudinal study to examine solitary drinking as a key explanatory variable in the negative-affect pathway to harmful drinking.

METHODS

Emerging adults (N = 308) completed online self-reports of depression and anxiety at Time 1 (the beginning of their first semester in university), and drinking context and harmful drinking at Time 2 (the end of their first semester of university).

RESULTS

Structural equation modeling supported indirect effects from negative affect to harmful drinking via solitary drinking. Specifically, emerging adults with high levels of negative affect at the beginning of their first semester engaged in frequent solitary drinking over the rest of the semester, and subsequently experienced increased harmful drinking (controlling for Time 1 solitary/social drinking and harmful use). Social drinking was not a mediator of this effect.

CONCLUSIONS

The findings reveal that solitary drinking uniquely mediated the relation between negative affect and harmful drinking. Reducing solitary drinking might mitigate negative affect-related risk for harmful drinking in emerging adults.

Identity as a cannabis user is related to problematic patterns of consumption among emerging adults

INTRODUCTION

Cannabis use has become a more normative, socially-acceptable behavior in the United States, despite research indicating that frequent use may become problematic for some individuals. Emerging adulthood, a time of identity development, is the most common time for cannabis use. Cannabis self-concept, or one's identification with cannabis as part of their personality or identity, is one factor that may influence use behavior. This study extends previous research that reported a link between self-concept, motivational factors, and normative beliefs by evaluating relationships between cannabis self-concept, motives for use, motivation to change, perceived descriptive norms, as well as cannabis-related outcomes (use, using alone, and cannabis-related problems).

METHODS

Emerging adults who used cannabis in the previous month (n=345, 53.9% male, mean age 21.0, 67.5% Non-Latino White) were recruited from a community sample for a health behaviors study. Participants were assessed for explicit cannabis self-concept, frequency of use, problems associated with use, motives for use, motivation to change, and normative beliefs about others' use.

RESULTS

Participants reported using cannabis on an average of 17.9 (SD=11.1) days of the previous month. Correlational analyses revealed that cannabis self-concept was positively associated with frequency of use, use-related problems, several motives for use, descriptive norms, and with using cannabis alone. Multivariate analyses revealed that rates of use, problems, and social and enhancement motives were independently and positively associated (p<0.05) with cannabis self-concept, while self-concept was negatively associated with desire to reduce cannabis use.

CONCLUSIONS

Cannabis self-concept may be a marker for more problematic patterns of use.

Social discomfort moderates the relationship between drinking in response to negative affect and solitary drinking in underage drinkers

OBJECTIVE

Research shows that solitary drinking is associated with negative reinforcement motives (i.e., relieving negative affect). An untested hypothesis proposes that this association may be especially strong for individuals who experience social discomfort. This study aimed to 1) replicate findings linking solitary drinking to social discomfort (i.e., loneliness, social anxiety, and lack of perceived social support), alcohol problems, and drinking in response to negative affect (i.e., drinking to cope motives and inability to resist alcohol during negative affect), and 2) investigate whether greater social discomfort moderates the relationship between drinking in response to negative affect and solitary drinking in underage drinkers.

METHOD

Current alcohol drinkers ages 18 to 20 (N=664) recruited from a TurkPrime panel reported the percentage of time they drank solitarily and completed measures assessing social discomfort, drinking in response to negative affect, and alcohol involvement. Structural equation modeling was used to test the moderation model.

RESULTS

Results replicated prior literature supporting the first aim. For the second aim, analyses indicated a positive association between solitary drinking and drinking in response to negative affect across all individuals, but contrary to prediction, this relationship was stronger for individuals with lower, rather than higher, social discomfort.

CONCLUSION

Underage drinkers with lower, rather than higher, social discomfort appear to be at greater risk for drinking alone. These findings may inform our understanding of individuals at greatest risk for drinking alone and promote new avenues for intervention.

Do alcohol use reasons and contexts differentiate adolescent high-intensity drinking? Data from U.S. high school seniors, 2005-2016

The purpose of this study was to examine associations between (a) self-reported reasons for and contexts of alcohol use and (b) high-intensity drinking (i.e., having 10+ drinks in a row in the past 2 weeks) among national samples of U.S. 12th grade students. Data were obtained from 16,902 students who reported any past 12-month alcohol use from nationally representative annual 12th grade student samples from 2005-2016. When asked about drinking behavior during the past 2 weeks, 72% reported consuming less than 5 drinks at most during 1 drinking occasion; 14% reported 5-9 drinks, 7% reported 10-14 drinks, and 7% reported 15+ drinks. Adolescent drinkers in all categories (<5, 5-9, 10-14, and 15+ drinks) endorsed "to have a good time" as the most prevalent reason for alcohol use, and "at a party" as the most prevalent context of alcohol use. However, high-intensity drinking was particularly likely among adolescents drinking for coping, compulsive use, and drug effect reasons, as well as those who enjoyed the taste. Having 15+ drinks (vs. 10-14 drinks) was particularly associated with compulsive use and enjoying the taste. The relative risk of any high-intensity drinking, and of higher levels of high-intensity drinking involvement, increased with the total number of reasons and contexts endorsed. Alcohol appears to serve a larger number of functions for high-intensity drinking adolescents than non-high-intensity drinking youth. (PsycINFO Database Record

Association of drinking pattern with risk of coronary heart disease incidence in the middle-aged and older Chinese men: Results from the Dongfeng-Tongji cohort

Background

Epidemiologic studies have found that moderate alcohol consumption was associated with a decreased risk of coronary heart disease (CHD) incidence. Nevertheless, whether the drinking pattern is associated with CHD incidence still remains inconclusive.

Methods

We included 8,469 Chinese men aged 45–81 years, who were free of CHD, stroke, or cancer at baseline from Dongfeng-Tongji cohort. A semi-structured questionnaire was used to collect information on alcohol consumption and other covariates. Cox proportional hazard regression model was applied to estimate the multivariable-adjusted hazard rations (HRs) and 95% confidence intervals (95% CIs).

Results

During an average of 4.36 years of follow-up, we identified 959 incident CHD events. Compared with non-drinkers, the multivariable-adjusted HR (95% CI) of CHD incidence was 0.84 (0.71–0.98) in current drinkers. With respect to drinking pattern, men who consumed 20.01–40 grams ethanol once a time had a 24% lower risk of incident CHD (HR = 0.76, 95% CI = 0.62, 0.94) compared with non-drinkers. The adjusted HRs (95% CI) of CHD incidence were 0.80 (0.65, 0.99), 1.02 (0.84, 1.22), and 0.75 (0.59–0.96) in subjects who consumed 0.01–10, 10.01–30, and > 30 grams ethanol per day, respectively. Participants who consumed 20.01–40 grams ethanol per time with less than 5 times per week had the lowest risk of CHD incidence (HR = 0.73, 95% CI = 0.52, 0.96). No significant associations were observed between type or frequency of alcohol consumption and CHD incidence.

Conclusions

Drinking was associated with a lower risk of CHD incidence in middle-aged and older Chinese men and moderate quantity of ethanol amounts once a time with lower frequency could been considered as a healthy drinking pattern, which might modify the relationship between alcohol consumption and incident CHD.

Perceived racial discrimination and negative-mood-related drinking among African American college students

OBJECTIVE

Research consistently shows a positive association between racial discrimination and problematic alcohol use among African Americans, but little is known about the micro-processes linking this pernicious form of stress to drinking. One possibility is that the cumulative effects of discrimination increase individuals' likelihood of negative-mood-related drinking. In the current study, we examined whether individual differences in lifetime perceived racial discrimination among African American college students moderate relations between daily negative moods and evening alcohol consumption in both social and nonsocial contexts.

METHOD

Data came from an online daily diary study of 441 African Americans (58% female) enrolled at a historically black college/university. Lifetime discrimination was measured at baseline. For 30 days, students reported the number of drinks they consumed the night before both socially and nonsocially, as well as their daytime level of negative mood.

RESULTS

In support of the hypotheses, only men who reported higher (vs. lower) lifetime discrimination showed a positive association between daily negative mood and that evening's level of nonsocial drinking. Contrary to expectation, women who reported higher (vs. lower) discrimination showed a negative association between daily negative mood and nonsocial drinking. Neither daily negative mood nor lifetime discrimination predicted level of social drinking.

CONCLUSIONS

These findings provide further evidence that the cumulative impact of racial discrimination may produce a vulnerability to negative-mood-related drinking--but only for African American men. Importantly, these effects emerged only for nonsocial drinking, which may further explain the robust association between discrimination and problematic alcohol use.

Friends in low places: The impact of locations and companions on 21st birthday drinking

The present research examined how various locations and companions were associated with hazardous drinking during 21st birthday celebrations. The sample included 912 college students (57% female) who completed an online survey to examine 21st birthday drinking. Locations included bars, friends' houses, restaurants, outdoor barbecues, homes, parents' homes, and Fraternity/Sorority houses. Companions included friends, family members, casual acquaintances, roommates, significant others, Fraternity/Sorority members, and none (alone). Participants consumed an average of 7.6 drinks and reached an average eBAC of .15 during their 21st birthday celebrations. Locations accounted for 20%/18% of the variance in number of drinks and eBAC, respectively, whereas companions accounted for 23%/20% of the variance. Drinking with romantic partners was associated with less drinking, whereas drinking with Fraternity/Sorority members was associated with more drinking. Stepwise regressions combining locations and companions suggested that, overall, celebrating in a bar setting and with Fraternity and Sorority members were the strongest variables associated with drinking. With the exception of a bar setting, companions were the most important contextual factors associated with 21st birthday drinking.

Solitary cannabis use in adolescence as a correlate and predictor of cannabis problems

BACKGROUND

Most adolescent cannabis use occurs in social settings among peers. Solitary cannabis use during adolescence may represent an informative divergence from normative behavior with important implications for understanding risk for cannabis problems. This longitudinal study examined associations of adolescent solitary cannabis use with levels of cannabis use and problems in adolescence and in young adulthood.

METHODS

Cannabis using-adolescents aged 12-18 were recruited from clinical programs (n=354; 43.8% female; 83.3% Caucasian) and community sources (n=93; 52.7% female; 80.6% Caucasian). Participants reported on cannabis use patterns and diagnostic symptoms at baseline and multiple follow-ups into young adulthood.

RESULTS

Compared to social-only users, adolescent solitary cannabis users were more likely to be male and reported more frequent cannabis use and more DSM-IV cannabis use disorder (CUD) symptoms. Regression analyses showed that solitary cannabis use in adolescence predicted CUD symptom counts in young adulthood (age 25) after controlling for demographic variables and the frequency of adolescent cannabis use. However, solitary adolescent cannabis use was no longer predictive of age 25 CUD symptoms after additionally controlling for adolescent CUD symptoms.

CONCLUSIONS

Solitary cannabis use is associated with greater cannabis use and problems during adolescence, but evidence is mixed that it predicts young adult cannabis problems.

Change over time in adolescent and friend alcohol use: Differential associations for youth with and without childhood attention-deficit/hyperactivity disorder (ADHD)

Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for experiencing alcohol-related problems by adulthood. However, few studies have examined contextual factors that may contribute to this risk. The current study examined 1 widely investigated social-contextual risk factor, friend alcohol use, in a sample of adolescents with and without a history of ADHD. One hundred and 59 adolescents (14-17 years old) with childhood ADHD and 117 demographically similar youth without ADHD were interviewed annually in the Pittsburgh ADHD Longitudinal Study. Adolescents reported the frequency of their own alcohol use in the prior 12 months and the number of friends who used alcohol regularly or occasionally (perceived friend alcohol use). Multiple-group parallel process models indicated that increases in friend alcohol use were more strongly associated with increases in adolescent alcohol use over time for individuals with ADHD (r = .15, SE = 0.04; 95% confidence interval [CI] = [0.08, 0.22]) than for those without ADHD (r = .06, SE = 0.03; 95% CI [0.00, 0.11]). These results suggest that social factors are an important part of escalating alcohol use among adolescents with ADHD histories, and they highlight the possibility that interventions focused on the peer context could be important for these at-risk youth. Additional social network research on adolescent alcohol use within the larger context of other relationships (e.g., family and romantic relationships) is indicated.

Sleep and circadian contributions to adolescent alcohol use disorder

Adolescence is a time of marked changes across sleep, circadian rhythms, brain function, and alcohol use. Starting at puberty, adolescents' endogenous circadian rhythms and preferred sleep times shift later, often leading to a mismatch with the schedules imposed by secondary education. This mismatch induces circadian misalignment and sleep loss, which have been associated with affect dysregulation, increased drug and alcohol use, and other risk-taking behaviors in adolescents and adults. In parallel to developmental changes in sleep, adolescent brains are undergoing structural and functional changes in the circuits subserving the pursuit and processing of rewards. These developmental changes in reward processing likely contribute to the initiation of alcohol use during adolescence. Abundant evidence indicates that sleep and circadian rhythms modulate reward function, suggesting that adolescent sleep and circadian disturbance may contribute to altered reward function, and in turn, alcohol involvement. In this review, we summarize the relevant evidence and propose that these parallel developmental changes in sleep, circadian rhythms, and neural processing of reward interact to increase risk for alcohol use disorder (AUD).

A Participant Walks Into a Bar…

Alcohol is commonly used to cope with social pain, but its effectiveness remains unknown. Existing theories offer diverging predictions. Pain overlap theory predicts that because alcohol numbs physical pain it should also numb people to the negative effects of ostracism. Alcohol myopia predicts that because alcohol intensifies salient emotions it should enhance the negative effects of ostracism. We conducted a field experiment in a bar, exposing individuals to ostracism or inclusion using Cyberball on an iPad. Subjective intoxication, but not blood alcohol concentration, was associated with less distress for participants who were ostracized, and more distress in participants who were included. We conclude that alcohol reduces both the pain of ostracism and the pleasure of inclusion.

Male solitary drinking and hazardous alcohol use in nine countries of the former Soviet Union

BACKGROUND

Despite evidence that many people engage in solitary drinking and that it might be associated with negative consequences, to date, little research has focused on this form of drinking behaviour. This study examined the prevalence and factors associated with solitary drinking, and assessed whether it is linked with hazardous alcohol use among males in nine countries of the former Soviet Union (fSU).

METHODS

Data came from a cross-sectional population-based survey undertaken in 2010/11 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. Information was obtained on the frequency of solitary drinking among male regular drinkers (i.e., those consuming alcoholic drinks at least once a month), and on problem drinking (CAGE) and heavy episodic drinking (HED). Logistic regression analysis was used to examine associations between the variables.

RESULTS

The prevalence of occasional and frequent solitary drinking ranged from 8.4% (Georgia) to 42.4% (Azerbaijan), and 3.1% (Kazakhstan) to 8.2% (Armenia), respectively. Solitary drinking was associated with being older, divorced/widowed, living alone, having a bad/very bad household financial situation, lower levels of social support, and poor self-rated health. Occasional solitary drinking was linked to problem drinking and HED, while frequent solitary alcohol use was related to problem drinking.

CONCLUSIONS

Solitary drinking is relatively common among male regular drinkers in the fSU and is linked to older age, social and economic disadvantage, and hazardous alcohol use.

Personality, negative affect coping, and drinking alone: a structural equation modeling approach to examine correlates of adolescent solitary drinking

AIMS

This study examined the personality traits of negative emotionality and constraint and the ability to resist drinking during negative affective states as correlates of solitary drinking in adolescence. We hypothesized that higher levels of negative emotionality and lower levels of constraint would predict solitary drinking and that these relationships would be mediated by the ability to resist drinking in response to negative emotions.

DESIGN

Structural equation modeling was used to fit a path model from the personality traits of negative emotionality and constraint to solitary drinking status through intermediate effects on the ability to resist drinking during negative emotions using cross-sectional data.

SETTING

Clinical and community settings in Pennsylvania, USA.

PARTICIPANTS

The sample included 761 adolescent drinkers (mean age = 17.1).

MEASUREMENTS

Adolescents completed the Lifetime Drinking History, the Multidimensional Personality Questionnaire, the Constructive Thinking Inventory and the Situational Confidence Questionnaire.

FINDINGS

The path model provided a good fit to the data. The association between trait negative emotionality and solitary drinking was fully mediated by adolescents' ability to resist drinking during negative affective states (b = 0.05, P = 0.01). In contrast, constraint had a direct effect on solitary drinking (odds ratio (OR) = 0.79, b = -0.23, P<0.01), as well as an indirect effect through the ability to resist drinking during negative affective states (b = -0.03, P = 0.02).

CONCLUSIONS

The ability to resist drinking while experiencing negative feelings or emotions may be an important underlying mechanism linking trait negative emotionality (a tendency toward depression, anxiety and poor reaction to stress) and constraint (lack of impulsiveness) to adolescent solitary drinking.

Having friends and feeling lonely: a daily process examination of transient loneliness, socialization, and drinking behavior

Loneliness is a well-known indicator of relationship deficits, with potentially severe consequences on health and well-being (Perlman & Peplau, 1981). Research has used cross-sectional methods to examine behavioral consequences of loneliness (e.g., Cacioppo et al., 2002). However, within-person associations between daily fluctuations in loneliness and subsequent behavioral outcomes have yet to be explored. Using a sample of community-dwelling adults, the authors examined associations between daily loneliness on daily time with others, and subsequent context-specific alcohol consumption (i.e., social and solitary consumption), and individual differences in these patterns of behavior. Daytime loneliness significantly and uniquely predicted patterns of social behavior and context-specific consumption; time with others mediated loneliness-social consumption associations, but not loneliness-solitary consumption relationships. These findings contribute to existing literature by demonstrating the unique properties of solitary versus social consumption as behavioral responses to loneliness, thus addressing inconsistent findings regarding the effects of loneliness on alcohol consumption.

Alcohol and marijuana use in middle school: comparing solitary and social-only users

PURPOSE

Middle school students with a history of solitary substance use are at elevated risk for substance problems by young adulthood. Understanding how these students differ from social-only users on substance use behaviors and consequences, normative beliefs, social influences, and attitudes can inform efforts to reduce solitary use and its related negative consequences.

METHODS

Sixth- to seventh-grade students completed an in-school survey. We compared those with a history of solitary versus social-only alcohol use (n = 202 and n = 616, respectively) and marijuana use (n = 92 and n = 208, respectively) on a range of substance use-related characteristics.

RESULTS

Any solitary use was reported by 25% of lifetime alcohol users and 31% of lifetime marijuana users. Those with a history of solitary use of either substance were more likely to hold positive expectancies about their use but also reported more negative consequences during the past year. Solitary users tended to have greater exposure to substance-using peers and more difficulty resisting offers to use. Compared with social-only drinkers, those with a history of solitary drinking perceived that more of their peers were alcohol users. Significant group differences were not found on negative outcome expectancies or attempts to cut down on substance use.

CONCLUSIONS

Solitary use is an important, yet, overlooked problem among middle school students who have just begun drinking or using marijuana. Results suggest that positive expectancies, peer influences, resistance self-efficacy, and normative beliefs may be important areas to target in reducing solitary use and the risk it poses for problematic use in young adulthood.