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Armstrong GM, Hopper KM, Friedman HP, Bilsky SA. Adolescent Sleep Quality and Alcohol Use: An Initial Examination of the Serial Indirect Effects of Anxiety Symptoms and Coping Motives for Alcohol Use. Subst Use Misuse 2024; 59:1383-1393. [PMID: 38769730 DOI: 10.1080/10826084.2024.2352107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background: Insufficient sleep and insomnia are associated with alcohol use as well as anxiety during adolescence and young adulthood. A negative reinforcement path to explain the association between sleep difficulties and alcohol misuse has been proposed. Within this pathway, it is speculated that while sober, insomnia and insufficient sleep lead to increased anxiety as well as anxiolytic responses to alcohol, thereby increasing the risk for both alcohol use and alcohol use problems. No work to date has examined the negative reinforcement path to alcohol use among adolescents who have consumed alcohol. Objectives: The current study aims to address this gap in the literature by examining if sleep quality is related to adolescent alcohol use problems and frequency through serial indirect effects of adolescent anxiety symptoms and coping motives for alcohol use. A total of 147 adolescents between the ages of 13 and 18 years (Mage = 16.31; SD = 0.96) from all geographic regions in the US were recruited using social media platforms (i.e., Facebook and Instagram). Participants who reported having tried alcohol at least once completed self-report measures to examine sleep quality, anxiety symptoms, alcohol use problems, alcohol use frequency, and coping motives for alcohol use. Results: Adolescent sleep quality was found to be associated with higher levels of both alcohol use problems and alcohol use frequency through the serial indirect effect of anxiety symptoms and coping motives for alcohol use. Conclusions: Overall, these findings represent a step towards understanding the complex relationship between sleep quality, alcohol, anxiety, and coping motives among adolescents.
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Affiliation(s)
| | - Kayce M Hopper
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
| | - Hannah P Friedman
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
| | - Sarah A Bilsky
- Department of Psychology, University of Mississippi, Oxford, Mississippi, USA
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Watts AL, Doss MI, Bernard DL, Sher KJ. Psychopathology as dynamic markers of alcohol initiation across development: A three-year longitudinal examination. Dev Psychopathol 2024; 36:919-928. [PMID: 36939078 PMCID: PMC10509330 DOI: 10.1017/s0954579423000184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Sipping, an early form of alcohol initiation, is associated with aspects of psychopathology and personality that reflect long-term risk for harmful alcohol use. In the Adolescent Brain and Cognitive Development cohort (N = 11,872), sipping by age 9-10 was concurrently associated with impulsivity, other aspects of externalizing, and prodromal schizophrenia symptoms. Still, these associations were cross-sectional in nature, leaving open the possibility that these features of psychopathology and personality might not reflect long-term risk for alcohol consumption and related harm across development. Here, we attempted to replicate baseline concurrent associations across three waves of data to extend concurrent associations to prospective ones. Most cross-sectional associations replicated across waves, such that impulsivity, other aspects of externalizing, reward sensitivity (e.g., surgency, sensation seeking), and prodromal schizophrenia symptoms were associated with increased odds of having sipped alcohol by the age of 12. Nevertheless, not all concurrent associations replicated prospectively; impulsigenic features did not reflect long-term risk for sipping. Thus, some psychopathology features appeared to reflect stable risk factors, whereas others appeared to reflect state-dependent risk factors. All told, sipping might not reflect long-term risk for harmful alcohol use, and the nature of sipping may change across development.
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Bhuptani PH, López G, Orchowski LM, Zlotnick C. Correlates of Sexual Victimization Among Community College Women. VIOLENCE AND VICTIMS 2024; 39:38-52. [PMID: 38453367 DOI: 10.1891/vv-2022-0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
The current study documents the correlates associated with the severity of sexual victimization among women enrolled in a 2-year community college. Comparisons between women with a history of severe sexual victimization (i.e., rape and attempted rape), moderate sexual victimization (i.e., unwanted contact and sexual coercion), and no history of sexual victimization revealed that women with a history of severe sexual victimization endorsed more drinks per week, increased problem drinking behavior, and more use of drug before sex and higher levels of self-protective dating behaviors compared with women with no history of sexual victimization. These findings suggest that programs should target the intersection of alcohol and drug use as correlates of sexual victimization among community college women.
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Affiliation(s)
- Prachi H Bhuptani
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Gabriela López
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
| | - Lindsay M Orchowski
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Caron Zlotnick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Ahn-Horst RY, Bourgeois FT. Mental Health-Related Outpatient Visits Among Adolescents and Young Adults, 2006-2019. JAMA Netw Open 2024; 7:e241468. [PMID: 38451523 PMCID: PMC10921253 DOI: 10.1001/jamanetworkopen.2024.1468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/18/2024] [Indexed: 03/08/2024] Open
Abstract
Importance Concerns over the mental health of young people have been increasing over the past decade, especially with the rise in mental health burden seen during the COVID-19 pandemic. Examining trends in mental health-related outpatient visits provides critical information to elucidate contributing factors, identify vulnerable populations, and inform strategies to address the mental health crisis. Objective To examine characteristics and trends in mental health-related outpatient visits and psychotropic medication use among US adolescents and young adults. Design, Setting, and Participants A retrospective cross-sectional analysis of nationally representative data from the National Ambulatory Medical Care Survey, an annual probability sample survey, was conducted from January 2006 to December 2019. Participants included adolescents (age 12-17 years) and young adults (age 18-24 years) with office-based outpatient visits in the US. Data were analyzed from March 1, 2023, to September 15, 2023. Main Outcomes and Measures Mental health-related outpatient visits were identified based on established sets of diagnostic codes for psychiatric disorders. Temporal trends in the annual proportion of mental health-related outpatient visits were assessed, including visits associated with use of psychotropic medications. Analyses were stratified by age and sex. Results From 2006 to 2019, there were an estimated 1.1 billion outpatient visits by adolescents and young adults, of which 145.0 million (13.1%) were associated with a mental health condition (mean [SD] age, 18.4 [3.5] years; 74.0 million females [51.0%]). Mental health-related diagnoses were more prevalent among visits by male (16.8%) compared with female (10.9%) patients (P < .001). This difference was most pronounced among young adults, with 20.1% of visits associated with a psychiatric diagnosis among males vs 10.1% among females (P < .001). The proportion of mental health-related visits nearly doubled, from 8.9% in 2006 to 16.9% in 2019 (P < .001). Among all outpatient visits, 17.2% were associated with the prescription of at least 1 psychotropic medication, with significant increases from 12.8% to 22.4% by 2019 (P < .001). Conclusions and Relevance In this cross-sectional study, there were substantial increases in mental health-related outpatient visits and use of psychotropic medications, with greater overall burden among male patients. These findings provide a baseline for understanding post-pandemic shifts and suggest that current treatment and prevention strategies will need to address preexisting psychiatric needs in addition to the effects of the COVID-19 pandemic.
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Affiliation(s)
- Rosa Y. Ahn-Horst
- Department of Psychiatry, Massachusetts General Hospital, Boston
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Florence T. Bourgeois
- Computational Health Informatics Program, Boston Children’s Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Ferdous Khan MT, Mazumder S, Rahman MH, Afroz MA, Kiser H, Nobel Bhuiyan MA. The Transition of Sociodemographic and Substance Abuse Characteristics, Pairwise Co-occurrences and Factors Associated with Polysubstance Use Among US Adolescents and Young Adults. ADDICTION & HEALTH 2024; 16:42-50. [PMID: 38651027 PMCID: PMC11032615 DOI: 10.34172/ahj.2024.1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/09/2023] [Indexed: 04/25/2024]
Abstract
Background Substance abuse by adolescents and young adults is a major public health issue. This study aimed to (i) show the transition of sociodemographic and substance abuse characteristics from 1992 to 2017 among US adolescents and young adults, (ii) evaluate the likelihood of co-occurrence of substances, and (iii) identify significant sociodemographic characteristics in association with polysubstance abuse. Methods This study extracted data for adolescents and young adults from 1992 and 2017 Treatment Episode Data Set-Admission (TEDS-A) datasets. The extracted sample included 337858 admissions in 1992 and 333322 in 2017. Findings Both years experienced significant admissions. A significant transition in 2017 compared to 1992 was evident in education, living status, and ethnicity. Substance-specific transition showed alcohol was dominant in 1992, while marijuana/ hashish was dominant in 2017. Also, heroin, other opiates/synthetics, and methamphetamine experienced an increase, while cocaine/crack decreased. The pairwise co-occurrences exhibited a considerable variation in the likelihood of using one substance given another one. The odds ratios (ORs) obtained from generalized ordered logit models showed significantly higher odds of one or more substances with age, while education showed the opposite scenario. A mixed effect of gender was evident in 1992, whereas females were significantly less likely with one or more substances than males in 2017. Other significant vulnerable groups were those not in the labor force, homeless, white, and Mexican Americans. Conclusion The findings may help to understand the overall changes between 1992 and 2017 and take necessary measures to reduce the burden of this public health problem.
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Affiliation(s)
- Md Tareq Ferdous Khan
- Department of Mathematics and Statistics, Cleveland State University, Cleveland, OH, USA
| | - Shrabanti Mazumder
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Md Habibur Rahman
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Most Alina Afroz
- Office of Research, LSU Health Sciences Center-Shreveport, Shreveport, Louisiana, USA
| | - Humayun Kiser
- Department of Statistics, Comilla University, Comilla, Bangladesh
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Charles NE, Strong SJ, Floyd PN, Burns LC, Sigurdson L, Barry CT. Test-Retest Reliability of Self-Reported Substance Use and Sexual Risk Behavior Among at-Risk Adolescents. Psychol Rep 2024; 127:432-446. [PMID: 35699603 DOI: 10.1177/00332941221100459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescents often engage in behaviors such as substance use and risky sexual activity that can lead to negative health and psychological consequences for themselves and others. Accurate measurement of these behaviors in surveys is challenging given that the behaviors are often viewed as undesirable and/or are illegal, so it is important to test the psychometric properties of instruments used to assess adolescent risk behaviors. The current study aimed to assess the test-retest reliability of a widely used measure of youth risk-taking behavior, the Youth Risk Behavior Survey (YRBS). A sample of 156 at-risk adolescents aged 16-18 years (81% male; 61% White) completed the YRBS retrospectively across intervals ranging from 3 to 12 days during their stay in a residential program at which they were under close supervision and had limited ability to engage in new risk behaviors. Participants were asked to complete the YRBS based on their "typical" (pre-program) behavior at both administrations, which were 10-14 weeks into their stay. The reliability of responses was assessed using kappa and weighted kappa analyses. Findings indicate moderate to substantial reliability for nearly all items, suggesting that at-risk youth reliably reported their engagement in health risk behaviors across multiple administrations and supporting the psychometric strength of the YRBS measure for use with this population.
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Affiliation(s)
- Nora E Charles
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Stephanie J Strong
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Paula N Floyd
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Lauren C Burns
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Lydia Sigurdson
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
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Aber-Odonga H, Babirye JN, Engebretsen IMS, Nuwaha F. Prevalence of probable substance use disorders among children in Ugandan health facilities. BMC Public Health 2024; 24:314. [PMID: 38287328 PMCID: PMC10823678 DOI: 10.1186/s12889-024-17732-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/10/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Globally, there is a concerning surge in the prevalence of substance use among adolescents and children, creating a substantial public health problem. Despite the magnitude of this issue, accessing healthcare explicitly for substance use remains challenging, even though many substance users frequently visit healthcare institutions for other health-related issues. To address this gap, proactive screening for substance use disorders has emerged as a critical strategy for identifying and engaging patients at risk of substance use. The purpose of this study was to investigate the prevalence of probable alcohol and other substance use disorders, and associated factors, among children aged 6 to 17 years old attending health facilities in Mbale, Uganda. METHODS We conducted a health facility cross-sectional study, involving 854 children aged 6-17 years. The prevalence of probable alcohol and other substance use disorders was assessed using a validated Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) screening tool. Univariable and multivariable modified Poisson regression analyses were performed using STATA 15 software. RESULTS The overall prevalence of probable alcohol use disorders (AUD) and other substance use disorders (SUD) was 27.8% (95% CI 1.24-1.31) while that of probable AUD alone was 25.3% (95% CI 1.22-1.28). Peer substance use (APR = 1.24, 95% CI 1.10-1.32), sibling substance use (APR = 1.14, 95% CI 1.06-1.23), catholic caregiver religion (APR = 1.07 95% CI 1.01-1.13), caregiver income of more than $128 (APR = 0.90, 95% CI 0.82-0.98), having no parental reprimand for substance use (APR = 1.05, 95% CI 1.01-1.10) and having no knowledge of how to decline an offer to use substances (APR = 1.06, 95% CI 1.01-1.12) were found to be significantly associated with probable AUD/SUD. CONCLUSIONS Our findings suggest a high prevalence of probable AUD and SUD among children and adolescents visiting healthcare facilities for other conditions, along with a strong link between AUD and SUD prevalence and social factors. The implication for our healthcare system is to actively screen for and treat these conditions at primary healthcare facilities.
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Affiliation(s)
- Harriet Aber-Odonga
- Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda.
| | - Juliet Ndimwibo Babirye
- Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
| | - Ingunn Marie S Engebretsen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Fred Nuwaha
- Makerere University College of Health Sciences School of Public Health, Kampala, P.O Box 7072, Uganda
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Hashemi R, Vogel EA. Adolescents' perceptions of substance use messaging in the age of social media: resolving cognitive dissonance. HEALTH EDUCATION RESEARCH 2024; 39:1-11. [PMID: 38183674 PMCID: PMC10805388 DOI: 10.1093/her/cyad046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/08/2024]
Abstract
This study interviewed adolescents about their exposure to and perceptions of substance-related social media content and substance use prevention messages. Participants (analytic sample N = 30, age 14-18 years, in CA, USA, 40% male) were recruited from Instagram and Facebook for online semi-structured interviews. An interview transcript coding guide was developed based on the interview questions and emerging themes. Most (27/30) participants reported exposure to peers using substances on social media through posts made on personal accounts. All peer posts portrayed substance use in a positive light. Most participants reported exposure to formal prevention messages on social media (i.e. public service announcements) (19/30) and in schools (i.e. drug education) (21/30; 70.0%) teaching the negative consequences of substance use. Responses to the differences between peer posts and prevention messages included dismissing prevention messages (7/30), believing that their peers were more credible (4/30), desiring comprehensive substance information (3/30) and believing that the no-use message was ineffective for at-risk youth (4/30). Messages shared by peers online significantly contrasted with prevention messages (i.e. public service announcements and drug education). This difference appeared to undermine prevention message credibility. Balanced prevention messages acknowledging the spectrum of risk and reward when using different substances may reduce dissonance and increase engagement.
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Affiliation(s)
- Rhana Hashemi
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA 94305, USA
| | - Erin A Vogel
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA 94305, USA
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McConaha CD, McCabe BE, Falcon AL. Anxiety, Depression, Coping, Alcohol Use and Consequences in Young Adult College Students. Subst Use Misuse 2023; 59:306-311. [PMID: 37849302 DOI: 10.1080/10826084.2023.2270550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND Young adult college students experience a high risk for heavy alcohol use and resulting consequences. Symptoms of anxiety and depression increase this risk. Coping style has been associated with alcohol use and consequences, with approach coping being inversely related to use and consequences, and avoidance coping being directing related to use and consequences. The purpose of this study is to examine whether coping style moderates or mediates the relationship between anxiety/depression and alcohol use and consequences. METHODS 250 young adult college students ages 18 to 25 years (Women = 85, 34%) anonymously self-reported anxiety, depression, coping style, alcohol use and consequences. RESULTS Path analysis showed that avoidance coping was positively related to alcohol use (β = 0.33, p < 0.05), social consequences (β = 0.39, p < 0.05), and personal consequences (β = 0.26, p < 0.05), while approach coping was inversely related to use (β = -0.20, p = 0.005). Coping did not moderate the relationship between anxiety and depression and alcohol use or consequences. Avoidance coping mediated the relationship between depression and alcohol use (β = 0.14, p < 0.05), social consequences (β = 0.16, p < 0.05), and personal consequences (β = 0.11, p < 0.05). CONCLUSION Findings build on alcohol use and consequences research, and support further research into implementing coping-based alcohol use interventions. Interventions aimed at reducing avoidance coping and increasing approach coping may be beneficial for young adult college students.
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Affiliation(s)
- Candace D McConaha
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
| | - Ashley L Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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Boerma M, Beel N, Jeffries C, Ruse J. Review: Recommendations for male-friendly counselling with adolescent males: A qualitative systematic literature review. Child Adolesc Ment Health 2023; 28:536-549. [PMID: 36604844 DOI: 10.1111/camh.12633] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND There are growing calls to tailor counselling practices for adolescent males, a population reluctant to engage in psychological treatment despite concerning rates of mental illness. The objective of this systematic review (PROSPERO: CRD4202125547) was to collate and synthesise recommendations for individual counselling with adolescent males (12-18 years). METHOD The databases Psychology and Behavioural Science Collection, PsycArticles, PsycINFO, Academic Search Complete, EBSCO eBook Collection, Wiley Science Collection, Taylor and Francis Collection and ProQuest One Academic were searched for articles published between 1995 and November 2021. The quality of evidence was assessed using the JBI critical appraisal checklists, and thematic analysis was employed to synthesise findings across the literature. RESULTS A total of 1625 texts were identified, of which 16 met the inclusion criteria. Generated themes included (a) therapist knowledge of masculinity, gender socialisation, and male-relational styles; (b) necessity of therapists to address masculinity in the therapeutic space; and (c) customising engagement and treatment practices to appeal to adolescent males. CONCLUSIONS The themes highlighted the unique developmental, and sociocultural considerations practitioners should be aware of when working with young men. Through a multicultural counselling competency framework, masculinity and adolescent male identity are expressions of diverse sociocultural identities that psychological assessment and intervention should ideally be tailored to suit. The findings of the review suggest that empirical research focusing on the experiences of adolescent males receiving psychological treatment is sparse. Further research is needed to inform the development of practicable, gender-sensitive adaptions to counselling practice for young men.
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Affiliation(s)
- Micah Boerma
- School of Psychology & Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
| | - Nathan Beel
- School of Psychology & Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
- Applied Psychology, Counselling, Australian College of Applied Professions, Brisbane, Australia
| | - Carla Jeffries
- School of Psychology & Wellbeing, University of Southern Queensland, Ipswich, QLD, Australia
| | - Jesse Ruse
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
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Qi B, Thornton LM, Breiner CE, Kuja-Halkola R, Baker JH, Lichtenstein P, Lundström S, Agrawal A, Bulik CM, Munn-Chernoff MA. Differential genetic associations between dimensions of eating disorders and alcohol involvement in late adolescent twins. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1677-1689. [PMID: 38051153 PMCID: PMC10699207 DOI: 10.1111/acer.15150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/14/2023] [Accepted: 06/30/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Twin studies have demonstrated shared genetic and environmental effects between eating disorders and alcohol involvement in adults and middle adolescents. However, fewer studies have focused on late adolescents or investigated a wide range of eating disorder dimensions and alcohol involvement subscales in both sexes. We examined genetic and environmental correlations among three eating disorder dimensions and two alcohol involvement subscale scores in late adolescent twins using bivariate twin models. METHODS Participants were 3568 female and 2526 male same-sex twins aged 18 years old from the Child and Adolescent Twin Study in Sweden. The Eating Disorder Inventory-2 (EDI) assessed the drive for thinness, bulimia, and body dissatisfaction. Alcohol involvement was assessed with the Alcohol Use Disorder Identification Test consumption (AUDIT-C) and problem (AUDIT-P) subscales. RESULTS Only phenotypic and twin correlations in female twins met our threshold for twin modeling. The proportion of total variance for each trait accounted for by additive genetic factors ranged from 0.50 to 0.64 in female twins, with the rest explained by nonshared environmental factors and measurement error. Shared environmental factors played a minimal role in the variance of each trait. The strongest genetic correlation (ra ) emerged between EDI bulimia and AUDIT-P (ra = 0.46, 95% confidence interval: 0.37, 0.55), indicating that the proportion of genetic variance of one trait that was shared with the other trait was 0.21. Nonshared environmental correlations between eating disorder dimensions and alcohol involvement ranged from 0.03 to 0.13. CONCLUSIONS We observed distinct patterns of genetic and environmental effects for co-occurring eating disorder dimensions and alcohol involvement in female vs. male twins, supporting sex-specific treatment strategies for late adolescents with comorbid eating disorders and alcohol use disorder. Our findings emphasize the importance of assessing family history of multiple eating disorder dimensions while treating late adolescents with problematic alcohol use, and vice versa, to improve detection and treatment.
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Affiliation(s)
- Baiyu Qi
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
| | - Courtney E. Breiner
- Department of Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jessica H. Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Kranzler HR, Feinn R, Xu H, Ho BL, Saini D, Nicastro OR, Jacoby A, Toikumo S, Gelernter J, Hartwell EE, Kember RL. Does polygenic risk for substance-related traits predict ages of onset and progression of symptoms? Addiction 2023; 118:1675-1686. [PMID: 37069489 PMCID: PMC10525011 DOI: 10.1111/add.16210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/25/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND AND AIMS Genetic risk can influence disease progression. We measured the impact of genetic risk for substance use disorders (SUDs) on substance use onset and progression of symptoms. DESIGN, SETTING, PARTICIPANTS Using findings from genome-wide association studies (GWASs) of alcohol use disorder (AUD), opioid use disorder (OUD) and smoking trajectory (SMK) as discovery samples, we calculated polygenic risk scores (PRSs) in a deeply phenotyped independent target sample. Participants in the target sample were recruited from 2000 to 2020 from US inpatient or outpatient settings or through advertisements and comprised 5692 European-ancestry individuals (EUR) (56.2% male) and 4918 African-ancestry individuals (AFR) (54.9% male). MEASUREMENTS This study measured age of first substance use, regular use, reported problems and dependence diagnosis and progression from regular use to onset of problems and dependence for alcohol, opioids and smoking. We examined the contribution of PRS to each milestone and progression measure. FINDINGS EUR and males reported an earlier onset and shorter progression times than AFR and females, respectively. Among EUR, higher AUD PRS predicted earlier onset and more rapid progression to alcohol-related milestones (P < 0.001). Although the AUD PRS was a stronger moderator of problem onset among females (P = 0.017), it was more predictive of the progression to problems among males (P = 0.005). OUD and SMK PRS in EUR also predicted earlier onset of the respective milestones (P < 0.001). Among AFR, where power is lower due to the smaller discovery sample, AUD PRS predicted age of regular alcohol use (P = 0.039) and dependence (P = 0.001) and progression from regular use to diagnosis (P = 0.045), while SMK PRS predicted earlier age of initiation (P = 0.036). CONCLUSIONS Genetic risk for SUDs appears to predict substance use milestones and symptom progression among European-ancestry individuals and, to a lesser extent, African-ancestry individuals.
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Affiliation(s)
- Henry R. Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104
| | - Richard Feinn
- Department of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, CT 06473
| | - Heng Xu
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Brendan L. Ho
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Divya Saini
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Olivia R. Nicastro
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Anya Jacoby
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Sylvanus Toikumo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511 and VA Connecticut Healthcare System, West Haven, CT 06516
| | - Emily E. Hartwell
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
- Department of Medical Sciences, Frank H. Netter School of Medicine at Quinnipiac University, North Haven, CT 06473
| | - Rachel L. Kember
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
- Mental Illness Research, Education and Clinical Center, Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104
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13
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Steinhoff A, Shanahan L, Bechtiger L, Zimmermann J, Ribeaud D, Eisner MP, Baumgartner MR, Quednow BB. When Substance Use Is Underreported: Comparing Self-Reports and Hair Toxicology in an Urban Cohort of Young Adults. J Am Acad Child Adolesc Psychiatry 2023; 62:791-804. [PMID: 36731790 DOI: 10.1016/j.jaac.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 10/05/2022] [Accepted: 11/02/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Large-scale epidemiological research often uses self-reports to determine the prevalence of illicit substance use. Self-reports may suffer from inaccurate reporting but can be verified with objective measures. This study examined the following: the prevalence of illicit and non-medical substance use with self-reports and hair toxicology, the convergence of self-reported and objectively quantified substance use, and the correlates of under- and overreporting. METHOD The data came from a large urban cohort study of young adults (n = 1,002, mean age = 20.6 years, 50% female). The participants provided 3 cm of hair (covering the previous 3 months) and reported their illicit and non-medical substance use and their sociodemographic, psychological, and behavioral characteristics. Hair toxicology analyses targeted cannabinoids, ketamine, opiates/opioids, stimulants including 3,4-methylenedioxymethamphetamine, and relevant metabolites. RESULTS Self-reports underestimated the prevalence of most substances by 30% to 60% compared to hair tests. The average detection ratio (hair test/self-report) was 1.50. Hair tests were typically more sensitive than self-reports. Underreporting was associated with a low level of that substance in hair. Self-reported delinquency and psychopathology were correlated with an increased likelihood of concordant positive self-reports and hair tests compared to underreporting. Overreporting was associated with infrequent self-reported use. CONCLUSION Our study suggests that self-reports underestimate young adults' exposure to illicit substances and non-medical use of prescription drugs. Consequently, estimates of associations between substance use and risk factors or outcomes are likely biased. Combining self-reports with hair tests may be most beneficial in study samples with occasional substance use. Researchers can use specific factors (eg, detection ratios) to adjust prevalence estimates and correlations based on self-reports.
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Affiliation(s)
- Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Josua Zimmermann
- Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Manuel P Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; University of Cambridge, United Kingdom
| | - Markus R Baumgartner
- Centre for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Boris B Quednow
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Switzerland.
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14
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Cooper DK, Felt JM, Riobueno-Naylor A, Lai BS, Bámaca MY, Fishbein D. The mediating role of self-regulation on the link between child maltreatment and later substance use among Latinx youth. CHILD ABUSE & NEGLECT 2023; 140:106151. [PMID: 36965435 PMCID: PMC10164059 DOI: 10.1016/j.chiabu.2023.106151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Children who experience maltreatment are at heightened risk for substance use initiation and mental health disorders later in life. Few studies have assessed the relationship between child maltreatment and substance use among Latinx youth. OBJECTIVE The current study assessed the potential mediating effect of three aspects of self-regulation (emotional, behavioral, and cognitive) on the association between child maltreatment and substance use and examined whether effects varied depending on maltreatment type and severity. PARTICIPANTS AND SETTING This study involved a random sample of 504 Latinx youth (52 % girls, 48 % boys) between the ages of 10-12 at the start of the study. METHODS Study hypotheses were tested through structural equation modeling and bootstrapped random errors using the R programming language. RESULTS Our results indicated that higher levels of child maltreatment predicted higher levels of later substance use, as mediated by emotional and behavioral dysregulation (β = 0.09, p < 0.01), but not cognitive regulation. When separating maltreatment by subtype, we found the mediating effect was present for abuse (β = 0.09, p < 0.01), but not neglect. CONCLUSIONS Findings contribute to our understanding of potential causal mechanisms for the association between child maltreatment and substance use for Latinx youth.
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Affiliation(s)
- Daniel K Cooper
- Department of Psychology, University of South Carolina, United States of America.
| | - John M Felt
- College of Health and Human Development, Pennsylvania State University, United States of America
| | - Alexa Riobueno-Naylor
- Department of Counseling, Developmental, and Educational Psychology, Boston College, United States of America
| | - Betty S Lai
- Department of Counseling, Developmental, and Educational Psychology, Boston College, United States of America
| | - Mayra Y Bámaca
- Department of Psychological Sciences, University of California Merced, United States of America
| | - Diana Fishbein
- College of Health and Human Development, Pennsylvania State University, United States of America; Frank Porter Graham Child Development Institute, University of North Carolina, United States of America
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15
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Goldway N, Eldar E, Shoval G, Hartley CA. Computational Mechanisms of Addiction and Anxiety: A Developmental Perspective. Biol Psychiatry 2023; 93:739-750. [PMID: 36775050 PMCID: PMC10038924 DOI: 10.1016/j.biopsych.2023.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
A central goal of computational psychiatry is to identify systematic relationships between transdiagnostic dimensions of psychiatric symptomatology and the latent learning and decision-making computations that inform individuals' thoughts, feelings, and choices. Most psychiatric disorders emerge prior to adulthood, yet little work has extended these computational approaches to study the development of psychopathology. Here, we lay out a roadmap for future studies implementing this approach by developing empirically and theoretically informed hypotheses about how developmental changes in model-based control of action and Pavlovian learning processes may modulate vulnerability to anxiety and addiction. We highlight how insights from studies leveraging computational approaches to characterize the normative developmental trajectories of clinically relevant learning and decision-making processes may suggest promising avenues for future developmental computational psychiatry research.
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Affiliation(s)
- Noam Goldway
- Department of Psychology, New York University, New York, New York
| | - Eran Eldar
- Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Cognitive and Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gal Shoval
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey; Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel; Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Catherine A Hartley
- Department of Psychology, New York University, New York, New York; Center for Neural Science, New York University, New York, New York.
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16
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Wiese AL, Sease TB, Joseph ED, Becan JE, Knight K, Knight DK. Avoidance Self-Efficacy: Personal Indicators of Risky Sex and Substance Use among At-Risk Youth. CHILDREN AND YOUTH SERVICES REVIEW 2023; 147:106846. [PMID: 36844888 PMCID: PMC9957012 DOI: 10.1016/j.childyouth.2023.106846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Adolescent substance use (SU) is associated with risky sex behavior and sexually transmitted infections and is a risk factor for subsequent risky sex decisions. Based on a sample of 1,580 youth in residential SU treatment, this study investigated how a static factor (race) and two dynamic personal factors (risk-taking, assertiveness) contributed to adolescents' perceived ability to avoid high-risk SU and sex behavior (avoidance self-efficacy). Results showed that race correlated with risk-taking and assertiveness, with White youth reporting higher ratings of assertiveness and risk-taking. Self-reported assertiveness and risk-taking also predicted SU and risky sex avoidance. This study underscores the importance of race and personal factors in relation to adolescents' confidence in avoiding high-risk situations.
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Affiliation(s)
- Amanda L Wiese
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Thomas B Sease
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Elizabeth D Joseph
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Jennifer E Becan
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
| | - Danica K Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Ave., Fort Worth, TX 76109
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17
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Rosmarin DH, Pirutinsky S, Kaufman CC, Harris SK, Sneider JT, Silveri MM. Religious affiliation protects against alcohol/substance use initiation: A prospective study among healthy adolescents. J Adolesc 2023; 95:372-381. [PMID: 36345114 PMCID: PMC9908826 DOI: 10.1002/jad.12119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/31/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND A substantial volume of the literature suggests that religious factors buffer against alcohol/substance use among adults, but research among adolescents is sparse. Further, few studies in this area have been prospective, and therefore it is unclear how religion may impact less alcohol/substance use among adolescents. METHOD We prospectively evaluated effects of religious affiliation on initiation of alcohol/substance use in a sample of 81 psychiatrically healthy 13-14-year-olds from New England, over a 3-year period (from November 2015 to January 2019). Known risk factors were also evaluated including anxiety, depression, and impulsivity; family history of mental illness and alcohol/substance misuse; and volume of brain regions implicated in adolescent alcohol/substance misuse (assessed by Magnetic Resonance Imaging). RESULTS Religiously affiliated adolescents were significantly less likely to initiate use of alcohol/substances (hazard ratio [HR] = 0.38). The addition of family history of alcohol/substance misuse to the model increased the predictive value of religious affiliation (HR = 0.34). Other risk factors did not diminish nor increase observed effects. CONCLUSIONS These findings support and extend the current research by suggesting that religious affiliation protects against initiation of alcohol/substance use during early adolescence, particularly in individuals with elevated risk.
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Affiliation(s)
- David H. Rosmarin
- Department of Psychiatry, Harvard Medical School
- Spirituality and Mental Health Program, McLean Hospital
| | | | - Caroline C. Kaufman
- Department of Psychiatry, Harvard Medical School
- Spirituality and Mental Health Program, McLean Hospital
| | - Sion K. Harris
- Department of Pediatrics, Harvard Medical School
- Center for Adolescent Behavioral Health Research, Boston Children’s Hospital
| | - Jennifer T. Sneider
- Department of Psychiatry, Harvard Medical School
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital
| | - Marisa M. Silveri
- Department of Psychiatry, Harvard Medical School
- Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital
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18
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Opara I, Lardier DT, Boyd D, Boateng ACO, Brawner BM. The Association Between Racial Attitudes, Alcohol Use and Mood Disorders Among Black Adolescents. JOURNAL OF PREVENTION (2022) 2023; 44:85-104. [PMID: 36156761 PMCID: PMC9892305 DOI: 10.1007/s10935-022-00706-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 02/04/2023]
Abstract
Alcohol is the most widely used substance among adolescents. Although Black adolescents use alcohol at lower rates than White adolescents, Black adolescents tend to have worse outcomes. This includes higher rates of mood disorders and criminal justice involvement associated with alcohol use and misuse compared to any other racial group. Black adolescents are also more likely to experience racial discrimination and be exposed to traumatic events within their communities, which may increase their chances of using substances. Understanding the relationship between racial attitudes (towards one's own group and others) and substance use and mental health can provide unique and meaningful insight into prevention programming for Black adolescents. Yet, these concepts have been understudied. To fill this gap, we examined the association between racial attitudes and alcohol use and mood disorders in Black adolescents in Philadelphia, PA (N = 154). We used the revised Adolescent Survey of Black Life to measure pro-Black (positive attitudes toward being Black and factors related to Black people), anti-White (negative attitudes toward White people due to experiences of racism and discrimination) and racism awareness (recognition of racism) domains. Logistic regression analyses were conducted to test the associations. Results showed that: higher pro-Black attitudes were associated with a lower odds of mood disorder (odds ratio [OR] = 0.72, 95% CI = 0.55, 0.89); and higher racism awareness was associated with an increased odds of alcohol use (OR = 1.18, 95% confidence interval [CI] = 1.06, 1.29). Findings provide preliminary support for interventions and policies for Black adolescents that bolster positive racial identity and eliminate experiences of racism as alcohol use and mood disorder prevention strategies.
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Affiliation(s)
- Ijeoma Opara
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, USA.
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, USA.
| | - David T Lardier
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - Donte Boyd
- Center for Interdisciplinary Research On AIDS, School of Public Health, Yale University, New Haven, USA
- School of Social Work, Ohio State University, Columbus, USA
| | | | - Bridgette M Brawner
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, USA
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19
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Kohen CB, Cofresí RU, Bartholow BD, Piasecki TM. Alcohol craving in the natural environment: Moderating roles of cue exposure, drinking, and alcohol sensitivity. Exp Clin Psychopharmacol 2023; 31:57-71. [PMID: 35025586 PMCID: PMC9276840 DOI: 10.1037/pha0000540] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Effects of cue exposure and alcohol consumption (e.g., priming doses) on craving for alcohol have been examined in largely separate literature, limiting what is known about their potential interaction. Individuals with low alcohol sensitivity, a known risk factor for alcohol use disorder (AUD), exhibit stronger cue-elicited craving than their higher-sensitivity (HS) peers in both laboratory and real-world contexts. Here, underage drinkers (N = 155) completed a 21-day ecological momentary assessment (EMA) protocol in which they recorded exposure to alcohol cues and levels of craving during both nondrinking and postdrinking moments. Multilevel modeling detected a significant interaction of cue exposure and postdrinking status on craving. Cue-induced craving was increased in postdrinking moments compared to nondrinking moments. Contrary to prediction, cue-elicited increase in craving during nondrinking moments was stronger in participants reporting higher sensitivity to alcohol. In the presence of cues, lower sensitivity was robustly related to craving intensity in the postdrinking state but unrelated to craving during nondrinking moments. Craving during drinking episodes in the natural environment is magnified by the presence of alcohol cues, potentially contributing to the maintenance or acceleration of drinking episodes. Moreover, lower-sensitivity drinkers may be particularly susceptible to the combined effects of cue exposure and postdrinking status on alcohol craving. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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20
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The Association between the School Environment and Adolescent Alcohol Drinking Behavior in Six Cities in China. Nutrients 2023; 15:nu15020368. [PMID: 36678238 PMCID: PMC9865810 DOI: 10.3390/nu15020368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
Drinking alcohol during adolescence has short-term and long-term effects on physical and mental health. At this stage, teenagers are greatly influenced by their schoolmates and friends. We conducted a multicenter cross-sectional study to investigate the association between school environment factors and adolescents’ drinking behavior in China. Using multistage stratified cluster sampling, the study investigated 27,762 middle school students from six cities in China. The logistic regression model was used to explore the association between the school environment and adolescent alcohol drinking behaviors after adjusting for confounders, including gender, age, city, location, and smoking status. Compared with students with none of their close friends drinking, students with more than half of their close friends drinking were more likely to drink in a year (OR = 20.148, 95% CI: 17.722−22.905, p < 0.001) and in a month (OR = 13.433, 95% CI: 11.779−15.319, p < 0.001). In addition, classmates’ drinking behaviors, friends’ persuasion, and attending parties were risk factors for adolescents’ drinking behavior, while the propaganda and regulations of banning drinking in school were protective factors. The school environment, especially friends drinking, is associated with students’ drinking behavior. It is necessary to mobilize the strength of schools and peers to strengthen the prevention and control of adolescent drinking.
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21
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Guo R, Vaughan DT, Rojo ALA, Huang YH. Sleep-mediated regulation of reward circuits: implications in substance use disorders. Neuropsychopharmacology 2023; 48:61-78. [PMID: 35710601 PMCID: PMC9700806 DOI: 10.1038/s41386-022-01356-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/11/2022]
Abstract
Our modern society suffers from both pervasive sleep loss and substance abuse-what may be the indications for sleep on substance use disorders (SUDs), and could sleep contribute to the individual variations in SUDs? Decades of research in sleep as well as in motivated behaviors have laid the foundation for us to begin to answer these questions. This review is intended to critically summarize the circuit, cellular, and molecular mechanisms by which sleep influences reward function, and to reveal critical challenges for future studies. The review also suggests that improving sleep quality may serve as complementary therapeutics for treating SUDs, and that formulating sleep metrics may be useful for predicting individual susceptibility to SUDs and other reward-associated psychiatric diseases.
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Affiliation(s)
- Rong Guo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- Allen Institute, Seattle, WA, 98109, USA
| | - Dylan Thomas Vaughan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Ana Lourdes Almeida Rojo
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA
| | - Yanhua H Huang
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
- The Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA, USA.
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22
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Ranganath P, Hjetland GJ, Finserås TR, Brunborg GS, Hesse M, Skogen JC. Negative experiences, social exclusion and unwanted attention on social media: exploring the association with adolescent alcohol use. BMC Public Health 2022; 22:2361. [PMID: 36527010 PMCID: PMC9756586 DOI: 10.1186/s12889-022-14679-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adolescents' presence on Social Media (SoMe) facilitates peer connections making them susceptible to peer-influences and approval. Negative experiences on SoMe can affect adolescent stress and wellbeing, impelling their use of alcohol. This paper provides a novel understanding of the relationship between negative experiences on SoMe and key indicators of alcohol use in adolescents. METHODS Data was collected from upper secondary school students (n = 3528, ages 16-19, 45% boys) in Bergen (Norway) using a web-based questionnaire during school-hours in 2020 and 2021. Dependent variables were alcohol consumption, binge drinking and scoring ≥ 2 points on the CRAFFT instrument screening for substance use problems in adolescents. Independent variables were two scales indicating "negative acts and exclusion" and "unwanted attention from others". Covariates included age, gender, country of birth and subjective socioeconomic status. Results are presented as relative risk ratios (RRR), odds ratios (OR) and incidence rate ratios (IRR) with 95% confidence intervals. RESULTS Using multinomial logistic regression models, "negative acts and exclusion" and "unwanted attention" were positively associated with trying alcohol (OR: 1.50 (95% CI 1.28-1.76) and 1.86 (95% CI 1.66-2.09) respectively, both p ≤ 0.001), with frequency and amount of alcohol consumed. Findings from logistic regression models indicated that "negative acts and exclusion" and "unwanted attention" were positively associated with i. CRAFFT-caseness (OR: 2.13 and 1.86) and ii. frequent binge drinking (OR: 1.55 and 1.89). CONCLUSION Both exclusion and unwanted attention on SoMe were associated with indicators of problematic drinking, including frequency, quantity, and consequences related to alcohol.
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Affiliation(s)
- Priya Ranganath
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Gunnhild Johnsen Hjetland
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Turi Reiten Finserås
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Geir Scott Brunborg
- grid.418193.60000 0001 1541 4204Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway ,grid.4714.60000 0004 1937 0626 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Jens Christoffer Skogen
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway ,grid.412835.90000 0004 0627 2891Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
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23
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Stephenson M, Aliev F, Kuo SIC, Edwards AC, Pandey G, Su J, Kamarajan C, Dick D, Salvatore JE. The role of adolescent social relationships in promoting alcohol resistance: Interrupting the intergenerational transmission of alcohol misuse. Dev Psychopathol 2022; 34:1841-1855. [PMID: 36873306 PMCID: PMC9976711 DOI: 10.1017/s0954579422000785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Genetic factors contribute to the intergenerational transmission of alcohol misuse, but not all individuals at high genetic risk develop problems. The present study examined adolescent relationships with parents, peers, and romantic partners as predictors of realized resistance, defined as high biological risk for disorder combined with a healthy outcome, to alcohol initiation, heavy episodic drinking, and alcohol use disorder (AUD). Data were from the Collaborative Study on the Genetics of Alcoholism (N = 1,858; 49.9% female; mean age at baseline = 13.91 years). Genetic risk, indexed using family history density and polygenic risk scores for alcohol problems and AUD, was used to define alcohol resistance. Adolescent predictors included parent-child relationship quality, parental monitoring, peer drinking, romantic partner drinking, and social competence. There was little support for the hypothesis that social relationship factors would promote alcohol resistance, with the exception that higher father-child relationship quality was associated with higher resistance to alcohol initiation (β ^ = - 0.19 , 95% CI = -0.35, -0.03). Unexpectedly, social competence was associated with lower resistance to heavy episodic drinking (β ^ = 0.10 , 95% CI = 0.01, 0.20). This pattern of largely null effects underscores how little is known about resistance processes among those at high genetic risk for AUD.
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Affiliation(s)
- Mallory Stephenson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Gayathri Pandey
- Department of Psychiatry and Behavioral Sciences, Downstate Medical Center, State University of New York, Brooklyn, NY, USA
| | - Jinni Su
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, Downstate Medical Center, State University of New York, Brooklyn, NY, USA
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica E. Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
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24
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Klein RJ, Nguyen ND, Gyorda JA, Jacobson NC. Adolescent Emotion Regulation and Future Psychopathology: A Prospective Transdiagnostic Analysis. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:1592-1611. [PMID: 35301763 PMCID: PMC10152987 DOI: 10.1111/jora.12743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/13/2021] [Accepted: 02/17/2022] [Indexed: 05/04/2023]
Abstract
Transdiagnostic frameworks posit a causal link between emotion regulation (ER) ability and psychopathology. However, there is little supporting longitudinal evidence for such frameworks. Among N = 1,262 adolescents, we examined the prospective bidirectional relationship between ER and future pathological anxiety, depression, and substance dependence symptoms in 10 assessment waves over 7 years. In Random-intercept cross-lagged panel models, within-person results do not reveal prospective lag-1 effects of either ER or symptoms. However, between-person analyses showed that dispositional ER ability at baseline predicted greater risk for developing clinically significant depression, anxiety, and substance dependence over the 7-year follow-up period. These findings provide some of the first direct evidence of prospective effects of ER on future symptom risk across affect-related disorders, and should strengthen existing claims that ER ability represents a key transdiagnostic risk factor.
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Gonçalves SF, Mauro KL, Kinsey-Kerr MG, Fuentes AG, Thompson JC, Chaplin TM. Behavioral inhibition and approach tendencies are associated with striatal activation to loss: Implications for adolescent substance use. Neuropsychologia 2022; 176:108371. [PMID: 36210572 PMCID: PMC11008605 DOI: 10.1016/j.neuropsychologia.2022.108371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 10/31/2022]
Abstract
Behavioral inhibition/avoidance and approach systems (BIS/BAS), which facilitate avoidance of aversive stimuli and approach of enticing stimuli, are thought to underlie engagement in substance use (SU). However, little is known about the neural correlates of these systems, particularly in adolescence. The current study examined associations between BIS/BAS tendencies and neural response to reward and loss and then examined whether there was an indirect effect of BIS/BAS on later SU initiation through these neural responses. 79 12-14 year olds underwent fMRI at baseline during a card guessing task. Adolescents reported on their BIS/BAS at baseline and on their SU at baseline and through a 3-year follow-up period. Results showed that higher BIS was associated with lower striatal activation and higher BAS with higher striatal activation to monetary loss. BIS and BAS were not associated with neural activation to monetary reward. There was no support that BIS or BAS predicted SU initiation through striatal activation to monetary loss. Overall, these results may suggest that adolescents with the tendency to avoid aversive stimuli assign less salience and adolescents with the tendency to approach enticing stimuli assign more salience to monetary loss.
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Affiliation(s)
- Stefanie F Gonçalves
- Department of Psychology, George Mason University, Fairfax, VA, 22030, United States.
| | - Kelsey L Mauro
- Department of Psychology, George Mason University, Fairfax, VA, 22030, United States
| | - Max G Kinsey-Kerr
- Department of Psychology, George Mason University, Fairfax, VA, 22030, United States
| | | | - James C Thompson
- Department of Psychology, George Mason University, Fairfax, VA, 22030, United States
| | - Tara M Chaplin
- Department of Psychology, George Mason University, Fairfax, VA, 22030, United States
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Kumar L, Skrzynski CJ, Creswell KG. Meta-analysis of associations between empathy and alcohol use and problems in clinical and non-clinical samples. Addiction 2022; 117:2793-2804. [PMID: 35546448 PMCID: PMC9796795 DOI: 10.1111/add.15941] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/13/2022] [Indexed: 01/07/2023]
Abstract
AIMS To (1) measure the aggregated effect size of empathy deficits in individuals with alcohol use disorder (AUD) compared with healthy controls, (2) measure the aggregated effect sizes for associations between lower empathy and heavier alcohol consumption and more alcohol problems in non-clinical samples and (3) identify potential moderators on the variability of effect sizes across studies in these meta-analyses. METHOD PsycINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We meta-analyzed (using random-effects models) mean differences in empathy between individuals with AUD compared with healthy controls and associations between empathy and alcohol consumption and alcohol problems in non-clinical samples. A total of 714 participants were included in the meta-analysis on clinical samples; 3955 were included in the meta-analyses on non-clinical samples. RESULTS Individuals with AUD reported significantly lower empathy than healthy controls [Hedges' g = -0.53, 95% confidence interval (CI) = -0.91, -0.16, k = 9, P < 0.01, Q = 40.09, I2 = 80.04]. Study quality [Q = 1.88, degrees of freedom (d.f.) = 1, P = 0.17] and gender (β = -0.006, Z = -0.60, P = 0.55) were not moderators. Increases in age corresponded to an increase in effect size (β = 0.095, Z = 3.34, P < 0.001). Individuals with AUD (versus healthy controls) had significantly lower cognitive (Hedges' g = -0.44, CI = -0.79, -0.10, P < 0.05), but not affective empathy (Hedges' g = -0.19, CI = -0.51, 0.14, P = 0.27), and the difference between these was significant (Z = 2.34, k = 6, P < 0.01). In non-clinical samples, individuals with lower (versus higher) empathy reported heavier alcohol consumption (r = -0.12, CI = -0.15, -0.09, k = 11, P < 0.001, Q = 9.68, I2 = 0.00) and more alcohol problems (r = -0.08, CI = -0.14, -0.01, k = 7, P = 0.021, Q = 6.55, I2 = 8.34). There was no significant heterogeneity across studies. CONCLUSION Individuals with alcohol use disorder appear to show deficits in empathy compared with healthy controls. Deficits are particularly pronounced for older individuals and for cognitive (versus affective) empathy. In non-clinical samples, lower empathy appears to be associated with heavier alcohol consumption and more alcohol problems.
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Affiliation(s)
- Lakshmi Kumar
- Department of PsychologyCarnegie Mellon UniversityPittsburghPA
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Pascale A, Stephenson M, Barr P, Latvala A, Aaltonen S, Piirtola M, Viken R, Rose RJ, Kaprio J, Maes H, Dick DM, Salvatore JE. Exploring the relationships between adolescent alcohol misuse and later life health outcomes. Alcohol Clin Exp Res 2022; 46:1753-1765. [PMID: 36115067 PMCID: PMC9509441 DOI: 10.1111/acer.14917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND We sought to clarify the impact of adolescent alcohol misuse on adult physical health and subjective well-being. To do so, we investigated both the direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction and the indirect effects on these outcomes attributable to subsequent alcohol problems. METHOD The sample included 2733 twin pairs (32% monozygotic; 52% female) from the FinnTwin16 study. Adolescent alcohol misuse was a composite of frequency of drunkenness, frequency of alcohol use, and alcohol problems at ages 16, 17, and 18.5. The early midlife outcomes included somatic symptoms, self-rated health, and life satisfaction at age 34. The mediators examined as part of the indirect effect analyses included alcohol problems from the Rutgers Alcohol Problem Index at ages 24 and 34. Serial mediation and co-twin comparison models were applied and included covariates from adolescence and early midlife. RESULTS There were weak direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction. However, there was stronger evidence for indirect effects, whereby young adult and early midlife alcohol problems serially mediated the relationship between adolescent alcohol misuse and early midlife somatic symptoms (β = 0.03, 95% CI [0.03, 0.04]), self-rated health (β = -0.02, 95% CI [-0.03, -0.01]), and life satisfaction (β = -0.03, CI [-0.04, -0.02]). These serial mediation effects were robust in co-twin comparison analyses. CONCLUSIONS These results provide evidence that alcohol problems are a primary driver linking adolescent alcohol misuse and poor health outcomes across the lifespan.
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Affiliation(s)
- Angela Pascale
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Mallory Stephenson
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
- Virginia Institute for Psychiatric and Behavioral GeneticsRichmondVirginiaUSA
| | - Peter Barr
- Department of Psychiatry and Behavioral SciencesSUNY Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Antti Latvala
- Institute of Criminology and Legal PolicyUniversity of HelsinkiHelsinkiFinland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland (FIMM)University of HelsinkiHelsinkiFinland
| | - Maarit Piirtola
- Institute for Molecular Medicine Finland (FIMM)University of HelsinkiHelsinkiFinland
- UKK Institute for Health Promotion ResearchTampereFinland
| | - Richard Viken
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
| | - Richard J. Rose
- Department of Psychological and Brain SciencesIndiana UniversityBloomingtonIndianaUSA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM)University of HelsinkiHelsinkiFinland
| | - Hermine Maes
- Virginia Institute for Psychiatric and Behavioral GeneticsRichmondVirginiaUSA
| | - Danielle M. Dick
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA
- Department of Human and Molecular GeneticsVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Jessica E. Salvatore
- Department of PsychiatryRutgers Robert Wood Johnson School of MedicinePiscatawayNew JerseyUSA
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Alemu BT, Young B, Beydoun HA, Olayinka O. Substance Use Disorder among Hospitalized Adolescents in North Carolina. South Med J 2022; 115:616-621. [PMID: 35922048 DOI: 10.14423/smj.0000000000001426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Individuals who began using alcohol or other drugs before the age of 15 are 7 times more likely to develop a substance use disorder (SUD) in adulthood. This study sought to determine the common characteristics of SUD-related hospitalizations and patterns of discharge diagnoses among adolescents in North Carolina. METHODS Using the 2014 State Inpatient Database (SID), discharge records associated with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes for SUD were identified. Adolescents between the ages of 13 and 19 years were included. SUD and non-SUD groups were compared using the Student t test for continuous variables and the χ2 test for categorical variables. A total of 1.1 million hospital discharges were analyzed. A uniform and standardized coding system called Clinical Classifications Software was used to identify cases. The Clinical Classifications Software collapses the ICD-9-CM codes into 679 clinically meaningful categories. A cluster of 3900 ICD-9-CM procedure codes also was used to identify clinically relevant groups of procedures performed during hospitalization. RESULTS An estimated 3276 adolescents associated with SUD were discharged from North Carolina hospitals during the study year. Discharged patients with a SUD spent a total of 21,242 inpatient days, at a cost of $62 million. Among the adolescents with a SUD, 53% were boys, 62% were White, 24% were Black, 8% were Hispanic (8%), and 6% were of other races. Compared with patients without a SUD, those with a SUD had longer mean hospital stays (6.5 days vs 4.7 days; P < 0.0001) and lower mean hospital charge per hospitalization ($18,932 vs 24,532; P < 0.0001). Adolescents with a SUD also were diagnosed primarily as having mood disorders (44.78%), followed by schizophrenia and other psychological disorders, upon discharge. Approximately 37% of the SUD-related discharges occurred in areas, denoted in this study using ZIP code designations, with mean household annual incomes <$38,999. A large proportion of the SUD-related hospitalizations (44%) were billed to Medicaid. Frequently observed diagnoses associated with adolescents with a SUD were mood disorders (45%), schizophrenia (7%), and poisoning by other medications and drugs (4%). In 16% of hospitalized adolescents with a SUD, there were at least 2 procedures performed. There was a statistically significant mean hospital charge difference of $5600 between SUD and non-SUD teens. CONCLUSIONS The literature reflects the connection between adolescent use and the propensity for diagnosis with a SUD in adulthood; it is evident that this is a growing public health crisis. This study identified patterns of adolescent substance use that, based on the current literature, are indicative of problematic futures for these individuals. The concerning data and literature identify a significant need to address prevention, treatment, and recovery services for adolescents, not only in North Carolina but throughout the United States. The need for focused interventions, access to care, and funding of substance-specific adolescent education and services is greatly needed to change the trajectory of these adolescents' lives.
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Affiliation(s)
- Brook T Alemu
- From the Health Sciences Program School of Health Sciences, and the Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, North Carolina, the Department of Research Programs, Fort Belvoir Community Hospital, Department of Defense, Fort Belvoir, Virginia, and the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Beth Young
- From the Health Sciences Program School of Health Sciences, and the Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, North Carolina, the Department of Research Programs, Fort Belvoir Community Hospital, Department of Defense, Fort Belvoir, Virginia, and the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Hind A Beydoun
- From the Health Sciences Program School of Health Sciences, and the Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, North Carolina, the Department of Research Programs, Fort Belvoir Community Hospital, Department of Defense, Fort Belvoir, Virginia, and the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Olaniyi Olayinka
- From the Health Sciences Program School of Health Sciences, and the Department of Social Work, College of Health and Human Sciences, Western Carolina University, Cullowhee, North Carolina, the Department of Research Programs, Fort Belvoir Community Hospital, Department of Defense, Fort Belvoir, Virginia, and the Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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Aiken A, Chan G, Yuen WS, Clare PJ, Hutchinson D, McBride N, Najman JM, McCambridge J, Upton E, Slade T, Boland VC, De Torres C, Bruno R, Kypri K, Wadolowski M, Mattick RP, Peacock A. Trajectories of parental and peer supply of alcohol in adolescence and associations with later alcohol consumption and harms: A prospective cohort study. Drug Alcohol Depend 2022; 237:109533. [PMID: 35752023 DOI: 10.1016/j.drugalcdep.2022.109533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/17/2022] [Accepted: 06/06/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Supply of alcohol to adolescents is associated with increased alcohol consumption and harms including alcohol use disorder (AUD). We aimed to identify: (1) trajectories of alcohol supply to adolescents; (2) sociodemographic characteristics associated with supply trajectory; (3) patterns of alcohol consumption by supply trajectory; and (4) supply trajectory associations with adverse alcohol outcomes. METHODS We used Australian longitudinal survey data (N = 1813) to model latent trajectories of parent and peer alcohol supply over five annual follow-ups (Waves 2-6; Mage 13.9-17.8 years). Regression models assessed associations between supply trajectories and Wave 1 (Mage=12.9 years) sociodemographic factors and associations between supply trajectories and Wave 7 (Mage=18.8 years) alcohol outcomes. RESULTS We identified five alcohol supply classes: (1) minimal supply (n = 739, 40.8%); (2) early parent sips, late peer/parent whole drinks (n = 254, 14.0%); (3) late peer/parent whole drinks (n = 419, 23.1%); (4) early parent sips, mid peer/parent whole drinks (n = 293, 16.2%); (5) early peer/parent whole drinks (n = 108, 6.0%). Compared to minimal supply, the other classes were 2.7-12.9 times as likely to binge drink, 1.6-3.0 times as likely to experience alcohol-related harms, and 2.1-8.6 times as likely to report AUD symptoms at age 19. CONCLUSION Earlier supply of whole drinks, particularly from peers, was associated with increased risk of early adulthood adverse alcohol outcomes. While minimal supply represented the lowest risk, supplying sips only in early-mid adolescence and delaying supply of whole drinks until late adolescence is likely to be less risky than earlier supply of whole drinks.
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Affiliation(s)
- Alexandra Aiken
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia.
| | - Gary Chan
- National Centre For Youth Substance Use Research, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Wing See Yuen
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Philip J Clare
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; Prevention Research Collaboration, The Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Delyse Hutchinson
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia; Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, WA 6845, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, QLD 4072, Australia
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, United Kingdom
| | - Emily Upton
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Tim Slade
- Sydney Medical School / The Matilda Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Veronica C Boland
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Clara De Torres
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Raimondo Bruno
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Monika Wadolowski
- Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia
| | - Amy Peacock
- National Drug & Alcohol Research Centre, UNSW Sydney, NSW 2052, Australia; School of Psychology, University of Tasmania, Hobart, TAS 7000, Australia
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The joint development of externalizing and internalizing behaviors in black and Hispanic youth and the link to late adolescent substance use. Dev Psychopathol 2022; 34:1144-1162. [PMID: 33517946 PMCID: PMC8325714 DOI: 10.1017/s0954579420001881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There is a need to understand how the joint development of externalizing and internalizing behaviors is related to substance use, particularly among historically understudied and often disadvantaged populations. Latent class models were used to estimate patterns of externalizing behaviors and internalizing behaviors in the form of depressive and anxious symptoms from age 6 to 14 among 390 Black and Hispanic youth. Then, growth curve models of substance use between the ages of 15 and 19 were estimated as a function of joint latent class membership. Only elevated levels of externalizing behaviors were associated with higher levels of substance use through age 18. Internalizing behaviors appeared to serve as a protective factor among those with moderate displays of externalizing behavior only. Additionally, growth in substance use from ages 15 to 19 was slower among those who displayed the highest level of externalizing behaviors, and internalizing behaviors appeared to moderate growth (and serve as protective factor) among those who displayed moderate levels of externalizing behaviors. The findings underscore the importance of pattern profiles based on observations of the joint development of problem behaviors to assess risk for substance use, particularly in understudied populations where risk/protective factors may operate in a unique manner.
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Li SD, Xie L, Wu K, Lu J, Kang M, Shen H. The Changing Patterns and Correlates of Adolescent Substance Use in China's Special Administrative Region of Macau. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137988. [PMID: 35805651 PMCID: PMC9266093 DOI: 10.3390/ijerph19137988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/23/2022] [Accepted: 06/28/2022] [Indexed: 01/27/2023]
Abstract
Most of the research on adolescent substance use is from either the U.S, Europe, or other non-Eastern countries, but very little attention is paid to that in the Greater China Region. As a special administrative region of China, Macau is known for its gambling industry, its proximity to the Golden Triangle, and its lenient drug laws, all of which can be conducive to high-level drug use in the population, including its adolescents. Yet, the extent and patterns of adolescent substance use in Macau are not well understood. Using the data collected from two large representative samples of secondary school students in 2014 and 2018, this study provided population-based estimates of the prevalence rates of lifetime and past 30-day substance use among Macau adolescents in the two separate survey years. By comparing the two sets of estimates, it established the patterns of changes in cigarette smoking, alcohol use, and illicit drug use among adolescents in Macau during the period. Additionally, through the analysis of the data in the latest year, it identified risk factors for adolescent substance use in the special administrative region. Among the key results, the rates of cigarette smoking and illicit drug use were low to moderate while the rates of alcohol use were relatively high; cigarette smoking decreased during the period, but alcohol use and illicit drug use remained stable; Macau adolescents shared similar risk factors for substance use with adolescents elsewhere, but unique circumstances might exist to influence their alcohol consumption.
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Affiliation(s)
| | | | | | - Jiaqi Lu
- Correspondence: or ; Tel.: +853-6324-0296
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McCabe BE, McConaha CD, Falcon AL. Social norms and club drug use of young adult college students during Music Week. J Addict Dis 2022; 41:149-155. [PMID: 35713275 DOI: 10.1080/10550887.2022.2086424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Young adult college students have high rates of substance use, theoretically related to social norms. Behavioral norms refer to the quantity of substances that students think others use, and attitudes refer to how much students or others approve of substance use. Prior research has shown a relationship between behavioral norms, student attitudes, and perceived parental attitudes and alcohol and marijuana use. However, the relationship between social norms and use of club drugs (e.g., MDMA) has not been studied.Objective: The purpose of this cross-sectional study was to expand knowledge about young adult college student social norms and club drug use.Methods: 200 young adult undergraduates (Women = 97, 49%) were recruited from a campus recreational facility on a large private Southeastern university in April 2019. Students self-reported behavioral norms, student attitudes, parental perceived attitudes, club drug use during a typical week and during music week, and substance use consequences.Results: Logistic and negative binomial regressions showed that student attitudes were significantly related to club drug use in a typical week (OR = 2.07, p = .005), during music week (OR = 2.08, p = .001), and consequences of use (RR = 1.23, p < .001), but behavioral norms and perceived parental attitudes were not.Conclusions: Findings build on social norms research with alcohol and marijuana use. Attitudes may be more important to consider than behavioral norms or perceived parental attitudes for interventions to reduce club drug use.Young adults (18-25 years old) have a high risk for substance use; both alcohol and drug use increase throughout adolescence and peak in young adulthood.1-3 Young adults have high heavy episodic drinking (35% past month) and illicit drug use (25% past month), with greater MDMA use (10% vs 7%) and marijuana use (35% vs. 15%) than other adults.4 Alcohol and marijuana use has been linked to many negative consequences, such as blackouts, physical injuries, unprotected sex, and even death.5,6 Club drug use is also linked to negative consequences, such as memory lapse, headaches, loss of energy, trouble sleeping, depression, confusion, anxiety, irritability, nausea, and changes in heart rate and blood pressure.7,8.
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Affiliation(s)
- Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Candace D McConaha
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, AL, USA
| | - Ashley L Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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Chi R, Lu S, Zhang N, Zhang M, Guo K, Du S, Guo J, Hu X, Ma G. The Association Between Family Environment and Adolescent Alcohol Drinking Behavior: A Cross-Sectional Study of Six Chinese Cities. Front Nutr 2022; 9:903216. [PMID: 35774539 PMCID: PMC9237503 DOI: 10.3389/fnut.2022.903216] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Adolescents' alcohol consumption has lifetime adverse physical and mental health effects. Family environment factors have a significant influence in shaping adolescents' beliefs and habits. We conducted the multicenter cross-sectional study aiming to investigate the association between family environment factors and adolescent drinking behavior in China. Methods The study investigated 27,762 middle school students from Beijing, Shanghai, Guangzhou, Jinan, Chengdu, and Harbin. A logistic regression model was used to explore the association between family environmental factors and adolescent drinking behavior. Participants were asked to self-report previous experiences of drinking and getting drunk to access their drinking status. Factors of family environment related to alcohol consumption included: parents' educational level, family economic status, family composition, the number of times parents drank alcohol in the past 30 days, and parents' attitudes toward their drinking behavior. The logistic regression model was used to adjust the demographic confounders, including gender, age, city, location, and smoking status, and to explore the association between family environmental factors and adolescent alcohol drinking behaviors. Results Compared with students whose parents prohibited drinking, students who were approved drinking were more likely to drink in this year (OR = 16.544, 95%CI:15.265–17.929, P < 0.001; Full adjustment: OR = 13.111, 95% CI: 12.031–14.288, P < 0.001), drink in this month (OR = 7.791, 95% CI: 7.077–8.565, P < 0.001; Full adjustment: OR = 6.010, 95% CI: 5.439–6.641, P < 0.001). In addition, Low family economic status, not living with the mother, parents' ambivalent attitudes toward their children's drinking and parental drinking were risk factors for drinking among middle school students. Conclusion The family environment, especially parents' attitudes, is associated with students' drinking and drunken behavior. Mobilizing the power of parents may play a positive role in the effective prevention and control of adolescent drinking.
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Affiliation(s)
- Ruixin Chi
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | - Shijun Lu
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Na Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | - Man Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | - Kaiwei Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
| | | | - Jing Guo
- Epidemiology Directorate, Department of Health WA, Perth, WA, Australia
| | - Xiaoqi Hu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Beijing, China
- *Correspondence: Guansheng Ma
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Mintz S, Ingram KM, Milliken A, Kuehl T, Espelage DL. Longitudinal Associations Between Sexual Victimization and Substance Misuse Among High School Youth in Colorado. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4415-NP4438. [PMID: 32954914 DOI: 10.1177/0886260520959628] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
There are consistently high rates of sexual victimization and substance misuse among youth in the United States. Although there is a known relation between sexual victimization and substance use, there is a gap in the research regarding the magnitude and temporality of these associations. This study examined whether latent classes of sexual victimization and help-seeking attitudes longitudinally predict intentions of future substance misuse 7-10 months later. Students from nine Colorado high schools (N = 533; M = age 16 years) completed surveys across two consecutive school semesters. Latent class analysis was used to identify classes of students who experienced at least one form of sexual victimization (e.g., sexual harassment, unwanted sexual contact) according to 13 sexual victimization items, and level of positive attitudes regarding help-seeking for sexual victimization. Classes were compared on demographic characteristics and for distal outcomes of likelihood of future substance misuse (cigarettes, alcohol, cannabis, prescription drugs, and electronic vaping products) using latent class regression, controlling for previous intentions to use. At Time 1, four classes of sexual victimization were identified with two main classes for comparison: low odds of experiencing sexual victimization (60.1% of sample) and high odds of endorsing all forms of sexual victimization (7.7% of sample). The high sexual victimization class had higher proportions of male and transgender students, compared to other classes. At Time 2 (7-10 months later), students in the high sexual victimization class reported a significantly greater likelihood of future cigarette (p = .017) and prescription drug misuse (p = .007) when compared to the low sexual victimization class. There was no evidence that having higher positive attitudes towards help-seeking resulted in lower intentions to use substances in the future. These findings highlight that addressing sexual violence in prevention programming may have crossover effects of reducing substance misuse and other forms of violence among youth.
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Affiliation(s)
- Sasha Mintz
- Violence and Injury Prevention, Mental Health Promotion Branch, Colorado Department of Public Health and Environment, Denver, CO, United States
| | | | - Anne Milliken
- Violence and Injury Prevention, Mental Health Promotion Branch, Colorado Department of Public Health and Environment, Denver, CO, United States
| | - Tomei Kuehl
- Violence and Injury Prevention, Mental Health Promotion Branch, Colorado Department of Public Health and Environment, Denver, CO, United States
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Crichlow QJ, Banks DE, Carson I, Fisher S, Barnes-Najor JV, Zapolski TCB. Racial discrimination and substance use among African American youth: Personal and collective self-esteem as mechanisms. J Ethn Subst Abuse 2022; 23:58-71. [PMID: 35343396 DOI: 10.1080/15332640.2022.2050873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Little is known about the mechanisms of the relationship between racial discrimination and substance use among Black youth. The current study examined the role of collective self-esteem and personal self-esteem in this relationship among Black adolescents in grades 5 through 12 (N = 1514; 57% female). Regression analyses estimated direct effects of perceived racial discrimination on substance use and indirect effects of discrimination on substance use through personal and collective self-esteem. Controlling for grade and sex, results revealed significant indirect effects such that experiences of discrimination were positively associated with substance use through lower reports of collective and personal self-esteem. Findings suggest that bolstering personal and race-related esteem may mitigate the deleterious influence of discrimination among Black youth.
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Affiliation(s)
- Queenisha J Crichlow
- University of Alabama at Birmingham, Birmingham, Alabama
- Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Devin E Banks
- Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
- University of Missouri-St. Louis, St. Louis, Missouri
| | - Ian Carson
- Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
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36
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Jackson S, Creo A, Al Nofal A. Management of Type 1 Diabetes in Children in the Outpatient Setting. Pediatr Rev 2022; 43:160-170. [PMID: 35229106 DOI: 10.1542/pir.2020-001388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Sarah Jackson
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine
| | - Ana Creo
- Division of Pediatric Endocrinology and Metabolism and Division of Endocrinology, Mayo Clinic, Rochester, MN
| | - Alaa Al Nofal
- Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Vermillion, SD
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37
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Nguyen NN. Family conflict and negative emotions as risk factors predicting alcohol use among Vietnamese teenagers. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2039968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ngoc N. Nguyen
- Department of Social Work, Thang Long University, Hanoi, Vietnam
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38
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Longmore MA, Sevareid EE, Manning WD, Giordano PC, Clemens W, Taylor H. Adolescents' Frequency of Alcohol Use and Problems from Alcohol Abuse: Integrating Dating Partners with Parent and Peer Influences. J Youth Adolesc 2022; 51:320-334. [PMID: 34797499 PMCID: PMC9341278 DOI: 10.1007/s10964-021-01486-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/22/2021] [Indexed: 02/03/2023]
Abstract
Despite the centrality of dating relationships for teens, it is unclear whether the influence of romantic partners' alcohol use on adolescents' under-age drinking is distinct from the influence of peers and parents. To address this gap, this study used longitudinal data from a population-based sample of 825 adolescents (49% male, 51% female), ages 12 to 19. Adolescents completed a survey using laptops for privacy, and a parent completed a survey separately. Ordinary least squares and logistic regression models assessed alcohol use frequency and alcohol problems and included dating partners' drinking, adolescents' prior drinking, peers' drinking, parents' substance use, parental monitoring, and sociodemographic background characteristics. Alcohol use frequency and alcohol problems were influenced by dating partners' alcohol use and dating partners' influence was stronger on older adolescents and male adolescents. The study results are useful for public health messaging and prevention efforts by demonstrating the influence of parents, peers, and dating partners on teens' alcohol use.
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Affiliation(s)
- Monica A Longmore
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA.
| | - Eric E Sevareid
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA
| | - Wendy D Manning
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA
| | - Peggy C Giordano
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA
| | - William Clemens
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA
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Impulsivity and Stressful Life Events Independently Relate to Problematic Substance Use in At-Risk Adolescents. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00725-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Parsegian A, García-Fuster MJ, Hebda-Bauer E, Watson SJ, Flagel SB, Akil H. Adolescent cocaine differentially impacts psychomotor sensitization and epigenetic profiles in adult male rats with divergent affective phenotypes. Front Psychiatry 2022; 13:1024617. [PMID: 36311521 PMCID: PMC9599748 DOI: 10.3389/fpsyt.2022.1024617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/26/2022] [Indexed: 11/24/2022] Open
Abstract
Adolescent drug use reliably predicts increased addiction liability in adulthood, but not all individuals are equally impacted. To explore the biological bases of this differential reactivity to early life drug experience, we used a genetic rat model of temperament and evaluated the impact of adolescent cocaine exposure on adult psychomotor sensitization. Relative to adult bred low-responder (bLR) rats, bred high-responders (bHR) are more sensitive to the psychomotor-activating effects of cocaine and reinstate drug-seeking behavior more readily following prolonged cocaine exposure and/or abstinence. We found that a 7-day sensitizing cocaine regimen (15 mg/kg/day) during either adolescence or adulthood produced psychomotor sensitization in bHRs only, while a dual cocaine exposure prevented further sensitization, suggesting limits on neuroplasticity. By contrast, adolescent cocaine in bLRs shifted their resilient phenotype, rendering them more responsive to cocaine in adulthood following adolescent cocaine. To begin to explore the neural correlates of these behavioral phenotypes, we assessed two functionally opposite epigenetic chromatin modifications implicated in addiction liability, permissive acetylation (ac) and repressive tri-methylation (me3) on Histone 3 Lysine 9 (H3K9), in four striatal sub-regions. In bHRs, decreased H3K9me3 and increased acH3K9 in the nucleus accumbens (NAc) core associated with cocaine sensitization. In bLRs, the combination of cocaine exposure in adolescence and adulthood, which lead to an increased response to a cocaine challenge, also increased acH3K9 in the core. Thus, adolescent cocaine experience interacts with genetic background to elicit different behavioral profiles relevant to addiction in adulthood, with concurrent modifications in the epigenetic histone profiles in the NAc that associate with cocaine sensitization and with metaplasticity.
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Affiliation(s)
- Aram Parsegian
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - M Julia García-Fuster
- IUNICS, University of the Balearic Islands, Palma, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Elaine Hebda-Bauer
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States
| | - Stanley J Watson
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Shelly B Flagel
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Huda Akil
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, United States.,Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
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Exploring the impact of a transdiagnostic cognitive behavioural therapy-based intervention on a group of Malaysian adolescents with problematic drug use and emotional problems. Addict Behav Rep 2021; 14:100381. [PMID: 34938839 PMCID: PMC8664875 DOI: 10.1016/j.abrep.2021.100381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/18/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022] Open
Abstract
After participating in the intervention, symptoms of emotional problems were significantly reduced. There was a significant reduction in substance use and maladaptive emotion regulation strategies after the intervention. Girls benefitted significantly more from the intervention compared to boys.
Introduction Adolescents with problematic substance use frequently have anxiety and depression and tend to have “unhealthy” lifestyle such as having poor dietary patterns and physical inactivity. The overall aim of the present study was to explore the impact of a Transdiagnostic Cognitive Behavioral Therapy-based Intervention (“Super Skills for Life” – adolescent version; SSL-A) on emotional problems among adolescents with problematic substance use and to identify demographic factors which influence the intervention outcomes. Method A total of 108 adolescents (M = 16.30 years, SD = 1.6) with problematic substance use who showed high levels of anxiety and depression participated in this study. They completed a set of questionnaires to measure substance use, mental health problems, cognitive emotion regulation strategies, loneliness, and lifestyle and habits at pre- and post-intervention. Results The adolescents reported less emotional symptoms and more prosocial behavior after the intervention. These adolescents were also consumed less substance and used less maladaptive emotion regulation strategies after participating in SSL-A. Females compared to males showed more treatment gains (i.e., reduction in loneliness and improvement in psychological health and self-esteem) after the intervention. Conclusion This study provides empirical evidence for the utility of the SSL-A in reducing emotional problems and substance use among adolescents with problematic substance use.
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Ruffolo J, Frie JA, Thorpe HHA, Talhat MA, Khokhar JY. Alcohol and Vaporized Nicotine Co-Exposure During Adolescence Contribute Differentially to Sex-Specific Behavioral Effects in Adulthood. Nicotine Tob Res 2021; 24:1177-1185. [PMID: 34865152 DOI: 10.1093/ntr/ntab250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/25/2021] [Accepted: 11/30/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Co-occurrence of e-cigarette use and alcohol consumption during adolescence is frequent. Here, we examined whether adolescent co-exposure to alcohol drinking and vaporized nicotine would impact reward- and cognition-related behaviors in adult male and female rats during adulthood. METHODS Four groups of male and female Sprague Dawley rats (n=8-11/group/sex) received either nicotine (JUUL 5% nicotine pods) or vehicle vapor for 10 minutes daily between postnatal days 30-46, while having continuous voluntary access to ethanol and water during this time in a two-bottle preference design. Upon reaching adulthood, all rats underwent behavioral testing (i.e., Pavlovian conditioned approach testing, fear conditioning and a two-bottle alcohol preference). RESULTS A sex-dependent effect, not related to adolescent nicotine or alcohol exposure, on alcohol drinking in adulthood was found, such that females had a higher intake and preference for alcohol compared to males; both male and female adult rats also had greater alcohol preference compared to their alcohol preference as adolescents. Male rats exposed to vaporized nicotine with or without alcohol drinking during adolescence exhibited altered reward-related learning in adulthood, evidenced by enhanced levels of sign-tracking behavior. Male rats that drank alcohol with or without nicotine vapor in adolescence showed deficits in associative fear learning and memory as adults. In contrast, these effects were not seen in female rats exposed to alcohol and nicotine vapor during adolescence. CONCLUSIONS The present study provides evidence that co-exposure to alcohol and vaporized nicotine during adolescence in male, but not female, rats produces long-term changes in reward- and cognition-related behaviors. IMPLICATIONS These findings enhance our understanding of the effects of alcohol drinking and nicotine vapor exposure in adolescence. Moreover, they highlight potential sex differences that exist in the response to alcohol and nicotine vapor, underscoring the need for follow-up studies elucidating the neurobiological mechanisms that drive these sex differences, as well as the long-term effects of alcohol and nicotine vapor use.
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Affiliation(s)
- Jessica Ruffolo
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada.,Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
| | - Jude A Frie
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada.,Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
| | - Hayley H A Thorpe
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada.,Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
| | | | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada.,Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
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Ozeylem F, de la Torre-Luque A, Essau CA. Factors related to substance use among adolescents from six low-and middle-income countries. Addict Behav Rep 2021; 14:100370. [PMID: 34938831 PMCID: PMC8664775 DOI: 10.1016/j.abrep.2021.100370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/20/2021] [Accepted: 08/29/2021] [Indexed: 11/29/2022] Open
Abstract
Substance use is a common public health problem among adolescents in low- and middle-income countries (LMICs), however, factors that are associated with this condition are not clearly understood. The aim of the present study was to examine personal and interpersonal factors that contribute to risk for substance use among adolescents in six ASEAN (Association of Southeast Asian Nations) LMICs (i.e., Indonesia, Laos, Malaysia, Myanmar, Philippines and Thailand). Data of 57,825 adolescents (52.64% girls; median age = 14 years old) who participated in the Global School-based Student Health Survey (GSHS) were analysed. After the weighted prevalence was estimated for each country, multilevel models were employed to examine the influence of the risk factors on the prevalence of substance use across the countries. The results indicated a high prevalence of substance use among adolescents in all these six ASEAN LMICs. Alcohol use, smoking and drug use were more prevalent among adolescents in Thailand, Laos and Philippines. Adolescents who were bullied and who had no close friends had a high prevalence of alcohol and drug use. Problematic drinking and smoking were more prevalent among older adolescents, and smoking and drug use were more prevalent among boys. Furthermore, frequent worry, loneliness and regular physical activity were found to predict adolescents' heavy and binge drinking. This study contributed to knowledge on risk factors for specific substance use among adolescents and drew attention for the urgent need to strengthen the intervention, law policies and professional support for reducing substance use in ASEAN LMICs.
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Affiliation(s)
- Fatos Ozeylem
- University of Roehampton, Department of Psychology, London, UK
- Eastern Mediterranean University, Psychological Counseling Guidance and Research Center, Famagusta, Cyprus
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Clare PJ, Aiken A, Yuen WS, Upton E, Kypri K, Degenhardt L, Bruno R, McCambridge J, McBride N, Hutchinson D, Slade T, Mattick R, Peacock A. Alcohol use among young Australian adults in May-June 2020 during the COVID-19 pandemic: a prospective cohort study. Addiction 2021; 116:3398-3407. [PMID: 34105838 PMCID: PMC8212116 DOI: 10.1111/add.15599] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/20/2021] [Accepted: 05/26/2021] [Indexed: 01/07/2023]
Abstract
AIMS To estimate change in young people's alcohol consumption during COVID-19 restrictions in Australia in early-mid 2020, and test whether those changes were consistent by gender and level of consumption prior to the pandemic. DESIGN Prospective longitudinal cohort. SETTING Secondary schools in New South Wales, Tasmania and Western Australia. PARTICIPANTS Subsample of a cohort (n = 443) recruited in the first year of secondary school in 2010-11. Analysis data included three waves collected in September 2017-July 2018, September 2018-May 2019 and August 2019-January 2020), and in May-June 2020. MEASUREMENTS The primary predictors were time, gender and level of consumption prior to the pandemic. Outcome variables, analysed by mixed-effects models, included frequency and typical quantity of alcohol consumption, binge drinking, peak consumption, alcohol-related harm and drinking contexts. FINDINGS Overall consumption (frequency × quantity) during the restrictions declined by 17% [incidence rate ratio (IRR) = 0.83; 95% confidence interval (CI) = 0.73, 0.95] compared to February 2020, and there was a 35% decline in the rate of alcohol-related harms in the same period (IRR = 0.66; 95% CI = 0.54, 0.79). Changes in alcohol consumption were largely consistent by gender. CONCLUSIONS From a survey of secondary school students in Australia, there is evidence for a reduction in overall consumption and related harms during the COVID-19 restrictions.
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Affiliation(s)
- Philip J. Clare
- Prevention Research CollaborationUniversity of SydneyCamperdownNSWAustralia,National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Alexandra Aiken
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Wing See Yuen
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Emily Upton
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Kypros Kypri
- School of Medicine and Public HealthUniversity of NewcastleCallaghanNSWAustralia
| | - Louisa Degenhardt
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Raimondo Bruno
- School of Psychological SciencesUniversity of TasmaniaHobartTasmaniaAustralia
| | | | - Nyanda McBride
- National Drug Research InstituteCurtin UniversityPerthWAAustralia
| | - Delyse Hutchinson
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia,Centre for Social and Early Emotional DevelopmentDeakin UniversityMelbourneVICAustralia,Department of PaediatricsUniversity of MelbourneMelbourneVICAustralia,Murdoch Children's Research Institute, Royal Children's HospitalUniversity of MelbourneMelbourneVICAustralia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | - Richard Mattick
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Amy Peacock
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
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Creo A, Sriram S, Vaughan LE, Weaver AL, Lteif A, Kumar S. Risk of substance use disorders among adolescents and emerging adults with type 1 diabetes: A population-based cohort study. Pediatr Diabetes 2021; 22:1143-1149. [PMID: 34561948 DOI: 10.1111/pedi.13266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Adolescents and emerging adults with chronic health conditions such as type 1 diabetes mellitus (T1D) are more likely to engage in high-risk behaviors. Previous studies regarding substance use in adolescents and emerging adults with T1D are mostly derived from cross-sectional studies utilizing self-administered questionnaires and are limited by lack of population-based comparison groups. In addition, despite the rising popularity of vaping, little is known about the incidence of vaping in adolescents and emerging adults with T1D. METHODS We explored the incidence and prospective risk of substance use disorders (SUD) and vaping in adolescents and emerging adults with T1D compared to age and gender matched nondiabetic referents residing in Olmsted County, Rochester, MN. RESULTS Risk of incident SUD was higher in those with T1D compared to matched referents with alcohol, marijuana, and smoked tobacco being most common substances. When stratified by gender, these differences remained significant in males, but not females. CONCLUSIONS While further work is needed to delineate the causative relationships between T1D, mental health, and substance abuse, our findings confirm the critical need for substance use screening and mental health support for adolescents and emerging adults with T1D.
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Affiliation(s)
- Ana Creo
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Swetha Sriram
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lisa E Vaughan
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Amy L Weaver
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Aida Lteif
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Seema Kumar
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Masonbrink AR, Richardson T, Hall M, Catley D, Wilson K. Trends in Adolescent Cannabis-Related Hospitalizations by State Legalization Laws, 2008-2019. J Adolesc Health 2021; 69:999-1005. [PMID: 34511329 DOI: 10.1016/j.jadohealth.2021.07.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/06/2021] [Accepted: 07/21/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE Adolescent cannabis use is associated with adverse health outcomes. The impact of cannabis legalization on adolescent cannabis-related hospitalizations remains unknown. We sought to assess whether state cannabis legalization is associated with adolescent cannabis-related hospitalizations. METHODS We conducted a retrospective cohort study of adolescent (11-17 years) hospitalizations at children's hospitals between January 1, 2008 and December 31, 2019 using the Inpatient Essentials database. We investigated differences in adolescent cannabis-related diagnosis during a hospitalization by state cannabis legalization status, including states with no legal use to medical cannabis laws (MCLs) and states with MCLs to nonmedical (>21 years old) cannabis laws (NMCLs). RESULTS Of 1,898,432 adolescent hospitalizations in 18 states and Washington, DC, there were 37,562 (2%) hospitalizations with a cannabis-related diagnosis, with 8,457 (23%) in states with no legal use, 20,444 (54%) in MCL states, and 8,661 (23%) in NMCL states. There was an increase in adjusted odds of a cannabis-related hospitalization in MCL (odds ratio 1.05, 95% confidence interval 1.04-1.06) and NMCL states (odds ratio 1.03, 95% confidence interval 1.02-1.03) between 2008 and 2019. Characteristics associated with the greatest increase in adjusted odds of a cannabis-related hospitalization postpolicy change included adolescents without an underlying mental health or other substance use disorder in MCL and NMCL states (p < .001) and younger age in NMCL states (13 vs. 16 and 17 years old, p = .02 and p = .02). CONCLUSIONS Cannabis-related adolescent hospitalizations at children's hospitals are increasing, with a disproportionate increase postlegalization in states with NMCLs. Interventions are warranted to increase cannabis use identification and treatment among at-risk adolescents in the hospital-based setting.
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Affiliation(s)
- Abbey R Masonbrink
- Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
| | - Troy Richardson
- Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Department of Pediatrics, Children's Hospital Association, Lenexa, Kansas
| | - Matt Hall
- Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Department of Pediatrics, Children's Hospital Association, Lenexa, Kansas
| | - Delwyn Catley
- Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Karen Wilson
- Department of Pediatrics, Mount Sinai Health System and Kravis Children's Hospital, New York, New York
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Nyongesa MK, Mwangi P, Kinuthia M, Hassan AS, Koot HM, Cuijpers P, Newton CRJC, Abubakar A. Alcohol and illicit drug use among young people living with HIV compared to their uninfected peers from the Kenyan coast: prevalence and risk indicators. Subst Abuse Treat Prev Policy 2021; 16:86. [PMID: 34819121 PMCID: PMC8613997 DOI: 10.1186/s13011-021-00422-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa, there is paucity of research on substance use patterns among young people living with HIV (YLWH). To address the gap, we sought to: i) determine the prevalence of substance use, specifically alcohol and illicit drug use, among YLWH compared to their HIV-uninfected peers; ii) investigate the independent association between young people's HIV infection status and substance use; iii) investigate the risk indicators for substance use among these young people. METHODS Between November 2018 and September 2019, a cross-sectional study was conducted at the Kenyan coast recruiting 819 young people aged 18-24 years (407 HIV-positive). Alcohol and drug use disorders identification tests (AUDIT and DUDIT) were administered via audio computer-assisted self-interview alongside other measures. Logistic regression was used to determine substance use risk indicators. RESULTS The point prevalence of current substance use was significantly lower among YLWH than HIV-uninfected youths: current alcohol use, 13% vs. 24%, p < 0.01; current illicit drug use, 7% vs. 15%, p < 0.01; current alcohol and illicit drug use comorbidity, 4 vs. 11%, p < 0.01. Past-year prevalence estimates for hazardous substance use were generally low among young people in this setting (< 10%) with no significant group differences observed. Being HIV-positive independently predicted lower odds of current substance use, but not hazardous substance use. There was overlap of some risk indicators for current substance use between young people with and without HIV including male sex, khat use and an experience of multiple negative life events, but risk indicators unique to either group were also identified. Among YLWH, none of the HIV-related factors was significantly associated with current substance use. CONCLUSIONS At the Kenyan coast, substance use is a reality among young people. The frequency of use generally appears to be low among YLWH compared to the HIV-uninfected peers. Substance use prevention initiatives targeting young people, regardless of HIV infection status, are warranted in this setting to avert their potential risk for developing substance use disorders, including dependence. The multifaceted intrapersonal and interpersonal factors that place young people at risk of substance use need to be addressed as part of the substance use awareness and prevention initiatives.
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Affiliation(s)
- Moses K Nyongesa
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Box 230, Kilifi, Kenya.
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | - Paul Mwangi
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Box 230, Kilifi, Kenya
| | - Michael Kinuthia
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Box 230, Kilifi, Kenya
| | - Amin S Hassan
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Box 230, Kilifi, Kenya
| | - Hans M Koot
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Charles R J C Newton
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Box 230, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), Box 230, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
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48
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Effects of Brief Interventions on Internalizing Symptoms and Substance Use in Youth: A Systematic Review. Clin Child Fam Psychol Rev 2021; 25:339-355. [PMID: 34731373 DOI: 10.1007/s10567-021-00372-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 10/19/2022]
Abstract
Internalizing problems (e.g., depression, anxiety) and substance use are common among young people and often co-occur. However, youths face myriad barriers to access needed treatment, and existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than both simultaneously. Brief interventions that target both problems may, therefore, be an efficient and accessible resource for alleviating youth difficulties; however, this possibility has been insufficiently evaluated. This systematic review evaluated the intervention characteristics and quality of six studies spanning 2015 to 2019 that examined intervention effects on internalizing and substance use outcomes. Based on independent calculations and author reports (respectively), 3-4 interventions significantly reduced youth internalizing symptoms; 3-5 reduced youth substance use; and 2-3 reduced symptoms in both domains. All six interventions identified substance use as a primary target. Four interventions were administered by interventionists to youths in inpatient, outpatient, primary care, or school settings. The remaining two studies delivered content through voicemail messages or an online design. Interventions ranged from ~ 15 to 240 min. Results highlight the sparsity and heterogeneity of youth-focused brief interventions that have evaluated program effects on both internalizing problems and substance use outcomes, suggesting a clear need for integrated supports that are also designed for accessibility. Future investigations of brief youth-focused interventions should assess program effects on both internalizing and substance use outcomes; examine mechanisms driving the varied efficacy of identified interventions; and create, refine, and test interventions with potential to address co-occurring internalizing problems and substance use in young people.
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49
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Emery NN, Carpenter RW, Meisel SN, Miranda R. Effects of topiramate on the association between affect, cannabis craving, and cannabis use in the daily life of youth during a randomized clinical trial. Psychopharmacology (Berl) 2021; 238:3095-3106. [PMID: 34331080 PMCID: PMC8908944 DOI: 10.1007/s00213-021-05925-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE Topiramate is an anticonvulsant currently under study for treating substance use disorders. Topiramate is thought to reduce substance use by attenuating craving and the rewarding effects of acute substance use through its concurrent GABAergic agonism and glutamatergic antagonism. Importantly, topiramate also impacts mood states central to many models of substance use. Despite this, little previous research has examined whether topiramate attenuates the respective associations of affect and craving with substance use. OBJECTIVES We conducted a secondary analysis of 63 youths that exhibited heavy cannabis use, aged 15-24 years, who were randomized in a double-blinded 6-week clinical trial comparing the effects of topiramate (up to 200 mg/day) and placebo on cannabis use. Ecological momentary assessment data were leveraged to model the role positive affect, negative affect, and craving on use over the 6-week period and whether topiramate attenuated associations between these feeling states and cannabis use. RESULTS Findings showed that craving was positively associated with use at the within-person level, while positive affect was negatively associated with use at the between-person level. Topiramate appears to attenuate the negative association of between-person positive affect (i.e., average) and cannabis use. Specifically, those in the placebo condition exhibited this inverse association between average positive affect and use while those in topiramate condition did not. No other significant affect or affect × medication condition interactions were observed. CONCLUSIONS These findings implicate craving and low positive affect as important risk factors for cannabis use in youth in treatment. Topiramate may attenuate this association for positive affect.
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Affiliation(s)
- Noah N. Emery
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Ryan W. Carpenter
- Department of Psychological Sciences, University of Missouri St. Louis, St. Louis, MO, USA
| | - Samuel N. Meisel
- Center for Alcohol and Addiction Studies, Brown University, Box S121-4, Providence, RI 02912, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University, Box S121-4, Providence, RI, 02912, USA.
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50
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Jackson KM, Marceau K, Colby SM, Barnett NP, Rogers ML, Hayes KL. Trajectories of early alcohol use milestones: Interrelations among initiation and progression. Alcohol Clin Exp Res 2021; 45:2294-2308. [PMID: 34585748 PMCID: PMC8642286 DOI: 10.1111/acer.14723] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Alcohol use shows age-graded patterning, with normative use progressing through characteristic milestones of escalating use or severity. Despite some knowledge about the timing of milestone attainment and sequencing across milestones, there is a gap in our understanding of the earliest stages of use. This study characterizes the timing, sequencing, and speed of progression through milestones beginning with the first sip of alcohol. METHODS Sixth through eighth graders (N = 1023; 52% female; 76% White; M = 12.23 years old) completed web surveys through the end of high school. Participants reported on alcohol experiences including the first sip, full drink, consumption of 3+ drinks/occasion (heavy drinking), being drunk, and experiencing acute consequences, from which milestone age and speed of progression (duration) were calculated. Milestone prevalence, sequencing, and timing were characterized, and associations between age of attainment and speed of progression were examined. We also examined whether milestone timing and progression varied by sex and racial/ethnic group. RESULTS Overall, milestones followed the expected ordering with the exception of heavy drinking (3+ drinks/occasion) and being drunk, which appear to index similar experiences. An earlier age of attainment was associated with an increased likelihood of attaining each of the milestones. In contrast, once a milestone was achieved, there was reduced risk of initiation of subsequent adjacent milestones for individuals with an earlier first sip and full drink, and earlier initiation was associated with a longer duration to subsequent milestones. Girls were more likely to attain all milestones than boys, but there was no sex difference in the age of attainment. In contrast, Hispanic youth reported earlier ages of initiation than White non-Hispanic youth, but the likelihood of attainment did not vary by race/ethnicity. Rapid progression was observed in females but did not vary by race/ethnicity. DISCUSSION Risks associated with early drinking are complex, with little support for normative ordering of milestones beyond the first sip. Although early drinking is associated with an increased risk of subsequent drinking, it does not appear to place the drinker on an accelerated course to heavier use. A nuanced understanding of risks associated with milestone timing may inform intervention efforts.
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Affiliation(s)
- Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Kristine Marceau
- Human Development and Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Nancy P Barnett
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
| | - Michelle L Rogers
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA
| | - Kerri L Hayes
- Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island, USA
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