Perceived family support, negative mood regulation expectancies, coping, and adolescent alcohol use: evidence of mediation and moderation effects

An Application of the Stressor-Vulnerability Model of Drinking in College Student Drinkers

Background: The stressor vulnerability model provides theoretical support for conditions under which drinking to cope (DTC) is likely to occur (i.e., decreased adaptive coping, increased positive alcohol expectancies). However, research has only tested this model in a college sample reporting trauma. Generalizability to a non-trauma-specific sample college drinkers would support applications of the model and inferences about coping-related drinking across a broader group of young adults. Objectives: Our sample included 565 college student drinkers (Mage = 20.3 years; SDage = 2.0 years; 77.0% female; 54.2% White) from a large southeastern university. Mediation analyses examined DTC as a mediator between negative affect and alcohol-related outcomes (i.e., drinking quantity, drinking frequency, binge drinking frequency, and alcohol-related consequences). Moderated mediation models tested the influence of tension reduction expectancies and cognitive reappraisal on mediation pathways. Results: Drinking to cope was found to be a full mediator for associations between negative affect and drinking-related outcomes. For associations between negative affect and alcohol-related consequences, DTC was a partial mediator. For all alcohol outcomes, results indicated the mediation between negative affect and outcomes through DTC is strongest for individuals with greater cognitive reappraisal use. Positive alcohol expectancies did not moderate any indirect effects. Conclusions: Although cognitive reappraisal is typically considered an adaptive emotion regulation technique, our results suggest that this may not always be the case with drinking outcomes. Given our findings, further research is needed to discern the conditions wherein cognitive reappraisal may and may not be adaptive. This could be useful in informing interventions to reduce harmful DTC behaviors.

Psychosocial determinants of sleep difficulties in adolescence: the role of perceived support from family, peers, and school in an Italian HBSC sample

The present study explores the concurrent contribution to sleep problems of individual-related, family-related, and school-related factors in adolescence. Gathering from the Italian 2018 Health Behavior in School-Aged Children (HBSC) data collection, we used hierarchical logistic regression on a sample of 3397 adolescents (51% females, Mage = 13.99, SD = 1.62) to explore the contribution to sleep problems of the individual (Model 1: alcohol use, smoking, screen time, physical activity), familial (Model 2: parental communication, parental support), and school-related (Model 3: peer support, schoolmates/students support, teacher support and school pressure) variables. 28.3 percent of adolescents reported having sleep difficulties. Overall, Model 3 significantly improved over Model 2 and Model 1. Data showed that increasing smoking (OR = 1.11; 95% CI: 1.03-1.20) and screen time (OR = 1.05; 95% CI: 1.02-1.08) were associated with sleep difficulties but not alcohol use and physical activity. Also, impaired communication with both parents and increasing parental support (OR = 0.84; 95% CI: 0.78-0.90) were associated with decreased odds of sleep problems. Finally, both increases in school pressure (OR = 1.40; 95% CI: 1.26-1.56) and lack of student support (OR = 1.25; 95% CI: 1.10-1.42) were associated with a higher likelihood of sleep problems, while peer support and teacher support were not.   Conclusion: Our findings highlight the importance of an integrated approach to the study of sleep difficulties in adolescence that includes specific psychosocial contributors such as the quality of parental communication and perceived parental support and considers the quality of the day-to-day relationship with schoolmates and the school level of demands. What is Known: • Adolescents' are at-risk of more significant sleep difficulties, and recent literature highlights the importance of an integrated approach to understanding this phenomenon, including biological, psychosocial, and contextual factors. • The literature lacks findings that consider the concurrent contribution of individual and psychosocial factors to sleep difficulties in adolescence. What is New: • The quality of parental communication and perceived parental support, as expressions of adult figures' emotional and behavioural availability in the adolescent's life, are significant determinants of sleep difficulties. • The quality of day-to-day relationships with schoolmates and the school level of demands contribute to adolescent sleep problems.

The role of substance use coping in linking depression and alcohol use from late adolescence through early adulthood

Although theoretical models highlight the role of coping motivations in promoting co-development of depression and alcohol use, few longitudinal studies have examined such processes across early adulthood. The current study examined the role of coping in the association between depression and alcohol use across late adolescence and early adulthood. A control sample of adolescents (N = 498) from a longitudinal prevention trial completed the Brief Symptom Inventory, Life Events Coping Inventory, and a self-report survey on alcohol use at ages 17, 22, and 23, as well as the Composite International Diagnostic Interview at age 28-30. Path analyses integrated self-report and diagnostic measures. Although gender differences were observed in mean levels of depression, alcohol use, and the use of substances to cope, we did not find gender differences in structural relations across these domains over time. Substance use coping served as an intervening pathway in the association between alcohol use and depression both at the symptom level from age 17 to 23, and in predicting longer term diagnostic outcomes at ages 28-30. Depressive symptoms in early adulthood were indirectly related to major depressive disorder (MDD) through two independent paths, including the stability of depressive symptoms over time, and through the influence of depression on increasing the tendency to use substances to cope with stress. Our results underscore that coping effects provide unique predictive power across developmental transitions, over and above the stability of depressive symptoms and alcohol use, underscoring coping motives as a promising intervention target that may prevent co-occurring depression and substance use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social Support Effects on Neural Stress and Alcohol Reward Responses

Social support (SS), or having people to depend on during times of stress, may offer an emotional and neurological buffer to problem drinking. Specifically, SS may modulate reward and stress-related brain responses to mitigate perceptions of alcohol reward and stress. There is limited evidence, however, on this topic and specifically on brain networks that may modulate SS effects on stress and alcohol reward. Here we present a review of the current literature on this topic as well as data from a large community sample of 115 social drinkers. Findings from a novel fMRI task viewing alcohol cue, stress, and neutral images, in separate blocks, while providing ratings on subjective feelings of alcohol craving, stress, and arousal are included. Lower SS significantly predicted greater alcohol craving during alcohol cue and stress conditions, higher baseline levels of stress, and greater arousal in the alcohol cue, relative to neutral condition. Remarkably, individuals with low SS showed greater reward activation (ventral medial prefrontal cortex (VmPFC) and ventral striatum) during alcohol cue exposure, while those with high SS showed no such activation (p < 0.001, family wise error corrected at 0.05). Furthermore, individuals with lower SS showed greater stress circuit (VmPFC, dorsal striatum, and periaqueductal gray) activation not observed in the high SS groups. Both groups showed increased amygdala activation under stress condition. The findings support the notion that SS is a powerful modulator of stress response and reward motivation. High SS buffers neural and subjective stress responses, while low SS potentiates greater reward seeking with higher alcohol craving and greater brain activation during alcohol cue exposure. Previous research and current results suggest the need to further explore the role of SS in those at risk of developing alcohol use disorder and assess novel prevention strategies to boost SS in at-risk drinkers.

Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis

The COVID-19 pandemic and the quarantine undergone by children in many countries is a stressful situation about which little is known to date. Children and adolescents' behaviors to cope with home confinement may be associated with their emotional welfare. The objectives of this study were: (1) to examine the coping strategies used out by children and adolescents during the COVID-19 health crisis, (2) to analyze the differences in these behaviors in three countries, and (3) to examine the relationship between different coping modalities and adaptation. Participants were 1,480 parents of children aged 3-18 years from three European countries (n _Spain = 431, n _Italy = 712, and n _Portugal = 355). The children's mean age was 9.15 years (SD = 4.27). Parents completed an online survey providing information on symptoms and coping behaviors observed in their children. The most frequent coping strategies were accepting what is happening (58.9%), collaborating with quarantine social activities (e.g., drawings on the windows, supportive applauses) (35.9%), acting as if nothing is happening (35.5%), highlighting the advantages of being at home (35.1%), and not appearing to be worried about what is happening (30.1%). Compared to Italian and Spanish children, Portuguese children used a sense of humor more frequently when their parents talked about the situation. Acting as if nothing was happening, collaborating with social activities, and seeking comfort from others were more likely in Spanish children than in children from the other countries. Compared to Portuguese and Spanish children, Italian children did not seem worried about what was happening. Overall, an emotional-oriented coping style was directly correlated with a greater presence of anxious symptoms, as well as to mood, sleep, behavioral, and cognitive alterations. Task-oriented and avoidance-oriented styles were related to better psychological adaptation (considered a low presence of psychological symptoms). Results also show that unaffected children or children with a lower level of impact were more likely to use strategies based on a positive focus on the situation. This study provides interesting data on the strategies to be promoted by parents to cope with the COVID-19 health crisis in children.

Associations between Family Support and Online Sexual Abuse in Chilean Adolescents: The Mediational Role of Online Risk Behaviors

This study evaluated the association between perceived family support, online risk behaviors, and online sexual abuse. This is a cross-sectional, quantitative study. The participants were 380 Chilean students aged 15 to 17 (M =16.12, SD = 0.59, 49.7% female, 50.3% male) who answered self-report instruments. Females experienced more online sexual abuse; however, males engaged in more online risk behaviors. The results of the regression analysis suggested that online risk behaviors was a predictor for online sexual abuse in both males and females. However, high perceived family support was only a protective factor against online risk behaviors and online sexual abuse for females. In addition, online risk behaviors was found to partially mediate the relationship between perceived family support and online sexual abuse for females only. The results of this study highlight the importance of online risk behaviors in the process of online sexual abuse. Also, the results highlighted the importance of family support as a protective factor against online sexual abuse and online risk behaviors mainly in females. For that reason, we think it is necessary to consider the gender variables in the prevention and intervention programs to face the risk of the internet during the adolescence.

The association of mental disorders with perceived social support, and the role of marital status: results from a national cross-sectional survey

Background

This study investigated whether (i) mental disorders were associated with perceived social support and its subcomponents, (ii) current marital status was related to perceived social support, and (iii) ‘Married’ status influenced the relationship between mental state and perceived social support.

Methods

Data from a cross-sectional national survey comprising 6126 respondents were used. Lifetime diagnosis for five mental disorders was assessed with a structured questionnaire. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support (MSPSS) that provides Global and subscale scores for Significant Other, Family and Friends. Multiple linear regression analyses were conducted to address the research questions with MSPSS score as the dependent variable. Structural equation modeling (SEM) was performed to test mediation by marital status.

Results

All mental disorders included in the study, except alcohol use disorder (AUD), were significantly and negatively associated with Global MSPSS scores. After controlling for sociodemographic factors and chronic physical illness, major depressive disorder (β = - 0.299, 95% CI: -0.484 – -0.113, p = 002) and having any of the five mental disorders (β = - 0.133, 95% CI: -0.254 – -0.012, p = 032) were negatively associated with support from Significant Other, while support from Family and Friends was lower among all disorders, except AUD. Being married was positively associated with perceived social support in people with and without mental disorders. Results of the SEM partially support mediation by mental state - perceived social support relationship by ‘Married’ status.

Conclusion

Having mental disorders was associated with lower perceived social support. Being married has potential to influence this relationship.

Exploring the association between problem drinking and language use on Facebook in young adults

Recent literature suggests that variations in both formal and content aspects of texts shared on social media tend to reflect user-level differences in demographic, psychosocial, and behavioral characteristics. In the present study, we examined associations between language use on Facebook and problematic alcohol use. We collected texts shared on Facebook by a sample of 296 adult social media users (66.9% females; mean age = 28.44 years (SD = 7.38)). Texts were mined using the closed-vocabulary approach based on the Linguistic Inquiry Word Count (LIWC) semantic dictionary, and an open-vocabulary approach performed via Latent Dirichlet Allocation (LDA). Then, we examined associations between emerging textual features and alcohol-drinking scores as assessed using the AUDIT-C questionnaire. As a final aim, we employed the Random Forest machine-learning algorithm to determine and compare the predictive accuracy of closed- and open-vocabulary features over users' AUDIT-C scores. We found use of words about family, school, and positive feelings and emotions to be negatively associated with alcohol use and problematic drinking, while words suggesting interest in sport events, politics and economics, nightlife, and use of coarse language were more frequent among problematic drinkers. Results coming from LIWC and LDA analyses were quite similar, but LDA added information that could not be retrieved only with LIWC analysis. Furthermore, open-vocabulary features outperformed closed-vocabulary features in terms of predictive power over participants’ AUDIT-C scores (r = .46 vs. r = .28, respectively). Emerging relationships between text features and offline behaviors may have important implications for alcohol screening purposes in the online environment.

Intergenerational continuity in alcohol misuse: Maternal alcohol use disorder and the sequelae of maternal and family functioning

Early onset of alcohol use is associated with a host of detrimental outcomes. As such, understanding the complex etiology of early onset alcohol use for prevention purposes is an important goal. Specific environmental stressors within the family (i.e., financial stress, negative parental well-being and negative family climate) heighten the risk of early onset alcohol use; however, the extent to which these factors are set in motion by prior maternal history of alcohol misuse has yet to be investigated. We used prospective, longitudinal data from 385 mother-child dyads to examine the link between a maternal alcohol use disorder and her child's early onset of alcohol use through the sequelae of maternal financial strain, maternal depressive symptoms, maternal excessive alcohol use, and negative family climate. Results indicate that a maternal alcohol use disorder itself, and the confluence of a maternal alcohol use disorder, subsequent financial strain, and depressive symptoms produce a negative family climate. In turn, a negative family climate increases the likelihood of alcohol use by the age of 15 among offspring. Moreover, we demonstrate that the cascade of consequences on maternal and family functioning linking a maternal alcohol use disorder to her child's early onset of alcohol use is proximal in nature, unfolding concurrently rather than in yearly spans of time. We discuss the implications of these findings with respect to the etiology of early onset alcohol use (and extant theoretical models) and prevention programming. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mediation analysis with zero-inflated substance use outcomes: Challenges and recommendations

Mediating mechanisms are important components of substance use research, as many substance use interventions work by targeting mediating variables. One issue that is common in substance use research is the presence of many responses of zero in a count variable that is the primary outcome of interest, such as number of drinks per week or number of substances used in the past month. The goal of this paper is to highlight the unique challenges that substance use researchers face when conducting mediation analysis with a zero-inflated count outcome. In this paper, we first describe the models that are commonly used for zero-inflated count data, and when it is appropriate to use them. We then describe general mediation analysis and summarize the small body of work that has focused on mediation for count and zero-inflated count outcomes. We identify the main issue of computing the mediated effect when outcomes are zero-inflated, namely, that the path leading to the zero-inflated count outcome (or mediator) is modeled in two parts. We then provide two examples of mediation models with different conclusions that have zero-inflated count outcomes using adolescent substance use data and define the issues that arise when assessing mediation for each. Finally, we describe the directions in which we must target future methodological research to create accessible solutions for handling mediation with zero-inflated count data in substance use research.

Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies

Gambling, video gaming, and Internet use are typically included as everyday activities that could potentially become behavioral addictions. There is growing evidence that views non-substance related addictions as coping mechanisms, and considers that attachment styles are likely to play a pivotal role on the development of such addictions, especially on young people. Therefore, the present study aimed to: (1) explore the association between attachment, coping, and behavioral addictions (i.e., gambling disorder, video game addiction, and problematic Internet use); and (2) to analyze the mediating/moderating effect that coping has in the relationship of attachment and these behavioral addictions. A sample consisting of 472 students from secondary education (Mean age = 15.6; SD = 1.33; 51.6% females) was recruited. The findings showed a negative association between attachment and behavioral addictions. Most coping strategies were found to be associated with attachment styles, except for self-critique and emotional avoidance. In particular, problem avoidance was significantly correlated to all behavioral addictions. In addition, self-blame and problem solving were significantly correlated to video game addiction and problematic Internet use. Finally, coping was found to act as a mediator and moderator between attachment and video game addiction and problematic Internet use.

Factors linking suicidal ideation with drinking to cope and alcohol problems in emerging adult college drinkers

There is a well-established association between suicidal behavior and alcohol misuse. However, few studies have applied relevant theory and research findings in the areas of both alcohol and suicidal behavior to aid in the understanding of why these may be linked. The current study examined whether three variables (problem-solving skills, avoidant coping, and negative urgency) suggested by theory and previous findings in both areas of study help to account for the previously found association of suicidal ideation with drinking to cope and alcohol problems. Participants were 381 college women (60.4%) and men (39.6%) between the ages of 18 and 25 who were current drinkers and had a history of (at a minimum) passive suicidal ideation. Structural equation modeling was used to examine hypothesized associations among problem-solving skills, avoidant coping, drinking to cope (DTC), impulsivity in response to negative affect (i.e., negative urgency), severity of suicidal ideation, heavy alcohol use, and alcohol problems. Model results revealed that problem-solving skills deficits, avoidant coping, and negative urgency were each directly or indirectly associated with greater severity of suicidal ideation, DTC, heavy alcohol use, and alcohol problems. The results suggest that the positive association between suicidal ideation and DTC found in this and other studies may be accounted for by shared associations of these variables with problem-solving skills deficits, avoidant coping, and negative urgency. Increasing at-risk students' use of problem-solving skills may aid in reducing avoidance and negative urgency, which in turn may aid in reducing suicidal ideation, DTC, and alcohol misuse. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The event-level impact of one's typical alcohol expectancies, drinking motivations, and use of protective behavioral strategies

INTRODUCTION

Much of the past research on the excessive consumption of alcohol by college students has focused on the interplay of individual factors and typical drinking patterns, but this is not adequate to understand behavior as it occurs. The need to understand drinking at the event-level is critical in order to develop event-level prevention. To this end, this study examined a conceptual model of college students' drinking events in order to determine the potential mediating effect of drinking motives and protective behavioral strategies (PBS) in the relationship between alcohol expectancies and event-level alcohol use and consequences.

METHODS

An existing data set containing information about 2279 college student drinking events were analyzed for this study. Students completed surveys during the administration of a commercial online alcohol course during 2010 and 2011. A theoretical model was analyzed with structural equation modeling.

RESULTS

Both typical use of PBS and drinking motives mediated the relationship between expectancies and event-level alcohol use and problems. Positive expectancies were associated with greater positive motives, greater motives were associated with less use of PBS, and less PBS use was then, in turn, associated with higher event-level intoxication. Lastly, higher intoxication was associated with more serious consequences during the event.

CONCLUSION

This is the first study to simultaneously explore the relationship between these factors and event-level drinking. There is a great need to continue to further explore the dynamic nature of drinking at the event-level to illuminate potential leverage points amendable to change.

Alvanzo AA, Mojtabai R, Pacek LR, Cullen BA, Reboussin BA. Transitions through stages of alcohol involvement: The potential role of mood disorders

INTRODUCTION

Although prior clinical and population-based studies have demonstrated comorbidity between mood and alcohol use disorders (AUD), there is a paucity of research assessing whether mood disorders predict transition across stages of alcohol involvement.

METHOD

Hypothesizing that mood disorders predict transition across sex-specific alcohol involvement stages, we used prospective data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of US adults, which included male (n = 14,564) and female (n = 20,089) participants surveyed in 2001-2 and re-interviewed in 2004-5. Latent class (LCA) and latent transition analyses (LTA) were used to assess patterns of alcohol involvement in the US and the association of lifetime mood disorders at baseline with transition across stages of alcohol involvement during follow-up.

RESULTS

A three-class model of AUD criteria was identified (No problems, Moderate problems and Severe problems) for both sexes. Positive cross-sectional associations between mood disorder and problem classes of alcohol involvement were found among both sexes, as were positive longitudinal associations. Propensity score adjustment mitigated the associations of baseline mood disorder with progressive transition for both sexes. However, among females, baseline mood disorder was consistently associated with reduction in remission from Severe to Moderate alcohol problems (aOR = 0.30, CI = 0.09-0.99, p = .048) over time.

DISCUSSION

Our study provides evidence that mood disorders impact transition through stages of alcohol involvement and are most strongly associated with hindering remission among females. Findings advance our understanding of these comorbid relationships and have clinical implications for ongoing assessment of drinking patterns among individuals with mood disorders.

Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review

In this meta-analytic and narrative review, we examine several overarching issues related to the study of coping, emotion regulation, and internalizing and externalizing symptoms of psychopathology in childhood and adolescence, including the conceptualization and measurement of these constructs. We report a quantitative meta-analysis of 212 studies (N = 80,850 participants) that measured the associations between coping and emotion regulation with symptoms of internalizing and externalizing psychopathology. Within the meta-analysis we address the association of broad domains of coping and emotion regulation (e.g., total coping, emotion regulation), intermediate factors of coping and emotion regulation (e.g., primary control coping, secondary control coping), and specific coping and emotion regulation strategies (e.g., emotional expression, cognitive reappraisal) with internalizing and externalizing symptoms. For cross-sectional studies, which made up the majority of studies included, we examine 3 potential moderators: age, measure quality, and single versus multiple informants. Finally, we separately consider findings from longitudinal studies as these provide stronger tests of the effects. After accounting for publication bias, findings indicate that the broad domain of emotion regulation and adaptive coping and the factors of primary control coping and secondary control coping are related to lower levels of symptoms of psychopathology. Further, the domain of maladaptive coping, the factor of disengagement coping, and the strategies of emotional suppression, avoidance, and denial are related to higher levels of symptoms of psychopathology. Finally, we offer a critique of the current state of the field and outline an agenda for future research. (PsycINFO Database Record

The Role of Positive Expectancies in Risk Behavior

Abstract. Background: Alcohol use and nonsuicidal self-injury (NSSI) appear to share a conceptual overlap in functions (e.g., tension reduction). Alcohol use has been identified as a risk factor for NSSI, and higher rates of alcohol use have been documented among those with NSSI history. Aims: This study examined whether NSSI-related alcohol expectancies affect relations between NSSI and alcohol use. Method: Participants were 367 college students (73% female) asked to complete an online survey about their drinking behavior and lifetime NSSI. Results: NSSI and alcohol use were highly prevalent in this sample: 56% endorsed lifetime NSSI and 74% endorsed current alcohol use. Of note, 43% (n = 147) endorsed both behaviors. Positive NSSI-related alcohol expectancies showed a significant association with lifetime NSSI. In addition, positive NSSI-related alcohol expectancies were associated with more frequent drinking behavior for individuals with a history of NSSI, particularly those who had engaged in two or more methods of lifetime NSSI. Conclusion: Alcohol use and NSSI represent high-risk behaviors commonly employed to regulate unwanted affective states. Interventions targeting substance use and/or NSSI may consider assessing positive NSSI and substance use expectancies, as the presence of these beliefs suggests a higher risk profile.

The Moderating Effect of State Anger on Treatment Outcome in Female Adolescents With PTSD

Trauma experienced in childhood and adolescence negatively affects the development of adaptive regulation of emotions and is associated with greater symptoms of anger. Prior research has suggested that high levels of anger may impede the outcome of treatment in adults with posttraumatic stress disorder (PTSD). The current study investigated whether high levels of anger resulted in poorer treatment outcomes in adolescent girls with PTSD. Participants included 61 female adolescent survivors of sexual abuse or assault who were randomized to either prolonged exposure for adolescents (PE-A) or client-centered therapy (CCT) for traumatized children for 8-14 weekly sessions. Participants were followed for 12 months posttreatment. High levels of state anger at baseline were associated with less improvement in PTSD symptoms in the CCT group than the PE-A group (d = 0.62). The moderating effects of state anger on improvement in PTSD symptoms was significant with emotion regulation difficulties, which may underlie anger symptoms (d = 0.58) in the model. The results of this study suggessted that high state anger was less of an impediment to treatment of PTSD for those receiving PE-A than those receiving less differentiated approaches such as CCT.

A Multilevel Study of Students in Vietnam: Drinking Motives and Drinking Context as Predictors of Alcohol Consumption

BACKGROUND

This study used multi-level analysis to estimate which type of factor explains most of the variance in alcohol consumption of Vietnamese students.

METHODS

Data were collected among 6011 students attending 12 universities/faculties in four provinces in Vietnam. The three most recent drinking occasions were investigated per student, resulting in 12,795 drinking occasions among 4265 drinkers. Students reported on 10 aspects of the drinking context per drinking occasion. A multi-level mixed-effects linear regression model was constructed in which aspects of drinking context composed the first level; the age of students and four drinking motives comprised the second level. The dependent variable was the number of drinks.

RESULTS

Of the aspects of context, drinking duration had the strongest association with alcohol consumption while, at the individual level, coping motive had the strongest association. The drinking context characteristics explained more variance than the individual characteristics in alcohol intake per occasion.

CONCLUSIONS

These findings suggest that, among students in Vietnam, the drinking context explains a larger proportion of the variance in alcohol consumption than the drinking motives. Therefore, measures that reduce the availability of alcohol in specific drinking situations are an essential part of an effective prevention policy.

Direct and indirect effects of alcohol expectancies through drinking motives on alcohol outcomes among students in Vietnam

OBJECTIVE

To investigate whether the links between alcohol expectancies (tension reduction; global positive change; improved cognitive and motor abilities; and change in social behavior) and alcohol outcomes (drinking volume, 6+ drinks, alcohol problems, and symptoms of alcohol dependence) are mediated by drinking motives (social, enhancement, conformity, and coping).

METHOD

A multi-stage sampling strategy was used in four Vietnamese provinces, resulting in a final sample of 4756 students (43.2% females) with mean age 20.6 (SD 1.8) years. Structural equation models, including indirect effects, were estimated for women and men separately.

RESULTS

Overall, there were many cases of full mediation (indirect effects range from -0.006 to 0.083 and p-values from <0.05 to <0.001) and little indication of partial mediation (indirect effects range from -0.009 to 0.025 and p-values from <0.05 to <0.001). In both men and women, coping motives most frequently mediated the influence of expectancies on alcohol outcomes. Among men, enhancement motives and, to a lesser extent, social motives also played a role in mediating the effects of expectancies on alcohol outcomes. Among women, full mediation was found far less often and less consistently.

CONCLUSION

By confirming that, in Vietnam, motives mediate the link between expectancies and drinking behavior, this study supports the cultural robustness of a key assumption of the motivational model (i.e. that drinking motives are more closely associated with alcohol use than expectancies). Enhancement, coping and social motives are most frequently found as mediators among male students whereas coping motive only is most frequently found as a mediator among female students. As most of the effects of expectancies were mediated by motives, drinking motives appear to be a promising factor for interventions.

Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study

INTRODUCTION AND AIMS

Adolescence is a period in which many have an onset of alcohol use, but there is much heterogeneity in the individual development of alcohol use. Further, there is a general increase in depressive symptoms from early to late adolescence, but less is known about how different alcohol habit trajectories are associated with symptoms of depression. The aims of the present study were: to identify trajectories of alcohol consumption and drinking to intoxication during adolescence (age 13-18 years); and examine to what extent the different trajectories of alcohol use were associated with symptoms of depression over the same age span, from early to late adolescence.

METHODS

Data from the Norwegian Longitudinal Health Behaviour Study were employed. Latent class growth analyses were employed to identify different trajectories of both alcohol consumption and drinking to intoxication. The resulting trajectories for each participant were used to estimate the gender-adjusted association between different development of alcohol use and symptoms of depression.

RESULTS

Four trajectories of both alcohol consumption and drinking to intoxication were identified. The trajectories with an early onset of alcohol consumption or drinking to intoxication were associated with higher levels of depressive symptoms compared with late onset or stable low use trajectories.

CONCLUSIONS

The findings from the present study suggest that early onset developmental trajectories of alcohol use are associated with depression. Therefore, broad assessment and interventions targeting both alcohol and depression may be indicated among early onset alcohol users, especially if they report increasing levels of consumption. [Skogen JC, Knudsen AK, Hysing M, Wold B, Sivertsen B. Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study. Drug Alcohol Rev 2016;35:307-316].

Young people in drug treatment in Ireland: their views on substance use aetiology, trajectory, parents' role in substance use and coping skills

OBJECTIVES

The aim of the current study was to gain insight into the process of initiation and progression to problematic use among young people who reach clinically significant levels of substance use requiring treatment.

METHOD

Twenty young people, aged between 15 and 19 years from two different drug treatment centres in Ireland were interviewed regarding their views on their pathway into substance use, their progress to more problematic use, their perception of their parents' role, if any, in their trajectory and their typical coping style before treatment. Content analysis was conducted on the resulting narratives.

RESULTS

The use of substances to cope with life stressors emerged as a prominent theme at initial and problematic stages of use. Multiple maladaptive coping approaches were reported. Both direct and indirect influences from parents in their substance use problem were cited. However, some participants reported that parents had no causal role in their substance use trajectory, in particular regarding mothers.

CONCLUSIONS

The current findings suggest that substance misuse is a multi-determined problem and a number of intervention strategies are suggested to delay onset and related harms associated with adolescent substance use.

Statistical Power of Alternative Structural Models for Comparative Effectiveness Research: Advantages of Modeling Unreliability

The advantages of modeling the unreliability of outcomes when evaluating the comparative effectiveness of health interventions is illustrated. Adding an action-research intervention component to a regular summer job program for youth was expected to help in preventing risk behaviors. A series of simple two-group alternative structural equation models are compared to test the effect of the intervention on one key attitudinal outcome in terms of model fit and statistical power with Monte Carlo simulations. Some models presuming parameters equal across the intervention and comparison groups were underpowered to detect the intervention effect, yet modeling the unreliability of the outcome measure increased their statistical power and helped in the detection of the hypothesized effect. Comparative Effectiveness Research (CER) could benefit from flexible multi-group alternative structural models organized in decision trees, and modeling unreliability of measures can be of tremendous help for both the fit of statistical models to the data and their statistical power.

Self-regulation and alcohol use involvement: a latent class analysis

Although alcohol use can be problematic, research suggests considerable heterogeneity in problems across various drinking classes; particularly among the heaviest drinking groups. Differences in self-regulation may differentiate drinking classes. The current study evaluated differences in emotional and behavioral self-regulation across four empirically derived drinking classes. Participants (n=1895 college students) completed online measures of demographics, alcohol involvement, and self-regulation. Using latent class analysis (LCA), four drinking classes were empirically derived. Moderate drinkers were the largest class (38.1%) followed by light drinkers (37.4%), heavy drinkers (17.8%), and problem drinkers (6.8%). Each class was predicted by self-regulation indicators in the LCA. With the exception of urgency, behavioral self-regulation distinguished primarily between light drinkers and the other three classes. Emotional self-regulation and urgency were not associated with use, but did distinguish among the most problematic class. Specifically, emotional instability and urgency were higher in the problem use class than all other classes. Overall, the findings suggest important differences in behavioral and emotional self-regulation across drinking classes that differentially contribute to use and consequences. Further, the results highlight the importance of examining homogenous subpopulations of drinkers that may differ on indices other than consumption.

Underage drinking: prevalence and risk factors associated with drinking experiences among Argentinean children

The aim of this study was to describe the prevalence and predictors of alcohol drinking behavior in children. Data were obtained from 367 children, aged 8-12 years (M = 10.44 years, SD = 1.21 years; 61.9% female) from the city of Córdoba, Argentina. Several scales were used to assess risk factors, including personality traits, alcohol expectancy (i.e., beliefs about the consequences of using alcohol), and perceived peer alcohol use, for alcohol drinking and alcohol drinking experiences. Hierarchical regression analysis was used to determine the contribution of multiple risk factors to the quantity of alcohol consumed. The results showed that 58% of the children had tasted alcohol, and approximately one-third drank alcohol again after the first drinking experience. Twelve-year-old children had a significantly higher prevalence of tasting and drinking alcohol and a significantly greater frequency and quantity of alcohol consumed than younger children. Eighty percent of the children who liked alcohol during their first drinking experience reported that they drank alcohol again. Among the children who did not like alcohol during their first drinking experience, only 31% drank alcohol again. Underage drinking usually occurred under adult supervision in family settings when parents or other relatives allowed them to drink or were aware of their children's drinking. The hierarchical regression analysis showed that being older and male, having more peers that drink alcohol, having higher levels of extroversion, and having alcohol expectancy for social facilitation increased the risk for greater alcohol use. The final model explained 33% of the total variance.

[Adolescent substance use and family problems]

This study aimed to evaluate the association between substance use (alcohol, tobacco, and illicit drugs) and family problems among 965 adolescents from 50 public schools in two cities in São Paulo State, Brazil, in 2007. The Drug Use Screening Inventory (DUSI) was used for data collection. Use of alcohol, tobacco, and illicit drugs was associated with a negative assessment of the family relationship, lack of monitoring/support, and psychoactive substance use by family members (p < 0.05). Adolescents that reported having used alcohol, tobacco, and illicit drugs had more family problems than those who did not consume any substance (p < 0.001). Adolescents that used alcohol and tobacco (p = 0.028) and illicit drugs (p < 0.001) reported having more family problems than those who used only alcohol. The results highlight the importance of awareness of alcohol and tobacco use by adolescents, since such use was associated with significant family impairments, similar to illicit drug use.

The association between drinking motives and alcohol-related consequences - room for biases and measurement issues?

AIMS

To investigate whether the predominant finding of generalized positive associations between self-rated motives for drinking alcohol and negative consequences of drinking alcohol are influenced by (i) using raw scores of motives that may weight inter-individual response behaviours too strongly, and (ii) predictor-criterion contamination by using consequence items where respondents attribute alcohol use as the cause.

DESIGN

Cross-sectional study within the European School Survey Project on Alcohol and other Drugs (ESPAD).

SETTING

School classes.

PARTICIPANTS

Students, aged 13-16 (n = 5633).

MEASUREMENTS

Raw, rank and mean-variance standardized scores of the Drinking Motives Questionnaire--Revised (DMQ-R); four consequences: serious problems with friends, sexual intercourse regretted the next day, physical fights and troubles with the police, each itemized with attribution ('because of your alcohol use') and without.

FINDINGS

As found previously in the literature, raw scores for all drinking motives had positive associations with negative consequences of drinking, while transformed (rank or Z) scores showed a more specific pattern: external reinforcing motives (social, conformity) had negative and internal reinforcing motives (enhancement, coping) had non-significant or positive associations with negative consequences. Attributed consequences showed stronger associations with motives than non-attributed ones.

CONCLUSION

Standard scoring of the Drinking Motives Questionnaire (Revised) fails to capture motives in a way that permits specific associations with different negative consequences to be identified, whereas use of rank or Z-scores does permit this. Use of attributed consequences overestimates the association with drinking motives.

Suicidal ideation and drinking to cope among college binge drinkers

Suicidality among college students is associated with binge drinking and alcohol-related problems. Consistent with motivational models of alcohol use, drinking to cope (DTC) is a significant intervening variable in the association between suicidal ideation and alcohol use and problems among students. This study examined whether several factors shown to be associated with both suicidal ideation and DTC (i.e., impulsivity, mood regulation expectancies, and coping skills) account for the relationship between these variables, as well as the associations of depression and hopelessness with DTC. Participants were 109 emerging adult (18- to 25-year-old) college students who reported at least one episode of binge drinking during a typical month in the past year. Hierarchical regression analyses revealed that while greater negative urgency and low negative mood regulation expectancies were significantly associated with DTC, suicidal ideation remained significantly associated with DTC, even when controlling for depression. Suicidal ideation showed a stronger association with DTC than either depression or hopelessness both before and after accounting for other variables. These findings suggest that suicidal ideation has a direct association with DTC, and that negative urgency and mood regulation expectancies may be useful treatments targets for reducing alcohol misuse among emerging adult students who experience suicidal ideation.

Measuring college students' motives behind prepartying drinking: development and validation of the prepartying motivations inventory

Drinking motives are vital in identifying risk factors and better understanding alcohol-related outcomes. However, context-specific motivations could provide greater motivational perspective on high-risk context-specific alcohol use behaviors such as prepartying (consuming alcohol prior to attending one's intended destination) than general alcohol motivations. In the current study, students' open-ended responses to reasons for prepartying were collected from a large diverse sample (n=2497), and the most commonly offered reasons were used to create a prepartying motivations inventory (PMI) that was then administered to a different sample (n=1085). A split-half validation procedure was used for the purpose of evaluating the PMI's factor structure. Exploratory and confirmatory factor analyses yielded a final 16-item measure consisting of four distinct, but inter-related, factors: Interpersonal Enhancement, Situational Control, Intimate Pursuit, and Barriers to Consumption. Internal consistency reliability, discriminant validity, and criterion-related validity were empirically demonstrated. Results support the notion that individuals preparty for a variety of reasons that are distinct from general motives. Researchers are encouraged to use the PMI in future research with young adults to provide further understanding of prepartying behavior and its psychosocial correlates.

Human laboratory paradigms in alcohol research

BACKGROUND

Human laboratory studies have a long and rich history in the field of alcoholism. Human laboratory studies have allowed for advances in alcohol research in a variety of ways, including elucidating neurobehavioral mechanisms of risk, identifying phenotypically distinct subtypes of alcohol users, investigating the candidate genes underlying experimental phenotypes for alcoholism, and testing mechanisms of action of alcoholism pharmacotherapies on clinically relevant translational phenotypes, such as persons exhibiting positive-like alcohol effects or alcohol craving. Importantly, the field of human laboratory studies in addiction has progressed rapidly over the past decade and has built upon earlier findings of alcohol's neuropharmacological effects to advancing translational research on alcoholism etiology and treatment.

METHODS AND RESULTS

To that end, the new generation of human laboratory studies has focused on applying new methodologies, further refining alcoholism phenotypes, and translating these findings to studies of alcoholism genetics, medication development, and pharmacogenetics. The combination of experimental laboratory approaches with the recent developments in neuroscience and pharmacology has been particularly fruitful in furthering our understanding of the impact of individual differences in alcoholism risk and in treatment response.

CONCLUSIONS

This review of the literature focuses on human laboratory studies of subjective intoxication, alcohol craving, anxiety, and behavioral economics. Each section discusses opportunities for phenotype refinement under laboratory conditions, as well as its application to translational science of alcoholism. A summary and recommendations for future research are also provided.

Differences in drinking expectancies and motives for regular education and special education high school students with emotional/behavioral disorders

Alcohol expectancies and drinking motives were compared for regular education students (n=159) and students with emotional/behavioral disorders (EBD) receiving special education services (n=51). Differences existed between groups with respect to expected negative social consequences and emotional and physical outcomes associated with drinking. Across groups, drinkers reported more positive alcohol expectancies than non-drinkers, while non-drinkers reported more negative alcohol expectancies than drinkers. Differences also existed between the regular education and EBD students who drank with respect to coping, conformity, and social motives. Accounting for sample sizes differences, the relationship between alcohol use and negative physical effect was stronger for regular education students, while the relationship between alcohol use and conformity motives was stronger for the EBD group.

The relationship between coping strategies, alcohol expectancies, drinking motives and drinking behaviour

Numerous models have been proposed in an attempt to explain both alcohol use and alcohol abuse. Many of these models propose that drinking behaviour is the result of a complex interplay of cognitive and behavioural variables including coping strategies, alcohol expectancies and motives for drinking. However few studies have explored how these elements may work together to predict drinking. The current study proposed a mediational model of alcohol use in which coping strategies are related to alcohol expectancies, which in turn are related to drinking motives. Drinking motives were then viewed as proximal predictors of drinking behaviour. There were 454 participants (55.78% female) who completed self-report questionnaires assessing the above constructs. Approximately half the participants completed the questionnaires online, while the others completed the paper and pencil versions of the same measures. Findings generally supported the hypothesised model. The relationship between avoidant coping and drinking behaviour was mediated by alcohol expectancies of increased confidence and tension reduction, which in turn were related to drinking motives. As expected, drinking motives were positively related to drinking behaviour. Negative expectancies were also directly related to drinking behaviour. The results are discussed in light of cognitive models of drinking, and implications for prevention and early intervention of alcohol-use problems.

Why might adverse childhood experiences lead to underage drinking among US youth? Findings from an emergency department-based qualitative pilot study

Research suggests that adverse childhood experiences (e.g., child abuse, interparental violence) predispose youth to early drinking initiation, but specifics about how and why adolescents progress from these exposures to alcohol use are not well understood. This National Institute on Alcohol Abuse and Alcoholism supported study presents data from semistructured interviews with 22 adolescents who reported both initiating drinking ≤18 years old and ≥2 adverse childhood experiences. Data were collected in 2007 as part of a formative research effort for an emergency department-based intervention to reduce adolescent drinking. Findings suggest that prevention initiatives for youth from challenging environments may need to do more than address conformity and social motivations for underage alcohol initiation. Study limitations are noted and future research is suggested.

Parental alcohol involvement and adolescent alcohol expectancies predict alcohol involvement in male adolescents

Current models of adolescent drinking behavior hypothesize that alcohol expectancies mediate the effects of other proximal and distal risk factors. This longitudinal study tested the hypothesis that the effects of parental alcohol involvement on their children's drinking behavior in mid-adolescence are mediated by the children's alcohol expectancies in early adolescence. A sample of 148 initially 9-11 year old boys and their parents from a high-risk population and a contrast group of community families completed measures of drinking behavior and alcohol expectancies over a 6-year interval. We analyzed data from middle childhood (M age = 10.4 years), early adolescence (M age = 13.5 years), and mid-adolescence (M age = 16.5 years). The sample was restricted only to adolescents who had begun to drink by mid-adolescence. Results from zero-inflated Poisson regression analyses showed that 1) maternal drinking during their children's middle childhood predicted number of drinking days in middle adolescence; 2) negative and positive alcohol expectancies in early adolescence predicted odds of any intoxication in middle adolescence; and 3) paternal alcoholism during their children's middle childhood and adolescents' alcohol expectancies in early adolescence predicted frequency of intoxication in middle adolescence. Contrary to predictions, child alcohol expectancies did not mediate the effects of parental alcohol involvement in this high-risk sample. Different aspects of parental alcohol involvement, along with early adolescent alcohol expectancies, independently predicted adolescent drinking behavior in middle adolescence. Alternative pathways for the influence of maternal and paternal alcohol involvement and implications for expectancy models of adolescent drinking behavior were discussed.

Perceived parental reactions and peer respect as predictors of adolescent cigarette smoking and alcohol use

Cigarette smoking and alcohol use contribute substantially to the global burden of morbidity and premature mortality. Most use begins during adolescence, often with experimentation taking place between 11 and 15 years of age. This study examined the importance of perceived parental reactions to, and peer respect for, cigarette smoking and alcohol use. Particular attention was given to the relative importance of these variables compared with the more widely examined influences of perceived parental and peer support. Our final models explained 44% of the variance in cigarette smoking and 46% in alcohol use. Most of the explained variance in both cigarette smoking and alcohol use was accounted for by only three variables: peer use, perceived parental reaction to use, and perceived respect from peers if using. Our findings indicate that perceived parental reaction to use and peer respect for use may be important contributors to adolescent cigarette smoking and alcohol use.

Adverse events and substance use among female adolescent offenders: effects of coping and family support

This study examined a stress-coping model for substance use among female adolescents (N = 305, 69% African American) involved in the Mississippi juvenile justice system. Participants were interviewed in 2006 , regarding exposure to adverse and traumatic events, and they completed self-administered measures of social support from relatives, coping strategies, and questions on frequency of alcohol and other drug use. Results from nested regression models revealed that stressors are associated with drug, but not alcohol use. The use of supportive kinship ties and religion to cope were protective factors. The implications and limitations of the study are discussed.

Parental history of anxiety and alcohol-use disorders and alcohol expectancies as predictors of alcohol-related problems

OBJECTIVE

Research has consistently identified a family history of alcoholism as a risk factor for alcohol-related problems, and global positive expectancies have been found to moderate this association. High rates of comorbidity between alcohol use and anxiety disorders suggest that a family history of anxiety disorders may also increase risk. Further, expectations of negative reinforcement (e.g., tension reduction) have been found to moderate the influence of anxiety-related traits. The current study sought to extend previous research by examining the influence of parental history of alcoholism, anxiety disorders, and the combination, as predictors of alcohol-related problems. Expectancies of global positive changes and tension reduction were hypothesized to moderate the influence of parental history of alcoholism and anxiety, respectively.

METHOD

Direct interviews with parents assessed their history of alcoholism and anxiety for 144 offspring (ages 18-32; 53.5% male) creating four groups: those with a parental history of alcoholism (27.80%), anxiety (22.20%), both alcoholism and anxiety (33.30%), and no history of psychopathology (16.70%). Established measures assessed the offsprings'alcohol expectancies, alcohol use, and alcohol-related problems.

RESULTS

Although expected interactions between parental alcoholism and global positive expectancies and between parental anxiety and tension-reduction expectancies were not found, global positive expectancies were associated with alcohol-related problems among the group with parental history of both alcoholism and anxiety.

CONCLUSIONS

The results suggest that the relation between parental history of alcoholism and global positive expectancies observed in previous studies may be strongest among individuals with a comorbid parental history of alcohol and anxiety disorders. Incorporating expectancies into interventions targeting individuals with a comorbid parental history of alcohol and anxiety disorders may have utility.

Why My Classmates Drink

A structural equation model was estimated based on a Swiss national sample of 5649 12- to 18-year-olds to test whether individual drinking motives mediate the link between classmates' motives and individual alcohol use. Results showed that the social, enhancement, coping and conformity motives of individual students are associated with the corresponding motive dimension of other students in the class. No direct effect of the four classmates' motives on individual drinking, but an indirect effect via individual motives was observed. It appears that drinking motives within the adolescent social environment exert their influence on drinking by way of shaping individual motives.

Binge-drinking in Britain as a Social and Cultural Phenomenon

Techniques and procedures of Strauss and Corbin's grounded theory were used to develop a conditional matrix on binge-drinking in Britain, reflecting data of 32 participants, aged between 22 and 58. The core category was `binge-drinking as a social and cultural phenomenon'. Results show the value of binge-drinking as an enjoyable way of socializing and counter-balancing the demands of daily hassles and routines. Intervening and contextual factors indicate fluctuations in binge-drinking behaviour and the social and cultural constraints that may operate, such as `no drink-driving', `not when the next day is a work day' and `not on one's own'.

Mood regulation beliefs in depressed psychiatric inpatients: Examining affect, behavior, cognitive, and social strategies

The present study was designed to evaluate patient expectations regarding their ability to manage negative emotional reactions. Strategies for managing negative emotional reactions were classified in terms of a focus on affect regulation, behavioral activation, cognitive restructuring, and social involvement. Depressed psychiatric inpatients (N=137) reported weak expectations regarding their ability to regulate their negative moods (M = 82.37, SD = 16.61). Depression severity was closely related to male patients' expectations regarding their ability to control negative moods through affect regulation (r(44)=- 0.37, P<0.05), behavioral activation (r(44)=- 0.59, P< 0.01), cognitive restructuring (r(44)- 0.50, P<0.01), and social involvement (r(44)=- 0.33, P<0.05). Suicide risk was significantly related to male patients' expectations regarding their ability to control negative moods. Similar results were observed for female patients. Recent suicide attempters, past attempters, and non-suicidal depressed inpatients reported similar mood regulation expectations (F(2,134)=0.46, ns). Therapy may help patients develop confidence in their ability to manage negative emotional reactions. It may be useful to assess patient expectations in order to guide therapy toward specific coping actions that may help them control their negative moods.