Stress-coping and temptation-coping as predictors of adolescent substance use

The Moderating Role of Stress Mindset on the Relationship between Drinking to Cope and Alcohol Consumption among Undergraduate College Student Drinkers

OBJECTIVE

Previous research suggests drinking alcohol to cope with negative affect, including stress, is a risk for increased alcohol consumption and alcohol-related problems. Stress mindset, the individually held belief that stress can lead to either enhancing or debilitating outcomes, has yet to be studied within the context of alcohol use. Studying stress mindset among college students as it relates to alcohol consumption may provide important insight into heavy alcohol use in this population.

METHOD

A sample of 320 undergraduates (Mage = 19.06 (SD = 0.06); 63.44% female; 65.49% White) who endorsed past-year alcohol use completed self-report measures of drinking motives, stress mindset, alcohol consumption, and alcohol-related consequences. Zero-inflated negative binomial regressions were utilized to examine the moderating effect of stress mindset on the relationship between drinking to cope and alcohol consumption.

RESULTS

Stress mindset significantly moderated the relationship between drinking to cope and alcohol consumption (IRR = 0.98, se = 0.01, p < 0.05, CI = 0.96, 1.00), such that the relationship was stronger among those with a debilitating stress mindset compared to those with an enhancing stress mindset. Stress mindset did not significantly moderate the relationship between drinking to cope and alcohol-related consequences.

CONCLUSIONS

Individuals with high drinking to cope scores and who hold a debilitating stress mindset may be at a particular vulnerability for heavy alcohol consumption. The present study furthers our understanding of predictors of alcohol use in a college sample and suggests the importance of future research focused on stress mindset among college student drinkers.

Negative Life Events, Negative Copying Style, and Internet Addiction in Middle School Students: A Large Two-year Follow-up Study

Through a two-year follow-up study among 2,845 middle school students, we examined the impact of baseline negative life events (NLE) on follow-up negative copying style (NCS) and Internet addiction (IA), and the mediation of NCS between NLE and IA. We found that all NLE, NCS, and IA were correlated, and that both NLE and NCS were risk factors for IA. Structural equation modeling (SEM) results showed that NLE were associated with increased NCS (β = 0.17, p < 0.01) and IA (β = 0.16, p < 0.01), that NCS was associated IA ( β = 0.33, p < 0 0.01), and that NCS partially mediated the effect of NLE on IA ( β = 0.17, p < 0.01). This large longitudinal study provided solid empirical evidence that NLE and NCS played important roles in IA among middle school students. Educators and policy makers may adopt corresponding approaches to address IA among this population.

Gender-based differences in abstention and desistance from drug use among American Indian adolescents

Informed by the social control theoretical perspective, this study intends to identify the factors more likely to differentiate American Indian (AI) adolescents who never used illicit drugs (abstainers) and those who used drugs in the past but did not report recent drug usage (desisters) from their peers who reported lifetime and recent drug usage (persisters). This secondary analysis is based on data from a multi-site study conducted between 2009 and 2013. It is based on a gender-balanced sample (N = 3,380) of AI adolescents (50.50% male; Mean age = 14.75; SD = 1.69) representing the major AI languages and cultural groups in the U.S. Half of the AI adolescents reported lifetime drug use (50.40%), 37.50% never used drugs, and 12.10% stopped using drugs. When controlling for the variables included in the analysis, AI boys were significantly more likely than AI girls to desist from drug use. Both boys and girls who never used drugs tended to be younger, were less likely to have delinquent friends and a lower level of self-control, had stronger bonds to school, but lower levels of family attachment, and reported increased parental supervision. Compared to drug users, desisters associated significantly less with delinquent peers. While school attachment, self-control, and parental monitoring did not differentiate female desisters from female drug users, adolescent boys who desisted from drug use were more likely to report higher levels of school attachment and parental monitoring and their level of self-control was less likely to be low.

Classmates' Discrimination Experiences and Adolescent Depressive Symptoms: Evidence From Random Assignment of Students to Classrooms in South Korea

PURPOSE

The purpose of this study is to examine the association between classmates' discrimination experiences and an individual student's depressive symptoms. A set of social-psychological and behavioral variables were considered as potential mechanisms underlying this association.

METHODS

The data came from the Gyeonggi Education Panel Study of seventh graders in South Korea. This study leveraged quasi-experimental variation generated from random assignment of students to classes within schools to address the endogenous school selection problem and account for the unobserved school-level confounders. To formally test for mediation, Sobel tests were conducted and peer attachment, school satisfaction, smoking, and drinking were explored as mechanism variables.

RESULTS

An increase in classmates' discrimination experiences was positively associated with an individual student's depressive symptoms. This association remained statistically significant even after adjusting for personal discrimination experience, a myriad of individual- and class-level covariates, as well as school fixed effects (b = 0.325, p < .05). Classmates' discrimination experiences were also associated with a decline in peer attachment and school satisfaction (b = -0.386, p < .01 and b = -0.399, p < .05, respectively). These psychosocial factors explained about one-third of the association between classmates' discrimination experiences and individual students' depressive symptoms.

DISCUSSION

The findings of this study suggest that exposure to peer-level discrimination experience leads to friend detachment and school dissatisfaction, which in turn increases an individual student's depressive symptoms. This study reaffirms the importance of fostering a more cohesive and nondiscriminatory school environment to promote adolescents' psychological health and well-being.

Anger and substance use in HIV-positive patients with chronic pain

Chronic pain increases the risk of substance use in people living with HIV (PLWH). Depression and anxiety have also been identified as risk factors for substance use among PLWH. Relatedly, other negative mood states, such as anger, may influence chronic pain among PLWH. The current cross-sectional study examined whether the distinct negative mood state of anger is associated with substance use among 187 PLWH who report chronic pain. Using negative binomial regression analyses, we found higher levels of anger were positively associated with alcohol use. Higher levels of anger were inversely associated with benzodiazepine use. No association was found between anger and marijuana use, and there were no significant interactions between anger and pain severity on substance use. Our findings suggest that anger is an independent risk factor for substance use among PLWH and chronic pain. Addressing anger may be useful when adapting behavioral therapies in the treatment of pain among PLWH.

Crystallin Mu in Medial Amygdala Mediates the Effect of Social Experience on Cocaine Seeking in Males but Not in Females

BACKGROUND

Social experiences influence susceptibility to substance use disorder. The adolescent period is associated with the development of social reward and is exceptionally sensitive to disruptions to reward-associated behaviors by social experiences. Social isolation (SI) during adolescence alters anxiety- and reward-related behaviors in adult males, but little is known about females. The medial amygdala (meA) is a likely candidate for the modulation of social influence on drug reward because it regulates social reward, develops during adolescence, and is sensitive to social stress. However, little is known regarding how the meA responds to drugs of abuse.

METHODS

We used adolescent SI coupled with RNA sequencing to better understand the molecular mechanisms underlying meA regulation of social influence on reward.

RESULTS

We show that SI in adolescence, a well-established preclinical model for addiction susceptibility, enhances preference for cocaine in male but not in female mice and alters cocaine-induced protein and transcriptional profiles within the adult meA particularly in males. To determine whether transcriptional mechanisms within the meA are important for these behavioral effects, we manipulated Crym expression, a sex-specific key driver gene identified through differential gene expression and coexpression network analyses, specifically in meA neurons. Overexpression of Crym, but not another key driver that did not meet our sex-specific criteria, recapitulated the behavioral and transcriptional effects of adolescent SI.

CONCLUSIONS

These results show that the meA is essential for modulating the sex-specific effects of social experience on drug reward and establish Crym as a critical mediator of sex-specific behavioral and transcriptional plasticity.

Service Provider Perspectives of Minority Stress among Black, Asian and Minority Ethnic Lesbian, Gay and Bisexual People in the UK

Mental health inequalities among Black, Asian and Minority Ethnic (BAME) people from lesbian, gay and bisexual (LGB) communities persist and remain under-researched. This study is the first in the UK to explore, from the perspective of service providers, minority stress experienced by BAME LGB people. Twenty-three participants were interviewed and data were analyzed using qualitative thematic analysis. Minority stress theory was utilized to inform the analysis, yielding the following themes: (1) Stress induced by conflicting sociocultural norms, (2) interpersonal inhibitors of coming out, (3) and problematic coping. BAME LGB individuals are exposed to stressors due to their intersecting sexual, gender, religious, and cultural identities. Major psychological stressors include stigmatized identity, expectations of a heterosexual marriage, and maladaptive coping strategies. This study sheds light on the potential steps that can be taken to ensure effective coping responses among BAME LGB people.

Sex-Specific Transcriptional Changes in Response to Adolescent Social Stress in the Brain's Reward Circuitry

BACKGROUND

Sex differences in addiction have been described in humans and animal models. A key factor that influences addiction in both males and females is adolescent experience. Adolescence is associated with higher vulnerability to substance use disorders, and male rodents subjected to adolescent social isolation (SI) stress form stronger preferences for drugs of abuse in adulthood. However, little is known about how females respond to SI, and few studies have investigated the transcriptional changes induced by SI in the brain's reward circuitry.

METHODS

We tested the hypothesis that SI alters the transcriptome in a persistent and sex-specific manner in prefrontal cortex, nucleus accumbens, and ventral tegmental area. Mice were isolated or group housed from postnatal day P22 to P42, then group housed until ∼P90. Transcriptome-wide changes were investigated by RNA sequencing after acute or chronic cocaine or saline administration.

RESULTS

We found that SI disrupts sex-specific transcriptional responses to cocaine and reduces sex differences in gene expression across all three brain regions. Furthermore, SI induces gene expression profiles in males that more closely resemble group-housed females, suggesting that SI "feminizes" the male transcriptome. Coexpression analysis reveals that such disruption of sex differences in gene expression alters sex-specific gene networks and identifies potential sex-specific key drivers of these transcriptional changes.

CONCLUSIONS

Together, these data show that SI has region-specific effects on sex-specific transcriptional responses to cocaine and provide a better understanding of reward-associated transcription that differs in males and females.

The Fast Track intervention's impact on behaviors of despair in adolescence and young adulthood

How to mitigate the dramatic increase in the number of self-inflicted deaths from suicide, alcohol-related liver disease, and drug overdose among young adults has become a critical public health question. A promising area of study looks at interventions designed to address risk factors for the behaviors that precede these -often denoted-"deaths of despair." This paper examines whether a childhood intervention can have persistent positive effects by reducing adolescent and young adulthood (age 25) behaviors that precede these deaths, including suicidal ideation, suicide attempts, hazardous drinking, and opioid use. These analyses test the impact and mechanisms of action of Fast Track (FT), a comprehensive childhood intervention designed to decrease aggression and delinquency in at-risk kindergarteners. We find that random assignment to FT significantly decreases the probability of exhibiting any behavior of despair in adolescence and young adulthood. In addition, the intervention decreases the probability of suicidal ideation and hazardous drinking in adolescence and young adulthood as well as opioid use in young adulthood. Additional analyses indicate that FT's improvements to children's interpersonal (e.g., prosocial behavior, authority acceptance), intrapersonal (e.g., emotional recognition and regulation, social problem solving), and academic skills in elementary and middle school partially mediate the intervention effect on adolescent and young adult behaviors of despair and self-destruction. FT's improvements to interpersonal skills emerge as the strongest indirect pathway to reduce these harmful behaviors. This study provides evidence that childhood interventions designed to improve these skills can decrease the behaviors associated with premature mortality.

Gender discrimination and illicit drug use among African American and European American adolescents and emerging adults

Objective: The present study aimed to characterize the association of perceived gender discrimination and illicit drug use among a sample of African American (AA) and European American (EA) adolescent girls and young women. Method: Data were drawn from a high-risk family study of alcohol use disorder of mothers and their offspring (N = 735). Multinomial regressions were used to examine whether experience of offspring and maternal gender discrimination were associated with offspring illicit drug use (cannabis, cocaine, ecstasy, PCP, opiates, hallucinogens, solvents, sedatives, or inhalants). Outcomes included offspring age of drug use initiation (age ≤ 14) and lifetime heavy drug use (≥ 50 times) of 1 or more illicit substances. Interactions between race and offspring gender discrimination were modeled to assess for race differences. Results: Results revealed that gender discrimination was associated with a greater likelihood of offspring early initiation (relative risk ratio [RRR] = 2.57, 95% CI [1.31, 5.03]) versus later initiation (RRR = 1.33, 95% CI [0.80, 2.24]). Offspring gender discrimination was associated with offspring heavy drug use (RRR = 2.09, 95% CI [1.07, 4.06]) and not associated with moderate/light use (RRR = 1.44, 95% CI [0.86, 2.42]), but post hoc tests revealed no significant group differences. Conclusions: Findings suggest that perceived offspring gender discrimination is associated with early drug use initiation. Gender discrimination, particularly at an early age, has a potential to cause harm, including drug use. Implementation of policies that foster environments that eliminate gender bias and discrimination at an early age should be prioritized. Gender-responsive treatment merits consideration by substance use treatment providers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Racial differences in alcohol and tobacco use in adolescence and mid-adulthood in a community-based sample

PURPOSE

Smoking and alcohol use have been posited as possible contributors to racial health disparities, despite higher smoking and alcohol use among non-Hispanic White youth and young adults compared to Blacks. To further investigate this claim, we aim to assess variation in alcohol and cigarette use across two distinct points of the life course.

METHOD

Data are from a subset of 559 (279 male, 280 female) self-identified Black and White participants of the Child Health and Development study. Self-report alcohol and cigarette use were collected between age 15-17 and at mean age 50. Logistic regressions were estimated; supplementary analyses adjusted for maternal age, prenatal smoking, household income, childhood SES, and education.

RESULTS

White participants were more likely to drink regularly (Odds ratio (OR) 2.2; 95%CI 1.2, 4.0) and be intoxicated (OR 2.0; 95%CI  1.2, 3.2) in adolescence compared with Blacks. In mid-adulthood, Whites remained more likely to currently drink (OR  2.3; 95%CI 1.6, 3.4) but among drinkers, less likely to binge drink (OR 0.4; 95%CI  0.2, 0.8). White participants were less likely to smoke in mid-adulthood (OR  0.4; 95%CI  0.3, 0.6), but among smokers, were more likely to smoke ≥ ½ a pack per day (OR 3.4; 95%CI  1.5, 7.8).

CONCLUSIONS

Blacks were less likely to engage in drinking across the life course, but, among drinkers, more likely to binge drink in mid-adulthood. Blacks were more likely to smoke in mid-adulthood, but smoked infrequently compared with Whites. These patterns suggest that a reframing of disparities mechanisms to focus on broader structural and social factors may benefit progress in understanding and ameliorating inequities.

The role of perceived discrimination in substance use trajectories in Hispanic young adults: A longitudinal cohort study from high school through emerging adulthood

PURPOSE

Associations between discrimination and substance use have been identified cross-sectionally in multiple populations including Hispanics. However, there is limited research exploring this phenomenon longitudinally in Hispanic youth over the transition from adolescence through emerging adulthood (EA).

METHODS

Hispanic youth in Southern California (n = 1457) completed surveys over 11 years, from 2006 to 2017, including three high school collection waves and five EA collection waves. Multinomial logistic regression models were used to explore the associations between perceived discrimination during high school and cigarette and marijuana use in both high school and EA, controlling for gender, socioeconomic status, acculturation, and EA discrimination.

RESULTS

Compared with those who never used cigarettes or marijuana in high school and EA, perceived discrimination in high school was a significant predictor of two patterns of use: high school initiators who discontinued use of smoking (RRR = 1.677, 95%CI = 1.292-2.176) and/or marijuana (RRR = 1.464, 95%CI = 1.162-1.844), and high school initiators who continued smoking (RRR = 1.492, 95%CI = 1.196-1.861) and/or marijuana use (RRR = 1.249, 95%CI = 1.052-1.482) into EA. For late initiators who did not use in high school but started in EA, perceived high school discrimination was a significant predictor for cigarette smoking (RRR = 1.193, 95%CI = 1.036-1.373) but not for marijuana use.

CONCLUSIONS

Perceived discrimination during adolescence is associated with substance use trajectories across both adolescence and EA. Culturally tailored prevention programs that provide training in skills to cope with psychosocial stressors could improve Hispanic adolescent health.

African American adolescent substance use: The roles of racial discrimination and peer pressure

Peer pressure to use drugs and alcohol is one of the strongest predictors of adolescent substance use. In addition to this normative adolescent stressor, African American adolescents often also face race-related stress in the form of racial discrimination, which has been linked to maladaptive coping responses such as substance use. The interaction of these stressors may help explain substance using behaviors for African American adolescents. The present study explored the relationship between eighth-grade school-based racial discrimination experiences, peer pressure to use drugs and alcohol, and gender to predict 11th-grade marijuana and alcohol use (N = 610; 49% female). Logistic regression analyses indicated teacher- and peer-perpetrated racial discrimination experiences were related to higher alcohol use. Eighth-grade peer pressure to use drugs moderated the relations between teacher- and peer-perpetrated racial discrimination and 11th-grade marijuana use. Overall, results indicate that school-based racial discrimination increases risk for adolescent substance use, and peer pressure moderates this relation for multiple types of racial discrimination. No moderation by gender was found. The importance of considering race-related stress in conjunction with more general adolescent stress to understand African American adolescent substance use is discussed.

Interpersonal Consequences Predicting Adolescent Substance Use: Examining the Role of Temptation Coping, Motivation, and Impulsivity

Background: Adolescent substance use is highly prevalent and problematic; it has been reported as one of the most pertinent leading health concerns in the United States. The current longitudinal study examined the presence of peer and parental interpersonal relationship consequences (IP) as a motivating factor in activating coping skills to decrease the frequency of adolescent substance use, while further evaluating the role of impulsivity within that process. Objectives: Two main hypotheses were proposed: (1) IP will decrease substance use frequency mediated by increases in motivation and temptation coping; and (2) impulsivity will moderate the link between coping and substance use frequency. Participants included 343 adolescents between the ages of 13-19 (M = 16.23) referred to Project READY, a school-based substance use intervention. Assessments were completed during Sessions 1 and 4 of the intervention. Results: Serial mediation analyses indicated temptation coping, baseline alcohol use, and Time 2 marijuana use were the only statistically significant predictors of Time 2 alcohol use. Temptation coping and baseline marijuana use were the only statistically significant predictors of Time 2 marijuana use. Conclusions: Once adolescents' baseline and concurrent substance use were incorporated into the model, there was no statistical significance of the indirect effects. Results provided a stronger examination of the factors related to long-term substance use among adolescents. Knowing that temptation coping and baseline substance use levels were significant predictors of time 2 substance use independent of interpersonal consequences and motivation to change provides a structural frame and highlights need for early intervention.

Social stress-potentiated methamphetamine seeking

Human studies of substance use disorder show that psychological stress and drug availability interact following rehabilitation, contributing to the high relapse potential. Social stressors trigger particularly strong motivation for drug, but how this affects neuronal function to increase relapse is unknown. Animal models, which allow for the dissection of neural mechanisms, primarily utilize physical stressors to trigger relapse. To recapitulate psychosocial post-rehabilitation challenges in animals, we developed a model of social stress-potentiated methamphetamine (METH) seeking. Rats receive a single social defeat (SD) session after completion of self-administration and extinction of lever pressing. While a reminder of the SD was insufficient to reinstate METH seeking on its own, rats that received a reminder of SD followed by a METH-priming injection displayed potentiated reinstatement over METH-priming alone. Examination of neuronal activation patterns of the METH-primed reinstatement session identified c-Fos-immunoreactivity in the basolateral amygdala (BLA) as correlated with SD score, a measure of defeat latency. Rapidly defeated rats showed potentiated METH-primed reinstatement and elevated BLA c-Fos compared with controls. Conversely, rats that were undefeated during the social stress did not show potentiated METH-primed reinstatement or elevated BLA c-Fos. Interestingly, inactivation of the BLA with baclofen/muscimol prior to the stress reminder and METH-priming generated a potentiation of METH seeking in the undefeated rats, suggesting the BLA may mediate resilience to the stressor. This model provides a tool for the further dissection of neural mechanisms mediating social stress-potentiated relapse and for the development of relapse-reducing therapeutics.

Childhood maltreatment and alcohol use in young adulthood: the role of self-regulation processes

INTRODUCTION

Childhood maltreatment has been linked to later alcohol use and disorders. Few studies have examined the pathways linking child maltreatment to alcohol use during the transition to adulthood. Currently, minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in self-regulation processes are critical factors that mediate the association between childhood maltreatment and risk for alcohol use.

METHOD

Young adults (N = 335; mean age = 21.7), who were recruited from the community, completed self-report measures of childhood maltreatment, different facets of self-regulation processes, and alcohol use. Multiple structural equation modeling (SEM) analyses were performed to specify the roles of two related, but different, self-regulation processes (i.e., behavioral self-control and behavioral dysregulation) in linking child maltreatment to four different patterns of drinking behaviors, including drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. Common risk factors for alcohol use, such as psychological symptoms and peer alcohol use, were also entered into the models.

RESULTS

We found that behavioral dysregulation particularly plays a mediating role in the associations between childhood emotional abuse and problematic alcohol use during young adulthood.

CONCLUSION

The results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have had exposure to childhood maltreatment.

Sociocultural determinants of substance misuse among adult Latinas of Caribbean and South and Central American descent: A longitudinal study of a community-based sample

Few studies have examined the socio-cultural determinants of alcohol and drug misuse trajectories among adult Latinas. To assess the associations between socio-cultural determinants and alcohol and drug misuse, we used a longitudinal design to follow a sample of adult Latina mother-daughter-dyads (N = 267) for ten years, and collected four waves of data. They were adult Latinas of Caribbean, South and Central American descent. Specifically, this study investigated the effects of the following factors: (1) Individual Determinants (e.g., socioeconomic conditions, mental health, and medical status); (2) Cultural Determinants (e.g., acculturation to US culture); (3) Interpersonal Determinants (e.g., interpersonal support, relationship stress, mother-daughter attachment, intimate partner violence); (4) Community Determinants (e.g., neighborhood related stress); and (5) Institutional Determinants (e.g., religious involvement, involvement with the criminal justice system). Using hierarchical modeling, we found that taking prescribed medication on a regular basis for a physical problem, religious involvement, and mother-daughter attachment were negatively associated with drug misuse, while involvement in criminal activity was positively associated with drug misuse. Regarding alcohol misuse, results showed that age at arrival in the United States, number of years in the United States, and religious involvement were negatively associated with alcohol misuse, while involvement in criminal activity was positively associated with alcohol misuse. Based on our findings, explicit implications are provided for culturally relevant interventions.

Relapse prevention

Addiction and related disorders are chronic lapsing and relapsing disorders where the combination of long term pharmacological and psychosocial managements are the mainstay approaches of management. Among the psychosocial interventions, the Relapse Prevention (RP), cognitive-behavioural approach, is a strategy for reducing the likelihood and severity of relapse following the cessation or reduction of problematic behaviours. Here the assessment and management of both the intrapersonal and interpersonal determinants of relapse are undertaken. This article discusses the concepts of relapse prevention, relapse determinants and the specific interventional strategies.

Review of the Relationships Among Psychosocial Stress, Secondhand Smoke, and Perinatal Smoking

OBJECTIVE

To summarize and evaluate the recently published literature in which the relationships among psychosocial stress, smoking, and exposure to secondhand smoke during the perinatal period are examined, and to describe the characteristics and demographics of the samples.

DATA SOURCES

Electronic databases MEDLINE, Academic Search Complete, CINAHL, Psychology and Behavioral Sciences Collection, and PsychINFO. In addition, hand searches of reference lists supplemented the electronic search.

STUDY SELECTION

English language, peer-reviewed studies published between 2010 and 2015 on the relationships of self-reported or perceived stress, smoking, and secondhand smoke exposure during pregnancy and postpartum were included. Twenty-four studies met the inclusion criteria.

DATA EXTRACTION

Data that specified the relationships among smoking, stress, and secondhand smoke exposure during pregnancy and postpartum were extracted from the studies. A table matrix, available as supplemental material, to summarize the literature and sample characteristics and demographics was created.

DATA SYNTHESIS

Evidence from the included studies supported an association between psychosocial stress specific to pregnancy or from other sources and smoking or smoking relapse during pregnancy or in the postpartum period. In the studies in which it was included, exposure to secondhand smoke was cited as a barrier to abstinence.

CONCLUSION

It is probable that women who persistently smoke in pregnancy experience elevated stress. Further research with longitudinal designs and inclusion of secondhand smoke as a variable are needed.

Parental divorce and initiation of alcohol use in early adolescence

Parental divorce/separation is among the most commonly endorsed adverse childhood events. It has been shown to increase subsequent risk of alcohol dependence and problems across adolescence and early adulthood, but its influence on early stages of alcohol involvement has only recently been explored. In the present study, we examined whether time to first full drink was accelerated among youth who experienced parental divorce/separation. To determine specificity of risk, models controlled for perceived stress as well as family history of alcoholism, current parental drinking, and internalizing and externalizing problems. Developmental specificity in terms of timing of both parental divorce and first drink was also examined. Participants were 931 middle-school students (488 girls, 443 boys) who were enrolled in a prospective study on drinking initiation and progression (52% female; 23% non-White, 11% Hispanic). Students indicated whether and at what age they had consumed a full drink of alcohol. Parental divorce/separation was coded from a parent-reported life-events inventory and was grouped based on age experienced (ages 0-5, ages 6-9, age 10+). Cox proportional hazard models showed increased risk for onset of drinking as a function of divorce/separation, even controlling for stress, parental alcohol involvement, and psychopathology. There was no evidence for developmental specificity of the divorce/separation effect based on when it occurred nor in timing of first drink. However, the effect of parental divorce/separation on initiation was magnified at higher levels of parental drinking. Given the rates of parental divorce/separation and its association with increased risk of early drinking, investigation of the mechanisms underlying this link is clearly warranted. (PsycINFO Database Record

Victimization and depressive symptomology in transgender adults: The mediating role of avoidant coping

Victimization and depressive distress symptoms represent serious and interconnected public health problems facing transgender communities. Avoidant coping is hypothesized to temporarily alleviate the stress of victimization, but has potential long-term mental and behavioral health costs, such as increasing the probability of depressive symptoms. A community sample of 412 transgender adults (M age = 32.7, SD = 12.8) completed a one-time survey capturing multiple forms of victimization (i.e., everyday discrimination, bullying, physical assault by family, verbal harassment by family, childhood sexual abuse, intimate partner violence), avoidant coping, and past-week depressive symptomology. Structural equation modeling examined the mediating role of avoidant coping in the association between victimization and depressive symptomology. A latent victimization variable comprised of 6 measures of victimization was positively associated with avoidant coping, which in turn was positively associated with depressive symptoms. Victimization was also positively associated with depressive symptomology both directly and indirectly through avoidant coping. Avoidant coping represents a potentially useful intervention target for clinicians aiming to reduce the mental health sequelae of victimization in this highly stigmatized and vulnerable population. (PsycINFO Database Record

Family Dynamics May Influence an Individual's Substance Use Abstinence Self-Efficacy

BACKGROUND

Previous work on substance use suggests the influence of family dynamics on emotion regulation.

OBJECTIVE

The present study examined the role of family in substance use recovery. It is of importance to examine whether conflict with various family members influences an individual's abstinence self-efficacy.

METHODS

We examined individual abstinence self-efficacy scores and lifetime conflict with mother, father, and siblings in a sample of 200 women who had been justice involved.

RESULTS

We found that conflict with mother was the best predictor of abstinence self-efficacy compared to conflict with father and conflict with siblings. Individuals who indicated having conflict with mother over their lifetime had lower confidence that they could abstain from use in potentially emotionally triggering situations.

CONCLUSIONS/IMPORTANCE

These findings suggest that family dynamics, specifically lifetime conflict with mother, do play a role in an individual's confidence to regulate emotions in high-risk relapse situations without turning to substances. Limitations include using abstinence self-efficacy as a proxy for emotion regulation and not directly measuring emotion regulation. Examining family relationships may be especially important in the treatment of women in recovery from substance use.

The Brief Intervention for School Clinicians (BRISC): A mixed-methods evaluation of feasibility, acceptability, and contextual appropriateness

To maximize impact across the broad spectrum of mental health needs exhibited by youth in school settings, interventions must be designed to be effective, efficient, and demonstrate good fit with the educational context. The current paper reports on the second phase of an iterative development process for a short-term, "Tier 2" intervention for use by school-based mental health providers - the Brief Intervention for School Clinicians (BRISC) - using mixed qualitative and quantitative analyses to evaluate feasibility, acceptability, and appropriateness while emphasizing student experiences. This phase was intended to yield information to drive further protocol refinement and testing across subsequent phases. We describe the rationale for, development of, and formative testing of the BRISC intervention. Results suggest that BRISC may be feasible to deliver, acceptable to students, and appropriate to the school context. In particular, the BRISC process appears to be effective in enhancing student engagement in the intervention and identifying and addressing individualized student needs. These findings and directions for further enhancing BRISC's potential for positive impact highlight how treatment development may benefit from initial, small-scale evaluations focused both on client and implementation outcomes.

Affective Self-Regulation Trajectories During Secondary School Predict Substance Use Among Urban Minority Young Adults

This study explored the relationship between trajectories of affective self-regulation skills during secondary school and young adult substance use in a large multi-ethnic, urban sample (N = 995). During secondary school, participants completed a measure of cognitive and behavioral skills used to control negative, unpleasant emotions or perceived stress. As young adults, participants reported on the frequency and quantity of their alcohol, cigarette, and marijuana use in a telephone interview. Controlling for demographic variables, self-regulation did not significantly change over adolescence, although there was significant variation in participants' rates of growth and decline. Lower seventh grade self-regulation and less steep increases in self-regulation were predictive of higher young adult substance use. Male participants had significantly lower initial self-regulation and higher young adult substance use. The results suggest that interventions that build affective self-regulation skills in adolescence may decrease the risk of young adult substance use.

Parental-adolescent drug use discussions: physiological responses and associated outcomes

PURPOSE

Although talking to youth about drugs is often recommended to parents, we know little about how parents actually discuss drugs with their children in the moment and how parental advice is linked to youth arousal and substance use. This study examined observed parental drug use advice and parenting behaviors during parent-adolescent drug use discussions and associations with adolescent physiological responses and substance use.

METHODS

Fifty-eight 12-17 year olds and their primary caregivers participated in a laboratory session in which parents and youth discussed the topic of alcohol and/or drug use for 10 minutes. This discussion was videotaped and coded for drug use advice (rules against drug use, information on drug use consequences, scenarios or learning advice [discussing drug use scenarios and what the child has learned about drugs]) and general parenting behaviors (parental warmth and/or support, negative and/or critical parenting). Before, during, and after the discussions, adolescents' heart rate, blood pressure (BP), and salivary cortisol levels were assessed.

RESULTS

Parental discussion of scenarios and/or learning was associated with lower adolescent BP responses to the discussions and lower likelihood of substance use. Parental discussion of rules against drug use was associated with higher heart rate and BP responses and greater likelihood of substance use. Criticism and/or negative parenting was associated with higher cortisol responses and greater likelihood of substance use at a trend level.

CONCLUSIONS

Parenting characterized by greater discussion of drug use scenarios and less stating of rules against drug use and criticism may make youth feel more comfortable and be linked to lower substance use.

Coping style and substance use intention and behavior patterns in a cohort of BC adolescents

Adolescence is a developmental period during which young teenagers are particularly susceptible to shifting from well-defined behavioral intentions to abstain from substance use to intentions that include experimentation with substance use and in many cases engagement substance use. Coping mechanisms are often an important determinant of adolescent well-being, and the style of coping adopted by the individual can influence positive or negative health behavior. The goal of this study was to examine how the levels of positive coping style (i.e., engagement) and negative coping style (i.e., disengagement) associated with increased risk for tobacco and marijuana use, and intentions to use among those who have never tried. Higher levels of engagement coping were associated with lower odds of tobacco and marijuana use (AOR=0.96 (95% CI: 0.94-0.98), p<0.001 and AOR=0.95 (95% CI: 0.93-0.97) p<0.001, respectively). Higher levels of disengagement coping were associated with greater odds of tobacco and marijuana use (AOR=1.03 (95% CI: 1.01-1.05), p<0.001 and AOR=1.05 (95% CI: 1.03-1.07), p<0.001, respectively). Engagement coping was also protective against the intention to use tobacco (AOR=0.97 (95% CI: 0.96-0.99), p<0.001) or marijuana (AOR=0.98 (95% CI: 0.96-0.99), p<0.01). These findings suggest that psychoeducational programs supporting the development of engagement oriented coping strategies may contribute not only to reductions in adolescents' use of tobacco and marijuana, but also to reductions in adolescents' intentions to use in the future.

Perceived stress and substance use in methadone-maintained smokers

BACKGROUND

In methadone maintenance treatment programs (MMTPs), 80-90% of participants smoke cigarettes. Patients in MMTPs are at particular risk for life stress, and nicotine, as well as other substances like alcohol, benzodiazepines, cocaine, marijuana, and opiates have been shown to reduce the effects of stress. Use of these addictive substances to cope with stress may precipitate illicit opiate relapse in MMTP patients. In the current study, we examined the relationship between perceived stress and substance abuse.

METHODS

Participants were 315 cigarette smokers recruited from nine MMTPs for a smoking cessation study. Logistic regression was used to evaluate the adjusted association of perceived stress with dichotomous indicators of hazardous alcohol use and recent substance use at baseline.

RESULTS

After controlling for demographic and smoking-related variables, perceived stress was associated positively and significantly with the likelihood of screening positive for hazardous drinking or alcohol-related problems (OR=1.13, 95%CI 1.02; 1.25), with the likelihood of recent cocaine use (OR=1.18, 95%CI 1.02; 1.37), and with the likelihood of recent benzodiazepine use (OR=1.24, 95%CI 1.07).

CONCLUSIONS

Perceived stress may be a marker of patients' risk for illicit substance use, a known risk factor for illicit opiate relapse. These findings indicate that cigarette use might not be sufficient in managing stress and methadone-maintained persons turn to other substances for relief.

[Self-esteem, coping, perceived social support and substance use in young adults with a cannabis dependence disorder]

INTRODUCTION

Self-esteem, coping strategies and perceived social support play a role in the adaptive functioning of the human being: they allow the adjustment of the subject to his/her environment. These dimensions could be protective factors regarding multiple risks associated with adolescent development, and particularly substance use. Thus our objective was twofold: to evaluate self-esteem, coping strategies and perceived social support in adolescents and young adults with a cannabis dependence in comparison with subjects from the general population; to establish the correspondence between these psychological dimensions and the patients' substance use pattern.

METHOD

Data from 43 young patients (36 males; mean age=19.6±3), consulting for their cannabis dependence, and 50 young adults from the general population (39 males; mean age=19.7±3.4) were included. Participants completed the Rosenberg Self-Esteem Inventory, the Social Self-Esteem Inventory of Lawson, the Coping Inventory for Stressful Situation of Endler & Parker, and the Perceived Social Support Questionnaire of Sarason. The MINI was administered to evaluate cannabis abuse or dependence; a semi-structured clinical interview was given to determine psychoactive substance use.

RESULTS

Between-group comparisons (two independent sample t-tests) showed that the patients had significantly lower scores on global (P=0.002) and social (P=0.035) self-esteem, task-oriented coping (P<0.001) and both availability and satisfaction regarding perceived social support (respectively P=0.029 and P<0.001). Conversely, patients had significantly higher scores on emotion-focused coping subscale (P=0.003). Logistic regressions showed that the satisfaction regarding social support and task-oriented coping scores were the more powerful to distinguish the patients from the controls (respectively β=1.16, P=0.043 and β=1.06, P=0.015). Unvaried linear regression analyses revealed a negative association between the age of first cannabis use and the avoidant-social coping score (P=0.025), and positive associations between the length of daily cannabis use and emotion-focused coping score (P=0.028), and frequency of cannabis use and global self-esteem scores (P=0.028). Moreover, polysubstance misuse is associated with low distraction-avoidant coping scores. No association was found between clinical scores and tobacco and alcohol uses variables.

CONCLUSION

These results suggest that cannabis dependent patients may present a lack in individual and interpersonal resources. This clinical study underscores the potential contribution of maladaptive coping to the development or maintenance of substance use in young adulthood.

Discrimination, drugs, and alcohol among Latina/os in Brooklyn, New York: differences by gender

BACKGROUND

Based on a stress-coping framework, the present study investigates the relationship between discrimination and substance use, and the moderating effects of gender.

METHODS

This cross-sectional study analyzes data from Latina/o young adults aged 18-25 (N = 401) from Brooklyn, New York. Multinomial logistic regression was used to test the association between discrimination and substance use.

RESULTS

Discrimination was significantly associated with increased odds of substance use adjusting for covariates (e.g. age, education). Gender was a moderator. Discrimination was associated with increased risk of alcohol/cannabis and hard drug use among young Latina women. However, discrimination was associated with decreased risk of alcohol/cannabis use and increased risk of hard drug use among young Latino men.

CONCLUSION

These findings suggest that discrimination is generally associated with risk for substance use, but further that the outcomes vary by gender. Future research should explore gender-specific dimensions of discrimination and their associations with other outcomes.

Mechanisms of Association Between Paternal Alcoholism and Abuse of Alcohol and Other Illicit Drugs Among Adolescents

The current study examines the effect of paternal alcohol problems on adolescent use of alcohol and other illicit drugs as a function of maternal communication, as well as adolescent social and coping skills (N = 145). Structural equation modeling (SEM) analyses indicated that adolescents with a paternal history of alcohol problems reported higher levels of problematic communication with their mothers than did adolescents with fathers who were light drinkers or who were non-drinkers. Moreover, problematic maternal communication functioned as a partial mediator for both adolescent negative social skills and self-blame coping skills. Adolescents who reported using self-blame coping skills more frequently also tended to use alcohol more frequently. Findings suggest that these high-risk adolescents might need more intensive and targeted social and psychological services in their schools and communities.

Life Stress, Coping and Comorbid Youth: An Examination of the Stress-Vulnerability Model for Substance Relapse

The stress-vulnerability model of addiction relapse states that the impact of life stress on alcohol and other drug use is influenced by several types of psychosocial risk and protective factors. Coping skills have been shown to be protective against alcohol or other drug use in adolescents and adults. To date, the influence of life stress and coping on addiction relapse has not been investigated among substance use disordered youth with comorbid Axis I psychopathology. In the present study, 80 adolescents, ages 13 to 17, were followed six months after treatment for substance use and Axis I disorders. Participants completed measures of psychopathology, substance use, life stressors and coping during treatment and at three and six months following treatment. Coping ability best predicted youth substance use at six months. Negative life events moderated the relation between coping and frequency of substance use. These results suggest that coping is a protective factor for return to substance involvement post-treatment, particularly for comorbid youth who have experienced high levels of life stress.

Does avoidant coping influence young adults' smoking?: a ten-year longitudinal study

INTRODUCTION

Young adults who avoid their emotions may be at risk for starting smoking or not quitting smoking. This study investigated whether a preliminary measure of avoidant coping longitudinally predicts young adults' smoking escalation and cessation.

METHODS

In a sample of the 3,305 participants, originally from Washington State, a preliminary measure of self-reported avoidant coping at age 18 was used to predict both smoking escalation and cessation at ages 20 and 28 with both probability and logistic regression models (10-year retention: 98.5%).

RESULTS

Individuals who scored high on avoidant coping at 18 were 2.52 (p = .001) times more likely to acquire smoking by 20. However, there was no evidence that avoidant coping at age 18 predicted smoking escalation at 28 or cessation for 20- and 28-year-olds.

CONCLUSIONS

An avoidant coping style may have a short-term effect on young adults' smoking acquisition. Future research using a precise and well-validated measure of avoidant coping is now needed to test this possibility.

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.

Correlates of heavy drinking behaviors of Latino mothers and their adult daughters

This study explored associations between adult Latina heavy drinking behaviors and potential psychosocial and demographic correlates. It used mother-daughter dyads and a cross-sectional design. Data were drawn from a community-based sample of 158 dyads of adult Latinas (n=316), age 18 years or older, recruited between 2004 and 2006. Bivariate and multivariate statistical methods, including logistic regression and pathway models, were used to analyze data. The study found that protective factors for heavy drinking behaviors for the mother included daughter's social support and mother's age, while for the daughter, they were mother's attachment and daughter's country of birth. Risk factors for daughter's heavy drinking behaviors were mother's social support and daughter's education. For both mother and daughter, chronic stress and drinking behavior associations were mediated by attachment and social support. Preventive interventions should target increasing levels of mother-daughter attachment and daughter's social support while decreasing stress levels for mothers and daughters.

Written emotional expression during recovery from cocaine dependence: group and individual differences in craving intensity

We conducted a prospective, single-blind, parallel group, controlled trial to evaluate effects of written emotional expression in patients receiving intensive treatment for cocaine dependence in a residential-unit setting. Randomization to the emotional expression treatment produced changes in blood pressure and mood during writing sessions, possibly because of its ability to stimulate active coping behavior. At an initial follow-up visit, patients that had received written emotional expression reported lower values for craving intensity and were less likely to self-report use of cocaine. These results may indicate a therapeutic effect of written emotional expression during recovery from cocaine dependence.

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.

Childhood maltreatment, perceived stress, and stress-related coping in recently abstinent cocaine dependent adults

The authors examined associations between a personal history of childhood maltreatment and the perceived stress and stress-coping styles of recently abstinent and treatment-engaged cocaine dependent adults. Fifty men and 41 women at an inpatient treatment and research facility were administered the short form of the Childhood Trauma Questionnaire (D. P. Bernstein & L. Fink, 1998; D. P. Bernstein et al., 2003), the Perceived Stress Scale (S. Cohen, T. Kamarck, & R. Mermelstein, 1983), and the COPE Questionnaire (C. S. Carver, M. R. Scheier, & J. K. Weintraub, 1989). Simple and multiple linear regression analyses were used to analyze relationships while adjusting for relevant covariates. Findings indicate that overall childhood maltreatment severity was significantly associated with greater perceived stress and greater use of avoidance stress-coping strategies. These findings suggest that having a history of childhood maltreatment may influence how recently abstinent cocaine dependent individuals experience and cope with stress. Stress and stress-coping focused interventions may be particularly indicated for cocaine dependent individuals with histories of childhood maltreatment.