Elementary school drinking: the role of temperament and learning

Longitudinal test of a developmental model of the transition to early drinking

This article reports on a longitudinal test of a developmental model of early drinking that specifies transactions among personality, learning, and behavior in the risk process. The model was tested on 1,906 children making the transition from elementary school to middle school across 3 time points: the spring of 5th grade, the fall of 6th grade, and the spring of 6th grade. In a transaction that has been referred to as acquired preparedness, individual differences in the trait positive urgency at the end of 5th grade were associated with increases in expectancies for social facilitation from alcohol at the start of 6th grade, which then predicted drinker status at the end of 6th grade. In addition, the alcohol expectancy and drinker status predicted each other reciprocally across time. Multiple factors appear to transact to predict early drinking behavior.

Interactive association of dopamine receptor (DRD4) genotype and ADHD on alcohol expectancies in children

Positive and negative alcohol expectancies (AEs) are beliefs about the consequences of alcohol use (e.g., happy, sad, lazy) and they predict patterns of adolescent and adult alcohol engagement in clinical and nonclinical samples. However, significantly less is known about predictors of AE in children, despite significant variability in AE early in and across development. To identify temporally ordered risk factors that precede AE, we evaluated the independent and interactive association of the functional 7-repeat polymorphism of the dopamine D4 receptor (DRD4) genotype and attention-deficit/hyperactivity disorder (ADHD) with respect to individual differences in positive-social, negative-arousal, sedated/impaired, and wild/crazy AE in school-age children (N = 149) prospectively followed from 6-9 to 8-13 years of age. Controlling for age, sex, and wave, DRD4 7+ carriers reported more wild/crazy AE, but DRD4 was unrelated to the remaining AE domains. ADHD symptoms independently predicted higher negative-arousal, sedated/impaired, and wild/crazy AE, but not positive-social. We also observed a significant interaction in which ADHD symptoms positively predicted wild/crazy AE only in youth with the 7-repeat DRD4 genotype; the same interaction marginally predicted sedated/impaired AE. No interactive effects were observed for the remaining AE domains. These preliminary results suggest that, among DRD4 youth, early ADHD symptoms predict that children will expect alcohol to have wild/crazy effects. We consider these results within a developmental framework to better understand pathways to and from youth alcohol problems.

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.

Self-medication or social learning? A comparison of models to predict early adolescent drinking

The current study examined the effects of social anxiety, depressive symptoms, and alcohol expectancies of social behavior change on alcohol involvement to determine whether the self-medication and/or social learning models predicted drinking behavior in a sample of over 400 eighth grade students. Middle school students completed confidential surveys that assessed current alcohol use and expectancies as well as negative affectivity including social anxiety and depressive symptoms. Consistent with the self-medication hypothesis, depressive symptoms predicted more frequent and heavier alcohol use as well as solitary drinking. The social learning model was supported by a negative association between social anxiety and quantity/frequency of drinking and less drinking at parties, and a positive association between alcohol expectancies and all drinking outcomes. Additionally, social anxiety moderated the association between expectancies and alcohol use. These findings suggest that self-medication and social learning processes may both play a role in predicting early adolescent alcohol use and the contexts in which youths drink.

Friends or foes: social anxiety, peer affiliation, and drinking in middle school

OBJECTIVE

The relation between social anxiety and alcohol consumption suggests aspects of both risk and protection, but most research has focused on late adolescents and emerging adults.

METHOD

We investigated the synergistic impact of social anxiety, a need for affiliation with others, and perceived peer alcohol use on drinking in a sample of more than 1,500 early adolescents from southern California (48% girls). Via school-wide surveys, middle school students completed the Social Anxiety Scale for Children-Revised, a modified version of the Interpersonal Orientation Scale, as well as measures of perceived peer drinking and self-reported lifetime and current drinking.

RESULTS

For socially anxious youths, high levels of perceived peer use in conjunction with high levels of affiliation need was associated with greater alcohol use on average and more frequent episodic drinking. Specific to heavy episodic drinking, the interaction of social anxiety and perceived peer drinking seemed to affect girls and boys differentially. Sex differences emerged for the moderation of social anxiety's influence on drinking initiation by perceived peer influence.

CONCLUSIONS

These findings suggest that alcohol-related risks associated with social anxiety might be gender specific and more important in earlier stages of alcohol use than previously believed.

Affective and personality risk and cognitive mediators of initial adolescent alcohol use

OBJECTIVE

This study examined the role of cognitive factors--such as expectancies regarding the consequences of not drinking and perceptions of peer drinking--in mediating affective and personality-based risk associated with adolescents' decisions to initiate alcohol use.

METHOD

Nondrinking high school students (N = 1,268) completed confidential surveys on adolescent attitudes and behaviors related to substance use in 2 consecutive years. Self-reported alcohol use was assessed in both years, and social anxiety, depression, sensation seeking, expectancies for not drinking, and perceived peer alcohol use were assessed in the second year.

RESULTS

The odds of initiation were considerably lower for students with higher expectancies for not drinking, compared with those with lower expectancies. Odds of initiation rose significantly with each additional perceived peer drink reported. Both cognitive factors mediated the relationships between social anxiety, depression, sensation seeking, and alcohol-use initiation.

CONCLUSIONS

Beliefs regarding the consequences of not drinking and perceived peer drinking play key roles in the relationship between affective and personality styles on adolescent drinking. These cognitive differences may explain varying affective risk profiles for alcohol initiation and use during adolescence, and they can provide tools for prevention efforts.

Middle School Drinking: Who, Where, and When

The goal of this research was to describe the most common drinking situations for young adolescents (N=1171; 46.6% girls), as well as determine predictors of their drinking in the seventh and eighth grades. Middle school students most frequently drank at parties with three to four teens, in their home or at a friend's home, and reported alcohol-related problems including conflicts with friends or parents, memory loss, nausea, and doing things they would not normally do. Differences emerged in predicting higher levels of drinking on the basis of sex, race, grade, positive alcohol expectancies, impulsivity, and peer drinking. These findings suggest both specific and general factors are implicated in drinking for middle school students. Contextual factors, including drinking alone, in public places, and at or near school, are characteristic of the most problematic alcohol involvement in middle school and may have utility in prevention and early intervention.

Risk factors for elementary school drinking: pubertal status, personality, and alcohol expectancies concurrently predict fifth grade alcohol consumption

Little is known about the correlates and potential causes of very early drinking. The authors proposed this risk theory: (a) pubertal onset is associated with increased levels of positive urgency (the tendency to act rashly when experiencing intensely positive mood), negative urgency (the tendency to act rashly when distressed), and sensation seeking; (b) those traits predict increased endorsement of high-risk alcohol expectancies; (c) the expectancies predict drinker status among fifth graders; and (d) the apparent influence of positive urgency, negative urgency, and sensation seeking on drinker status is mediated by alcohol expectancies. The authors conducted a concurrent test of whether the relationships among these variables were consistent with the theory in a sample of 1,843 fifth grade students. In a well-fitting structural model, their hypotheses were supported. Drinker status among fifth graders is not just a function of context and factors external to children: it is predictable from a combination of pubertal status, personality characteristics, and learned alcohol expectancies.

Alcohol expectancies and drinking refusal self-efficacy mediate the association of impulsivity with alcohol misuse

BACKGROUND

Recent work suggests that 2 biologically based traits convey risk for alcohol misuse: reward sensitivity/drive and (rash) impulsiveness. However, the cognitive mechanisms through which these traits convey risk are unclear. This study tested a model predicting that the risk conveyed by reward sensitivity is mediated by a learning bias for the reinforcing outcomes of alcohol consumption (i.e., positive alcohol expectancy). The model also proposed that the risk conveyed by rash impulsiveness (RI) is mediated by drinkers' perceived ability to resist alcohol (i.e., drinking refusal self-efficacy).

METHODS

Study 1 tested the model in a sample of young adults (n = 342). Study 2 tested the model in a sample of treatment-seeking substance abusers (n = 121). All participants completed a battery of personality, cognitive, and alcohol use questionnaires and models were tested using structural equation modeling.

RESULTS

In both studies, the hypothesized model was found to provide a good fit to the data, and a better fit than alternative models. In both young adults and treatment-seeking individuals, positive alcohol expectancy fully mediated the association between reward sensitivity and hazardous alcohol use. For treatment seekers, drinking refusal self-efficacy fully mediated the association between RI and hazardous drinking. However, there was partial mediation in the young adult sample. Furthermore, neither trait was directly associated with the other cognitive mediator.

CONCLUSIONS

The hypothesized model was confirmed on a large sample of young adults and replicated on a sample of treatment-seeking substance abusers. Taken together, these findings shed further light on the mechanisms through which an impulsive temperament may convey risk for alcohol misuse.

The measurement of dispositions to rash action in children

Among adolescents and adults, there appear to be at least four different personality traits that dispose individuals to rash or ill-advised action: sensation seeking, negative urgency, lack of planning, and lack of perseverance. The four are only moderately correlated and they appear to play different roles in dysfunction. It is important to determine whether the traits are present among preadolescents because of their possible influence on subsequent development. The authors developed assessments of the four traits for preadolescent children and found evidence supporting (a) the internal consistency of each trait measure, (b) the convergent and discriminant validity of the four measures using the multitrait, multimethod technique, and (c) the hypothesis that the different traits correlated with different dysfunctional behaviors as predicted by theory. Pending further validation efforts, it appears to be the case that researchers may be able to distinguish among different dispositions to rash action prior to adolescence.

Behavioral inhibition and activation systems: differences in substance use expectancy organization and activation in memory

We used multidimensional scaling to model the semantic network of alcohol and marijuana expectancies (N=897). Preference mapping was used to estimate vectors representing patterns of activation through the network as a function of levels of behavioral inhibition (BIS) and behavioral activation (BAS). Individuals with low BIS combined with high BAS levels exhibited patterns of activation emphasizing behavioral activation similar to heavier drug users in previous research. High BIS, low BAS individuals exhibited activation patterns with greater emphasis on inhibitory expectancies similar to low-level users. Differences in expectancy activation patterns were maintained after controlling for substance use and gender. Individual differences in BIS/BAS are associated with the organization of semantic networks and patterns of activation of expectancies contributing to differences in substance use behavior.

Genetic and non-genetic influences on the development of co-occurring alcohol problem use and internalizing symptomatology in adolescence: a review

AIMS

Alcohol problem use during adolescence has been linked to a variety of adverse consequences, including cigarette and illicit drug use, delinquency, adverse effects on pubertal brain development and increased risk of morbidity and mortality. In addition, heavy alcohol-drinking adolescents are at increased risk of comorbid psychopathology, including internalizing symptomatology (especially depression and anxiety). A range of genetic and non-genetic factors have been implicated in both alcohol problem use as well as internalizing symptomatology. However, to what extent shared risk factors contribute to their comorbidity in adolescence is poorly understood.

DESIGN

We conducted a systematic review on Medline, PsycINFO, Embase and Web of Science to identify epidemiological and molecular genetic studies published between November 1997 and November 2007 that examined risk factors that may be shared in common between alcohol problem use and internalizing symptomatology in adolescence.

FINDINGS

Externalizing disorders, family alcohol problems and stress, as well as the serotonin transporter (5-HTT) S-allele, the monoamine oxidase A (MAOA) low-activity alleles and the dopamine D2 receptor (DDR2) Taq A1 allele have been associated most frequently with both traits. An increasing number of papers are focusing upon the role of gene-gene (epistasis) and gene-environment interactions in the development of comorbid alcohol problem use and internalizing symptomatology.

CONCLUSIONS

Further research in adolescents is warranted; the increasing availability of large longitudinal genetically informative studies will provide the evidence base from which effective prevention and intervention strategies for comorbid alcohol problems and internalizing symptomatology can be developed.

Really underage drinkers: the epidemiology of children's alcohol use in the United States

Little attention has been paid to alcohol use by children aged 12 and younger. The present article summarizes findings on the prevalence of alcohol use from US national and statewide surveys of children in grades 6 and younger based on reports located in searches of the literature and the Internet. Four national surveys and seven statewide surveys of children's alcohol and drug use were located that present rates of lifetime sipping and tasting, lifetime experience of more than a sip, alcohol use in the past year, use in the past month, and use in the past week. Prevalence rates decrease with the level of involvement assessed. Alcohol use increases with age, doubling between grades four and six, with the largest jump in prevalence between grades five and six. At each grade level, boys are more likely to have used alcohol than girls. African-American children are nearly as likely as white and Hispanic children to have used alcohol. Over the past decade or so, the prevalence of both lifetime and current alcohol use has been declining in children. The failure to assess intensity of children's use hampers evaluation of the level of risk experienced by children. There is a need for ongoing nationwide surveillance of alcohol use in this population and for greater education of parents regarding the dangers of introducing children to alcohol use.

Examining personality and alcohol expectancies using functional magnetic resonance imaging (fMRI) with adolescents

OBJECTIVE

Personality and alcohol expectancies have been examined as risk factors for the initiation and maintenance of alcohol use in adolescents and young adults. Differences in processing appetitive stimuli are seen as a mechanism for personality's influence on behavior, and that mechanism predisposes individuals to form more positive expectancies for alcohol. The go/no-go task has been used to show how personality differences influence responding to appetitive stimuli in adolescents and adults, and functional magnetic resonance imaging (fMRI) has been used to examine the relation of go/no-go responding to personality in adult males. However, no study to date has examined the relation between fMRI responding, personality and alcohol expectancies in adolescents.

METHOD

Forty-six adolescents (ages 12-14 years; 61% male) with minimal substance use histories completed measures of neuroticism, extraversion, and alcohol expectancies, and performed a go/no-go task during fMRI acquisition.

RESULTS

Greater blood oxygen level-dependent (BOLD) response to inhibition predicted fewer expectancies of cognitive and motor improvements but more expectancies of cognitive and motor impairment from alcohol. In addition, extraverted youths reported more positive alcohol expectancies. However, BOLD response did not predict neuroticism or extraversion.

CONCLUSIONS

These preliminary results suggest that decreased inhibitory neural processing may contribute to more positive and less negative expectancies, which can eventually lead to problem drinking. Further, extraversion may also yield more positive expectancies and could underlie a vulnerability to disordered alcohol use.