Growth trajectories of alcohol information processing and associations with escalation of drinking in early adolescence

Social influences on alcohol outcome expectancy development from childhood to young adulthood: A narrative review

Purpose of Review

Alcohol outcome expectancies emerge in early childhood, develop throughout adolescence, and predict alcohol outcomes well into adulthood. Social factors shape how expectancies are learned in myriad ways, yet such social learning influences seldom are examined in the context of developmental factors. This review summarized literature on the social origins of alcohol expectancies through vicarious (observational) and experiential (direct) alcohol-related learning from childhood to young adulthood within a social learning framework.

Recent Findings

Young children primarily endorse negative expectancies, which decline rapidly with age amidst escalations in positive expectancies across adolescence. Parents and peers can contribute to vicarious learning about alcohol and facilitate experiential learning in different ways and to varying degrees across development. Media and social media, which children are increasingly exposed to as they mature, often depict alcohol-outcome relations that may further contribute to expectancy development in later adolescence and young adulthood.

Summary

Social influences on alcohol expectancy learning are complex and change over time, although this dynamic complexity typically is not depicted in extant literature. Developmentally-informed research capturing co-occurring shifts in social influences and alcohol expectancies is needed.

Sociocultural influences on alcohol expectancies in early adolescence: Findings from the ABCD study

OBJECTIVE

Alcohol expectancies (AE) during early adolescence predict early alcohol use initiation and problem drinking both cross-sectionally and prospectively well into adulthood. Yet, our understanding of the sociocultural factors associated with AE during this development period remains limited. This study examines associations between AE and sociocultural factors across various domains (i.e., individual, family, peer, school, community, and culture) in a demographically diverse sample of 10- to 14-year-old youth in the Adolescent Brain Cognitive Development Study (ABCD Study).

METHOD

This cross-sectional study used 2-year follow-up data from the ABCD Release 3.0 for N = 5,322 early adolescents (Mage = 12 years [SD = 0.6]; 47% male). Approximately 60% identified as non-Hispanic/Latinx White, 17% as Hispanic/Latinx, 11% as non-Hispanic/Latinx Black, 2% as non-Hispanic/Latinx Asian, and 11% as mixed/other race-ethnicity. Separate models for positive and negative AE outcomes were conducted using linear mixed-effect models while controlling for demographic covariates.

RESULTS

Positive AE were most strongly associated with familism, followed by other peer, school, community, and cultural level factors. Negative AE were most strongly associated with the peer-level factor of relational victimization and the individual-level factor of negative life events, followed by other peer, school, and community-level factors.

CONCLUSION

The present findings reveal the potential constellation of sociocultural factors that may serve as targets for modifying AE during the middle school years. Study results also underscore the need for future research that integrates cultural factors into our understanding of alcohol use risk and resilience during early adolescence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effect of parental alcohol use on alcohol use disorder in young adulthood: Exploring the mediating roles of adolescent alcohol expectancies and consumption

INTRODUCTION

Parental alcohol use and problems are risk factors for alcohol use disorder (AUD), and these effects may be mediated by adolescent alcohol expectancies and consumption. In the present study, we tested the direct effects of mothers' and fathers' alcohol consumption on young adult AUD, as well as the indirect effects through adolescent maximum alcohol use, alcohol consumption, and alcohol expectancies.

METHODS

Participants were 5160 individuals (49.1% female) and their biological parents from the Avon Longitudinal Study of Parents and Children, a cohort study of children born in southwestern England during 1991 and 1992. Structural equation modeling (SEM) was used to test associations of mothers' and fathers' alcohol use (assessed when children were 12 years old) with age 24 AUD. Potential mediator variables included the maximum number of alcoholic drinks consumed within a 24-h period by age 13.5 and alcohol expectancies and alcohol consumption at ages 17 and 20.

RESULTS

Higher maternal and paternal alcohol use were associated with higher levels of alcohol consumption at age 17. Greater alcohol consumption, in turn, was related to a more severe presentation of AUD. The overall indirect effects of mothers' (b = 0.033, 95% confidence interval [CI] = 0.006, 0.059) and fathers' drinking (b = 0.041, 95% CI = 0.018, 0.064) on AUD were modest but significant, and were primarily comprised of adolescent alcohol consumption rather than alcohol expectancies.

CONCLUSIONS

Our findings underscore the importance of both mothers' and fathers' drinking for the development of alcohol use and problems across adolescence and young adulthood.

Ambivalence in Adolescents’ Alcohol Expectancies: A Longitudinal Mixed Methods Study Among 12-to-18-Year-Olds

Drawing on the framework of alcohol expectancies and their importance for drinking behaviors, this longitudinal mixed-methods study examined changes and continuities in development of alcohol expectancies during adolescence. Quantitative and qualitative data were prospectively collected at four time points between 2015 and 2020 from nationwide, socio-economic, and gender-balanced samples of Norwegian adolescents aged 12–18. Quantitative data ( n = 3425) were analyzed using linear mixed-effects models, and qualitative data ( nT1 = 118) using thematic analysis. Quantitative and qualitative results were juxtaposed in the discussion. Quantitative results indicated an increase in social facilitation and tension reduction expectancies from age 13 to 18, and a simultaneous decrease in negative emotional expectancies. This development could partly be explained by experience with alcohol use in adolescence. Similarly, qualitative findings showed adolescents’ expectancies of alcohol evolving with age; from one-sided negative expectancies of aggression and harm to increased positive expectancies of fun, sociability, and relaxation. Both analyses showed that negative expectances remained high throughout the study period, but by late adolescence, many participants held positive and negative expectations simultaneously. The qualitative data illustrated how adolescents’ alcohol expectancies became increasingly ambivalent and complex with age, as alcohol use became more common. Prevention strategies aiming to reduce underage alcohol use should acknowledge this complexity.

Disentangling the within- and between-person aspects of implicit alcohol associations on hazardous drinking

Indirect measures have been used to assess the strength of automatically activated, alcohol-related associations and their relation to hazardous drinking. However, little is known about the longitudinal contributions of between-person and within-person components of implicit alcohol associations (IAAs) to college students' hazardous drinking over time. This study examined how within- and between-person variability in three measures of IAA (drinking identity, alcohol approach, and alcohol excite) are related to hazardous drinking while controlling for their explicit, self-report counterparts. First- and second-year U.S. college students (N = 506; 57% female) completed web-based assessments once every 3 months up to eight assessments, which included IAA measures (Implicit Association Tests), explicit counterparts of the IAAs, and self-reported hazardous drinking (alcohol consumption, problems, and risk of alcohol use disorder). Bayesian generalized multilevel models were used to examine between- and within-person associations among IAA, their explicit counterparts, and hazardous drinking. Results showed that between persons, mean levels of all three IAAs were positively associated with hazardous drinking over time. Once their explicit, self-report counterparts were included, however, only drinking identity IAA remained significant. Within persons, increases in drinking identity IAA were associated with increases in subsequent hazardous drinking risk, even after controlling for its explicit counterpart. These results suggest the importance of disentangling and simultaneously investigating between- and within-person processes in IAAs. Although the between-person component of IAAs may play a larger role in the prediction of hazardous drinking, examining the within-person component of IAA, at least for drinking identity, also appears to be important. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Pathways of personality and learning risk for addictive behaviors: A systematic review of mediational research on the Acquired Preparedness model

OBJECTIVE

The Acquired Preparedness (AP) model proposes that impulsive personality traits predispose some individuals to learn certain behavior-outcome associations (expectancies), and that these expectancies in turn influence the escalation of risky behaviors. This theory has been applied to the development of behaviors such as drinking, drug use, gambling, and disordered eating. In the current study, we aimed to summarize empirical tests of this model over the 20 years since it was proposed.

METHOD

We used a descriptive approach to summarize tests of mediation across 50 studies involving n=21,715 total participants.

RESULTS

We observed a consistent effect of personality on expectancies (median effect size = .22), of expectancies on behavior (.24), and a small mediated effect (.05) of personality on behavior via expectancies. Impulsive traits that involve positive or negative affect showed the most consistent support for AP, as did positive expectancies. Most studies testing AP focused on alcohol, but research on other behaviors also showed support for AP.

CONCLUSIONS

The literature appears to support a small mediated effect consistent with the AP model. Future research should continue to clarify which AP pathways are most influential in explaining risky behaviors, and supplement correlational research with experimental and quasi-experimental designs.

Depressive Symptoms, Alcohol Beliefs and Heavy Episodic Drinking in Adolescents

Adolescents who engage in heavy episodic drinking (HED—i.e., 5+ drinks on a single occasion) increase risks for psychopathology, alcohol dependence, and similar negative consequences in adulthood. We explored associations among depressive symptoms, positive alcohol beliefs, and progression of heavy episodic drinking (HED) in 3021 German adolescents (M(SD) age at baseline = 12.4 (1.0)) followed for 30 months in 4 waves, using a conditional parallel process linear growth model, with full information maximum likelihood estimation. By wave 4, 40.3% of participants had engaged in HED more than once; 16.4% had done so ≥5 times. Depressive symptoms were indirectly related to baseline values of HED (through positive beliefs and wave 1 drinking frequency and quantity) and to the rate of growth in HED (through positive beliefs and wave 1 quantity). Adolescents with higher levels of depressive symptoms and positive alcohol beliefs drink more frequently and at greater quantities, which is associated with initiating HED at a higher level and escalating HED more rapidly than peers with similar depressive symptoms who lack those beliefs. This suggests that, to the extent that positive alcohol beliefs can be tempered through public health campaigns, education and/or counseling, HED among depressed adolescents might be reduced.

Comprehensive measurement invariance of alcohol outcome expectancies among adolescents using regularized moderated nonlinear factor analysis

Alcohol outcomes expectancies (AOEs) are robust predictors of alcohol initiation and escalation of drinking behavior among adolescents. Although measurement invariance is a prerequisite for inferring valid comparisons of AOEs across groups (e.g., age), empirical evidence is lacking. In a secondary data analysis study, we employed regularized moderated nonlinear factor analysis (MNLFA) to simultaneously test differential item functioning (DIF) across age, sex, race, ethnicity, socioeconomic status (SES), and alcohol initiation for a 22-item, two-factor measure of positive and negative AOEs among adolescents (analytic n = 936 drawn from a parent study of 1023 adolescents). Evidence of DIF was minimal, with no DIF for the negative AOE factor and DIF for only two items of the positive AOE factor. The item "feel grown up" exhibited DIF by age, and the item "feel romantic" exhibited DIF by SES. After accounting for DIF, the positive AOE latent factor mean differed by SES, age, and alcohol initiation, and exhibited lower variability by alcohol initiation. The negative AOE latent factor mean differed by sex and SES, with greater variability by SES and age and lower variability by alcohol initiation. Group-differences findings for age and alcohol initiation are consistent with prior work, and differences by sex and SES are a new contribution to the literature that should prompt additional research to ensure replicability. The present study demonstrates the utility of the MNLFA technique for examining comprehensive measurement invariance, particularly for applied researchers who seek to examine substantive research questions while accounting for any DIF present in the scales used.

Associations between pre-adolescents' cognitive responses to alcohol-related cues, maternal drinking, and direct exposure to alcohol

The current study investigated pre-adolescent children's (N = 140, M_age = 10.11 years, SD = 1.48, 59.5% girls) implicit evaluations of and explicit expectancies about alcohol-related cues as a function of their mothers' drinking behaviors and their exposure to alcohol. Children's implicit evaluative responses were measured using the Affect Misattribution Procedure (AMP), which consisted of trials that depicted pictures of either alcoholic or non-alcoholic beverages, half of which were presented alone (inactive) and half of which were presented with a human interacting with the beverage (active). In addition, children's explicit expectancies, whether they had ever tasted alcohol, and their mothers' alcohol dependency and escape drinking motivations were measured. Results indicated that overall children's implicit evaluations were less positive for alcohol- than for non-alcohol-related cues, and those whose mothers reported higher alcohol dependency evaluated inactive alcohol-related cues more negatively. Moreover, those who had previously tasted alcohol endorsed positive expectancies more than negative expectancies. These findings contribute to our understanding of the processes through which implicit associations are learned in the context of addiction. Understanding cognitive as well as other potential biological and environmental factors that may predict drinking behaviors in youth will aid in the development of more effective evidence-based strategies for the prevention of alcoholism.

Measurement Invariance of the Sex-Related Cannabis Expectancies Scale across Age and Gender

Sex-related cannabis expectancies have been found to be associated with intentions to use cannabis, cannabis use, and sexual behavior. However, the construct of sex-related cannabis expectancies has been adapted from research with limited examination of the scales themselves. We tested (N = 350 adolescents age 13-17; N = 929 young adults age 18-29) measurement invariance of a sex-related cannabis expectancies scale and found the scale invariant between adolescents and emerging adults as well as between genders. But the partial invariance across age groups suggested that one item from the scale contained systematic errors in assessing the age group differences and warrants additional examination. Latent mean difference tests revealed that young people's sex-related cannabis expectancies differ between age groups and genders.

Measuring Gambling Outcome Expectancies in Adolescents: Testing the Psychometric Properties of a Modified Version of the Gambling Expectancy Questionnaire

The Gambling Expectancy Questionnaire (GEQ; Gillespie et al. 2007a) is a 23-item scale assessing three positive outcome expectancies (Enjoyment/Arousal, Money, Self-Enhancement) and two negative outcome expectancies (Over-Involvement, Emotional Impact) related to gambling. It is the most used instrument to assess gambling outcome expectancies in adolescents and it has good psychometric properties. To allow a greater and more useful application of the scale, the present study aimed to modify the GEQ to make it usable with all adolescents, regardless of their gambling behaviour and to verify its psychometric properties. To that aim, the items were modified and the response scale was reduced from a seven-point to a five-point Likert scale. To verify the adequacy of the modified scale, two studies were conducted among Italian adolescents. In the first study (n = 501, 75% males, Mage = 16.74, SD = .88), after having removed four items and relocating another through explorative factor analysis, the original five-factor structure of the scale was confirmed by applying a confirmatory factor analysis. Reliability and validity evidence were also provided. The second study (n = 1894, 61% males, Mage = 15.68, SD = .71) attested its invariance across gambling behaviour status and gender. The modified version of the GEQ (GEQ - MOD) can be profitably used for research and preventive purposes with youth.

[Changes in tobacco and alcoholic beverage consumption among adolescents from Curitiba in the State of Paraná: a longitudinal study]

The scope of this study was to verify alterations in cigarette and alcohol consumption in a sample of adolescents from the state education system of the city of Curitiba in the State of Paraná between 2015 and 2017. It involved a longitudinal prospective cohort study conducted with 799 adolescents (11 to 15 years of age) between 2015 and 2017. The Youth Risk Behavior Surveillance System (YRBS) questionnaire evaluated mild and excessive alcohol and tobacco consumption. Modifications of alcohol and tobacco consumption were evaluated through Generalizable Estimating Equation (GEE) models with Poisson distribution to obtain Incidence Risk Ratios (IRR) with 95% confidence intervals (95%CI). The "time" variable was treated as an independent variable along with other possible predictors (gender, age bracket, nutritional status, socioeconomic level, head of household education, physical activity and screen time). Tobacco consumption (IRR= 1,32, 95%CI = 1,02; 1,71), mild (IRR= 1,32, 95%CI = 1,13; 1,53) and excessive (IRR= 1,21, 95%CI = 1,04; 1,40) alcohol consumption increased between 2015 and 2017. This study indicates that adolescents participating in this research are modifying their behaviors towards a less healthy lifestyle.

Testing the dual process model of adolescent cannabis use with prospective three-way interactions between self-regulation, negative outcome expectancies, and implicit cannabis attitudes

OBJECTIVE

Dual-process models of substance use (Wiers et al., 2007) propose that whether automatic processes (i.e., implicit attitudes) influence use depends on self-regulation, such that an individual is more likely to act in accordance with automatically activated implicit attitudes when there is limited capacity for self-regulation (a two-way interaction). In this model, the relevance of self-regulation likely depends on whether an individual recognizes reasons or the need to inhibit substance use. The current study tested a three-way interaction between implicit cannabis attitudes, self-regulation, and negative expectancies to prospectively predict adolescent cannabis use.

METHOD

A community sample of late adolescents (N = 246; M age = 19.02) were assessed across two annual time points. Negative binomial regressions predicting adolescent cannabis use were estimated to test the proposed interaction using two indictors of self-regulation (effortful control and working memory) above and beyond prior cannabis use and demographic covariates.

RESULTS

There was support for a three-way interaction with effortful control, but not working memory. As hypothesized, implicit cannabis attitudes were positively associated with cannabis use for adolescents with low levels of negative expectancies and low levels of effortful control.

CONCLUSION

Findings suggest expecting negative outcomes of cannabis use is germane to dual process interactions between controlled and automatic processes. How to best operationalize self-regulation is an important consideration for future work.

Drinking frequency matters: links between consumption pattern and implicit/explicit attitudes towards alcohol

RATIONALE

Attitudes towards alcohol constitute a central factor to predict future consumption. Previous studies showed that young adults with risky alcohol consumption present positive implicit and explicit attitudes towards alcohol.

OBJECTIVES

It appears crucial to disentangle the relationship between specific consumption patterns (e.g., binge drinking or moderate daily drinking) and these alcohol-related attitudes.

METHODS

We compared implicit/explicit positive attitudes towards alcohol among 101 university students distributed in 4 groups [control low-drinking participants (CP), daily drinkers (DD), low binge drinkers (LBD), high binge drinkers (HBD)] differing regarding alcohol consumption profile, to explore the impact of consumption characteristics on alcohol-related attitudes. Participants performed a visual version of the Implicit Association Test (evaluating implicit attitudes towards alcohol), followed by self-reported measures of explicit alcohol-related attitudes and expectancies.

RESULTS

HBD and DD (but not LBD) presented stronger implicit positive attitudes towards alcohol than CP. All drinkers explicitly considered alcohol consumption as pleasant, but only DD qualified it as something good.

CONCLUSION

Beyond and above the quantity consumed and the presence of binge drinking habits, consumption frequency appears as a central factor associated with high implicit/explicit positive attitudes towards alcohol in young drinkers. This underlines the need to consider this factor not only in future studies exploring implicit/explicit attitudes but also in the development of prevention and intervention campaigns in youth.

The association between child alcohol sipping and alcohol expectancies in the ABCD study

BACKGROUND

Underage drinking is a serious societal concern, yet relatively little is known about child sipping of alcohol and its relation to beliefs about alcohol. The current study aimed to (1) examine the contexts in which the first sip of alcohol occurs (e.g., type of alcohol, who provided sip, sip offered or taken without permission); (2) examine the association between sipping and alcohol expectancies; and (3) explore how different contexts of sipping are related to alcohol expectancies. We expected to find that children who had sipped alcohol would have increased positive expectancies and reduced negative expectancies compared to children who had never sipped alcohol.

METHODS

Data were derived from the 2.0 release of the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal study of children in the United States. We utilized data from 4,842 children ages 9-11; 52% were male, 60% were White, 19% were Hispanic/Latinx, and 9% were Black/African American.

RESULTS

We found that 22% of the sample had sipped alcohol. Children reported sipping beer most frequently, and the drink most often belonged to the child's father. We found that children who had sipped had higher positive alcohol expectancies than children who had not while accounting for variables related to alcohol expectancies. Child sipping was not significantly associated with negative expectancies and the context of the first sip of alcohol was not significantly associated with positive and negative expectancies.

CONCLUSIONS

Providing sips of alcohol to children is associated with them having more favorable expectations about drinking.

Relevance of Athlete-Specific Psychosocial Factors in High School Student-Athlete Alcohol Consumption

Background: Research suggests that adolescent student-athletes are at heightened risk for alcohol consumption. The identification of unique, modifiable risk factors for alcohol use in this population is needed. Purpose/Objectives: Building on previous work highlighting the importance of each of athlete-specific drinking motives and alcohol expectancies, this study investigated whether athlete-specific psychosocial predictors optimize our ability to predict adolescent athlete alcohol consumption after accounting for general psychosocial predictors. Methods: Participants were 352 current high school student-athletes who completed a self-report questionnaire about their alcohol use attitudes, behaviors, and cognitions. Results: Hierarchical regression revealed that among the total sample, gender, class year, liquid courage/sociability, sexuality, and negative alcohol expectancies, and negative athletic-functioning alcohol expectancies predicted alcohol consumption. Among lifetime drinkers, gender, class year, enhancement motives, conformity motives (negative), negative athlete-functioning alcohol expectancies, and sport-related coping motives predicted alcohol consumption. Conclusions/Importance: Negative athletic-functioning alcohol expectancies and sport-related coping motives emerged as important, athlete-specific predictors of adolescent athlete alcohol use. These factors provide important opportunities for targeted prevention efforts.

The Altered Course of Learning: How Alcohol Outcome Expectancies Are Shaped by First Drinking Experiences

According to expectancy theory, outcome expectancies are first formed vicariously (through observing other people) and then through direct experience. This cohort-sequential longitudinal study explored these expectancy origins in 1,023 youths (52% female, ages 10.5-15.5 years at recruitment, M = 12.47 years, SD = 0.95). Discontinuous multilevel growth models described patterns of change in expectancies before and after the first experience of distinct drinking milestones (i.e., first sip, first full drink, first heavy-drinking situation). Youths' expectations for positive and negative drinking outcomes generally increased and decreased over adolescence, respectively, reflecting general developmental trends. Drinking experiences altered learning trajectories, however, reifying positive expectancies and invalidating negative expectancies at each milestone and altering the course of expectancy change thereafter. For positive outcome expectancies, the influence of direct experience on learning was stronger when drinking milestones were met at an earlier age. Conversely, invalidation of negative expectancies was stronger when the first-drink milestone was met at a later age.

Change in implicit alcohol associations over time: Moderation by drinking history and gender

Implicit measures of alcohol-related associations or implicit alcohol associations are associated with drinking outcomes over time and can be understood as vulnerability markers for problem drinking. Longitudinal research remains rare, leaving open questions about how implicit alcohol associations themselves change over time and what factors moderate that change. We examined these questions with data from a larger study of first and second year U.S. college students. We investigated how these implicit alcohol associations change over time and potential moderators of those changes (gender, lifetime drinking history, family history of problem drinking, and class standing). A sample of 506 students (57% women) completed baseline demographic measures and implicit measures (variants of the Implicit Association Test [IAT]) assessing associations with drinking and the self [drinking identity], alcohol and excite [alcohol-excite], and alcohol and approach [alcohol-approach]). IATs were completed at 3-month intervals for a total of 8 assessments. Results indicated small, but significant, change in alcohol-excite and alcohol-approach IAT scores over time, and mixed findings for hypothesized moderators. Drinking history moderated change in drinking identity IAT scores, with increases over time among individuals with no history of drinking or no history of intoxication and decreases among individuals with a history of intoxication. Gender moderated change in alcohol-excite IAT scores with greater change among women (vs. men). No significant moderators of change in alcohol approach IAT scores were found. Results point to the importance of evaluating implicit associations' trajectories and identifying additional factors that predict those trajectories and concomitant vulnerability to problem drinking.

SPORTS PARTICIPATION ASSOCIATED WITH HEALTH RISK BEHAVIORS IN ADOLESCENT ATHLETES

ABSTRACT Introduction Participation in structured sports activities is essential for the health of adolescents, since adolescence is a period in which several physical, psychological, cognitive and social changes occur, where the sense of autonomy in decision-making may prompt them to adhere to certain health risk behaviors. Objective To verify the association of sports participation with health risk behaviors in adolescent athletes. Methods A cross-sectional study with 367 athletes (15.68 ± 0.78 years) from Curitiba/PR (state of Paraná). Associated factors and health risk behaviors (HRB) were assessed using questionnaires. Poisson regression with robust variance was used to analyze factors associated with HRB, adopting p <0.05. Results Team sport was positively associated with longer TV viewing time (PR: 3.11; 95% CI: 1.13-8.58). Years of participation were positively associated with longer TV viewing (PR: 1.14, 95% CI: 1.01-1.29) and video game playing time (PR: 1.12, 95% CI: 1.01-1.25). Negative associations were found for weekly training volume in longer video game playing time (OR: 0.92, 95% CI: 0.86-0.99), low vegetable consumption (PR: 0.98, 95% CI: 0.96-0.99), and in light (PR: 0.95, 95%CI: 0.92-0.99) and excessive (PR: 0.94, 95%CI: 0.89-0.99) alcoholic consumption. Conclusion The weekly training volume favors a reduction in video game playing time, lower alcohol consumption, and increased vegetable consumption in adolescent athletes. Level of Evidence III; Diagnostic studies - Investigation of a diagnostic test; Study of non-consecutive patients, without a “gold standard” applied uniformly.

Childhood social context in relation to alcohol expectancy through early adolescence: A latent profile approach

BACKGROUND

The present study aims to (i) identify patterns in the changes of endorsed positive alcohol expectancies (AEs) through early adolescence and (ii) examine associated childhood social context predictors of such profiles.

METHODS

We used three waves of longitudinal data from the Alcohol-Related Experiences among Children. The baseline sample comprised 928 6th graders from 17 elementary schools in northern Taiwan (response rate = 60 %); subsequent follow-up was conducted at 7th and 8th grade (follow-up rate = 88 %). Data concerning three domains of positive AEs (i.e., global positive transformation, enhancing social behaviors, and promoting relaxation), social context, and alcohol drinking were collected by self-administered questionnaires. Longitudinal latent profile and survey multinomial logistic regression analyses were used to evaluate the association estimates, stratified by childhood alcohol initiation.

RESULTS

Three distinct profiles (decreasing, stable, and increasing) of positive AEs were identified for the alcohol-naïve children (n = 466); observing paternal drinking and watching TV more than two hours per day at baseline were strongly linked with the stable and increasing AE profiles (aOR = 1.96-4.80). For the alcohol-experienced children, four profiles (low decreasing, low increasing, high decreasing, and high increasing) emerged; observing maternal drinking was predictive for the high-increasing profile (aOR = 2.94). Regardless of childhood alcohol initiation, recent alcohol use appeared to be the strongest predictor for the increasing profiles of positive AEs.

CONCLUSIONS

Strategies addressing pro-alcohol social contexts that facilitate a prominent increase in positive AEs should be considered when devising preventive programs targeting underage drinking behaviors and problems.

Internalizing symptoms and cannabis and alcohol use: Between- and within-person risk pathways with coping motives

OBJECTIVE

To test reciprocal associations among internalizing symptoms (depression and social anxiety), using alcohol and cannabis to cope, and use-related problems.

METHOD

The study utilized a community sample (N = 387, 55% female; majority non-Hispanic Caucasian (83.1%) or African American (9.1%) and a longitudinal design that spanned 17 to 20 years of age, and distinguished within- and between-person associations using latent curve models with structured residuals.

RESULTS

Reciprocal prospective within-person associations were supported for alcohol, such that elevated depression symptoms were associated with increased alcohol coping motivates 1 year later, which, in turn, was associated with subsequent increased depression symptoms. Bidirectional associations were not supported for social anxiety, although high levels of social anxiety were associated with elevated levels of coping drinking 1 year later. Cannabis coping motives were associated with exacerbation of depression, but not social anxiety symptoms, 1 year later. Between- and within-person contemporaneous associations suggested that depression and social anxiety were more strongly associated with coping than social/enhancement motives, and that coping motives were associated with use-related problems.

CONCLUSION

Findings suggest that alcohol coping motivates exacerbate rather than ameliorate depression symptoms, which, in turn, leads to greater reliance on alcohol to cope. There was more consistent support for associations with substance use-related problems for depression than for social anxiety. Both between- and within-person associations may be useful for identifying targets and timing of coping-oriented interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A dual process perspective on advances in cognitive science and alcohol use disorder

There is a tremendous global and national (US) burden associated with alcohol misuse and alcohol use disorder (AUD). Further, of the mental health disorders, AUD has the widest treatment gap. Thus, there is a critical need for improved understanding of the etiology, maintenance, and treatment of AUD. The application of cognitive science to the study of AUD has a longstanding history of attempting to meet this need. In this selective review, we identified and focused on four domains of recent (i.e., in the last decade) applications of cognitive science to the study of AUD: implicit cognitive biases, executive function, behavioral economic approaches to alcohol decision making, and functional connectivity neuroimaging. We highlighted advances within these four domains and considered them in the context of dual process models of addiction, which focus on the contribution and interplay of two complementary neurocognitive systems (impulsive and control systems). Findings across the domains were generally consistent with dual process models. They also suggest the need for further model refinements, including integrating behavioral economic approaches and findings from functional connectivity neuroimaging studies. Research evaluating candidate interventions associated with these domains is emergent but promising, suggesting important directions for future research.

Internalizing and Externalizing Problem Behavior: a Test of a Latent Variable Interaction Predicting a Two-Part Growth Model of Adolescent Substance Use

Externalizing symptoms robustly predict adolescent substance use (SU); however, findings regarding internalizing symptoms have been mixed, suggesting that there may be important moderators of the relationship between internalizing problems and SU. The present study used a longitudinal community sample (N = 387, 55% female, 83% White) to test whether externalizing symptoms moderated the relationship between internalizing symptoms and trajectories of alcohol and marijuana use from early (age 11-12 years old) to late (age 18-19 years old) adolescence. Two-part latent growth models were used to distinguish trajectories of probability of use from trajectories of amount of use among users. Results suggested that externalizing symptoms moderated the association between internalizing symptoms and probability of alcohol, but not marijuana use. The highest probability of alcohol use was observed at high levels of externalizing symptoms and low levels of internalizing symptoms. A negative protective effect of internalizing symptoms on probability of alcohol use was strongest in early adolescence for youth high on externalizing symptoms. Although moderation was not supported for amount of use among users, both domains of symptomology were associated with amount of alcohol and marijuana use as first-order effects. High levels of externalizing symptoms and low levels of internalizing symptoms were associated with high levels of amount of use among users. These findings suggest that developmental models of substance use that incorporate internalizing symptomology should consider the context of externalizing problems and distinguish probability and amount of use.

Alcohol, tobacco, and marijuana expectancies as predictors of substance use initiation in adolescence: A longitudinal examination

Outcome expectancies have been found to be predictive of substance use. While development of expectancies may be dynamic during adolescence, it is unknown whether the rate of change (slope) in substance use expectancies is a risk factor for use onset across multiple substance use domains. The present study tested the hypothesis that the slope of positive and negative alcohol, tobacco, and marijuana use expectancies during mid-adolescence (9th-10th grade) would predict use onset of each respective substance during late adolescence (11th-12th grade). Data from 3,396 ethnically diverse high school students were collected across eight waves of assessment and analyzed within a latent growth modeling framework. Results revealed that the slopes of positive substance use expectancies among never-users of each respective substance predicted increased odds of onset (Alcohol: ORB = 7.73, p < .001; Tobacco: ORB = 5.58, p < .001; Marijuana: ORB = 2.49, p = .001). Only the slope of negative marijuana expectancies predicted increased odds of onset (Marijuana: ORB = .44, p = .04). Baseline level of positive and negative substance use outcome expectancies were also generally found to be associated with onset. For three common drugs used by adolescents, change in substance use expectancies during the first two years of high school may be a marker of risk propensity for substance use onset. Change in expectancies may be an important target in substance use prevention, with research indicating that expectancy challenge and life skills interventions being potentially efficacious. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evaluating Within-Person Change in Implicit Measures of Alcohol Associations: Increases in Alcohol Associations Predict Increases in Drinking Risk and Vice Versa

Aims

Implicit measures of alcohol associations (i.e. measures designed to assess associations that are fast/reflexive/impulsive) have received substantial research attention. Alcohol associations related to the self (drinking identity), the effects of alcohol (alcohol excite) and appetitive inclinations (alcohol approach) have been found to predict drinking cross-sectionally and over time. A critical next step in this line of research and the goal of this study is to evaluate whether increases in the strength of these associations predict increases in drinking and vice versa. These hypotheses were tested in a sample of first- and second-year US university students: a sample selected because this time period is associated with initiation and escalation of drinking, peak levels of alcohol consumption and severe alcohol-related negative consequences.

Short summary

This study's purpose was to evaluate whether increases in the strength of alcohol associations with the self (drinking identity), excitement (alcohol excite) and approach (alcohol approach) as assessed by implicit measures predicted subsequent increases in drinking risk and vice versa using a longitudinal, university student sample. Results were consistent with hypotheses.

Methods

A sample of 506 students' (57% women) alcohol associations and alcohol consumption were assessed every 3 months over a 2-year period. Participants' consumption was converted to risk categories based on NIAAA's criteria: non-drinkers, low-risk drinkers and high-risk drinkers. A series of cross-lagged panel models tested whether changes in alcohol associations predicted subsequent change in drinking risk (and vice versa).

Results

Across all three measures of alcohol associations, increases in the strength of alcohol associations were associated with subsequent increases in drinking risk and vice versa.

Conclusion

Results from this study indicate bi-directional relationships between increases in alcohol associations (drinking identity, alcohol excite and alcohol approach) and subsequent increases in drinking risk. Intervention and prevention efforts may benefit from targeting these associations.

Changes in implicit alcohol attitudes across adolescence, and associations with emerging alcohol use: Testing the reciprocal determinism hypothesis

Implicit alcohol-related cognitions develop during adolescence and are thought to play an important role in the etiology of adolescent alcohol use. Rooted in reciprocal determinism, a developmental theory of alcohol-related cognitions, the current study sought to enhance our understanding of the development of automatic alcohol associations and their relationship with alcohol use. To provide a theoretically aligned test of reciprocal determinism, we used latent change score models to examine whether growth in automatic alcohol associations and alcohol use was related to each other (between-person effects) and whether each construct led to changes in the other over time (within-person effects). Adolescents (N = 378) completed 4 annual assessments, spanning early to middle adolescence. Automatic alcohol associations were assessed with a Single Category Implicit Association Test, and we used a quadruple processing tree model to extract a more "process pure" index of these associations. Alcohol use increased from early to middle adolescence, as negative automatic alcohol associations weakened over that same time period. Although there was no support for between-person associations, on the within-person level, weak negative automatic alcohol associations at Waves 2 and 3 were associated with increases in drinking at subsequent waves. Alcohol use did not significantly predict changes in automatic alcohol associations. Findings suggest the utility of distinguishing within- and between-person associations to understand the development of automatic alcohol associations and that automatic alcohol associations are prospectively associated with alcohol use and a potential target for intervention, one that becomes an increasingly salient influence on drinking as adolescence progresses. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Early alcohol use with parental permission: Psychosocial characteristics and drinking in late adolescence

The earliest experiences with alcohol for many children occur in the family context with parental supervision. The current study examined individual and sociocultural characteristics associated with early (prior to age 13years) sipping and tasting alcohol with parental permission in two longitudinal community samples. Early sipping/tasting was also tested as a predictor of frequency and quantity of alcohol use, and alcohol-related problems seven years later in late adolescence. Early sipping/tasting with parental permission was associated with a sociocultural context supportive of alcohol use (e.g., parental alcohol use, permissive rules about alcohol use in the home, parental attitudes about underage drinking, perceived peer norms), adolescent sensation seeking and disinhibition (e.g., surgency, externalizing behavior) and appraisals of alcohol (negative outcome expectancies and negative implicit alcohol associations). Early sipping/tasting predicted increased frequency and quantity of alcohol consumption, and increased alcohol-related problems in late adolescence, even after controlling sociocultural and individual difference variables. Findings suggest that early sipping/tasting with parental permission is not benign and is a viable target for preventive interventions.

The Prospective Association Between Internalizing Symptoms and Adolescent Alcohol Involvement and the Moderating Role of Age and Externalizing Symptoms

BACKGROUND

As predicted by self-medication theories that drinking is motivated by a desire to ameliorate emotional distress, some studies find internalizing symptoms (e.g., anxiety, depression) increase risk of adolescent drinking; however, such a risk effect has not been supported consistently. Our prior work examined externalizing symptoms as a potential moderator of the association between internalizing symptoms and adolescent alcohol use to explain some of the inconsistencies in the literature. We found that internalizing symptoms were protective against early adolescent alcohol use particularly for youth elevated on externalizing symptoms (a 2-way interaction). Our sample has now been followed for several additional assessments that extend into young adulthood, and the current study tests whether the protective effect of internalizing symptoms may change as youth age into young adulthood, and whether this age-moderating effect varied across different clusters of internalizing symptoms (social anxiety, generalized anxiety, and depression). Internalizing symptoms were hypothesized to shift from a protective factor to a risk factor with age, particularly for youth elevated on externalizing symptoms.

METHODS

A community sample of 387 adolescents was followed for 9 annual assessments (mean age = 12.1 years at the first assessment and 55% female). Multilevel cross-lagged 2-part zero-inflated Poisson models were used to test hypotheses.

RESULTS

The most robust moderating effects were for levels of alcohol use, such that the protective effect of all internalizing symptom clusters was most evident in the context of moderate to high levels of externalizing problems. A risk effect of internalizing symptoms was evident at low levels of externalizing symptoms. With age, the risk and protective effects of internalizing symptoms were evident at less extreme levels of externalizing behavior. With respect to alcohol-related problems, findings did not support age moderation for generalized anxiety or depression, but it was supported for social anxiety.

CONCLUSIONS

Findings highlight the importance of considering the role of emotional distress from a developmental perspective and in the context of externalizing behavior problems.

Context and culture associated with alcohol use amongst youth in major urban cities: A cross-country population based survey

Background

Alcohol consumption patterns are dependent upon culture and context. The aim of this study was to interview people aged 18–34 year old living in four cities in different regions of the world to explore differences in a range of alcohol measures to assist in determining culturally appropriate alcohol initiatives for this age group.

Method

Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward and back translated into relevant languages and face-to-face interviewing undertaken. The data were weighted to the population of each city. Uni-variable analysis (ever consumed, first time consumed, age when drunk for first time, number of days consumed, type consumed) and logistic regression modeling were undertaken. The final model for each city was adjusted for age, sex, marital status, highest education and employment status. In total 6235 interviews were undertaken (1391 in Ilorin, 1600 in Montevideo, 1604 in Moscow and 1640 in Wuhan).

Results

Alcohol was consumed by 96.4% in Montevideo, 86.1% in Moscow, 53.4% in Wuhan and 33.3% in Ilorin. There was very little difference by gender except Ilorin males were more likely to consume alcohol than females. Alcohol was consumed on more days for Ilorin males; Wuhan females consumed alcohol on the least number of days; Ilorin had the most abstainers; Montevideo and Moscow the highest proportion of light drinkers; Ilorin and Montevideo the highest proportion of heavy drinkers. Differences by type of alcohol were also apparent. The final logistic regression model provided different models including higher alcohol consumption rates for males, 25–34 years of age, divorced/separated marital status and employed part time for Ilorin respondents; males and higher educated for Montevideo; males, 25 to 29 years of age and higher educated for Moscow; and 25–29 years of age, non-married and vocationally trained for those in Wuhan.

Conclusion

Alcohol consumption in these four cities does not increase with age as found in most high income countries. The alcohol consumption patterns during this stage of the life cycle are important to assess so that high level, as well as country-specific, planning and interventions can be implemented.

Cognitive appraisals of alcohol use in early adolescence: Psychosocial predictors and reciprocal associations with alcohol use

Early adolescence is a dynamic period for the development of alcohol appraisals (expected outcomes of drinking and subjective evaluations of expected outcomes), yet the literature provides a limited understanding of psychosocial factors that shape these appraisals during this period. This study took a comprehensive view of alcohol appraisals and considered positive and negative alcohol outcome expectancies, as well as subjective evaluations of expected outcomes. Developmental-ecological theory guided examination of individual, peer, family, and neighborhood predictors of cognitive appraisals of alcohol and use. A community sample of 378 adolescents (mean age 11.5 years at Wave 1, 52% female) was assessed annually for 4 years. Longitudinal path analysis suggested that the most robust predictors of alcohol appraisals were peer norms. Furthermore, perceived likelihood of positive and negative alcohol outcomes prospectively predicted increases in drinking. There was limited support for appraisals operating as mediators of psychosocial risk and protective factors.

The Prospective Joint Effects of Self-Regulation and Impulsive Processes on Early Adolescence Alcohol Use

OBJECTIVE

Dual-process models propose that behavior is influenced by the interactive effect of impulsive (automatic) and self-regulatory (controlled) processes. Elaborations of this model posit that the effect of impulsive processes on alcohol use is influenced by capacity and motivation to self-regulate. The interactive effect of these three processes on drinking has not previously been tested. The goal of this study was to provide a developmental extension of this model to early adolescent alcohol use and to test the three-way interaction between impulsive processes (implicit alcohol cognition), self-regulatory capacity (inhibitory and activation control), and self-regulatory motivation (negative alcohol outcome expectancies [AOE]) in a 1-year prospective prediction of adolescent alcohol use.

METHOD

Adolescents (N = 325; 54% girls, mean age = 13.6 years at baseline) completed the Single Category Implicit Association Test and self-reports of alcohol expectancies and use. Inhibitory and activation control were based on parental report.

RESULTS

Negative AOE and inhibitory/activation control were supported as moderators of the effect of implicit alcohol cognition on 1-year prospective alcohol use. As expected, weak implicit negative alcohol cognition was associated with elevated alcohol use when both negative AOE and inhibitory control were low. Contrary to hypothesis, when activation control was high, weak implicit negative alcohol cognition was unrelated to alcohol use if negative AOE were high (p = .72) (vs. low, p <.01). Activation control may reflect the ability to plan ahead and act pro-socially.

CONCLUSIONS

Our study supports current theory suggesting alcohol use is influenced by a complex interplay of impulsive and self-regulatory processes.

Social Goals and Grade as Moderators of Social Normative Influences on Adolescent Alcohol Use

BACKGROUND

The literature distinguishes 2 types of social normative influences on adolescent alcohol use, descriptive norms (perceived peer alcohol use) and injunctive norms (perceived approval of drinking). Although theoretical formulations suggest variability in the salience and influence of descriptive and injunctive norms, little is understood regarding for whom and when social norms influence adolescent drinking. Strong agentic and communal social goals were hypothesized to moderate the influence of descriptive and injunctive norms on early adolescent alcohol use, respectively. Developmental changes were also expected, such that these moderating effects were expected to get stronger at later grades.

METHODS

This longitudinal study included 387 adolescents and 4 annual assessments (spanning 6th to 10th grade). Participants completed questionnaire measures of social goals, social norms, and alcohol use at each wave.

RESULTS

Multilevel logistic regressions were used to test prospective associations. As hypothesized, descriptive norms predicted increases in the probability of alcohol use for adolescents with strong agentic goals, but only in later grades. Injunctive norms were associated with increases in the probability of drinking for adolescents with low communal goals at earlier grades, whereas injunctive norms were associated with an increased probability of drinking for adolescents with either low or high communal goals at later grades. Although not hypothesized, descriptive norms predicted increases in the probability of drinking for adolescents high in communal goals in earlier grades, whereas descriptive norms predicted drinking for adolescents characterized by low communal goals in later grades.

CONCLUSIONS

The current study highlights the importance of social goals when considering social normative influences on alcohol use in early and middle adolescence. These findings have implications for whom and when normative feedback interventions might be most effective during this developmental period.

Moral Disengagement, Anticipated Social Outcomes and Adolescents' Alcohol Use: Parallel Latent Growth Curve Analyses

Moral disengagement is a social cognitive process that has been extensively applied to transgressive behaviors, including delinquency, aggression and illicit substance use. However, there has been limited research on moral disengagement as it relates to underage drinking. The current study aimed to examine moral disengagement contextualized to underage drinking and its longitudinal relationship to alcohol use. Moreover, the social context in which adolescent alcohol use typically occurs was also considered, with a specific emphasis on the social sanctions, or social outcomes, that adolescents anticipate receiving from friends for their alcohol use. Adolescents were assessed across three time-points, 8 months apart. The longitudinal sample consisted of 382 (46% female) underage drinkers (12-16 years at T1). Parallel latent growth curve analysis was used to examine the bi-directional influence of initial moral disengagement, anticipated social outcomes, and alcohol use on subsequent growth in moral disengagement, anticipated social outcomes and alcohol use. The interrelation of initial scores and growth curves was also assessed. The findings revealed that, in the binary parallel analyses, initial moral disengagement and anticipated social outcomes both significantly predicted changes in alcohol use across time. Moreover, initial anticipated social outcomes predicted changes in moral disengagement. These findings were not consistently found when all three process analyses were included in a single model. The results emphasize the impact of social context on moral disengagement and suggest that by targeting adolescents' propensity to justify or excuse their drinking, as well as the social outcomes adolescents anticipate for being drunk, it may be possible to reduce their underage drinking.