Social anxiety, disengagement coping, and alcohol-use behaviors among adolescents

Perceived psychological control relates to coping-related drinking motives via social anxiety among adolescents: A cross-sectional mediation analysis

Accumulating evidence suggests that particular parenting behaviors (e.g., elevated psychological control) may increase risk for both problematic social anxiety and alcohol use among youth; however, no work has yet examined these factors together in a single model. Building developmentally sensitive models of problematic alcohol use trajectories is key to developing effective prevention and intervention strategies. The present study includes 94 adolescents (ages 14-17 years; 53.3% girls; 89.2% White) entering a treatment facility for a variety of internalizing and externalizing forms of psychological distress. Levels of perceived parental psychological control, social anxiety, and coping-related drinking motives were assessed. Higher levels of perceived psychological control were associated with a greater endorsement of coping-related drinking motives; however, a significant proportion of that association was accounted for by elevated social anxiety symptoms. These data extend the existing literature and lay groundwork for more sophisticated experimental and longitudinal designs to corroborate the findings. Moreover, personality-targeted drinking interventions for adolescents may benefit from identifying elevated perceived psychological control as a developmentally relevant risk factor for social anxiety and problematic drinking motives and administering relevant interventions (e.g., personality-targeted coping skills training, parent-involved care) before drinking patterns are established.

Exploring the longitudinal associations between census division income inequality and BMI trajectories among Canadian adolescent: Is gender an effect modifier?

Background

Income inequality is a structural determinant of health linked to increased risk of overweight and obesity, although its links to the health of adolescent populations are not well understood. This study investigated the longitudinal associations between census-division-level (CD) income inequality and BMI trajectories among Canadian adolescents, and determine if these associations vary by gender.

Methods

Study data are from the Cannabis use, Obesity, Mental health, Physical Activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) cohort of adolescents attending secondary schools in Canada. Our sample included 14,675 adolescents who were followed up across three waves of the COMPASS study (2016-2017, 2017-2018, and 2018-2019) and linked to 30 CDs. Measures of income inequality and other area-level covariates were derived and linked to COMPASS participants using data from the 2016 Canadian Census. We utilized multilevel mixed-effects linear regression modelling to quantify the associations between income inequality and BMI and test for effect modification by gender. Sensitivity analyses were run excluding those with BMI scores in the range considered overweight or obesity at baseline.

Results

Higher CD income inequality was significantly associated with higher z-transformed BMI scores (β = 0.11, 95% CI = 0.034 to 0.19). The interaction term between income inequality and time was not statistically significant, indicating that this association remained constant over time. Once stratified by gender, the association between inequality and BMI became stronger for males (β = 0.14, 95% CI = 0.060 to 0.022) and attenuated for females (β = 0.063, 95% CI = -0.047 to 0.17).

Conclusion

Attending schools in CDs with higher income inequality was associated with higher BMI scores among male but not female adolescents. Further work is needed to investigate this discrepancy and identify the structural mechanisms that mediate the relationship between inequality and adolescent health.

Problem Solving and Emotion Coping Styles for Social Anxiety: A Meta-analysis of Chinese Mainland Students

Studies of how positive and negative coping styles affect social anxiety show mixed results. Hence, our two meta-analyses determined the overall effect sizes of problem solving-focused coping (PSC) styles and emotion-focused coping (EFC) styles on social anxiety in mainland China (PSC: k = 49 studies, N = 34,669; EFC: k = 52, N = 36,531). PSC was negatively linked to social anxiety (- .198), and EFC was positively linked to social anxiety (.223). In years with more national income, PSC's and EFC's effect sizes were larger. PSC's effect sizes were smaller among rural students (vs. urban students), larger among older students (university, high school, middle school), and larger in cross-sectional (vs. longitudinal) studies. When using SAD (vs. others) social anxiety measures, PSC effect sizes were larger, but EFC effect sizes were smaller. EFC effect sizes were larger in studies with convenience (vs. representative) samples. Gender, single child status, and coping style measurement showed no moderation effects. These findings suggest that using problem solving-focused coping styles rather than emotion-focused may reduce social anxiety, so future experimental studies can test this idea more rigorously.

The BDNF Val68Met polymorphism causes a sex specific alcohol preference over social interaction and also acute tolerance to the anxiolytic effects of alcohol, a phenotype driven by malfunction of BDNF in the ventral hippocampus of male mice

BACKGROUND

The brain-derived neurotrophic factor (BDNF) Valine 66 to Methionine human polymorphism results in impaired activity-dependent BDNF release and has been linked to psychiatric disorders including depression and anxiety. We previously showed that male knock-in mice carrying the mouse Methionine homolog (Met68BDNF) exhibit excessive and compulsive alcohol drinking behaviors as compared to the wild-type Val68BDNF mice.

OBJECTIVE

Here, we set out to determine the potential mechanism for the heightened and compulsive alcohol drinking phenotypes detected in Met68BDNF mice.

RESULTS

We found that male, but not female Met68BDNF mice exhibit social anxiety-like behaviors. We further show that male Met68BDNF mice exhibit a preference for alcohol over social interaction. In contrast, alcohol place preference without an alternative social reward, is similar in male Met68BDNF and Val68BDNF mice. Since the Met68BDNF mice show social anxiety phenotypes, we tested whether alcohol reliefs anxiety similarly in Met68BDNF and Val68BDNF mice and found that male, but not female Met68BDNF mice are insensitive to the acute anxiolytic action of alcohol. Finally, we show that this acute tolerance to alcohol-dependent anxiolysis can be restored by overexpressing wild-type Val68BDNF in the ventral hippocampus (vHC) of Met68BDNF mice.

CONCLUSIONS

Together, our results suggest that excessive alcohol drinking in the Met68BDNF may be attributed, in part, to heighted social anxiety and a lack of alcohol-dependent anxiolysis, a phenotype that is associated with malfunction of BDNF signaling in the vHC of male Met68BDNF mice.

Social Motivation as a Moderator of the Relationship Between Problematic Internet Use and Alcohol Use Among Adolescents in Mexico

BACKGROUND

Prior research shows a link between alcohol use and problematic Internet use among adolescents. This relationship likely indicates a vulnerability to addiction; however, little is known about factors that may increase this vulnerability. One potential factor is social motivation. Adolescents often engage in Internet use and alcohol use as a way of connecting socially. This study examines the moderating effects of social motivation for Internet use on the relationship between problematic Internet use and alcohol use among adolescents.

METHODS

A cross-sectional survey was administered to 582 adolescents selected randomly from one middle school and one high school in Nuevo Laredo, Tamaulipas, Mexico. Participants answered questions related to demographics/background (including reasons for Internet use), problematic Internet use, and alcohol use. Hierarchical regression modeling examined the moderating effects of social Internet use on problematic Internet use and alcohol use, controlling for age and gender.

RESULTS

Social Internet use and problematic Internet use accounted for a significant amount of variance in alcohol use (R2 = .126, F(4, 575) = 20.77, p < .001). When the interaction term was entered, social Internet use was found to moderate the relationship between problematic Internet use and alcohol use (β = .525, t = 3.293, p = .001), and the direct effects of social Internet use (β = -.062, t = -0.663, p = .507) and problematic Internet use (β = -.129, t = -1.053, p = .293) were no longer significant.

CONCLUSION

This study highlights the role that social connections may play in contributing to problematic Internet use and alcohol use among adolescents. Interventions aimed at preventing problematic and addictive behaviors among adolescents should address the role of social motivations.

Social anxiety and depression symptoms in Chinese left-behind children after the lifting of COVID-19 lockdown: A network analysis

BACKGROUND

Returning to social life after the lifting of COVID-19 lockdown may increase risk of social anxiety, which is highly co-morbid with depression. However, few studies have reported the association between them.

AIMS

To explore the complex relationship between social anxiety and depression symptoms in left-behind children after the lifting of the COVID-19 lockdown.

METHODS

A cross-sectional survey was conducted 6 months after the lockdown removal. A total of 3,107 left-behind children completed the survey with a mean age of 13.33 and a response rate of 87.77%. Depression and social anxiety severity were assessed by the DSM-5 Patient Health Questionnaire for Adolescents and the DSM-5 Social Anxiety Disorder Questionnaire, respectively. The symptom-level association between the two disorders was examined using network analysis.

RESULTS

After the lifting of COVID-19 lockdown, the prevalence of depression and social anxiety in left-behind children was 19.57% and 12.36%, respectively, with a co-morbidity rate of 8.98%. Network analysis showed that "Social tension" and "Social avoidance" had the greatest expected influence; "Humiliation" and "Motor" were bridge symptom nodes in the network. The directed acyclic graph indicated that "Social fright" was at the upstream of all symptoms.

CONCLUSION

Attention should be paid to social anxiety symptoms in left-behind children after the lifting of COVID-19 lockdown. Prevention and intervention measures should be taken promptly to reduce the comorbidity of social anxiety and depression symptoms in the left-behind children after the lifting of lockdown.

An interrupted time series analysis of hospital admissions due to alcohol intoxication during the COVID-19 pandemic in Tehran, Iran

The COVID-19 outbreak affected mental health globally. One of the major concerns following the COVID-19 pandemic was increased incidence of risky behaviors including alcohol consumption. This study evaluates the trend of alcohol poisoning in Loghman-Hakim Hospital (LHH), the main referral center of poisoning in Tehran, during the 2-year period from 1 year prior to 1 year after the onset (February 23rd, 2020) of the COVID-19 epidemic in Iran. All patients admitted with alcohol intoxication from February 23rd, 2019 to February 22nd, 2021 were evaluated and patient data extracted from LHH electronic hospital records. Alcohols were categorized as toxic (methyl alcohol) and non-toxic (ethyl alcohol). Of 2483 patients admitted, 796/14,493 (5.49%) and 1687/13,883 (12.15%) had been hospitalized before and after the onset of the COVID-19 epidemic in Iran, respectively. In total, 140 patients did not survive, of whom 131 (93.6%) were confirmed to have methanol intoxication. Mortality was significantly higher during the outbreak (127 vs 13; P < 0.001; OR: 4.90; CI 95%: 2.75 to 8.73). Among the patients, 503 were younger than age 20. Trend of alcohol intoxication showed increases in children (57 vs 17) and adolescents (246 vs 183) when compared before and after the COVID-19 epidemic outbreak. A total of 955 patients were diagnosed with methanol toxicity which occurred more frequently during the COVID-19 era (877 vs 78; P < 0.001; OR: 10.00; CI 95%: 7.75 to12.82). Interrupted time series analysis (April 2016–February 2021) showed that in the first month of the COVID-19 epidemic (March 2020), there was a significant increase in the alcohol intoxication rate by 13.76% (P < 0.02, CI = [2.42–24.91]). The trend of alcohol intoxication as well as resulting mortality increased in all age groups during the COVID-19 epidemic in Iran, indicating urgent need for the prevention of high-risk alcohol use as well as improved treatment.

State LGBTQ policies and binge drinking among sexual minority youth in the US: a multilevel analysis

PURPOSE

Though higher rates of binge drinking have been reported among sexual minority (lesbian, gay, and bisexual) youths compared to their heterosexual peers in the United States, questions remain about which specific structural factors drive these inequities. We test whether state LGBTQ (lesbian, gay, bisexual, transgender, queer/questioning) policy climate is associated with youth binge drinking, as well as whether that association is unique to sexual minority youth.

METHODS

We use LGBTQ policy scores compiled by the Movement Advancement Project in 2017 and analyze 2017 Youth Risk Behavior Survey data (126,432 youths living in 24 states). We fit multi-level logistic regression models to estimate odds ratios for binge drinking with state-level LGBTQ policy scores.

RESULT

More progressive state-level overall LGBTQ policies were associated with lower odds of binge drinking among sexual minority youths (interaction term OR = 0.990, CI 0.984-0.996, p = 0.0009), but not among heterosexuals (OR = 1.001, CI 0.992, 1.009, p = 0.881). For sexual minorities, living in the most LGBTQ-affirming state was associated with a probability of binge drinking 27% lower than that of those living in the least LGBTQ-affirming state. In sensitivity analyses, policies specific to LGBTQ youth (opposed to general LGBTQ people) were even more strongly related to sexual minorities' binge drinking (interaction term: state-level youth policy score × individual-level sexual identity-of OR = 0.949, CI 0.927-0.971, p = 0.00001). In sex-stratified models, associations with overall LGBTQ policy scores were significant only for girls (OR = 0.986, CI 0.979-0.993, p < 0.001), not boys (OR = 0.997, CI 0.986-1.008, p = 0.551), while associations with youth-focused LGBTQ policies were significant for both sexual minority girls and boys.

CONCLUSION

Our findings point to state-level LGBTQ policy climate as a potential social determinant of binge drinking problems among sexual minority youths.

Maternal Parenting Stress, Disengagement Strategies for Managing Parenting Stress, and Hazardous Alcohol Use among Mothers of Adolescents

Objective: According to the reward- stress dysregulation model of addiction and parenting, parenting stress may play a critical role in the etiology and maintenance of substance misuse. To date, limited work has examined how parenting stress may relate to hazardous alcohol use among mothers of adolescents. The present study examined if parenting stress interacted with maternal stress responses (i.e., disengagement coping, involuntary disengagement stress responses) in relation to maternal hazardous alcohol use. Method: Two hundred and fifty-three mothers (n = 147 hazardous alcohol users; 58% of the sample) of adolescents between the ages of 12 and 16 years participated in the current study. Mothers were recruited using Qualtrics panel services. Mothers reported on their parenting stress, strategies for managing parenting stress, and use of alcohol. Mothers also reported basic demographic information (Mage = 41.10 years, 86.6% identified as white, 81.1% of mothers were married). Interaction analyses were used to test hypotheses. Results: Maternal parenting stress interacted with maternal involuntary disengagement stress responses in relation to maternal hazardous alcohol use, such that at average and high levels of disengagement stress responses, parenting stress was associated with hazardous alcohol use. These results were robust to covariates (i.e., family income, maternal anxiety symptoms, maternal depressive symptoms, general levels of maternal stress, maternal cigarette use). Maternal disengagement coping strategies were not related to maternal hazardous alcohol use. Conclusion: Results suggest that parenting stress and involuntary disengagement stress responses may be associated with hazardous alcohol use among mothers of adolescents.

Coping with Relationship Stress in Adolescence: A Decade in Review

At a moment in history when stress levels among adolescents are high and coping capacities are taxed, it seems timely and important to review a decade's accomplishments in elucidating how, and with what effects, adolescents cope with relationship stress. We provide an update on research about coping with parent, peer, and romantic stress and discuss the effectiveness of coping strategies across cultures, developmental periods, and levels of social stress. We explore relations between coping and other automatic and reflective responses to stress and highlight innovations in lab-based and ambulatory assessments. We recommend studies of variability in the success of coping at different intensities of relationship stress and research with real-time and repeated assessments to capture the process of coping.

Mediating Effects of Coping Strategies on the Relationship Between Mental Health and Quality of Life Among Indonesian Female Migrant Workers in Taiwan

INTRODUCTION

Mental health is a major concern among migrant workers worldwide. More than 200,846 female migrant workers in Taiwan are from Indonesia. The study's purpose was to investigate mediating effects of coping strategies on the relationship between mental health problems and the quality of life (QoL).

METHOD

This cross-sectional study was conducted in Taiwan. In total, 500 Indonesian female migrant workers completed four questionnaires. A mediation test was conducted to estimate direct and indirect effects.

RESULTS

Coping strategies, namely substance use, behavioral disengagement, denial, and religious dedication, partially mediated the relationship between mental health problems (depression, anxiety, and stress) and QoL among Indonesian female migrant workers in Taiwan.

DISCUSSION

Health promotion programs should be developed for Indonesian female migrant workers in Taiwan to help them detect and overcome their mental health problems. Interventions that facilitate effective coping strategies should be administered to improve their QoL.

Desire to drink as a function of laboratory-induced social stress among adolescents

BACKGROUND AND OBJECTIVES

Research consistently demonstrates a link between social anxiety and alcohol-related problems; however, the majority of work has been retrospective, and conducted with adults. Despite an extensive literature highlighting coping-related motives as an underlying mechanism, real-time work presents mixed findings, and no published research has examined an adolescent sample using experimental psychopathology techniques.

METHODS

The current study tested whether (1) history of social anxiety symptoms positively correlated with alcohol-related cognitions following laboratory-induced social stress, (2) state anxiety was positively correlated with alcohol-related cognitions, and (3) whether the nature of the stressor (performance versus rejection) impacted the strength of identified relations, in a sample of community-recruited adolescents reporting recent alcohol use. Participants (n = 114; Mage = 16.01; 64% girls) were randomly assigned to either a performance- or rejection-oriented task.

RESULTS

Findings indicated that history of social anxiety symptoms was positively correlated with state anxiety elicited by both tasks. Further, history of social anxiety symptoms was not related to change in desire to drink, but was positively related to the belief that alcohol 'would make me feel better.' State anxiety was positively related to both desire to drink and relief outcome expectancies across both tasks. Finally, the nature of the task did not moderate responding.

LIMITATIONS

Single site, community sampling confines interpretations, and the tasks did not fully perform as expected.

CONCLUSIONS

Further study is needed; however, the current findings support the contention that socially-oriented distress may be a developmentally-relevant, malleable target for prevention efforts aimed at problematic alcohol use among adolescents.

Neonatal temperament and neuromotor differences are predictive of adolescent alcohol intake in rhesus monkeys (Macaca mulatta)

Identifying predictors of teenage alcohol use disorder (AUDs) is a major health initiative, with studies suggesting that there are distinct personality-related traits that underlie patterns of alcohol intake. As temperament is biologically based, identifiable early in life, and stable across time, it is considered the foundation of personality. As such, we hypothesized that neonatal temperament traits would predict anxiety-mediated adolescent alcohol consumption. To test this, N = 145 rhesus macaque (Macaca mulatta) infants (14 days of age), reared in a neonatal nursery (n = 82) or in a control condition with their mothers (n = 63) were assessed with a widely used standardized nonhuman primate testing battery, the Infant Behavioral Assessment Scale (IBAS), modeled after the Brazelton Neonatal Assessment Scale, evaluating visual orienting, temperament, motor maturity and, more recently, sensory sensitivity. As adolescents (3-4 years of age), these same subjects were allowed unfettered access to a sweetened-alcohol solution for 1 hr/day, 4 days/week, over 5-7 weeks. Subjects were allowed to self-administer alcohol while housed alone (n = 70) or socially in their home cage (n = 55). Linear regressions showed that alcohol intake was predicted by neonatal orienting ability (β = -.35; p = .01), state control (β = -.19; p = .04), and motor maturity (β = -.24; p = .01). Poor neonatal orienting, state control (ease of consolability), and motor maturity were associated with higher adolescent alcohol intake in rhesus monkeys. These findings suggest that neonatal temperament is predictive of patterns of adolescent alcohol intake. To the extent that these results generalize to humans, they provide evidence that early-life temperament and neurodevelopment may be important risk factors for adolescent AUDs and that the IBAS may be used as an assessment tool for identifying such risk.

Social Support and Substance Use as Moderators of the Relationship Between Depressive Symptoms and Suicidal Ideation in Adolescents

Literature reports that depressive symptoms may precede suicidal ideation. Several studies have identified social support and substance use as moderators of this relationship. However, no study has evaluated these variables together by testing how substance use can affect the moderating effect of social support in this relationship. The purpose of this article is to individually evaluate dimensions of social support (friends, family, significant others, and school) and substance use (alcohol, marijuana, and other illicit drugs), as moderators of the relationship between depressive symptoms and suicidal ideation, as well as analyze the moderating role of substance use in the moderation exerted by social support in this relationship. This study, quantitative and cross-sectional, considered 775 adolescents [Average age = 15.48 (SD = 0.96), 45.9% women], from 20 randomly selected schools in Santiago de Chile. Simple moderation models were used to analyze possible moderators separately, and double moderation models were used to analyze the moderating role of substance use in the moderating effect of social support. The results show that the four dimensions of social support moderate the relationship between depressive symptomatology and suicidal ideation, showing the strongest interaction in the case of family support, followed by support of a significant person, support at school, and support of friends, in that order. On the other hand, alcohol was the only drug that moderated the relationship in question. In addition, the results show that the use of alcohol limits the moderating effect of social support in the fields of family, significant person, and school support, but not in the case of support of friends. The use of marijuana and other illicit drugs did not affect the moderating effects of social support for any of the areas evaluated. The results are discussed according to the different roles that alcohol use can play in adolescence, and how these, together with perceived social support, are related to the emergence of suicidal ideation from depressive symptoms.

Perceived Social Discrimination, Socioeconomic Status, and Alcohol Consumption among Chinese Adults: A Nationally Representative Study

Perceived social discrimination in China has significant effects on drinking behavior. This finding was reached through multivariate logistic regression analysis of a sample of 22,566 adults in the 2016 China Family Panel Studies (CFPS). This was a cross-sectional study conducted with computer-assisted face-to-face interviews to assess alcohol drinking problems and associated factors among Chinese adults. The proportion of adults prone to alcoholism tends to be higher in eastern than central China, and higher in central than western China. Furthermore, gender discrimination and delays in government interactions as a result of unfair treatment have a positive and significant effect on individuals’ drinking. The alcohol consumption rate among Chinese men is about 13 times that of Chinese women. Additionally, older people have a stronger tendency to drink alcohol. In terms of education, those with lower education levels are more prone to alcoholism than those with higher education levels. Regarding marital status, those who are married are more prone to alcoholism than those who are not. Further, those who have been diagnosed with a chronic disease within the past six months are less prone to alcoholism than those without such diagnosis. People with an annual income between 50,000 and 150,000 yuan are more prone to alcoholism than those with an income under 50,000 yuan. Groups that have experienced unequal treatment in public services are also more prone to alcoholism than those who do not suffer such unequal treatment.

Individual Variables Involved in Perceived Pressure for Adolescent Drinking

Adolescence is a stage when individuals are especially vulnerable to the influence of their peer group, which could lead to the development of problematic behavior, such as drinking alcohol, due to perceived pressure. The objective of this study was to analyze the role of self-esteem, impulsivity, anxiety sensitivity and expectations for use under perceived pressure to drink alcohol among young people.

METHODS

The sample was made up of 1287 high school students aged 14 to 18, with a mean age of 15.11. The Bayes factor and mediation models were estimated to evaluate the data.

RESULTS

The results showed the existence of a positive relationship of impulsivity, anxiety sensitivity and expectations for use with perceived pressure. However, this relationship was negative with self-esteem and perception of pressure to drink alcohol. Furthermore, the model results showed that self-esteem mediates the relationship between physical, cognitive and social anxiety sensitivity and positive expectations with perceived pressure to drink alcohol in adolescence.

CONCLUSIONS

Given the strong need for affiliation during youth, it is hard to control grouping and peer influence on drinking behavior. However, knowledge of the role of individual variables, such as those described here, in perceived pressure could improve the prevention and intervention of such behaviors.

Real-time social stress response and subsequent alcohol use initiation among female adolescents

Adolescents who are particularly sensitive to social stress may be vulnerable to earlier alcohol consumption and related problems. Although a small literature supports this contention, previous studies mostly relied on retrospective self-report. The current study used discrete-time survival analysis (DTSA) to test whether real-time social stress responding (via laboratory induction) and social anxiety symptoms predicted 12-month alcohol onset in an alcohol-naïve sample of young female adolescents. Anxiety elicited by the task was expected to predict greater and earlier rates of alcohol incidence, particularly among girls with higher levels of self-reported social anxiety symptoms. Participants were 104 community-recruited girls (ages 12-15 years) who completed a modified Trier Social Stress Test and questionnaires; follow-up calls were conducted at 3, 6, 9, and 12 months after the laboratory visit. Self-reported anxiety was assessed in response to the stressor following acclimation (baseline), instruction (anticipation), and speech (posttask). By 12 months, 30.8% of the sample had consumed a full alcoholic beverage. The DTSA revealed that girls with higher levels of social anxiety and greater elevations in anticipatory (but not posttask) anxiety compared to baseline had earlier alcohol initiation. This is the first study to examine the role of both laboratory-induced anxious responding and retrospective reports of social anxiety as prospective predictors of alcohol incidence. These preliminary findings suggest that adolescent girls who are more sensitive to social stress may be at risk for experimenting with alcohol earlier than their peers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Cluster Randomized-Controlled Trial of the MindOut Social and Emotional Learning Program for Disadvantaged Post-Primary School Students

School-based social and emotional learning programs aim to provide students with the skills they need to deal with life challenges, thereby enhancing their social and emotional wellbeing, academic outcomes, and reducing their risk of mental health difficulties. While there is a robust evidence base on the effectiveness of these programs originating from the US, there is a relative paucity of research on how these programs impact young people in other county contexts, especially for older adolescents and those at higher risk. This study sets out to address this research gap by evaluating the effectiveness of a social emotional learning program designed for older adolescents in Ireland, the MindOut program. MindOut is a universal school-based social and emotional learning program designed for older adolescents in Ireland which was developed based on a common elements approach underpinned by CASEL's framework. Employing a cluster randomized-controlled trial, data on social and emotional skills, academic performance and mental health outcomes were collected from students (n = 497; 51.1% female) ages 15-18 years in 32 disadvantaged schools. There were significant improvements in intervention students' social and emotional skills including, reduced suppression of emotions (p = 0.035), use of more positive coping strategies [reduced avoidance coping p = < 0.001) and increased social support coping p = 0.044)]. Improvements in mental health and wellbeing were also found with significantly reduced levels of stress (p = 0.017) and depressive symptoms (p = 0.030) as well as reduced anxiety scores for females students (p = 0.044). These short-term evaluation findings support the positive impact of school-based social and emotional learning programs, such as MindOut, when designed to be both age and culturally appropriate and delivered to older adolescents in disadvantaged schools.

The Links Between Social Anxiety Disorder, Insomnia Symptoms, and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States

Social anxiety disorder (SAD) is associated with increased risk of developing an alcohol use disorder (AUD). Most of the current literature has focused on the role of acute stress responding in this relation; however, both SAD and AUDs also are linked to insomnia symptoms (i.e., difficulty falling or staying asleep). As adolescence is a sensitive period for the onset of these disorders, the present study examined if insomnia symptoms might partially account for the SAD-AUD link in a large sample of adolescents. Data from the National Comorbidity Survey-Adolescent Supplement were examined. Participants (N = 10,140) completed interviews to assess past 12-month SAD and AUD diagnostic status as well as insomnia symptoms. Analyses tested whether insomnia symptoms accounted for a significant proportion of the SAD-AUD relation. Results indicated that insomnia symptoms were positively related to both SAD and AUD status, and the relation between SAD and AUD status was significantly reduced when insomnia symptoms were included in the model. Findings remained significant after controlling for the effects of age, gender, posttraumatic stress disorder, major depressive disorder, and other drug dependence status. Experimental examination and intensive longitudinal assessment of these relationships are needed before strong conclusions can be inferred about causality and temporal relationships. The current findings do indicate insomnia may be an important indirect and stigma-free treatment target to address in prevention and treatment efforts for SAD, AUDs, and their co-occurrence.

Drinking to Cope: a Latent Class Analysis of Coping Motives for Alcohol Use in a Large Cohort of Adolescents

Alcohol consumption during adolescence is widespread, although there is considerable variation in patterns of use. The aim of this study was to identify patterns of coping-motivated alcohol use in a UK birth cohort and examine individual and family characteristics associated with the resulting drinker profiles. At age 17, participants (n = 3957; 56 % female) reported their alcohol and drug use, internalising symptoms and use of alcohol to cope with a range of emotions. Socio-demographic data were collected via maternal report. Latent class analysis identified drinker subtypes based on the coping motives reported. Association between these profiles and socio-demographic characteristics and internalising disorders was examined. The vast majority (92 %) of adolescents reported alcohol consumption in the past year, and 26 % of those drank weekly or more often. Four distinct motive profiles were identified. These profiles were associated with different socio-demographic characteristics: adolescents from higher socio-economic backgrounds drank primarily for increased confidence, whereas adolescents from low socio-economic backgrounds were more likely to drink to cope with low mood. Adolescents with an anxiety or depressive disorder were six times more likely to fall within the high-risk subtype, characterised by a generalised pattern of drinking to cope with emotions across the board. Coping motives for drinking vary with individual and family factors. Adolescents from low versus high socio-economic backgrounds were characterised by distinct drinking profiles; thus, prevention messages may need to be tailored accordingly. Internalising disorders were strongly associated with a high-risk profile of coping-motivated drinking.

The Revised Child Anxiety and Depression Scale: A systematic review and reliability generalization meta-analysis

BACKGROUND

Anxiety and depression are among the most common mental disorders during childhood and adolescence. Among the instruments for the brief screening assessment of symptoms of anxiety and depression, the Revised Child Anxiety and Depression Scale (RCADS) is one of the more widely used. Previous studies have demonstrated the reliability of the RCADS for different assessment settings and different versions. The aims of this study were to examine the mean reliability of the RCADS and the influence of the moderators on the RCADS reliability.

METHODS

We searched in EBSCO, PsycINFO, Google Scholar, Web of Science, and NCBI databases and other articles manually from lists of references of extracted articles.

RESULTS

A total of 146 studies were included in our meta-analysis. The RCADS showed robust internal consistency reliability in different assessment settings, countries, and languages. We only found that reliability of the RCADS was significantly moderated by the version of RCADS. However, these differences in reliability between different versions of the RCADS were slight and can be due to the number of items.

LIMITATIONS

We did not examine factor structure, factorial invariance across gender, age, or country, and test-retest reliability of the RCADS.

CONCLUSIONS

The RCADS is a reliable instrument for cross-cultural use, with the advantage of providing more information with a low number of items in the assessment of both anxiety and depression symptoms in children and adolescents.

Assessment and Treatment of Adolescent Substance Use Disorders: Alcohol Use Disorders

Alcohol drinking in childhood and adolescence is a serious public health concern. Adolescence is a vulnerable period for risk-taking tendencies. Understanding the influences of problematic alcohol use is important for evolving interventions. Alcohol use in early years foreshadows a lifetime risk for psychiatric and substance use disorders. Early screening and assessment can alter tragic sequelae. We discuss clinical aspects such as confidentiality, differential levels of care, and criteria for best fitting treatments. Given the prevalence of drinking and its impact on psychiatric and substance use disorders, the need for further study and prevention are emphasized.

Social Anxiety and Cannabis-Related Impairment: The Synergistic Influences of Peer and Parent Descriptive and Injunctive Normative Perceptions

OBJECTIVES

Cannabis users, especially socially anxious cannabis users, are influenced by perceptions of other's use. The present study tested whether social anxiety interacted with perceptions about peer and parent beliefs to predict cannabis-related problems.

METHODS

Participants were 148 (36.5% female, 60.1% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of perceived descriptive and injunctive norms, social anxiety, and cannabis use behaviors. Hierarchical multiple regressions were employed to investigate the predictive value of the social anxiety X parent injunctive norms X peer norms interaction terms on cannabis use behaviors.

RESULTS

Higher social anxiety was associated with more cannabis problems. A three-way interaction emerged between social anxiety, parent injunctive norms, and peer descriptive norms, with respect to cannabis problems. Social anxiety was positively related to more cannabis problems when parent injunctive norms were high (i.e., perceived approval) and peer descriptive norms were low. Results further showed that social anxiety was positively related to more cannabis problems regardless of parent injunctive norms.

CONCLUSIONS

The present work suggests that it may be important to account for parent influences when addressing normative perceptions among young adult cannabis users. Additional research is needed to determine whether interventions incorporating feedback regarding parent norms impacts cannabis use frequency and problems.