Perceived Discrimination and Substance Use among Adolescents: Examining the Moderating Effect of Distress Tolerance and Negative Urgency

Associations of Major Lifetime and Everyday Discrimination with Cognitive Function among Middle-Aged and Older Adults

Objectives

We investigated the associations of lifetime and everyday discrimination with cognitive function.

Methods

Data were from the Chicago Community Adult Health Study (n=2952, mean age=43 years [SD=17]). We fitted multivariable linear regression models to quantify the discrimination-cognition associations.

Results

Major lifetime (β1 vs 0 episodes of discrimination  = 0.56; 95% CI, 0.15-0.96; β2+ vs 0 episodes of discrimination  = 0.64, 95% CI, 0.31-0.97) and everyday (β=0.10, 95% CI, 0.06-0.14) discrimination were positively associated with cognition, and these associations did not differ by race/ethnicity. Among older adults, major lifetime discrimination, but not everyday discrimination, was positively associated with cognition (β2+ vs 0 episodes of discrimination =1.79; 95% CI, 0.79-2.79).

Discussion

Measurement and selection bias may partially explain the counterintuitive study findings. We call for longitudinal research to further investigate the discrimination-cognition relationship.

Sexual Health and Drug Use Prevention for Black Girls (The Dreamer Girls Project): Protocol for an Intervention Development

BACKGROUND

Substance use among adolescent girls is associated with numerous risk characteristics, including engaging in sexual risk behaviors, which can lead to HIV and sexually transmitted infection (STI) diagnoses. This is an important phenomenon to target as there is a significant race-gendered paradox that occurs when Black girls use and misuse drugs. When misuse occurs among this group, they are more likely to face harsher consequences and worse health outcomes than boys and other ethnic-minority girls. Therefore, there is a need to understand the risk and protective factors of drug use and sexual risk behaviors among Black girls and develop a robust intervention that can cater for this group.

OBJECTIVE

We propose the development of a strengths-based prevention education intervention for Black girls between the ages of 13 and 18 years to promote protective factors.

METHODS

A sequential, mixed methods study will be conducted, and we will use the first 3 steps of the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework to begin the development of the intervention. Three aims will be described in this protocol. First, aim 1 is to explore sociocultural risk and protective factors among Black girls between the ages 13 and 18 years in drug use and HIV/STI prevention using focus group methodology and surveys. We will conduct at least 10 focus groups to include up to 75 Black girls or until we reach saturation. Our target sample size for the quantitative portion of the study will be 200 participants. Aim 2 will focus on deciding upon an intervention based on findings from aim 1 and forming a youth advisory board to guide intervention development. Aim 3 will be to conduct a pretest of the intervention with the youth advisory board to determine if the intervention is feasible and will be accepted by Black girls.

RESULTS

The study is part of a 2-year research pilot study award from the National Institutes of Mental Health. Data collection for this study began in October 2021. For aim 1, data collection is 95% complete. We expect to complete all data collection for aim 1 on or before May 30, 2023. Study activities for aim 2 are occurring simultaneously as data are being collected and analyzed and will be completed in the summer of 2023. Study activities for aim 3 will begin in the fall of 2023.

CONCLUSIONS

This study will be one of the few interventions that address both sexual health and drug use together and cater to Black girls. We anticipate that the intervention will be beneficial for Black girls across the nation to work on building culturally appropriate prevention education and building peer social supports, resulting in reduction or delayed substance use and improved sexual health.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05014074; https://clinicaltrials.gov/ct2/show/NCT05014074.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/45007.

Emerging Adulthood Attributes, Discrimination, Mental Health, and Substance Use in a Sample of Asian, Native Hawaiian/Pacific Islander, and White College Students

Although Asian/Pacific Islanders are considered a single ethnic/racial category in national studies, Native Hawaiians/other Pacific Islanders (NHOPIs) and Asians show marked disparities in health outcomes and risk behaviors, including substance use. Currently, knowledge regarding the psychosocial mechanisms by which NHOPI ethnicity is associated with increased substance use, compared with Asian or White, is limited, especially among emerging adults. The present study tested a model in which the relationship between NHOPI ethnicity and higher substance use (i.e., current tobacco, alcohol, marijuana, and illicit drug use) was hypothesized to be mediated through higher emerging adulthood stress (e.g., feeling "in-between," instability), higher self-reported racial/ethnic discrimination, substance use in one's social networks, and poorer mental health symptomology (i.e., depression, anxiety). Data collected at a single time-point from 2,344 college students (M age = 21.2 [SD = 2.1]; 54% Women; 24% NHOPI, 49% Asian, 27% White) were analyzed by employing structural equation modeling. NHOPI and Asian ethnicity were dummy coded with reference to White, and separate analyses were run for NHOPI and Asian groups, with White as the reference group. Results indicated that the association between NHOPI ethnicity and higher substance use was mediated in two steps, via higher racial/ethnic discrimination and poorer mental health symptomatology. NHOPI ethnicity, but not Asian, was associated with higher identification with emerging adulthood attributes, which in turn was associated with increased substance use. Implications are discussed in the context of reducing health disparities faced by NHOPIs.

Understanding the relationship between distress intolerance and problematic Internet use: The mediating role of coping motives and the moderating role of need frustration

INTRODUCTION

There is emerging research interest in exploring the relationship between distress intolerance and problematic Internet use, yet most of the existing studies are limited by cross-sectional design, convenience sampling method, and poor understanding of the potential mediating and moderating factors involved. Based on the distress intolerance theory of addictive behavior and the theory of compensatory internet use, this study investigated a moderated mediation model to explain the impact of distress intolerance on problematic Internet use in adolescents.

METHODS

A three-wave longitudinal survey was conducted with 709 adolescents in Shanghai, China. The gender distribution was even, 50.2% were boys and 49.8% were girls. The mean age at T1 was 14.79 years (SD = 2.87).

RESULTS

Distress intolerance at Time 1 was found to positively predict problematic Internet use at Time 3. This prospective relation was mediated by adolescents' coping motives for Internet use at Time 2. Further, the mediation effect of coping motives for Internet use was moderated by need frustration at Time 2. The moderated mediation model was statistically equivalent for both genders.

CONCLUSIONS

Findings of this study contribute to new knowledge and have practical implications for prevention and intervention of adolescent problematic Internet use.

A Systematic Review on Sexual Health and Drug Use Prevention Interventions for Black Girls

BACKGROUND

The relationship between drug use and poor sexual health outcomes in Black adolescent females such as diagnoses of sexually transmitted infections, HIV, and early/unwanted pregnancy has been established in the literature. Yet, very few interventions have been successful in reducing the risk of poor sexual health outcomes and drug use for adolescent girls. Even more rare are interventions that are catered to specifically to Black girls in the United States, which is a group that has the highest rates of poorer sexual health outcomes and negative consequences associated with drug use. Therefore, this systematic review sought to identify and organize interventions that are focused on preventing HIV, STIs, early pregnancy and drug use for and include large samples of Black girls. Fifteen interventions were identified that met the review's search criteria.

RESULTS

A total of 15 interventions that were published between 2005 and 2020 were included in the review. While all but one intervention focused on sexual health outcomes, two interventions infused drug use education for girls.

CONCLUSION

This review provides recommendations for sexual health and drug use prevention researchers to engage in an intersectional framework and concludes with a summary of next steps to guide future research and policy work to address disparities that impact Black girls.

Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis

BACKGROUND

Distress tolerance (DT) has received increased attention in recent years due to its purported role in dysregulated behaviours and their clinical manifestations, such as problematic substance use (PSU), disordered eating behaviours (e.g., binge-eating and purging; DEB), and borderline personality disorder (BPD) symptomatology. Despite the proposed transdiagnostic utility of DT across PSU, DEB, and BPD, there has yet to be a systematic and comprehensive examination characterising and comparing its association with this class of impulsive-type psychopathology.

METHODS

A systematic search was conducted across five electronic databases using search terms designed to capture extant literature on the association between DT and PSU, DEB, and BPD symptomatology. A series of meta-analyses were undertaken on correlation coefficients from 81 studies to examine the association between DT and each psychopathology domain, as well as impulsive-type psychopathology overall. Moderator analyses were conducted to examine whether these relationships were moderated by DT measurement type, sample type, age, and gender.

RESULTS

DT shared significant, negative, medium correlations with PSU (r = -.18,), DEB (r = -.20), and BPD symptomatology (r = -.27). The magnitude of these associations was not significantly different across the three psychopathology domains, supporting transdiagnostic conceptualisation. DT measurement type, age, and sample type moderated several of these indicated relationships.

LIMITATIONS

The majority of studies were conducted in adult samples from Western countries, limiting understanding of these relationships across development and different cultures.

CONCLUSIONS

The present findings support the putative transdiagnostic role of DT across PSU, DEB, and BPD, which may ultimately inform novel, cross-cutting interventions.

Perceived ethnic discrimination, ethnic-racial socialization, and substance use among ethnic minority adolescents

Perceived discrimination is a significant problem among ethnic minority adolescents and has been consistently linked to negative outcomes, including substance use, although few studies examine this relation with more than one time point. The present study adds to the literature by examining whether ethnic-racial socialization moderates the effects of perceived discrimination at time 1 on recent substance use six months later in a sample of ethnic minority, public high school students in Southern California. The results from analyses of survey data showed that perceived discrimination did not predict the likelihood of the outcomes, and they suggest that discrimination based on attributes other than ethnicity, such as immigration or documentation status, may be operating in the sample. Future research should simultaneously analyze effects of discrimination by type of attribute as well as level (e.g., intragroup, intergroup, and structural). With regard to ethnic-racial socialization in the multivariate models, cultural socialization was negatively related to the likelihood of the outcomes. Preparation for bias was positively related to the likelihood of the outcomes. Promotion of mistrust was not statistically significantly related to the likelihood of the outcomes. Although the socialization variables did not moderate the effect of perceived discrimination, they were clearly related to substance use in multiple ways, suggesting that future research continue to distinguish the effects of socialization by type to better understand how they can be addressed to optimize youth outcomes.