Longitudinal effects of age at onset and first drinking situations on problem drinking

"I've smoked weed with my daughter": Cannabis Use within Families Affected by Parental Opioid Misuse

Youth with parents who use opioids are more likely to engage in early substance use, especially cannabis use. The purpose of this study was to describe the context of cannabis use among families affected by parental opioid misuse. We conducted 25 in-depth interviews with families affected by parental opioid misuse. Participants were parents with a history of opioid misuse and young adults (ages 18-24) who had parents with a history of opioid misuse. Interviews were digitally recorded and professionally transcribed. Data were analyzed inductively using a qualitative content analytic approach. Familial cannabis use was common among young people and their parents. Participants described familial cannabis use as a bonding activity that felt safe and lightened the mood. Additional research is needed to understand the complex role that cannabis use may play in families affected by opioid misuse. Strategies for intergenerational substance use prevention are discussed.

Effects of parental mental health and family environment on impulsivity in preadolescents: a longitudinal ABCD study®

Introduction

Impulsivity is a known risk factor for the development of substance use disorders and other psychiatric conditions that is influenced by both genetics and environment. Although research has linked parental mental health to children's impulsivity, potential mediators of this relationship remain understudied. The current investigation leverages the large national Adolescent Brain Cognitive Development (ABCD) Study to assess the mediating role of family conflict - an important social context for youth development - in the relationship between parental mental health and youth impulsivity.

Methods

Data were from the first three annual waves of the ABCD study (Baseline N = 11,876 children, Mage = 9.9 years; 48% female; 52% White). Parental mental health conditions were self-reported internalizing, externalizing, and total problems. Youth completed the family conflict scale, and Urgency, Planning (lack of), Perseverance (lack of), Sensation Seeking, and Positive Urgency (UPPS-P) scale to measure impulsivity. To determine if within-family change in conflict from baseline to year 1 explained changes in the strength of relations between baseline parental mental health and year 2 youth impulsivity, longitudinal causal mediation analyses were conducted, controlling for demographic factors (i.e., age, sex, race, household income, parental education, marital status), as well as baseline levels of family conflict and outcomes. Separate mediation models were run for each mental health condition and each UPPS-P subscale.

Results

Above and beyond bivariate relations, longitudinal mediation models, which included covariates, showed family conflict significantly (ps < 0.001) mediated relations between all three parental mental health conditions and all but one (i.e., sensation seeking) UPPS-P subscales. The proportion mediated through family conflict for internalizing problems and total problems on facets of impulsivity (except sensation seeking) ranged from 9% (for lack of perseverance) to 17% (for lack of planning). Proportion mediated via family conflict for externalizing problems on youth's impulsivity (except sensation seeking) was slightly higher, ranging between 13% (lack of perseverance) to 21% (lack of planning).

Discussion

Family conflict may be an important intergenerational factor linking parental mental health and youth's impulsivity. Addressing parental mental health and family conflict may help curb increased impulsivity in youth, and in turn reduce adolescent substance use disorders.

Onset of the Non-Medical Use of Prescription and Over-the-Counter Medications during Early Adolescence: Comparison with Alcohol, Tobacco, and Marijuana

This study examined the prevalence and psychosocial predictors of the non-medical use of prescription and over-the-counter (OTC) medications and compared these to cigarette, marijuana, and alcohol use in a cohort of early adolescents (N = 1887) aged 11 to 13, a critical risk period for the initiation of substance use. Participants were students attending 22 middle schools in the northeastern United States. Participants completed surveys in the classroom, the first in the sixth grade and a second in the seventh grade, and the rate of overall substance use more than doubled from 5.5% to 11.9% over this period. Predictors of the onset of non-medical prescription and over-the-counter drug misuse overlapped substantially with those for marijuana and other substances. The perception of friends' substance use and the belief that substance use can help you deal with problems predicted the onset of marijuana use, OTC medication misuse, and prescription drug misuse. Decision-making skills were protective for the onset of all substance use outcomes. The findings of this study have important implications for prevention and suggest that a single comprehensive approach may be sufficient for preventing multiple forms of substance use onset during early adolescence.

A social contextual review of the effects of alcohol on emotion

Drinking and drinking problems are complex phenomena. Understanding the etiology of alcohol use disorder requires consideration of biological, psychological, and social processes. It is our view that the last of these dimensions is just beginning to receive adequate scrutiny. In this selective review, we discuss the concept of a biopsychosocial analysis of the effects of alcohol. After briefly addressing biological and psychological research on alcohol's emotional effects, we bid to make a case for the vital role that social processes play in understanding why people drink. The bulk of the paper describes research illustrating the contributions that a social psychological perspective can make to advance understanding of the rewarding effects of alcohol. Overall, studies incorporating social contexts have revealed reliable evidence that alcohol enhances emotional experience in many social environments and have identified socio-contextual variables that moderate responses to alcohol. Further, these studies have broadened the scope of constructs thought to be socially rewarding, including social bonding, relationship functioning, and humor enjoyment. Our analysis concludes by identifying research areas we believe would profit from additional research.

Disentangling the physical, social, and situational contexts of young adolescents' initiation to alcohol use and intoxication: A mixed methods study

BACKGROUND

The onset of alcohol use during adolescence is associated with concurrent and subsequent related problems. Research on drinking contexts that underly these key first-time experiences and how they differ by initiation type is needed. The current study examined the physical, social, and situational characteristics of three types of initiation: first drink, first heavy episodic drinking (HED), and first intoxication and considered variations between early and later initiating adolescents.

METHODS

A mixed-methods approach was used to survey and interview adolescents who reported lifetime drinking. Survey responses from 471 participants were analyzed using multilevel multinomial and logistic regressions accounting for nesting of drinking events (i.e., type of initiation) within respondents. A subsample of 50 participants recruited at baseline took part in-depth interviews that were thematically coded.

RESULTS

After controlling for demographics, initiation of HED and intoxication, compared to initiation of a whole drink, were more likely to occur when more close friends are present and when those close friends are also drinking. The likelihood of early initiation of a whole drink and intoxication was also positively associated with being in an outdoor setting. Narratives identified distinct and shared patterns of context characteristics across the types of alcohol initiation.

CONCLUSION

The quantitative and qualitative findings revealed several parallels as well as aspects that differ, enriching our understanding of early drinking contexts. Results highlight the importance of considering contextual characteristics by initiation type for prevention efforts.

A prospective investigation of youth alcohol experimentation and reward responsivity in the ABCD study

Rationale

Greater risk-taking behaviors, such as alcohol experimentation, are associated with different patterns of brain functioning in regions implicated in reward (nucleus accumbens, NA) and cognitive control (inferior frontal gyrus, IFG). These neural features have been observed in youth with greater risk-taking tendencies prior to substance use initiation, suggesting NA-IFG disruption may serve as an early marker for subsequent substance use disorders. Prospective studies are needed to determine if NA-IFG neural disruption predicts future substance use in school-age children, including those with minimal use of alcohol (e.g., sipping). The present large-sample prospective study sought to use machine learning to: (1) examine alcohol sipping at ages 9, 10 as a potential behavioral indicator of concurrent underlying altered neural responsivity to reward, and (2) determine if alcohol sipping and NA-IFG activation at ages 9, 10 can be used to predict which youth reported increased alcohol use at ages 11, 12. Additionally, low-level alcohol use and brain functioning at ages 9, 10 were examined as predictors of substance use and brain functioning at ages 11, 12.

Design and methods

This project used data from the baseline (Time 1) and two-year follow-up (Time 2) assessments of the Adolescent Brain Cognitive Development (ABCD) Study (Release 3.0). Support Vector Machine (SVM) learning determined if: (1) NA-IFG neural activity could correctly identify youth who reported alcohol sipping at Time 1 (n = 7409, mean age = 119.34 months, SD = 7.53; 50.27% female), and (2) NA-IFG and alcohol sipping frequency at Time 1 could correctly identify youth who reported drinking alcohol at Time 2 (n = 4000, mean age = 143.25 months, SD = 7.63; 47.53% female). Linear regression was also used to examine the relationship between alcohol sipping and NA-IFG activity at Time 1 and substance use and NA-IFG activity at Time 2. Data were also examined to characterize the environmental context in which youth first tried sips of alcohol (e.g., with or without parental permission, as part of a religious experience).

Results

Approximately 24% of the sample reported having tried sips of alcohol by ages 9, 10. On average, youth reported trying sips of alcohol 4.87 times (SD = 23.19) with age of first sip occurring at 7.36 years old (SD = 1.91). The first SVM model classified youth according to alcohol sipping status at Time 1 no better than chance with an accuracy of 0.35 (balanced accuracy = 0.52, sensitivity = 0.24, specificity = 0.80). The second SVM model classified youth according to alcohol drinking status at Time 2 with an accuracy of 0.76 (balanced accuracy = 0.56, sensitivity = 0.21, specificity = 0.91). Linear regression demonstrated that frequency of alcohol sipping at Time 1 predicted frequency of alcohol use at Time 2 (p < 0.001, adjusted R 2 = 0.075). Alcohol sipping at Time 1 was not linearly associated with NA or IFG activity at Time 2 (all ps > 0.05), and NA activity at Time 1 and Time 2 were not related (all ps > 0.05). Activity in the three subsections of the IFG at Time 1 predicted activity in those same regions at Time 2 (all ps < 0.02).

Conclusions and implications

Early sips of alcohol appear to predict alcohol use in early adolescence. Findings do not provide strong evidence for minimal early alcohol use (sipping) as a behavioral marker of underlying alterations in NA-IFG neural responsivity to reward. Improving our understanding of the neural and behavioral factors that indicate a greater propensity for future substance use is crucial for identifying at-risk youth and potential targets for preventative efforts.

Declining drinking among adolescents: Are we seeing a denormalisation of drinking and a normalisation of non-drinking?

BACKGROUND

In the early 2000s, alcohol use among young people began to decline in many western countries, especially among adolescents (ages between 12-17 years old). These declines have continued steadily over the past two decades, against the backdrop of much smaller declines among the general population.

ARGUMENT

Hypotheses examining individual factors fail adequately to provide the necessary 'big picture' thinking needed to understand declines in adolescent drinking. We use the normalisation thesis to argue that there is strong international evidence for both processes of denormalisation of drinking and normalisation of non-drinking occurring for adolescents in many western countries.

CONCLUSIONS

Research on declining adolescent drinking provides evidence of both denormalisation of alcohol consumption and normalisation of non-drinking. This has implications for enabling policy environments more amenable to regulation and increasing the acceptability of non-drinking in social contexts. Normalisation theory (and its various interpretations) provides a useful multi-dimensional tool for understanding declines in adolescent drinking.

Baseline brain and behavioral factors distinguish adolescent substance initiators and non-initiators at follow-up

Background

Earlier substance use (SU) initiation is associated with greater risk for the development of SU disorders (SUDs), while delays in SU initiation are associated with a diminished risk for SUDs. Thus, identifying brain and behavioral factors that are markers of enhanced risk for earlier SU has major public health import. Heightened reward-sensitivity and risk-taking are two factors that confer risk for earlier SU.

Materials and methods

We characterized neural and behavioral factors associated with reward-sensitivity and risk-taking in substance-naïve adolescents (N = 70; 11.1-14.0 years), examining whether these factors differed as a function of subsequent SU initiation at 18- and 36-months follow-up. Adolescents completed a reward-related decision-making task while undergoing functional MRI. Measures of reward sensitivity (Behavioral Inhibition System-Behavioral Approach System; BIS-BAS), impulsive decision-making (delay discounting task), and SUD risk [Drug Use Screening Inventory, Revised (DUSI-R)] were collected. These metrics were compared for youth who did [Substance Initiators (SI); n = 27] and did not [Substance Non-initiators (SN); n = 43] initiate SU at follow-up.

Results

While SI and SN youth showed similar task-based risk-taking behavior, SI youth showed more variable patterns of activation in left insular cortex during high-risk selections, and left anterior cingulate cortex in response to rewarded outcomes. Groups displayed similar discounting behavior. SI participants scored higher on the DUSI-R and the BAS sub-scale.

Conclusion

Activation patterns in the insula and anterior cingulate cortex may serve as a biomarker for earlier SU initiation. Importantly, these brain regions are implicated in the development and experience of SUDs, suggesting differences in these regions prior to substance exposure.

Impact of Early, Weekly Drinking on Latent Classes of Alcohol Involvement Progression and Recovery: Evidence from the NESARC Waves 1 and 2

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Weekly drinking before age 18 seems to impact alcohol progression over time.

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For females, extreme transitions from no problems to severe problems were impacted.

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For males, transitions from moderate to severe alcohol problems were impacted.

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Early, weekly drinking also predicted increased recovery for males.

Introduction

Early drinkers have been found to have higher risk of developing alcohol use disorder; however, the association of early drinking with progression to problematic alcohol involvement that does not meet disorder criteria (i.e., subclinical problems) or to severe stages of alcohol involvement, sex-specific associations, and relationship of early drinking with alcohol recovery have rarely been investigated.

Methods

Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we applied latent transition analyses to investigate the impact of weekly drinking before age 18 on alcohol progression and recovery operationalized as three classes of alcohol involvement using abuse and dependence indicators. We analyzed data separately for male (n = 12,276) and female (n = 14,750) drinkers and applied propensity score methods to address confounding.

Results

We observed significant associations between early, weekly drinking and alcohol involvement class membership at Wave 1 for both males and females. For males, early, weekly drinking was also associated with greater odds of transitioning from moderate to severe alcohol problems (aOR = 3.19, 95% CI = 1.72, 5.35). For females, early, weekly drinking predicted the transition from no to severe problems (aOR = 2.98, 95% CI = 1.11–8.00). Contrary to our hypothesis, early, weekly drinking was associated with greater likelihood of transition from severe to no problems for males (aOR = 3.23, 95% CI = 1.26, 8.26).

Discussion

Frequent, early drinking seems to be an important indicator of drinking progression with differential associations by sex. This information is useful to identify those at greater risk of progressing to severe drinking problems to intervene appropriately.

Incipient alcohol use in childhood: Early alcohol sipping and its relations with psychopathology and personality

Prior research has shown that sipping of alcohol begins to emerge during childhood and is potentially etiologically significant for later substance use problems. Using a large, community sample of 9- and 10-year-olds (N = 11,872; 53% female), we examined individual differences in precocious alcohol use in the form of alcohol sipping. We focused explicitly on features that are robust and well-demonstrated correlates of, and antecedents to, alcohol excess and related problems later in the lifespan, including youth- and parent-reported externalizing traits (i.e., impulsivity, behavioral inhibition and activation) and psychopathology. Seventeen percent of the sample reported sipping alcohol outside of a religiously sanctioned activity by age 9 or 10. Several aspects of psychopathology and personality emerged as small but reliable correlates of sipping. Nonreligious sipping was related to youth-reported impulsigenic traits, aspects of behavioral activation, prodromal psychotic-like symptoms, and mood disorder diagnoses, as well as parent-reported externalizing disorder diagnoses. Religious sipping was unexpectedly associated with certain aspects of impulsivity. Together, our findings point to the potential importance of impulsivity and other transdiagnostic indicators of psychopathology (e.g., emotion dysregulation, novelty seeking) in the earliest forms of drinking behavior.

Alcohol-related cognitions: Implications for concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse among young adults

INTRODUCTION

This study examined the associations between alcohol-related cognitions within the social reaction pathway of the Prototype Willingness Model and concurrent (use of two or more substances within a specified time period) use of 1) alcohol and marijuana and 2) alcohol and prescription stimulant misuse.

METHODS

A convenience sample of 1,062 emerging adults in the U.S. (18-20 years old; 54.5% female) who reported past 3-month alcohol use completed a baseline survey as part of a larger randomized controlled trial.

RESULTS

Results indicate that controlling for age, biological sex, race, ethnicity, and college enrollment, perceived descriptive norms and willingness to drink were associated with past 3-month concurrent alcohol and marijuana use and concurrent alcohol and prescription stimulant misuse. However, alcohol prototype similarity and alcohol-related perceived vulnerability were not associated with either concurrent use outcome examined.

DISCUSSION

These findings suggest that alcohol-related perceived descriptive norms and willingness to drink are associated with concurrent substance use among young adults. Thus, it is possible that existing efficacious alcohol interventions that target descriptive norms and willingness to drink may have the added benefit of also reducing concurrent substance cognitions and ultimately use.

Alcohol and Brain Development in Adolescents and Young Adults: A Systematic Review of the Literature and Advisory Report of the Health Council of the Netherlands

Young people, whose brains are still developing, might entail a greater vulnerability to the effects of alcohol consumption on brain function and development. A committee of experts of the Health Council of the Netherlands evaluated the state of scientific knowledge regarding the question whether alcohol negatively influences brain development in young people. A systematic literature search for prospective studies was performed in PubMed and PsychINFO, for longitudinal studies of adolescents or young adults ranging between 12 and 24 y of age at baseline, investigating the relation between alcohol use and outcome measures of brain structure and activity, cognitive functioning, educational achievement, or alcohol use disorder (AUD), with measures at baseline and follow-up of the outcome of interest. Data were extracted from original articles and study quality was assessed using the Newcastle-Ottawa Scale. A total of 77 studies were included, 31 of which were of sufficient quality in relation to the study objectives. There were indications that the gray matter of the brain develops abnormally in young people who drink alcohol. In addition, the more often young people drink or the younger they start, the higher the risk of developing AUD later in life. The evidence on white matter volume or quality, brain activity, cognitive function, and educational achievement is still limited or unclear. The committee found indications that alcohol consumption can have a negative effect on brain development in adolescents and young adults and entails a risk of later AUD. The committee therefore considers it a wise choice for adolescents and young adults not to drink alcohol.

The importance of psychology for shaping legal cannabis regulation

Different patterns of cannabis use can be traced directly back to different interactions between 2 types of variables: pharmacological and environmental. As legal cannabis expands in the U.S. and around the world, state and national regulatory agencies are gaining control over these variables. Specifically, regulatory agencies are increasingly capable of altering (a) the pharmacological properties of cannabis products and (b) the way these products are distributed to the population. Consequently, cannabis regulatory agencies are in a unique position to use evidence from psychological science to alter cannabis consumption patterns in ways that mitigate potential harm to public health. However, most state-level legal cannabis regulatory systems in the U.S. are not yet evidence-based or public health-oriented. This applied review and commentary draws on evidence from the psychological science literature to help regulators better understand the types of behaviors they must address and guide empirically supported regulation of THC-laden cannabis, whether used putatively for medical or recreational reasons. This review is organized into 3 parts that correspond to the 3 primary agents within the cannabis regulation ecosystem: (a) the cannabis consumer, (b) the cannabis industry, and (c) the cannabis regulatory agency. Within this structure, the review addresses critical psychological variables that drive cannabis consumer and industry behaviors and discusses how regulatory agencies can use this information to protect public health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Association Between Age at Initiation of Alcohol Consumption and Type 2 Diabetes Mellitus: A Cohort Study of 0.5 Million Persons in China

It is well known that alcohol consumption is associated with type 2 diabetes mellitus. However, the association of age at initiation of alcohol consumption and duration of alcohol drinking with type 2 diabetes mellitus among Chinese adults is not fully understood. This study was based on data from the China Kadoorie Biobank, which included 512,712 participants aged 30-79 years who were living in China in 2004-2008. A Cox proportional hazards model was used to estimate the association of AAI and drinking duration with type 2 diabetes. After adjustment for potential covariates, ages at alcohol initiation (AAIs) of 18.1-29.0 years, 29.1-39.0 years, and >39.0 years were associated with 22% (95% confidence interval (CI): 14, 30), 25% (95% CI: 17, 33), and 32% (95% CI: 24, 39) lower hazards of type 2 diabetes compared with abstaining, respectively. Drinking durations of <10.1 years, 10.1-20.0 years, and 20.1-30.0 years were associated with a lower risk of type 2 diabetes, compared with abstaining. Among current (weekly) drinkers, AAI <18.1 years and drinking duration >30.0 years were associated with 18% (95% CI: 4, 33) and 20% (95% CI: 3, 40) higher hazards of type 2 diabetes, compared with AAI 18.1-29.0 years and drinking duration <10.1 years, respectively. In conclusion, late AAI and a short drinking duration were associated with a lower risk of type 2 diabetes in this large prospective cohort study of Chinese adults, but early AAI and long drinking duration were not.

Why now? Examining antecedents for substance use initiation among African American adolescents

Current adolescent substance use risk models have inadequately predicted use for African Americans, offering limited knowledge about differential predictability as a function of developmental period. Among a sample of 500 African American youth (ages 11-21), four risk indices (i.e., social risk, attitudinal risk, intrapersonal risk, and racial discrimination risk) were examined in the prediction of alcohol, marijuana, and cigarette initiation during early (ages 11-13), mid (ages 16-18), and late (ages 19-21) adolescence. Results showed that when developmental periods were combined, racial discrimination was the only index that predicted initiation for all three substances. However, when risk models were stratified based on developmental period, variation was found within and across substance types. Results highlight the importance of racial discrimination in understanding substance use initiation among African American youth and the need for tailored interventions based on developmental stage.

Apoptosis-triggered decline in hippocampal microglia mediates adolescent intermittent alcohol exposure-induced depression-like behaviors in mice

Depression-alcohol addiction comorbidity is a common clinical phenomenon. Alcohol exposure in adolescence has been shown to induce depression-like behaviors in rodents. However, the mechanism of action for this type of depression remains unclear. Previous studies have reported that several different types of stress, such as chronic unpredictable stress and early social isolation, trigger depression-like symptoms in mice by inducing hippocampal microglial decline, which is mediated by the initial activation of the microglial cells. Since alcohol also activates microglia, we evaluated the dynamic changes in hippocampal microglia in mice receiving adolescent intermittent alcohol exposure (AIE). Our results showed that 14 days of AIE, followed by 21 days period of no treatment, induced behavioral abnormalities as well as a significant loss and dystrophy of hippocampal microglia in mice. We found that this AIE-induced decline in hippocampal microglia was mediated by both microglial activation and apoptosis, as (i) 1 day of alcohol exposure induced a distinct activation of hippocampal microglia followed by their apoptosis, and (ii) blocking the initial activation of hippocampal microglia by pretreatment with minocycline suppressed the AIE-induced apoptosis and loss of hippocampal microglia as well as the AIE-induced depression-like symptoms. Lipopolysaccharide (LPS), a classical activator of microglia, ameliorated the AIE-induced depression-like symptoms by reversing the decline in the hippocampal microglia. These results reveal a possible mechanism for AIE-induced depression and demonstrate that the restoration of hippocampal microglial homeostasis may be a therapeutic strategy for depression induced by alcohol intake and withdrawal.

"GiochiAMO," a Gaming Intervention to Prevent Smoking and Alcohol Habits Among Children: A Single-Arm Field Trial

Objectives: To evaluate the efficacy of the "GiochiAMO" prevention program on modifying children's knowledge and belief regarding the use and abuse of alcohol and tobacco smoking. Materials and Methods: "GiochiAMO" is a multicomponent single-arm field trial based on card and board games to teach and enhance knowledge about risk factors related to smoking and alcohol consumption. A structured questionnaire was administered before and after the intervention to assess any change in knowledge. Results: A total of 167 students between 9 and 11 years of age took part in the intervention. Data concerning knowledge about cigarette smoking showed a statistically significant improvement (P = 0.008) with an increase of the mean scores from 5.93 (standard deviation [SD] = 2.05) to 7.90 (SD = 2.03). The scores related to the life skills of the intervention performed in the fourth grade classes demonstrated statistically significant improvements (P = 0.027). The scores related to the knowledge about alcohol consumption highlighted a statistically significant improvement (P < 0.001), with mean scores that rose from 7.44 (SD = 1.99) to 9.41 (SD = 1.94). The scores related to the life skills of the intervention performed in the fifth grade classes demonstrated improvements, although they were not statistically significant (P = 0.770). Conclusions: "GiochiAMO" demonstrated significantly improved knowledge about the risk and consequences of cigarette smoking and alcohol consumption on health. Longer follow-up studies, including a larger sample size, will be needed.

Predictors of Alcohol Use Disorders Among Young Adults: A Systematic Review of Longitudinal Studies

AIMS

Alcohol use disorders (AUDs) are highly disabling neuropsychiatric conditions. Although evidence suggests a high burden of AUDs in young adults, few studies have investigated their life course predictors. It is crucial to assess factors that may influence these disorders from early life through adolescence to deter AUDs in early adulthood by tailoring prevention and intervention strategies. This review aims to assess temporal links between childhood and adolescent predictors of clinically diagnosed AUDs in young adults.

METHODS

We systematically searched PubMed, Scopus, PsycINFO and Embase databases for longitudinally assessed predictors of AUDs in young adults. Data were extracted and assessed for quality using the Newcastle-Ottawa quality assessment tool for cohort studies. We performed our analysis by grouping predictors under six main domains.

RESULTS AND CONCLUSION

Twenty two studies met the eligibility criteria. The outcome in all studies was measured according to the Diagnostic Statistical Manual of Mental Disorders. Our review suggests strong links between externalizing symptoms in adolescence and AUDs in young adulthood, as well as when externalizing symptoms co-occur with illicit drug use. Findings on the role of internalizing symptoms and early drinking onset were inconclusive. Environmental factors were influential but changed over time. In earlier years, maternal drinking predicted early adult AUD while parental monitoring and school engagement were protective. Both peer and parental influences waned in adulthood. Further high-quality large longitudinal studies that identify distinctive developmental pathways on the aetiology of AUDs and assess the role of early internalizing symptoms and early drinking onset are warranted.

Predicting hazardous drinking in late adolescence/young adulthood from early and excessive adolescent drinking - a longitudinal cross-national study of Norwegian and Australian adolescents

Background

Research has consistently shown that early onset of drinking (EOD) is associated with alcohol-related problems in adulthood. However, recent reviews have identified several limitations in the early onset literature, including the use of retrospective reports, insufficient control for potential confounders, ambiguous definitions of the concept, and an assumption that early onset is independent of cultural norms and national alcohol policies. This study addresses these limitations by examining whether EOD, independent of early onset of excessive drinking (EOE), prospectively predicts hazardous drinking in late adolescence/young adulthood in Norway and Australia, two countries with different drinking cultures.

Methods

Data were drawn from two population-based longitudinal studies; the Norwegian Tracking Opportunities and Problems Study (n = 329) and the Australian International Youth Development Study (n = 786). Data were collected prospectively from mid adolescence (14–16 years) to late adolescence/young adulthood (18–25 years) and a modified Poisson regression approach was used to estimate prevalence ratios. Adolescent self-reports included measures of EOD and EOE. Young adults completed the Alcohol Use Disorders Identification Test (AUDIT). The results were adjusted for adolescent factors; age, gender, impulsivity, hyperactivity, conduct problems, smoking, early sexual intercourse and friends’ substance use, and family factors; alcohol and drug use in the family, maternal education, family management and monitoring.

Results

Hazardous drinking was identified in 46.8 and 38.9% of young adults in Norway and Australia, respectively. Both EOD and EOE in adolescence were significantly related to an increased risk of alcohol-related problems in late adolescence/young adulthood in both studies, even when adjusting for possible confounders.

Conclusion

Our findings indicate that adolescent drinking behaviour is an indicator of alcohol-related problems in late adolescence/young adulthood, even when controlling for a variety of covariates. This finding is in contrast to previous research on older adults, where no association between adolescent drinking and later alcohol-related problems were found when controlling for covariates. The divergence in findings may suggest that the impact of EOD/EOE is limited to the late adolescent and young adult period. Preventing drinking in early adolescence may thus have some impact on the drinking patterns in late adolescence/young adulthood.

Predictors of quickly progressing from initiating alcohol use to engaging in binge drinking among adolescents

Background

A short delay to first intoxication confers alcohol-related risk, but risk factors for a short delay have yet to be examined.

Methods

230 high school students (55.7% male; age 16.52 [1.19] years; 70.9% White) were surveyed about alcohol use. We examined whether sex, race, parental history of alcohol problems, age of onset, type of alcohol consumed, drinking company, and subjective response to alcohol were associated with 1) delay to first binge episode and 2) binge drinking status (i.e., never bingers, individuals who binge drank on their first drinking occasion, and individuals who binge drank at a later date). Finally, we examined whether first-occasion bingers reported heavier drinking and alcohol-related problems than later-occasion and never bingers.

Results

Overall, a shorter delay was associated with being male an older age of onset, and, during one's first drinking experience, consuming liquor, drinking with friends or alone, and experiencing high arousal negative alcohol effects. First-occasion bingers were more likely to be male, consume liquor, and experience stronger high arousal positive and negative alcohol effects than never bingers and to have a later age of onset, experience stronger high arousal negative, and weaker low arousal negative alcohol effects than later-occasion bingers. First-occasion bingers also reported heavier current drinking and more alcohol-related problems.

Conclusions

Characteristics of underage drinkers that confer risk for a shorter delay and first-occasion binging may provide fruitful targets for intervention, as efforts to delay binge drinking may mitigate alcohol-related risk associated with underage alcohol use.

Epidemiology of alcohol-related emergency hospital admissions in children and adolescents: An e-cohort analysis in Wales in 2006-2011

OBJECTIVE

Harmful levels of alcohol consumption in young people are prevalent and of increasing public concern in the western world. Rates of alcohol-related emergency hospital admissions in children and young people between 10 to 17 years were described, and the reasons for these admissions and their association with socio-demographic factors were examined.

METHODS

E-cohort data were extracted from the Secure Anonymised Information Linkage Databank, which contained alcohol-related emergency hospital admissions (N = 2968) from 2006 to 2011 in children and adolescents aged 10 to 17 years in Wales. A generalised linear mixed model was fitted using a log-link with a population offset to the data to calculate incident rate ratios (IRRSs).

RESULTS

There was a general decreasing trend from 2006 to 2011 in the number and rate of alcohol-related emergency hospital admissions; the mean age of admission was 15.4 (standard deviation 1.4) years. In each of the four youngest age groups (10-13,14,15,16 years), females had higher IRRs than males. Males had slightly higher IRR compared to females only in the oldest age group (17 years). IRRs increased with increasing deprivation. The majority (92%) of the admissions lasted one day and most of the admissions (70%) occured during the last three days of the week with a peak on Saturday. The length of stay in hospital was longer in cases when self-harm were present. Multiple admissions showed high prevalance of serious self-harm cases in females. The number of admissions with injuries and falls were higher for males than females.

CONCLUSION

Female children and adolescents were more likely to be admitted to hospital for alcohol-related reasons. These data illustrate the significant burden of alcohol-related harm in young people and highlight the need for interventions and policies that promote safe drinking practices among young people to prevent future alcohol-related harm during the life-course.

Advanced School Progression Relative to Age and Early Family Formation in Mexico

Research has documented a negative association between women's educational attainment and early sexual intercourse, union formation, and pregnancy. However, the implications that school progression relative to age may have for the timing and order of such transitions are poorly understood. In this article, I argue that educational attainment has different implications depending on a student's progression through school grades relative to her age. Using month of birth and age-at-school-entry policies to estimate the effect of advanced school progression by age, I show that it accelerates the occurrence of family formation and sexual onset among teenage women in Mexico. Focusing on girls aged 15-17 interviewed by a national survey, I find that those who progress through school ahead of their birth cohort have a higher probability of having had sex, been pregnant, and cohabited by the time of interview. I argue that this pattern of behaviors is explained by experiences that lead them to accelerate their transition to adulthood compared with same-age students with fewer completed school grades, such as exposure to relatively older peers in school and completing academic milestones earlier in life. Among girls who got pregnant, those with an advanced school progression by age are more likely to engage in drug use, alcohol consumption, and smoking before conception; more likely to have pregnancy-related health complications; and less likely to attend prenatal care visits. Thus, an advanced school progression by age has substantial implications for the health and well-being of young women, with potential intergenerational consequences.

Predictors of Adverse Alcohol Use Consequences Among Tertiary Students

BACKGROUND

The alcohol consumption patterns of young adults are of concern. Critically, tertiary students consume greater quantities of alcohol, are at increased risk of injury/harm, and have higher rates of alcohol use disorders as compared to their nonuniversity enrolled peers. The Brief Young Adult Alcohol Consequences Questionnaire (BYAACQ) is one of several tools utilized to explore adverse alcohol-related outcomes among tertiary students. Alcohol intake behavior, assessed via retrospective summary measures, has been linked to BYAACQ score. It is unclear, however, how drinking assessed in real time, in conjunction with variables such as age of drinking onset, might predict severity of adverse alcohol consequences as captured by the BYAACQ.

METHODS

The psychometric properties of the BYAACQ were explored using a large Australian sample of tertiary students (N = 893). A subsample (n = 504) provided alcohol intake information in real time (21 days; event and notification contingent) via a smartphone app (CNLab-A) plus details related to age of drinking onset, drug use, parental alcohol/drug use, and anxiety/depression symptomology.

RESULTS

Average BYAACQ score was 7.53 (SD = 5.37). Classical and item response theory analyses revealed inconsistencies related to dimensionality, progressive item severity, and male/female differential item functioning. Current drinking-namely, frequency of intake and quantity per drinking occasion-plus age of drinking onset predicted BYAACQ score after controlling for age, other drug use, and depression symptomology.

CONCLUSIONS

The BYAACQ is a sound tool for use with Australian samples. Information related to current drinking, age of drinking onset, and drug use is useful for predicting severity of alcohol use consequences. These markers might enable tertiary institutions to better target students who could benefit from prevention/intervention programs.

Very early drinking: Event history models predicting alcohol use initiation from age 4 to 11 years

While it is not normative to initiate alcohol use prior to adolescence, substantial numbers of children do so. However, relatively little is known about the prevalence or predictors of alcohol initiation in childhood, compared to extensive research on adolescent initiation and alcohol use. The present study examines patterns and predictors of very early drinking initiation in childhood, focusing on child behavioral undercontrol and parent alcohol and drug use as time-varying risk factors across childhood, independent of sociodemographic background variables. Event history analyses model and predict the age of alcohol initiation across ages 4 to 11 in the ongoing Millennium Cohort Study. Methodological strengths include the prospective design initiated in infancy (prior to any alcohol consumption), multiple reporters, and large representative sample of children and parents (n = 11,355). Key predictors are child behavioral undercontrol and parent alcohol and drug use assessed across childhood. Weighted results show that <2% of children had their first drink of alcohol prior to their 8th birthday, rising to 13% by age 10-11 years. Odds of initiation are higher when parents rated children as behaviorally undercontrolled and when at least one parent in the household reported drinking alcohol and/or using illegal drugs, independent of sociodemographic group differences. Thus, an important minority initiated drinking during childhood, and there are key risk factors for early drinking. Increased focus on the epidemiology, etiology, and prevention of childhood drinking is needed.

Investigating the association between age at first alcohol use and suicidal ideation among high school students: Evidence from the youth risk behavior surveillance system

BACKGROUND

Although various studies have investigated and found a significant link between age at first alcohol use and health risk behaviors, few studies have investigated the effect of age at first alcohol use on suicidal ideation among adolescents. The objective of this study was to investigate the effect of age at first alcohol use on suicidal ideation.

METHODS

Data for this study were obtained from the 2015 Youth Risk Behavior Surveillance system. A sample of 10,745 adolescents aged 14-18 years (50.9% males) were analyzed using logistic regression with suicidal ideation as the outcome variable and age at first alcohol use as the main explanatory variable.

RESULTS

About 17% of adolescents experienced suicidal ideation during the past 12 months and 15.6% started having alcohol before age 13. Adolescents who started having alcohol before age 13 had 1.60 times higher odds of experiencing suicidal ideation and adolescents who started having alcohol by age 13 or over had 1.47 times higher odds of experiencing suicidal ideation. Other significant factors associated with suicidal ideation include experience of forced sex, physical teen dating violence, bullying, and feeling sad or hopeless. Having sufficient sleep lowered the odds of suicidal ideation.

LIMITATIONS

The use of cross-sectional data limits the extent to which we can make causal claims regarding age at first alcohol use and suicidal ideation.

CONCLUSIONS

Younger age at first alcohol use was associated with increased likelihood of suicidal ideation. Public health initiatives that seek to address the co-occurring problems of alcohol use and mental health illness, sexual violence, and victimization among sexual minority youth could help in reducing suicidal ideation.

Associations of Early Age of First Intoxication with Past Year Drinking Contexts and Problems

BACKGROUND

Mechanisms underlying associations between early drinking and problems are largely unknown.

OBJECTIVES

We investigated (a) associations between early age of first intoxication (≤15 years) and past year drinking in different contexts and (b) whether early age of first intoxication is differentially associated with problems in these contexts.

METHODS

We used survey data collected in 2013-2014 from 405 past-year adolescent drinkers in 24 midsized California cities. Data included demographics; drinking behaviors; age of first intoxication; frequency of being at and drinking at restaurants, bars/nightclubs, outdoor places, and home; and problems. We used multilevel logistic and negative binomial models to account for the clustering of adolescents within cities. Probabilities were corrected to maintain family-wise error rates.

RESULTS

Early age of first intoxication was associated with a 120% increase in the odds of drinking at outdoor settings (OR = 2.20, p_c < .05). Early age of first intoxication was associated with increased numbers of problems related to drinking in restaurants (IRR = 5.72, p_c < .001), outdoor settings (IRR = 3.40, p_c < .001), and homes (IRR = 2.84, p_c < .001). Later intoxication (≥16 years) was not significantly associated with increased drinking or problems in any of these contexts.

CONCLUSIONS

Results suggest that underage drinkers who report early intoxication are more likely to drink at outdoor settings, but not other contexts. However, they may differentially experience drinking problems across contexts. To target youths who have experienced intoxication at an early age and to reduce problems, prevention interventions should focus on outdoor settings.

Comparison of age of first drink and age of first intoxication as predictors of substance use and mental health problems in adulthood

BACKGROUND

International public policy on age of first alcoholic drink (AFD) has emphasised the long-term benefits of delaying AFD. This study aimed to compare AFD to age of first intoxication (AFI) as predictors of substance use disorder and mental disorder outcomes in adulthood.

METHODS

Data were obtained from a longitudinal birth cohort in Christchurch, New Zealand. Participants were born in 1977. Analysis samples ranged from n = 1025 (age 18) to n = 962 (age 35). Measures of AFD and AFI were generated using parental- and self-report data collected from age 11. Outcomes at age 18-35 were alcohol quantity consumed, DSM-IV alcohol use disorder (AUD) and AUD symptoms, major depression, anxiety disorder, and nicotine, cannabis, and other illicit drug dependence. Covariate factors measured during childhood included family socioeconomic status, family functioning, parental alcohol-related attitudes/behaviours, and individual factors.

RESULTS

There was a significant unadjusted association between AFD and symptoms of AUD (p < .001) and nicotine dependence (p < .05) but not other outcomes. AFI was significantly (p < .05) associated with all outcomes. After adjustment for covariates, the association between AFD and outcomes was not statistically significant. Conversely, in adjusted models, statistically significant (p < .05) associations remained between AFI and all AUD and substance use disorder outcomes but not alcohol consumption or mental disorder outcomes.

CONCLUSIONS

AFI was a more robust predictor of adult substance use disorder outcomes than AFD. Public health and policy interventions aimed at prevention of long term harms from alcohol should therefore focus on AFI rather than AFD.

Epidemiology of Alcohol Use in Late Adolescence in Greece and Comorbidity with Depression and Other Common Mental Disorders

BACKGROUND

The aim of the current study was to examine the prevalence and associations of hazardous alcohol use with sociodemographic variables and its comorbidity with depression and other common mental disorders in a sample of Greek adolescents between 16 and 18 year old.

METHODS

We recruited 2431 adolescents attending 25 senior high schools in Greece. We assessed depressive and anxiety disorders using the computerized version of a fully-structured psychiatric interview (the revised Clinical Interview Schedule / CIS-R). Alcohol use was assessed using questions taken from a previous WHO school survey.

RESULTS

Approximately one-third of adolescents (overall: 30.7%, boys: 39.2%, girls: 21.9%, p < 0.001) consumed alcohol on a weekly basis. The experience of excessive consumption, leading to drunkenness at least two or more times in their lifetime, was reported by 15.39% of the adolescents (19.42% for the boys and 11.24% for the girls, p < 0.001). Frequent alcohol consumption and drunkenness were strongly associated with the presence of depression, all other anxiety disorders except panic disorder, current smoking, and lifetime cannabis use, lower school performance, bad or fair relationship with parents, and increased health services use.

CONCLUSION

Alcohol use is highly prevalent among Greek adolescents. Special attention for the development of more focused preventive strategies should be paid to adolescents suffering from depression or other common mental disorders.

The Comprehensive Early Drinking History Form: A Novel Measure of Early Alcohol Exposure

BACKGROUND

Adolescent and young adult alcohol use is a major public health concern; alcohol is the most widely used substance by teenagers. It is imperative to better understand alcohol use during adolescence and early adulthood given the important changes that occur. Although numerous measures aim to capture alcohol use during this time, no existing measure gathers comprehensive information on alcohol use across these developmental stages. We developed the Comprehensive Early Drinking History Form (CEDHF), which retrospectively gathers drinking information for each year since onset of first regular use, including quantity/frequency of both regular use and periods of heaviest drinking. The CEDHF also collects information on aggregate drinking experiences between age of onset and age of first regular use.

METHODS

Using a sample of young adults (ages 21 to 27) from an ongoing longitudinal study, we examined whether the CEDHF predicted both concurrent (N = 303) and future (N = 75) alcohol-related problems over and above other commonly used alcohol use measures (e.g., age of onset, age of first intoxication, Timeline Follow-Back) and current alcohol problems.

RESULTS

Controlling for gender, age, and current problems, the CEDHF predicted both concurrent and future alcohol-related problems over and above these other widely used measures of alcohol exposure.

CONCLUSIONS

The CEDHF may be a valuable tool when longitudinal studies are not feasible as it provides more comprehensive information than other widely used measures of early alcohol exposure. Further, this measure can provide detailed information regarding who is at highest risk for future consequences.

Measuring adolescent drinking-refusal self-efficacy: Development and validation of the Drinking Refusal Self-Efficacy Questionnaire-Shortened Adolescent version (DRSEQ-SRA)

BACKGROUND

This study aimed to develop and validate a shortened version of the Drinking Refusal Self-Efficacy Questionnaire-Revised Adolescent version (DRSEQ-RA) using a large sample of adolescents.

METHODS

Secondary school students (N = 2609, M = 14.52 years, SD = 0.94) completed the DRSEQ-RA (consisting of subscales: Social Pressure; Opportunistic; Emotional Relief) and the Alcohol Use Disorders Identification Test (AUDIT). These data were analysed using non-parametric item response theory (NIRT) including Mokken scalability coefficients, and confirmatory factor analysis.

RESULTS

Social Pressure subscale items were better able to distinguish between adolescents with lower or higher levels of drinking refusal self-efficacy, while the Opportunistic and Emotional Relief subscale items were able to distinguish adolescents with low drinking-refusal self-efficacy. The DRSEQ-RA was reduced from 19-items to a 9-item scale and retained the original three-factor structure. The reduced scale was named the Drinking Refusal Self-Efficacy Questionnaire-Shortened Revised Adolescent version (DRSEQ-SRA). The DRSEQ-RA and the DRSEQ-SRA have almost identical psychometric properties. They both demonstrated good fit to the data, each explained 18% of the variance in alcohol consumption, Adj. R² = 0.18, p < .001 respectively. The DRSEQ-RA and the DRSEQ-SRA also have excellent scale and subscale internal reliability (αs = 0.92-0.99).

CONCLUSIONS

The DRSEQ-SRA is a short, 9-item, measure of adolescent drinking-refusal self-efficacy which demonstrates both reliability and validity. A significant advantage is brevity. The DRSEQ-SRA may be a valuable tool for identifying risk of adolescent drinking and prevention/treatment planning in settings where survey administration time is critical.

Concurrent and Prospective Associations Between Substance-Specific Parenting Practices and Child Cigarette, Alcohol, and Marijuana Use

PURPOSE

The current study aimed to understand whether substance-specific parenting practices predicted the probability of child alcohol, cigarette, or marijuana use beyond known family factors like family management and parental substance use and norms.

METHODS

Data were drawn from the Intergenerational Project, which used an accelerated longitudinal design and included 383 families surveyed seven times between 2002 and 2011. Analyses included 224 families with children ages 10-18 years (49% female). Multilevel models tested both concurrent and lagged (predictors at time t - 1, outcomes at time t) associations between child past year use of alcohol, cigarettes, and marijuana and time-varying measures of substance-specific parenting practices, including permitting child use of alcohol or cigarettes; family rules about alcohol, cigarette, and drug use; and child involvement in family member alcohol or cigarette use (getting, opening, or pouring alcoholic drinks; getting or lighting cigarettes for family members). Demographic controls were included.

RESULTS

Child involvement in family member substance use predicted an increased probability of child substance use both concurrently and 1 year later, even when controlling parent substance use, pro-substance norms, and family management. Family rules about substance use and parent provision of alcohol or cigarettes were not consistently related to child alcohol, cigarette, or marijuana use.

CONCLUSIONS

Family-based preventive interventions to reduce youth substance use should continue to focus on family management and include messaging discouraging parents from allowing children to get, open, or pour drinks or get or light cigarettes for family members.

Cue-Induced Ethanol Seeking in Drosophila melanogaster Is Dose-Dependent

Alcohol use disorder generates devastating social, medical and economic burdens, making it a major global health issue. The persistent nature of memories associated with intoxication experiences often induces cravings and triggers relapse in recovering individuals. Despite recent advances, the neural and molecular mechanisms underlying these memories are complex and not well understood. This makes finding effective pharmacological targets challenging. The investigation of persistent alcohol-associated memories in the fruit fly, Drosophila melanogaster, presents a unique opportunity to gain a comprehensive understanding of the memories for ethanol reward at the level of genes, molecules, neurons and circuits. Here we characterize the dose-dependent nature of ethanol on the expression of memory for an intoxication experience. We report that the concentration of ethanol, number of ethanol exposures, length of ethanol exposures, and timing between ethanol exposures are critical in determining whether ethanol is perceived as aversive or appetitive, and in how long the memory for the intoxicating properties of ethanol last. Our study highlights that fruit flies display both acute and persistent memories for ethanol-conditioned odor cues, and that a combination of parameters that determine the intoxication state of the fly influence the seemingly complex retention and expression of memories associated with intoxication. Our thorough behavioral characterization provides the opportunity to interrogate the biological underpinnings of these observed preference differences in future studies.

Age at drinking onset, age at first intoxication, and delay to first intoxication: Assessing the concurrent validity of measures of drinking initiation with alcohol use and related problems

INTRODUCTION

Drinking at an early age (AO) and quickly progressing to drinking to intoxication (Delay=Age of Intoxication[AI]-AO) confer risk for alcohol use and alcohol-related problems. However, inconsistencies exist in the literature, which may reflect the use of different definitions of AO and AI. We evaluated whether 1) defining AO as age at first sip of alcohol (AO sip) versus age at which at least one standard drink was consumed (AO drink); and 2) defining AI as age at first "drunk" (AI drunk) versus age at first binge episode (≥5 standard drinks consumed; AI binge) resulted in different self-reported ages or differentially predicted drinking outcomes.

METHODS

248 high school students (53.6% male; 16.50[1.19] years; 71.4% White) completed anonymous surveys assessing alcohol use.

RESULTS

Participants reported a younger AO (sip) than AO (drink) and a younger AI (drunk) than AI (binge), resulting in significantly different Delay values for the four AO-AI pairings. Univariate general linear models indicated that AO-Delay pairings accounted for more variance in maximum drinks and alcohol-related problems than did the individual AO and AI variables. Pairings comprising AO (drink) and Delay (drink-binge) and AO (sip) and Delay (sip-binge), respectively, uniquely accounted for variance in both maximum drinks and problems.

CONCLUSIONS

Clearly defining AO and AI using objective definitions that reflect specific amounts of alcohol (e.g., first sip; first standard drink; first binge) appears to outperform subjective definitions of alcohol use (e.g., first drunk).

The Gender Difference in the Association between Early Onset of Drinking and Problem Drinking between the U.S. and Japan

Using comparable survey data from the GENACIS Project, collected from representative samples of people aged 20 to 70 years old in the U.S. (n=2,598) and Japan (n=1,734), this study examined, across these two diverse societies, the gender difference in the association between the early onset of drinking and the development of drinking problems. The results of this study suggest that there does not appear to be a cross-national causal relationship between the early onset of drinking and problem drinking because of significant country and gender variations in this association and because there is no association found among Japanese females. As hypothesized, the early onset of drinking predicted problem drinking among males more strongly than among females in both countries.

Predicting early onset of intoxication versus drinking-A population-based prospective study of Norwegian adolescents

AIMS

Recent research suggests that early onset of intoxication (EOI) may be of greater importance for a wide range of subsequent adverse outcomes than early drinking experiences without intoxication. However, research on antecedents of EOI is scarce. The present study identifies predictors of EOI and whether they differ from those of early onset of drinking (EOD).

METHODS

Data was drawn from the prospective Tracking Opportunities and Problems (TOPP) study of Norwegian families (n = 382), which followed up mothers and their children with six data collections from childhood (age 1.5) to adolescence (age 14.5). Self-reports from the adolescents (parenting practices, adolescent's conduct problems and friends' deviant behaviour) and their mothers (adolescent temperament, socio-economic factors and household alcohol problems) were used to identify predictors of EOI and EOD.

FINDINGS

A variety of temperamental, socio-economic, and family factors predicted EOI, whereas EOD was predicted of substantially fewer variables. Particularly, when controlling for relevant covariates, low levels of shyness, own conduct problems and having friends with deviant behaviour prospectively predicted EOI, but not EOD.

CONCLUSIONS

Future research and prevention efforts should take into consideration that EOI and EOD without getting drunk appear to be predicted by different risk factors in childhood and adolescence.

Age of Alcohol Initiation and Progression to Binge Drinking in Adolescence: A Prospective Cohort Study

BACKGROUND

Early alcohol initiation is common and has been associated with the development of alcohol problems. Yet, past research on the association of age of initiation with later problem drinking has produced inconsistent findings. Using prospective data from the Australian Parental Supply of Alcohol Longitudinal Study cohort, this study examined age of alcohol initiation, and of first drunkenness, and associations with subsequent drinking in adolescence.

METHODS

A total of 1,673 parent-child dyads recruited through Australian secondary schools completed annual surveys for 5 years (grades 7 to 11). Limiting the sample to those adolescents who had initiated alcohol use by age 17 (n = 839), multinomial logistic regression models were used to examine associations between (i) age of initiation to alcohol use (consuming at least 1 full serve) and (ii) age of first drunkenness, and 2 outcomes: (i) binge drinking (consuming >4 standard drinks on a single occasion), and (ii) the total number of alcoholic drinks consumed in the past year, adjusted for a range of potential child, parent, family, and peer covariates.

RESULTS

Fifty percent of adolescents reported alcohol use and 36% reported bingeing at wave 5 (mean age 16.9 years), and the mean age of initiation to alcohol use for drinkers was 15.1 years. Age of initiation was significantly associated with binge drinking and total quantity of alcohol consumed in unadjusted and adjusted models. Age of first drunkenness was associated with total quantity of alcohol consumed in unadjusted models but not adjusted models and was not associated with subsequent bingeing.

CONCLUSIONS

Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol-related harms that may accompany this use.

Predictors of Recall Error in Self-Report of Age at Alcohol Use Onset

OBJECTIVE

The present study examined factors associated with recall error in the measurement of alcohol use onset and whether there was a tendency toward earlier or later self-reported age at alcohol use onset.

METHOD

This study estimated the effect of predictors on the presence and direction of recall error for age at alcohol use onset. The sample (n = 1,044) was from an existing longitudinal alcohol prevention trial in urban Chicago. Estimates were derived from a series of logistic regression models comparing agreement between a retrospective and a prospective measure of age at alcohol use onset.

RESULTS

Eligibility for free or reduced-price lunch in 6th grade, alcohol use in 6th grade, cigarette use in 12th grade, and alcohol use in 12th grade were significantly associated with recall error of age at alcohol use onset. Self-reported substance use (alcohol and tobacco) in 12th grade was also found to predict a later self-reported age at alcohol use onset when recalled.

CONCLUSIONS

Those most at risk for the negative outcomes associated with early alcohol initiation are also those most likely to misreport their age at alcohol use onset.

Effectiveness of the strengthening families programme 10-14 in Poland: cluster randomized controlled trial

Background

: The Strengthening Families Programme for youth aged 10-14 and parents/carers (SFP10-14) is a family-based prevention intervention with positive results in trials in the United States. We assessed the effectiveness of SFP10-14 for preventing substance misuse in Poland. : Cluster randomized controlled trial with 20 communities (511 families; 614 young people) were allocated to SFP10-14 or a control arms. Primary outcomes were alcohol, smoking and other drug use. Secondary outcomes included parenting practices, parent-child relations, and child problem behaviour. Interview-based questionnaires were administered at baseline and at 12- and 24-months post-baseline, with respective 70.4 and 54.4%, follow-up rates. : In Bayesian regression models with complete case data we found no effects of SFP10-14 for any of the primary or secondary outcomes at either follow-up. For example at 24-months, posterior odds ratios and 95% credible intervals for past year alcohol use, past month binge drinking, past year smoking, and past year other drug use, were 0.83 (0.44-1.56), 0.83 (0.27-2.65), 1.94 (0.76-5.38) and 0.74 (0.15-3.58), respectively. Although moderate to high attrition rates, together with some evidence of systematic attrition bias according to parent education and family disposable income, could have biased the results, the results were supported in further analyses with propensity score matched data and 40 multiple imputed datasets. : We found no evidence for the effectiveness of SFP10-14 on the prevention of alcohol or tobacco use, parenting behaviour, parent-child relations or child problem behaviour at 12- or 24-month follow-up in a large cluster randomized controlled trial in Poland.

Parental Supply of Alcohol in Childhood and Risky Drinking in Adolescence: Systematic Review and Meta-Analysis

Whether parental supply of alcohol affects the likelihood of later adolescent risky drinking remains unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating this association. We searched eight electronic databases up to 10 September 2016 for relevant terms and included only original English language peer-reviewed journal articles with a prospective design. Two reviewers independently screened articles, extracted data and assessed risk of bias. Seven articles met inclusion criteria, six of which used analytic methods allowing for meta-analysis. In all seven studies, the follow-up period was ≥12 months and attrition ranged from 3% to 15%. Parental supply of alcohol was associated with subsequent risky drinking (odds ratio = 2.00, 95% confidence interval = 1.72, 2.32); however, there was substantial risk of confounding bias and publication bias. In all studies, measurement of exposure was problematic given the lack of distinction between parental supply of sips of alcohol versus whole drinks. In conclusion, parental supply of alcohol in childhood is associated with an increased likelihood of risky drinking later in adolescence. However, methodological limitations preclude a causal inference. More robust longitudinal studies are needed, with particular attention to distinguishing sips from whole drinks, measurement of likely confounders, and multivariable adjustment.

From alcohol initiation to tolerance to problems: Discordant twin modeling of a developmental process

The current study examined a stage-based alcohol use trajectory model to test for potential causal effects of earlier drinking milestones on later drinking milestones in a combined sample of two cohorts of Australian monozygotic and same-sex dizygotic twins (N = 7,398, age M = 30.46, SD = 2.61, 61% male, 56% monozygotic twins). Ages of drinking, drunkenness, regular drinking, tolerance, first nontolerance alcohol use disorder symptom, and alcohol use disorder symptom onsets were assessed retrospectively. Ages of milestone attainment (i.e., age-of-onset) and time between milestones (i.e., time-to-event) were examined via frailty models within a multilevel discordant twin design. For age-of-onset models, earlier ages of onset of antecedent drinking milestones increased hazards for earlier ages of onset for more proximal subsequent drinking milestones. For the time-to-event models, however, earlier ages of onset for the "starting" milestone decreased risk for a shorter time period between the starting and the "ending" milestone. Earlier age of onset of intermediate milestones between starting and ending drinking milestones had the opposite effect, increasing risk for a shorter time period between the starting and ending milestones. These results are consistent with a causal effect of an earlier age of drinking milestone onset on temporally proximal subsequent drinking milestones.

The natural history of substance use disorders

PURPOSE OF REVIEW

Illicit drugs, alcohol, and tobacco use disorders contribute substantially to the global burden of disease. Knowledge about the major elements of the natural history of substance use disorders (incidence, remission, persistence, and relapse) is crucial to a broader understanding of the course and outcomes of substance use disorders.

RECENT FINDINGS

Prospective cohort studies in nonclinical samples indicate that externalizing psychopathology in earlier life, including early disordered substance use, delinquency, and personality disorders, are related to substance use disorders later in life and chronic course. Externalizing psychopathology may be initiated by early adverse experiences, for example, childhood maltreatment and stressful life events. After controlling for confounders, 'age at first use' as a causal factor for alcohol use disorder later in life and the 'drug substitution' hypothesis are not supported in general population data.

SUMMARY

Future research should focus on elaborating the causal framework that leads to the development and persistence of severe substance use disorders, with an emphasis on identifying modifiable factors for intervention by policy makers or health professionals. More research is needed on the natural history of substance use disorders in low-income and middle-income countries.

Is 'age at first drink' a useful concept in alcohol research and prevention? We doubt that

AIM

To address and discuss the weaknesses of age at first drink (AFD) as a concept in alcohol research and prevention.

METHODS

Narrative literature review.

RESULTS

Varying from one sip to the consumption of several full drinks, and sometimes including the specification of particular conditions (e.g. without parental consent), no exact definition and operationalization of AFD was found. Evidence reveals poor test-retest reliability when the same individuals report their AFD two or more times. Theoretical arguments and empirical evidence fail to explain why having one sip or one drink earlier than peers should cause heavier drinking and related problems later in life. Alternative explanations such as self-selection, third variable effects and systematic report bias are not considered in most studies. These shortcomings also make AFD unsuitable as an indicator or marker of underlying problems such as conduct problems and academic failure. Together with unjustified causal inferences, this has led to an over-emphasis on the relevance of postponing AFD as a way to prevent problems later in life.

CONCLUSION

We argue in favour of shifting the focus of alcohol research and prevention away from AFD towards a better understanding of the progression from infrequent, low-quantity drinking to more detrimental drinking patterns and the prevention of associated acute and short-term harm.

Should Parents Allow Their Adolescent Children to Drink at Home? Family Factors as Predictors of Alcohol Involvement Trajectories Over 15 Years

OBJECTIVE

The present study examined familial risk and protective factors as moderators of parents allowing their adolescent children to drink at home on longitudinal alcohol involvement trajectories.

METHOD

A total of 772 community adolescents and their parents provided data beginning in 1989 and at four subsequent time points over 15 years; Black adolescents were intentionally oversampled (50% at baseline).

RESULTS

Outcomes related to allowing adolescents to drink at home depended on family structure: Adolescents from intact families who were allowed to drink at home showed the lowest levels of alcohol use and problems over time, whereas those from nonintact families who were allowed to drink at home showed the highest levels of involvement. These results controlled for family history of alcohol problems, consistent parenting styles, and demographic characteristics.

CONCLUSIONS

Results suggest that allowing adolescents to drink at home is neither inherently protective nor risky but depends on the family context. Implications for the development of adolescent alcohol involvement are discussed.

The prospective association between sipping alcohol by the sixth grade and later substance use

OBJECTIVE

Although there is a clear association between early use of alcohol and short- and long-term adverse outcomes, it is unclear whether consumption of minor amounts of alcohol (less than a full drink) at a young age is prognostic of risk behaviors in later adolescence.

METHOD

Data were taken from 561 students enrolled in an ongoing prospective web-based study on alcohol initiation and progression (55% female; 25% White non-Hispanic). Based on a combination of monthly and semiannual surveys, we coded whether participants sipped alcohol before sixth grade and examined associations between early sipping and alcohol consumption by fall of ninth grade, as well as other indices of problem behavior. Participants also reported on the context of the first sipping event.

RESULTS

The prevalence of sipping alcohol by fall of sixth grade was 29.5%. Most participants indicated that their first sip took place at their own home, and the primary source of alcohol was an adult, usually a parent. Youth who sipped alcohol by sixth grade had significantly greater odds of consuming a full drink, getting drunk, and drinking heavily by ninth grade than nonsippers. These associations held even when we controlled for temperamental, behavioral, and environmental factors that contribute to proneness for problem behavior, which suggests that sipping is not simply a marker of underlying risk.

CONCLUSIONS

Our findings that early sipping is associated with elevated odds of risky behaviors at high school entry dispute the idea of sipping as a protective factor. Offering even just a sip of alcohol may undermine messages about the unacceptability of alcohol consumption for youth.

Relation between age of first drinking and mental health and alcohol and drug disorders in adulthood: evidence from a 35-year cohort study

AIMS

To estimate associations between age of first drinking (AFD) and alcohol use disorder, nicotine dependence, cannabis dependence, illicit drug dependence, major depression and anxiety disorder in adulthood, net of a series of covariate factors.

DESIGN

Data were obtained from a longitudinal birth cohort.

SETTING

Christchurch, New Zealand.

PARTICIPANTS

The Christchurch Health Development Study (CHDS), a longitudinal study of a cohort born in 1977 and studied to age 35 years. Analysis samples ranged in size from 1056 (ages 11-13 years) to 962 (age 35 years); 50.2% of the total sample was male.

MEASUREMENTS

A measure of AFD (ages 5-13+ years) was generated using latent class analysis. Outcome measures included: major depression, anxiety disorders, alcohol use disorder, nicotine dependence, cannabis dependence and other illicit drug dependence during the period 15-35 years. Covariate factors measured during childhood included family socio-economic status, family functioning, parental alcohol-related attitudes/behaviours and individual factors.

FINDINGS

Earlier AFD was associated significantly (P < 0.05) with increased risk of later alcohol use disorders, nicotine dependence and illicit drug dependence, and was associated marginally (P < 0.10) with cannabis dependence, but not depression or anxiety disorder. After controlling for covariate factors, the associations between AFD and outcomes were no longer statistically significant [alcohol use disorder: B = -0.07, 95% confidence interval (CI) = -0.22, 0.08; nicotine dependence: B = -0.15, 95% CI = -0.34, 0.04; illicit drug dependence: B = -0.29, 95% CI = -0.73, 0.15; cannabis dependence: B = -0.05, 95% CI = -0.31, 0.22].

CONCLUSIONS

The associations between age of first drinking and later alcohol/drug disorders appear to be accounted for at least to some degree by factors related to characteristics of the individual and family during childhood.