DRINKING AND MOTIVATIONS TO DRINK AMONG ADOLESCENT CHILDREN OF PARENTS WITH ALCOHOL PROBLEMS

Prevalence, Reasons, Predictors, Perceived Effects, and Regulation of Alcohol Use among Children in Ghana

Early initiation of alcohol consumption increases the risk of alcohol dependence and adverse health outcomes. Consequently, nations have enacted laws to make alcohol unlawful to be purchased by, sold to, or used in public by children. This study examined the lifetime prevalence of alcohol use among children and their reasons for consuming alcohol. In addition, the study investigated predictors of alcohol consumption and the effects of alcohol use on children. Finally, it examined the effectiveness of measures in place for regulating the sale and use of alcohol by children in the country. A total of 5024 children between the ages of 8 and 17 were sampled across the ten regions of Ghana using a cross-sectional convergent parallel mixed method. Children were interviewed with a semi-structured questionnaire, while focus group discussions were held with children, parents, and key informants. Lifetime prevalence of alcohol consumption was measured by "have you ever taken alcohol?". The study revealed that lifetime alcohol consumption was less prevalent (6.6%) among children. Sex, age, and region of residence were significant predictors of lifetime alcohol use among children. More than half of the children who reported ever taking alcohol were first introduced to drinking by friends, and more than six in ten children claimed having been intoxicated after drinking alcohol. The findings further revealed that efforts to control the sale and consumption of alcohol by children have proven difficult despite the existence of laws, policies, and national regulatory structures. While regulations on alcohol sales and consumption have been difficult to implement in rural areas, they have been successful in urban areas because institutions there ensure rigorous adherence to the regulations. The study encourages national organizations with responsibility for child protection and development to step up their regulation, investigation, and information-sharing efforts to discourage and limit children from purchasing and consuming alcohol.

Students with and Without Relatives with Problematic Substance Use: Do They Differ in Health, Substance Use and Study Success?

The aim of this cross-sectional study is (1) to describe the socio-demographic characteristics of students with relatives with problematic substance use and to examine differences between students with and without relatives with problematic substance use in (2) health, (3) substance use and (4) study success. We analyzed these differences in bivariate analyses between 881 (15.6%) students in a Dutch university population with relatives with problematic substance use (referred to as Affected Family Members (AFMs) and 4,781 students without such relatives. AFMs reported poorer health and used more substances, especially cannabis, than did non-AFM students and drank more often alone than did their peers. AFMs had more frequently study delay and missed class more often because of drug use. AFMs with more than one relative with problematic substance use had poorer health than AFMs with only one relative. Effect sizes were small to moderate. Health and educational professionals should provide support to deal with difficult life circumstances, for example, trauma-informed care programs.

Differences in perceived parental practices across attachment styles in adult children of alcoholic fathers

Background

Alcoholism is a growing problem in Pakistan. Problems related to alcoholism affects the family members especially children of alcoholics who are likely to have biased perceptions of parental practices which in turn affects their attachment patterns.

Objective

To analyze the differences in perceptions of parental practices across three attachment styles namely avoidant, anxious/ambivalent, and secure attachments of the adults who are children of alcoholic parents.

Method

The study is a correlational research design with a sample of 330 participants selected through purposive sampling technique. The participants were adults who are children of alcoholics from nuclear family systems, whose fathers were admitted in a rehabilitation center for the treatment of alcoholism for the second time.

Results

MANOVA computed to examine differences in perception of parental practices across attachment styles was significant [F(12, 632) = 53.130, p < .001, Pillai's Trace = 1.003, partial eta squared = .501], indicating that those with different attachment styles perceive parental overprotectiveness, emotional warmth, and rejection differently.

Conclusion

Perceptions about parental practices for father can be linked with alcoholism, while for mother the perceptions about parental practices are a product of attachment mainly.

Implications

The findings can be used to devise counseling and therapeutic plans for adults who are children of alcoholics and help in educating them about the condition of alcoholism.

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

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

Association between childhood negative life events with alcohol expectancies in early adolescence: Cumulative risk and latent class approaches

BACKGROUND

The present study aims to investigate the effects of childhood negative life events (NLEs) on alcohol expectancies (AEs) in early adolescence through cumulative risk and latent class approaches.

METHODS

Data were obtained from a prospective cohort of 945 sixth graders (age 11-12) ascertained from 17 elementary schools in northern Taiwan (response rate = 61.0 %_wt); subsequent assessments were conducted during eighth grade (n = 775, follow-up rate [FR] = 82.6 %_wt). Information concerning socio-demographics, 14 NLEs, alcohol-related experience, and four-domain AEs was collected by self-administered questionnaires at childhood and follow-up. Latent class and multivariate analyses were used to evaluate the association estimates.

RESULTS

Nearly one half of children had experienced at least one NLE in sixth grade, with one-tenth experiencing four or more NLEs. Three latent classes of NLEs were identified: "lesser experience (68.1 %_wt)," "stressed relationship (27.6 %_wt)," and "family instability (4.3 %_wt)." The observed NLE-associated increase in AEs was relatively stronger in the cumulative approach: children experiencing four or more NLEs (β_wt = 1.27, 95 % CI = 0.27-2.27) and in the "stressed relationship" NLE class appeared to develop greater AEs (β_wt = 0.86, 95 % CI = 0.30-1.42). Moreover, such NLE-associated increase was especially salient in the AE domains regarding "global positive transformation" and "promoting relaxation or tension reduction".

CONCLUSIONS

Our results provide insight into which experiences of multiple and "stressed relationship" negative life events arising from the family context in childhood may shape endorsed alcohol expectancies in adolescence, and implied that such effects may not uniformly operate across AE domain.

Let's Drink to Being Socially Active: Family Characteristics, Social Participation, and Alcohol Abuse across Mid- and Later-life

Researchers and practitioners often extol the health benefits of social relationships and social participation for older adults. Yet they often ignore how these same bonds and activities may contribute to negative health behaviors. Using data from the Wisconsin Longitudinal Study (16,065 observations from 7,007 respondents), we examined how family characteristics, family history, and social participation predicted three measures of alcohol abuse between ages 53 and 71. Results indicate that, generally, greater social participation is associated with increased drinking days per month. We also found that religious participation and having ever lived with an alcoholic are each associated with reporting possible alcohol dependence but not with alcohol consumption itself. Lastly, we identified gendered associations between marital dissolution and drinking behavior. These findings contextualize the increasing rates of alcohol abuse among older adults by emphasizing the possible negative consequences of "linked lives" on health via relationship stress and group norms.

Associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives in adolescents and young adults: a systematic review and meta-analysis

BACKGROUND AND AIMS

Emerging evidence suggests that solitary drinking may be an important early risk marker for alcohol use disorder. The current paper is the first meta-analysis and systematic review on adolescent and young adult solitary drinking to examine associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives.

METHODS

PsychINFO, PubMed, and Google Scholar were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology and a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (no. CRD42020143449). Data from self-report questionnaires regarding negative correlates of solitary drinking (e.g. alcohol problems) and solitary drinking motives (e.g. drinking to cope) were pooled across studies using random-effects models. Studies included adolescents (aged 12-18 years) and young adults (mean age between 18 and 30 years or samples with the majority of participants aged 30 years or younger).

RESULTS

Meta-analytical results from 21 unique samples including 28,372 participants showed significant effects for the associations between solitary drinking and the following factors: increased alcohol consumption, r = 0.23, 95% confidence interval (CI) = 0.12, 0.33; drinking problems, r = 0.23, 95% CI = 0.13, 0.32; negative affect, r = 0.21, 95% CI = 0.16, 0.26; social discomfort, r = 0.17, 95% CI = 0.06, 0.27; negative reinforcement, r = 0.28, 95% CI = 0.24, 0.31; and positive reinforcement, r = 0.10, 95% CI = 0.03, 0.17. These associations were not moderated by age group (i.e. adolescent versus young adult), study quality, or differing solitary drinking definitions. Accounting for publication bias increased the effect sizes from r = 0.23 to 0.34 for alcohol consumption and from r = 0.23 to 0.30 for drinking problems, and lowered it from r = 0.10 to 0.06 and r = 0.17 to 0.11 for positive reinforcement and social discomfort, respectively.

CONCLUSIONS

Solitary drinking among adolescents and young adults appears to be associated with psychosocial/alcohol problems and drinking to cope motives.

Perceptions of alcohol use among injury patients and their family members in Tanzanian society

Alcohol is one of the leading causes of death and disability worldwide. Rates of alcohol abuse in Moshi, Tanzania, are about 2.5 times higher than the Tanzanian average. We sought to qualitatively assess the perceptions of alcohol use among injury patients in Moshi, including availability, consumption patterns, abuse, and treatments. Participants were Emergency Department injury patients, their families, and community advisory board members. Participants were included if they were ≥18 years of age, a patient or patient's family member seeking care at the Kilimanjaro Christian Medical Center Emergency Department, Moshi, Tanzania, for an acute injury, clinically sober at the time of enrollment, medically stable, able to communicate in Swahili and consented to participate. Focus group discussions were audiotaped, transcribed, translated, and analyzed in parallel using an inductive thematic content analysis approach. Resultant themes were then reanalyzed to ensure internal homogeneity and external heterogeneity. Fourteen focus group discussions, with a total of 104 participants (40 patients, 50 family members, 14 community advisory board members), were conducted. Major themes resulting from the analysis included: 1) Early/repeated exposure; 2) Moderate use as a social norm with positive attributes; 3) Complications of abuse are widely stigmatized; and 4) Limited knowledge of availability of treatment. Our findings suggest that, among our unique injury population and their families, despite the normalization of alcohol-related behaviors, there is strong stigma toward complications stemming from excess alcohol use. Overall, resources for alcohol treatment and cessation, although broadly desired, are unknown to the injury population.

A systematic review of research on adolescent solitary alcohol and marijuana use in the United States

BACKGROUND AND AIMS

Alcohol use and marijuana use tend to be social activities among adolescents. Some youth use alcohol or marijuana while alone. This article provides a framework for examining the risk factors for and consequences of solitary alcohol and marijuana use, grounded in a motivational model that emphasizes coping with negative emotions, and provides the first systematic review of research on solitary alcohol and marijuana use among middle school- and high school-aged adolescents in the United States.

METHODS

PubMed, PsycINFO and Web of Science were searched. Articles were included if they mention solitary alcohol or marijuana (or illicit drug) use among adolescents aged 12-18 years. Studies on non-human animals, college students, non-English language publications and articles exclusively about solitary tobacco or inhalant use were excluded. Overall, 22 articles were selected.

RESULTS

Prevalence of adolescent solitary alcohol and marijuana use was relatively high (e.g. 14% life-time solitary drinking in the general adolescent population), particularly in high-risk subgroups (e.g. 38.8% life-time solitary drinking in a sample of youth recruited from clinical and community settings). Risk factors for solitary alcohol and marijuana use include earlier onset and heavier use, coping motives, negative emotions and positive expectancies about use. Solitary alcohol and marijuana use are prospectively associated with later substance use disorder (SUD) symptoms, diminished academic performance and perceived health.

CONCLUSIONS

Approximately 1 in 7 adolescents in the US appear to have engaged in solitary alcohol and marijuana use at some point. It is positively associated with extent of drinking and marijuana use, cop;ing motives, negative emotions, and positive expectancies, as well as subsequent SUD symptoms and poor academic and health-related outcomes.

Do Drinking Motives Mediate the Relationship between Neighborhood Characteristics and Alcohol Use among Adolescents?

Adolescents not only vary in their alcohol use behavior but also in their motivations for drinking. Young people living in different neighborhoods may drink for different reasons. The aims of this study were to determine if neighborhood characteristics were associated with adolescent drinking motives, and whether drinking motives mediate the relationship between neighborhood context and regular alcohol use. Data from the Scottish Health Behaviours in School-aged Children 2010 survey of students in their 4th year of secondary school were used. The study included 1119 participants who had data on neighborhood characteristics and had used alcohol in the past year. Students were asked questions about the local area where they lived, their alcohol use, and their motives for drinking alcohol, based on the Drinking Motives Questionnaire Revised Short Form (DMQR-SF). Multilevel multivariable models and structural equation models were used in this study. Coping motives showed significant variation across neighborhoods. Structural equation models showed coping motives mediated the relationships between neighborhood deprivation, living in an accessible small-town, and neighborhood-level disorder with regular alcohol use. Public health policies that improve neighborhood conditions and develop adaptive strategies, aimed at improving alcohol-free methods for young people to cope better with life's stresses, may be particularly effective in reducing inequalities in adolescent alcohol use if targeted at small towns and areas of increased deprivation.

Associations of perceived drinking motives of parents and friends on adolescents' own drinking motives

Adolescents form perceptions of why their parents and friends drink alcohol that may impact adolescents' own drinking motives. This study tested whether perceived drinking motives of parents and friends are associated with adolescents' own drinking motives. Participants included community-recruited adolescents 14-17 years (N = 105; 63.8% female) who drank alcohol in the past year. Perceived parent and friend motives both related to adolescent drinking motives at the bivariate level; however, only friend motives remained statistically significant in the final hierarchical regression models controlling for relevant covariates (e.g., alcohol frequency). Findings support a social-cognitive modeling pathway in the development of adolescents' own drinking motives and highlight the perception of why others drink as a potential intervention target.

Combining online Community Reinforcement and Family Training (CRAFT) with a parent-training programme for parents with partners suffering from alcohol use disorder: study protocol for a randomised controlled trial

INTRODUCTION

Partners and children of individuals with alcohol use disorder (AUD) present with impaired quality of life and mental health, yet seldom seek or participate in traditional supportive interventions. Engaging the parent/partner without AUD in treatment is a promising way of supporting behavioural change in both the child and the parent with AUD. Universal parent-training (PT) programmes are effective in increasing children's well-being and decreasing problem behaviours, but have yet to be tailored for children with a parent with AUD. Community Reinforcement Approach And Family Training (CRAFT) programmes are conceptually similar, and aim to promote behavioural change in individuals with AUD by having a concerned significant other change environmental contingencies. There has been no study on whether these two interventions can be combined and tailored for partners of individuals with AUD with common children, and delivered as accessible, online self-help. METHODS AND ANALYSIS: n=300 participants with a child showing mental health problems and partner (co-parent) with AUD, but who do not themselves present with AUD, will be recruited from the general public and randomised 1:1 to either a four-module, online combined PT and CRAFT programme or a psychoeducation-only comparison intervention. Primary outcome will be the child's mental health. Additional outcomes will cover the partner's drinking, the participants own mental health and drinking, the child's social adjustment, treatment seeking in all three parties and parental self-efficacy. Measures will be collected preintervention, mid-intervention and postintervention, and three times during a 2-year follow-up period. Data will be analysed using mixed-effects modelling.

ETHICS AND DISSEMINATION

This study has been approved by the Stockholm Regional Ethical Review Board (2016/2179-31). The results will be presented at conferences and published as peer-reviewed publications.

TRIAL REGISTRATION NUMBER

ISRCTN38702517; Pre-results.

"I Feel It In My Heart When My Parents Fight": Experiences of 7-9-Year-Old Children of Alcoholics

Children are vulnerable when exposed to parental alcohol abuse. Although much is known about children of alcoholics (COA), research examining the experiences of younger COA is scarce. To gain knowledge of the consequences for these children, it is important to ask the children themselves. This study explored the consequences for a child of having an alcoholic parent, from the point of view of 7-9-year-old COA. Eighteen children were interviewed, whose alcoholic parent was undergoing treatment, using a vignette. In the analysis, using qualitative content analysis, the findings show that the children of this young age had much experiences and took a great responsibility for their alcoholic parent, and the family. The most significant feeling of the children was a feeling of sadness. They tried to control the situation in different ways. They wished for a change in the future, but despite problems in the family they described things they did together with a loving parent. Implications include the importance of listening to and supporting all COA, also children as young as 7-9 years old. Further studies should address the support that can and should be offered to COA.

Communication About Problematic Drinking Between Young Adults and their Parents: An Application of Inconsistent Nurturing as Control Theory

Approximately 80% of college students drink, half of whom consume alcohol in the form of binge drinking. The current study applies Inconsistent Nurturing as Control Theory to examine the communication about excessive drinking that takes place between parents and their young adult children. Forty college students were asked to report on a moment or incident that led their parents to label their drinking as concerning and were then asked to report on how their parents acted towards the drinking before and after the moment of labeling. Interviews were transcribed and coded. The findings suggest that parents act with inconsistency when attempting to manage their children's drinking by enacting both reinforcing and punishing behaviors. Parents' reinforcing behaviors included drinking with their children and buying them alcohol, even after labeling the drinking as problematic. Parents' punishment behaviors included expressing concern about their children's sense of responsibility and making their children feel regretful about their drinking. Nearly 88% of the participants were able to recall the moment at which their parents labeled their drinking as problematic. Implications for using inconsistent messages in conversations about alcohol are discussed.

Change over time in adolescent and friend alcohol use: Differential associations for youth with and without childhood attention-deficit/hyperactivity disorder (ADHD)

Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for experiencing alcohol-related problems by adulthood. However, few studies have examined contextual factors that may contribute to this risk. The current study examined 1 widely investigated social-contextual risk factor, friend alcohol use, in a sample of adolescents with and without a history of ADHD. One hundred and 59 adolescents (14-17 years old) with childhood ADHD and 117 demographically similar youth without ADHD were interviewed annually in the Pittsburgh ADHD Longitudinal Study. Adolescents reported the frequency of their own alcohol use in the prior 12 months and the number of friends who used alcohol regularly or occasionally (perceived friend alcohol use). Multiple-group parallel process models indicated that increases in friend alcohol use were more strongly associated with increases in adolescent alcohol use over time for individuals with ADHD (r = .15, SE = 0.04; 95% confidence interval [CI] = [0.08, 0.22]) than for those without ADHD (r = .06, SE = 0.03; 95% CI [0.00, 0.11]). These results suggest that social factors are an important part of escalating alcohol use among adolescents with ADHD histories, and they highlight the possibility that interventions focused on the peer context could be important for these at-risk youth. Additional social network research on adolescent alcohol use within the larger context of other relationships (e.g., family and romantic relationships) is indicated.

Unintended Effects of an Intervention Supporting Mexican-Heritage Youth: Decreased Parent Heavy Drinking

OBJECTIVE

To assess the impact of a parenting intervention, Familias: Preparando la Nueva Generación (FPNG), intended to support children, on parents heavy drinking. We hypothesized that parent participants of FPNG would reduce their heavy drinking at 1-year follow-up.

METHODS

Parents (N = 281) of middle school children from a large, low-income metropolitan area in the Southwest United States participated in a randomized control trial over 2 years.

RESULTS

A logistic regression analysis using the maximum likelihood test determined that at Wave 3, parents receiving FPNG reduced heavy drinking behaviors compared to parents in the youth-only condition (odds ratio = .86, p < .05).

CONCLUSIONS

Participating in the parenting program can effectively curb heavy drinking behaviors in parents-an important mechanism through which one may expect changes in youth risk behavior. The practice, policy, and research implications of these unintended findings are promising to the overall effectiveness of a parenting intervention for Mexican-heritage families.

Substance-abusing mothers and fathers' willingness to allow their children to receive mental health treatment

The purpose of this study was to examine attitudes of substance-abusing mothers and fathers entering outpatient treatment toward allowing their children to participate in individual- or family-based interventions. Data were collected from a brief anonymous survey completed by adults at intake into a large substance abuse treatment program in western New York. Only one-third of parents reported that they would be willing to allow their children to participate in any form of mental health treatment. Results of chi-square analyses revealed that a significantly greater proportion of mothers reported that they would allow their children to participate in mental health treatment (41%) compared to fathers (28%). Results of logistic regression analyses revealed even after controlling for child age, mothers were more likely than fathers to indicate their willingness to allow their children to receive mental health treatment; however, type of substance abuse (alcohol versus drug abuse) was not associated with parents' willingness to allow their children to receive treatment. Parental reluctance to allow their children to receive individual or family-based treatment is a significant barrier in efforts to intervene with these at-risk children.

Self and partner alcohol-related problems among ACOAs and non-ACOAs: associations with depressive symptoms and motivations for alcohol use

The present study examined whether drinking motivations and depressive symptoms would have a stronger impact on alcohol-related problems among adult children of alcoholics (ACOAs) and their dating partners as compared to non-ACOAs and their dating partners. Participants were 197 undergraduate (60 ACOAs, 137 non-ACOAs) 18 to 25year-old female drinkers in dating relationships. Participants completed measures of ACOA screening, depressive symptoms, and drinking motives, as well as alcohol-related problems for themselves and their partner. Although no differences were found between ACOA and non-ACOA women's alcohol-related problems, ACOA women and women with greater depressive symptoms were at a higher risk of having a partner with more alcohol-related problems. In addition, we found that regardless of parental history of alcoholism, higher depressive symptoms coupled with stronger motives for drinking to cope with stressors predicted participants' own alcohol-related problems. These findings demonstrate the need for future research to examine additional factors that may moderate the effects of depressive symptoms and ACOA status on female college student drinking problems. A greater understanding of the unique and interactive effects of these variables on alcohol-related problems in both young women and their dating partners can aid in the development of prevention programs more targeted to the specific vulnerabilities of this population.

Alcohol Use among Very Early Adolescents in Vietnam: What Difference Does Parental Migration Make?

Little is known about the patterns of alcohol use among adolescents and the transmission of alcohol use behaviors from parents to children, including the passage into responsible and problem drinking, in the developing world. The following paper uses primary data from the Child Health and Migrant Parents in South-East Asia (CHAMPSEA) Project for older children aged 9, 10 and 11 to examine the prevalence (16.2 percent) and correlates of alcohol use initiation including parental migration status, caregiving arrangements and exposure to environmental alcohol use (family and friends) in Vietnam. Contrary to expectations, there is no observed migrant 'deficit.' There is some indication that early adolescents in the care of their grandparents are less likely to have a history of experimentation with alcohol use, although it is fully attenuated after controlling for other factors. Peer use is the most powerful explanatory measure of early adolescent drinking, with early adolescents more than five times as likely to have ever drunk alcohol if their friends drink also, and as expected, there is a strong child gender difference with girls much less likely to have a history of alcohol use. "A man without alcohol is like a flag without wind"- Popular Vietnamese saying.

Intergenerational transmission of drinking motives and how they relate to young adults' alcohol use

AIMS

This study examined whether parental drinking motives are associated with young adults' drinking motives, and their association with young adults' drinking behaviors.

METHODS

The sample consisted of 290 18-year-old and 289 20-year-old drinking young adults and their parents.

RESULTS

For the younger group, stronger maternal coping motives were related to stronger social and enhancement motives, while stronger paternal coping motives were associated with stronger young adult coping motives. For the older group, stronger maternal coping motives were related to stronger social motives and stronger paternal enhancement motives were associated with stronger overall young adult drinking motives. For the younger group, both enhancement and conformity motives were predictive of their alcohol use. For the older group, only higher social motives were predictive of higher alcohol use. Both groups' higher coping and enhancement motives were associated with more drinking problems.

CONCLUSIONS

While, concerning content, there are some differences due to parent gender and adolescent age, stronger parental drinking motives are indeed associated with stronger adolescent drinking motives, which in turn are quite consistently related to more adolescent alcohol use and alcohol-related problems.

Shared genetic contributions to early-onset drinking and drinking to cope motives

INTRODUCTION

Recent evidence from empirical studies indicates that individuals who begin drinking at an early age may be more likely to use alcohol to cope with negative mood states and stress; however, the mechanisms underlying this association are unclear. One possibility is that early drinking directly increases risk for drinking to cope (DTC). Alternatively, the association between early drinking and DTC may be indirect, attributable to overlapping genetic or environmental factors. No prior genetically informative study has investigated the sources of covariation underlying the early-onset drinking-DTC association.

METHOD

Early-onset drinking (before age 15) was assessed using structured clinical interviews in a sample of 7130 male and female participants aged 19-56 years from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD, Kendler & Prescott, 2006). DTC was assessed using the mood management scale of the alcohol use inventory (Horn & Wanberg, 1983). The sources of the covariation between early first drink and DTC were estimated using bivariate twin modeling.

RESULTS

Early drinking onset was reported by 28% of males and 16% of females and was associated with significantly higher DTC scores (phenotypic correlation: males = .19, females = .22). Results from bivariate twin models indicated that the association between early-onset drinking and DTC was completely attributable to shared genetic factors that contribute to both behaviors.

CONCLUSIONS

Greater DTC among early-onset drinkers may not reflect a direct causal process, as shared biological pathways may explain vulnerability to stress-related drinking seen among early-onset drinkers.

Levantamento sobre uso de álcool e outras drogas e vulnerabilidades relacionadas de estudantes de escolas públicas participantes do programa saúde do escolar/saúde e prevenção nas escolas no município de Florianópolis

Esta pesquisa investigou o uso de álcool e outras drogas e as vulnerabilidades relacionadas de estudantes de nove escolas públicas participantes do Programa Saúde do Escolar/Saúde e Prevenção nas Escolas no município de Florianópolis. Participaram 789 alunos entre o sétimo ano do Ensino Fundamental e o terceiro ano do Ensino Médio. O álcool foi utilizado por 30,1% dos participantes, o tabaco por 20,1%, a maconha por 7%, a cocaína por 1,3% e o crack por 0,6%. Os estudantes que utilizam álcool e outras drogas mataram mais aulas, participaram mais de brigas, são sexualmente mais ativos e declararam que se arriscaram mais frente ao HIV/Aids. Observou-se a importância da família tanto como fator de influência nos comportamentos do uso de álcool e outras drogas, como de proteção frente a este uso.

Health-related lifestyle, physical and mental health in children of alcoholic parents

AIM

To identify potential differences between children of alcoholics (COAs) and controls in their health-related lifestyle, mental and physical health.

METHODS

The recruitment of COAs took place in inpatient and outpatient treatment and rehabilitation units. Controls were recruited in elementary and high schools. 57 COAs (72% response rate) and 84 controls (88% response rate) aged between 12 and 18 years completed a postal questionnaire about their health-related lifestyle, and mental and physical health.

RESULTS

Bivariate analysis showed that COAs' families have higher unemployment rates and lower economic status (P = 0.000). COAs reported poorer school performance (P = 0.000), spending more time in sedentary (television: P = 0.000, Internet: P = 0.014, music: P = 0.040) and less time in physical activities (P = 0.048), having poorer eating habits (fruits and vegetables: P = 0.001, sweets: P = 0.001, fast food: P = 0.000, soft drinks: P = 0.004), a higher substance use (cigarettes: P = 0.030; marijuana: P = 0.564, heavy drinking: P = 0.050) and more mental health difficulties (emotional symptoms: P = 0.015, conduct problems: P = 0.012, suicidal tendencies: P = 0.007, mental disorder: P = 0.040). Among COAs, girls reported more emotional and somatic symptoms compared to boys (P = 0.020 and P = 0.047, respectively). Multivariate analysis showed that after controlling for socioeconomic status, significant mental health and health-related lifestyle inequalities between COAs and controls persist.

CONCLUSION

Our findings suggest that COAs have a less healthy lifestyle and more mental health difficulties above and beyond the poorer economic environment they live in.

An internalizing pathway to alcohol use and disorder

Research emanating from the field of developmental science indicates that initial risk factors for alcohol use and disorder can be evident in early childhood. One dominant developmental pathway connecting these initial risk factors with subsequent alcohol involvement focuses on the central role of disinhibited or externalizing behaviors. In the current paper, we delineate a second pathway that focuses on internalizing symptomatology. Several studies indicate that internalizing symptoms in early and middle childhood predict alcohol involvement in adolescence and young adulthood. We use a developmental psychopathology framework to describe a risk model that traces the potential developmental markers of this internalizing pathway and to consider the relation between the internalizing pathway and the more widely researched externalizing pathway. We outline the markers of risk in this pathway and conclude with a discussion of the implications of this model for prevention efforts and future research. In this manner, we strive for a translational goal, linking our existing understanding of internalizing processes and alcohol use and disorder with our efforts to develop effective prevention programs.

Risky alcohol use in adolescence: the role of genetics (DRD2, SLC6A4) and coping motives

BACKGROUND

Drinking to cope (i.e., drinking to forget or alleviate negative feelings) has been found to be associated with adolescents' heavy drinking and alcohol-related problems. Additionally, it is widely accepted that genetic factors are involved in alcohol use and dependence. Studies are only beginning to reveal, however, which specific genotypes are related to drinking behaviors, and it is unknown whether they may interact with coping motives in predicting adolescents' risky drinking. The aim of this study was to examine relationships between the dopamine D2 receptor gene (DRD2) Taq1A polymorphism (rs1800497), a serotonin transporter gene (SLC6A4) polymorphism (5-HTTLPR), coping motives, and adolescents' binge drinking and alcohol-related problems.

METHODS

Participants in this cross-sectional study were 282 Dutch adolescents (mean age 17.4, 47% men) who had consumed alcohol at least once in their life.

RESULTS

Coping motives were positively related to both binge drinking and alcohol-related problems, while DRD2 and SLC6A4 genotypes were not. DRD2, but not the SLC6A4 genotype, interacted with coping motives. The link between coping motives and alcohol outcomes was stronger among those carrying the DRD2 risk (A1) allele.

CONCLUSIONS

This study extends the present literature by providing additional insight into the etiological factors of adolescent drinking behavior. An interaction between a vulnerability gene (DRD2) and a cognitive factor (coping drinking) was found to be related to adolescents' binge drinking and alcohol-related problems.

A systematic evaluation and validation of subtypes of adolescent alcohol use motives: genetic and environmental contributions

BACKGROUND

Alcohol use motives are closely associated with specific profiles of alcohol use and reflect a subjectively derived decisional framework based on a motivational style of responding. Adult twin studies typically estimate the heritability of alcohol use motives to be between 7 and 42%, although relatively little is known about genetic and environmental influences upon alcohol use motives in adolescence.

METHODS

Latent class analysis (LCA) models containing 1 through 5 classes were fitted to the data derived from 1,422 adolescent twin and siblings self-reported alcohol use motives. Using twin models, we estimated the genetic, shared, and nonshared environmental influences to the class membership data derived from the LCA.

RESULTS

Four drinking motives classes were identified (family-oriented, social, enhancement/social, and coping/social). The coping/social and enhancement/social classes were differentiated from the social class on measures of depression, delinquency, and aggressive behavior. Analyses indicated that nonadditive genetic factors accounted for 76% of the variance in the coping/social motives class and additive genetic influences accounted for 66% of the variance in the social motives class. There was a moderate contribution of genetic factors and shared environmental factors influencing class membership of enhancement/social motivated drinkers (28 and 20% explained variance, respectively). Substantial shared environmental influences were revealed for membership of the family-oriented class (75%).

CONCLUSIONS

Heritable influences may predispose individuals to drink to cope with negative affect, for social reasons, and to a lesser extent for enhancement. Familial environmental influences shape family-oriented motives for drinking in adolescents.

Family history of alcohol abuse associated with problematic drinking among college students

Studies examining family history of alcohol abuse among college students are not only conflicting, but have suffered various limitations. The current report investigates family history of alcohol abuse (FH+) and its relationship with alcohol expectancies, consumption, and consequences. In the current study, 3753 student participants (35% FH+), completed online assessments. Compared to FH- same-sex peers, FH+ males and FH+ females endorsed greater overall positive expectancies, consumed more drinks per week, and experienced more alcohol-related negative consequences. Further, FH+ females evaluated the negative effects of alcohol to be substantially worse than FH- females. An ANCOVA, controlling for age, GPA, race, and alcohol expectancies, resulted in family history main effects on both drinking and consequences. An interaction also emerged between gender and family history, such that FH+ males were especially vulnerable to high levels of alcohol consumption. Results reveal the scope of FH+ individuals in the college environment and the increased risk for these students, particularly male FH+ students, suggesting a need for researchers and college health personnel to focus attention and resources on this issue.

A cognitive model for the intergenerational transference of alcohol use behavior

A family history of alcoholism has shown to be one of the greatest consistent risk factors in the intergenerational transference of alcohol problems. Whereas a large number of studies have attempted to identify the processes responsible for this interfamilial transfer, the mechanisms remain unclear. Family, twin and adoption studies, and environmental theories have resulted in a number of unanswered questions regarding the extent that these factors influence the transmission of alcohol behavior. Recently, cognitive theories have suggested that the observation of parental drinking habits contributes to the child's beliefs and expectations of alcohol's effects. A hypothesised cognitive model will be proposed suggesting that the mechanism for the transference of particular drinking styles from parent to offspring may be further explained by the transference of alcohol cognitions, in particular, alcohol expectancies and drinking refusal self-efficacy. This review focuses on research of bio/psycho/social factors that perpetuate alcohol misuse across generations, and will delineate the proposed cognitive mechanisms for the interfamilial transference of alcohol problems and discuss the implications of the proposed model.

Parental alcohol misuse is a powerful predictor for the risk of traumatic brain injury in childhood

BACKGROUND

Although the positive relationship between parental alcohol use and children's injuries is well established, it is not known whether parental alcohol misuse is a risk factor for traumatic brain injuries (TBIs) of their children and whether subjects with childhood TBI have hazardous drinking habits in adolescence.

METHODS

The authors conducted a longitudinal cohort study at Oulu University Hospital. The cohort consisted of 12 058 subjects born in 1966, of which 207 had sustained TBI before the age of 14 years. Data on parental alcohol problems were obtained from the Finnish Hospital Discharge Register and the adolescents' drinking habits were analysed based on a postal inquiry at the age of 14 years.

RESULTS

Parental alcohol misuse (RR 1.99, CI 1.19-3.33) and male gender (RR 1.53, CI 1.12-2.08) significantly predicted the risk of childhood TBI. Drinking to intoxication at the age of 14 was significantly associated with parental alcohol misuse (RR 1.62, CI 1.34-1.96), belonging to a one-parent family (RR 1.80, CI 1.61-2.02) and mild TBI (RR 1.67, CI 1.20-2.33).

CONCLUSIONS

It was observed that parental alcohol misuse is a major risk factor for TBI in children and drinking to intoxication is a common drinking pattern of adolescents who have sustained TBI in childhood.

Mood-related drinking motives mediate the familial association between major depression and alcohol dependence

BACKGROUND

Major depression and alcohol dependence co-occur within individuals and families to a higher than expected degree. This study investigated whether mood-related drinking motives mediate the association between major depression and alcohol dependence, and what the genetic and environmental bases are for this relationship.

METHODS

The sample included 5,181 individuals from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders, aged 30 and older. Participants completed a clinical interview which assessed lifetime major depression, alcohol dependence, and mood-related drinking motives.

RESULTS

Mood-related drinking motives significantly explained the depression-alcohol dependence relationship at both the phenotypic and familial levels. Results from twin analyses indicated that for both males and females, the familial factors underlying mood-related drinking motives accounted for virtually all of the familial variance that overlaps between depression and alcohol dependence.

CONCLUSIONS

The results are consistent with an indirect role for mood-related drinking motives in the etiology of depression and alcohol dependence, and suggest that mood-related drinking motives may be a useful index of vulnerability for these conditions.

Family history of alcohol abuse moderates effectiveness of a group motivational enhancement intervention in college women

This study examined whether a self-reported family history of alcohol abuse (FH+) moderated the effects of a female-specific group motivational enhancement intervention with first-year college women. First-year college women (N=287) completed an initial questionnaire and attended an intervention (n=161) or control (n=126) group session, of which 118 reported FH+. Repeated measures ANCOVA models were estimated to investigate whether the effectiveness of the intervention varied as a function of one's reported family history of alcohol abuse. Results revealed that family history of alcohol abuse moderated intervention efficacy. Although the intervention was effective in producing less risky drinking relative to controls, among those participants who received the intervention, FH+ women drank less across five weeks of follow-up than FH- women. The current findings provide preliminary support for the differential effectiveness of motivational enhancement interventions with FH+ women.

Parental alcohol dependence and the transmission of adolescent behavioral disinhibition: a study of adoptive and non-adoptive families

AIM

To examine the genetic and environmental influences of parental alcoholism on offspring disinhibited behavior.

DESIGN

We compared the effect of parental alcoholism history on offspring in adoptive and non-adoptive families. In families with a history of parental alcohol dependence, we examined the effect of exposure to parental alcoholism symptoms during the life-time of the adolescent. Setting Assessments occurred at the University of Minnesota from 1998 to 2004.

PARTICIPANTS

Adolescents adopted in infancy were ascertained systematically from records of three private Minnesota adoption agencies; non-adopted adolescents were ascertained from Minnesota birth records. Adolescents and their rearing parents participated in in-person assessments.

MEASUREMENTS

For adolescents, measures included self- reports of delinquency, deviant peers, substance use, antisocial attitudes and personality. For parents, we conducted DSM-IV clinical assessments of alcohol abuse and dependence.

FINDINGS

A history of parental alcohol dependence was associated with higher levels of disinhibition only when adolescents were related biologically to their rearing parents. Within families with a history of parental alcoholism, exposure to parental alcohol misuse during the life-time of the adolescent was associated with increased odds of using alcohol in adopted adolescents only.

CONCLUSIONS

These findings suggest that the association between a history of parental alcohol dependence and adolescent offspring behavioral disinhibition is attributable largely to genetic rather than environmental transmission. We also obtained some evidence for parental alcohol misuse as a shared environmental risk factor in adoptive families.

Differential drinking patterns of family history positive and family history negative first semester college females

OBJECTIVE

This study compares the natural drinking patterns of family history positive and family history negative women during their first semester of college, a transitional period known to coincide with considerable alcohol-related risks.

METHOD

Seventy-two incoming undergraduate females, approximately half of whom reported a family history of alcohol misuse, completed initial questionnaires as well as Timeline Followback assessments. In addition, participants completed five successive weeks of online behavioral diaries measuring three categories of prospective alcohol consumption: total drinks, maximum drinks, and heavy episodic drinking events. Repeated measures ANCOVA models, controlling for prior alcohol consumption, examined participants' drinking behavior.

RESULTS

Over the course of the five assessed weeks, first semester females with a genetic predisposition to alcohol problems were found to consume significantly more total drinks (p<.05), maximum drinks (p<.05), and were more likely to drink heavily (p<.05) than family history negative peers.

CONCLUSIONS

Findings highlight increased alcohol-related risks faced by incoming first-year college females with a reported family history of problematic drinking and, thus, emphasize the need for early interventions targeted toward this at-risk group.

Does resilience moderate the associations between parental problem drinking and adolescents' internalizing and externalizing behaviors? A study of Korean adolescents

BACKGROUND

This study examined the main and interactive effects of parental problem drinking and resilience on problem (externalizing and internalizing) behaviors among Korean adolescents.

METHODS

Data were collected from 482 adolescents (mean age=14.4 years, 57% girls) from four middle schools in two urban areas in Korea. A revised version of Kim's measure (2003) and Hyun's Problems Behaviors Profiles (2000) were employed to measure resilience and internalizing and externalizing behaviors, respectively.

RESULTS

Hierarchical multiple regression analyses showed that parental problem drinking was directly associated with externalizing and internalizing behaviors. Further, the effects of parental problem drinking on both outcomes were moderated by resilience, such that the negative effects of parental problem drinking decreased in magnitude as resilience increased. Simple slope analyses showed that (1) the effects of parental problem drinking on externalizing behaviors were significant only at low levels of resilience and (2) the effects of parental problem drinking on internalizing behaviors were significant at low and average levels of resilience.

CONCLUSIONS

Resilience may confer some protection against the adverse effects of parental problem drinking among Korean adolescents, but these protective effects are small in magnitude. Results highlight the importance of further research on culture-specific dimensions of resilience among Korean Children of Alcoholics (COAs).

Adult transition from at-risk drinking to alcohol dependence: the relationship of family history and drinking motives

BACKGROUND

Prospective studies have not previously examined whether a family history of alcoholism and drinking motives conjointly predict a diagnosed DSM-IV alcohol abuse or dependence in adults, despite a large literature that each is associated with alcohol consumption. The focus of this study is the conjoint, prospective examination of these risk factors in a 10-year longitudinal study of adults who were at-risk drinkers at baseline.

METHODS

Prospective, population-based cohort of drinkers aged 18 or older from a Northeastern U.S. area initially evaluated for history of alcohol use disorders and drinking motives in 1991 to 1992. New onset dependence was studied in those who never met the criteria for alcohol dependence at baseline (n = 423), and new onset abuse was studied in those who never met the criteria for alcohol abuse at baseline (n = 301) and who did not develop dependence during the follow-up.

RESULTS

Family history significantly interacted with 2 baseline drinking motives in predicting new onsets of DSM-IV alcohol dependence: drinking to reduce negative affect (OR 3.38; 95% CI 1.05, 10.9) and drinking for social facilitation (OR 3.88; CI 1.21, 12.5). Effects were stronger after conditioning the drinking motives on having a positive family history of alcoholism. In contrast, in predicting new onsets of alcohol abuse, drinking motives did not have direct effects or interact with family history.

CONCLUSIONS

Those who drank to reduce negative affect or for social facilitation at baseline were at greater risk of alcohol dependence 10 years later if they also had a family history of alcoholism. These results suggest an at-risk group that can be identified prior to the development of alcohol dependence. Further, the findings suggest utility in investigating the interaction of drinking motives with measured genetic polymorphisms in predicting alcohol dependence.

Work stress and alcohol use: Examining the tension-reduction model as a function of worker's parent's alcohol use

In an effort to identify groups who may be more vulnerable to tension-reduction drinking [Frone, M. (2003). Predictors of overall and on-the-job substance use among young workers. Journal of Occupational Health Psychology, 8, 39-54.], we examine whether drinking alcohol in response to work stress varies as a function of whether workers were raised in homes where (a) both parents abstained from alcohol, (b) at least one parent drank nonproblematically, (c) at least one parent drank problematically, or (d) both parents drank problematically. Employees participating in a large, longitudinal study who reported using alcohol in the previous year (N=895) completed various measures of work stressors, alcohol use, and alcohol problems. We found few mean group differences for either the work stressor or alcohol measures, but we did find a greater number of significant and moderate correlations between work stressors and alcohol for those reporting that both parents drank alcohol problematically. Interestingly, a number of significant correlations were found for those reporting that both parents abstained from alcohol; few were found for the two groups reporting that at least one parent drank with or without alcohol problems. Results are interpreted in light of where and how alcohol expectancies and other coping methods are learned.

Correlates of protective behavior utilization among heavy-drinking college students

Previous studies have suggested that college students who use protective strategies while drinking are at a lower risk for drinking-related consequences. This study evaluated the correlates of protective behavior utilization in a group of 281 heavy-drinking college students. Students who reported heavier drinking were less likely to use protective behaviors, even after adjusting for covariates. Male gender and perceived history of parental alcohol abuse also predicted lower protective behavior score. The most frequently endorsed strategies among females were "Knowing where your drink has been at all times" and "Going home with a friend," whereas the most frequently endorsed strategies among males were "Knowing where your drink has been at all times" and "Using a designated driver." For females, the factor structure of the protective behaviors measure was consistent with previous studies; however, for males, the results suggest a four-factor solution. Findings are discussed in terms of their implications on future research and prevention programming.

[Factors influencing juvenile alcohol consumption: the role of gene-environment interactions]

INTRODUCTION

Excessive alcohol consumption in youth increases the risk of subsequent alcohol use disorders. Despite the recognition of genetic and environmental factors, an appropriate aetiological model is needed to take adequate preventative steps. This is in part due to the complex interactions between genotype and environment. In this article we review research on factors determining alcohol use by adolescents and on the development of an unifying model.

METHOD

The data bank Medline Advanced was searched for topical articles that were then checked for relevance and sorted according to genetic factors, environmental factors, and their interactions.

RESULTS

Many factors, alone and in combination with others, influence juvenile alcohol consumption. Each single variable, however, can explain only a small part of the variation in consumption behaviour.

CONCLUSION

The manifold possibilities of interactions between these factors become clear. There is a strong need for comprehensive models of juvenile alcohol use and the integration of current results into these models.

Impaired control and undergraduate problem drinking

AIMS

Impaired control, one of the hallmarks of addiction, is also one of the earliest dependence symptoms to develop. Thus impaired control is particularly relevant to undergraduates and other young adults with relatively brief drinking histories. The main goal of this study was to determine whether impaired control predicted heavy episodic drinking and alcohol-related problems cross-sectionally in an undergraduate sample after controlling for gender, family history of alcohol and drug problems, and several other established predictor variables from the undergraduate alcohol literature.

METHODS

A sample of first-year undergraduates (n=312) completed Part 2 of the Impaired Control Scale (ICS) and other measures related to alcohol use as part of a larger study on problem drinking in undergraduates.

RESULTS

Scores on Part 2 of the ICS predicted heavy episodic drinking and alcohol-related problems cross-sectionally even after controlling for all other predictor variables. Notably, impaired control was a stronger predictor of alcohol-related problems than overall weekly alcohol consumption. Part 2 of the ICS was found to be a reliable and valid measure for use with undergraduates.

CONCLUSIONS

These findings support the notion that impaired control is one of the earliest dependence symptoms to develop. The ICS is an effective tool for identifying young adults at risk for problem drinking.

The Relative Importance of Mothers' and Youths' Neighborhood Perceptions for Youth Alcohol Use and Delinquency

Prior studies have examined the influence of neighborhood perceptions on youth outcomes, but few studies have examined whose report of neighborhoods, parents' or youths', are most important in predicting youth outcomes. This study addresses the relative associations of youths' and mothers' neighborhood perceptions with youth alcohol use and delinquency. The sample includes 499 mother-child dyads (youth age: 10 to 16 [mean = 13.3; SD = 2]). Structural equation modeling showed that youths' perceived neighborhood problems were significantly associated with their delinquency but not their alcohol use. However, mothers' perceived neighborhood problems were not related to either youth alcohol use or delinquency, suggesting that youths' perceptions are better indicators of youth behavior. Youth reports may reflect their activities in the neighborhood and their exposure to different forms of deviance, so youths' reports would be better indicators of exposure to neighborhood risk. Challenges for prevention are discussed.