Socio-environmental influences on adolescents' alcohol outcome expectancies: a prospective analysis

Factor structure of the alcohol expectancies questionnaire among adolescents in rural Ghana

INTRODUCTION

Children's early experiences with alcohol inform the development of alcohol-related beliefs which are known to predict alcohol consumption during the critical stage of adolescence. Yet, there has been considerably less research into these alcohol-related cognitions in low- and middle-income countries (LMIC) and existing measures of these beliefs are highly reflective of Western contexts, which may not be fully appropriate for use in LMICs. The aim is to ascertain the construct validity of the Alcohol Expectancies Questionnaire (AEQ) in a non-Western sample.

METHODS

A cross-sectional diagnostic accuracy study involving 500 adolescents aged 10 to 18 years randomly selected from the database of the Navrongo Health and Demographic Surveillance System. Participants were administered the locally back translated version of the 34-item AEQ. Confirmatory factor analysis using the lavaan package in R was conducted to generate indices for the factor structure of the AEQ.

RESULTS

Confirmatory factor analyses showed that while groupings of positive and negative expectancies were similar to those observed when expectancies have been assessed previously in Western studies, these formed a single 'alcohol expectancy' factor. Questions relating to positive tension reduction and negative physical expectancies showed inconsistent responses in this study.

DISCUSSION AND CONCLUSIONS

Commonly used tools for the assessment of alcohol expectancies may not be suitable for use in Ghana, possibly owing to their development and validation in Western contexts. These findings have implications for the assessment of alcohol-related beliefs in LMIC settings and begin to map out a research agenda to develop more contextually and culturally attune alcohol assessments.

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

Purpose of Review

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

Recent Findings

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

Summary

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

Parent Alcohol Use and Problems in Children's Alcohol-Related Learning and Subsequent Alcohol Use

Background: Alcohol cognitions can emerge early in life and have lasting associations with alcohol use behavior. Observational learning theories suggest that witnessing alcohol use and its consequences may be an important mechanism underlying early development of alcohol cognitions. Parents are among the earliest contributors to children's alcohol-related learning, although findings regarding the association of parental alcohol use and problems with children's alcohol-related beliefs and attitudes are considerably mixed. This study tested associations of parent alcohol use and problems with adolescent alcohol expectancies, motives, and subsequent alcohol use to help clarify this literature. Methods: Families (N = 227) comprising family alcohol use disorder cases and demographically matched controls were recruited as part of a longitudinal investigation on child development. Parents reported on their alcohol use and problems at seven assessments throughout the index adolescents' childhood, and adolescents reported on their own alcohol expectancies in 6th grade, alcohol motives in 8th grade, and alcohol use in 12th grade. Results: Father alcohol problems and mother alcohol use were linked to more positive and less negative child alcohol expectancies, respectively. However, these cognitions did not contribute unique variance in adolescent alcohol use after accounting for additional risks included in the model. Conclusions: Findings highlight the need for future research aimed at modeling broader and potentially indirect sources of parent influences on adolescent alcohol-related learning and subsequent drinking behavior.

Characterizing Alcohol Expectancies in the ABCD Study: Associations with Sociodemographic Factors, the Immediate Social Environment, and Genetic Propensities

Alcohol expectancies (AEs) are associated with likelihood of alcohol initiation and subsequent alcohol use disorders. It is unclear whether genetic predisposition to alcohol use and/or related traits contributes to shaping how one expects to feel when drinking alcohol. We used the Adolescent Brain Cognitive Development study to examine associations between genetic propensities (i.e., polygenic risk for problematic alcohol use, depression, risk-taking), sociodemographic factors (i.e., parent income), and the immediate social environment (i.e., peer use and disapproval toward alcohol) and positive and negative AEs in alcohol-naïve children (max analytic N = 5,352). Mixed-effect regression models showed that age, parental education, importance of the child's religious beliefs, adverse childhood experiences, and peer disapproval of alcohol use were associated with positive and/or negative AEs, to varying degrees. Overall, our results suggest several familial and psychosocial predictors of AEs but little evidence of contributions from polygenic liability to problematic alcohol use or related phenotypes.

Change in alcohol outcome expectancies from childhood to emerging adulthood: A meta-analysis of longitudinal studies

ISSUES

Knowledge on the development of alcohol outcome expectancies (AOE) is relevant because AOE predict change in drinking behaviours. The present meta-analysis integrates results of longitudinal studies on change in AOE from childhood to emerging adulthood (age 23/24).

APPROACH

A systematic search in electronic databases identified 64 studies that were analysed with three-level meta-analyses.

KEY FINDINGS

AOE about positive and social consequences tended to increase, on average, from childhood to middle or late adolescence, respectively. In contrast, negative AOE declined over time. Change in positive, social and tension reduction AOE were described as an inverted u-shaped curve. The strongest increase of more than two standard deviation units was observed with regard to social AOE between the age of 7 and 16, followed by small decline in the transition to emerging adulthood.

IMPLICATIONS

The meta-analysis found evidence for strong increases of positive AOE from childhood to middle or late adolescence.

CONCLUSIONS

The results inform about reasonable age-ranges for expectancy-challenging interventions. To obtain a clearer picture of change in AOE beyond adolescence, longitudinal research is needed on younger children and beyond college age.

Examining Social Influences on Why We Drink: Perceived Drinking Motives in the Social Network Impact Individuals' Own Drinking Motives and Alcohol Use

Introduction: A significant body of research has investigated the impacts of social influence and social selection on binge drinking and risk factors for binge drinking in emerging adults; however, one risk factor for binge drinking that has yet to be thoroughly investigated in this regard is drinking motives. Preliminary research suggests the motives of others may impact emerging adults' own alcohol use indirectly through their own motives (i.e., social influence). While these are important findings, research to date has been only conducted with adolescents or dyads and has not examined selection (i.e., selecting social network members with similar motives). We filled these gaps with a longitudinal egocentric social network design. Methods: Emerging adults (N = 177) completed measures on their alcohol use, drinking motives, and social networks at baseline (T1) and four-month follow-up (T2). Results: A cross-lagged panel model indicated T1 perceived network drinking motives predicted T2 participant drinking motives (for all motives but social), but T1 participant drinking motives did not predict T2 perceived network drinking motives. Path analysis indicated T1 perceived network drinking motives predicted T2 participant binge drinking frequency indirectly through T2 participant drinking motives for enhancement, coping-with-anxiety, and conformity, but not social or coping-with-depression, motives. Discussion: Results suggests drinking motives of those around emerging adults impact their own drinking motives, and indirectly, their own alcohol use. We found evidence of social influence, but not social selection. Conclusion: It appears that those around emerging adults have the capacity to influence their drinking behaviors and drinking motives.

Mechanisms Underlying Associations between Media Alcohol Exposure, Parenting, and Early Adolescent Drinking: A Moderated Sequential Mediation Model

Exposure to alcohol content in the media, especially in movies, is a demonstrated risk factor for adolescent alcohol use. This paper examines processes underlying this association and whether parenting mitigates such harms. A mediational model of parental restriction of mature media (W1), alcohol content exposure (W2), alcohol expectancies, peer norms (W3), and alcohol outcomes (W4) was tested using annual assessments from a study of adolescent drinking (N = 879; 52% female; 21% Non-White; 12% Hispanic). When restrictions are not in place, adolescents report greater exposure to alcohol content, leading to higher perceived peer drinking. Parental monitoring did not buffer the link between exposure and peer norms. Parental media restriction and perceptions about peers comprise mechanisms by which alcohol-saturated media influences youth drinking.

Social Networking Sites and Perceived Content Influence: An Exploratory Analysis from Focus Groups with French Adolescents

Social networking sites (SNSs) are invested in heavily by marketers aiming to reach a growing number of consumers. Concerns regarding the influence of posts displayed on SNSs in relation to behaviour were raised, in particular the promotion of ill-health behaviour directed to adolescents who may be at risk from suggestible practices. Although adolescents tend to be critical towards traditional forms of advertising, little is known about their perception of influencing strategies developed online, especially where sponsor- and user-generated content coexist. This exploratory study aims to gather information directly from adolescents about their use of SNSs their awareness of the influence that SNS content may have, particularly when it comes to tobacco and alcohol messages. Ten focus groups were conducted with 39 adolescents (11-16 years old; 56.4% male). Qualitative analysis documents the differences associated with adolescents' favourite SNSs. The different parameters linked to each SNS and the expectation to find entertaining content and values associated with friendship may decrease adolescents' perception of potential risk for health associated with SNS use. Authors advocate for the development of educational programs based on eHealth literacy and the use of social marketing techniques to facilitate and motivate adolescents to develop their competences.

Psychological Processes Underlying Effects of Alcohol Marketing on Youth Drinking

OBJECTIVE

Evidence increasingly suggests that alcohol marketing plays a significant role in facilitating underage drinking. This article presents a review of empirical studies and relevant theoretical models proposing plausible psychological mechanisms or processes responsible for associations between alcohol-related marketing and youth drinking.

METHOD

We review key psychological processes pertaining to cognitive mechanisms and social cognitive models that operate at the individual or intrapersonal level (attitude formation, expectancies) and the social or interpersonal level (personal identity, social identity, social norms). We use dominant psychological and media theories to support our statements of putative causal inferences, including the Message Interpretation Processing Model, Prototype Willingness Model, and Reinforcing Spirals Model.

RESULTS

Based on the evidence, we propose an integrated conceptual model that depicts relevant psychological processes as they work together in a complex chain of influence, and we highlight those constructs that have received the greatest support in the literature.

CONCLUSIONS

The evidence to date suggests that perceptions of others' behaviors and attitudes in relation to alcohol (social norms) may be a more potent driver of youth drinking than evaluations of drinking outcomes (expectancies). Considerably more research--especially experimental research--is needed to understand the extent to which theoretically relevant psychological processes have unique effects on adolescent and young adult drinking behavior, with the ultimate goal of identifying modifiable intervention targets to produce reductions in the initiation and maintenance of underage alcohol use.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Effects of Observable Parent Alcohol Consequences and Parent Alcohol Disorder on Adolescent Alcohol Expectancies

BACKGROUND

Parental drinking and parent alcohol use disorder (AUD) are known predictors of adolescent positive alcohol expectancies, but their link to negative expectancies is unclear. Research suggests that parent drinking may indirectly predict adolescent expectancies through exposure to parental drinking events. However, exposure to parent negative alcohol consequences may be more relevant to adolescents' expectancies. The present study tested the mediating effect of parent observable negative alcohol consequences in the association between parent AUD and adolescent expectancies.

METHODS

This study used parent and adolescent data from the Adult and Family Development Project. A total of 581 adolescents reported on their alcohol expectancies across 2 waves of data, and their parents reported on potentially observable alcohol-related negative consequences during the first wave. Past-year and lifetime parent AUD were assessed with diagnostic interviews across 6 waves of data.

RESULTS

Mothers' observable consequences mediated the effect of her past-year AUD on adolescent negative expectancies in adolescence, but this effect did not hold at a 1.5-year follow-up. Mothers' lifetime AUD was the only prospective predictor of later adolescent negative expectancies. No father drinking variables predicted expectancies, and all models were invariant across child biological sex. Finally, older adolescent age prospectively predicted higher positive expectancies, whereas the adolescents' own drinking predicted lower negative expectancies.

CONCLUSIONS

These findings, in line with other recent studies, suggest that exposure to mothers' negative experiences with alcohol may counterintuitively normalize negative alcohol effects. This may paradoxically increase risk for adolescents rather than buffering the effects of a family history of parental AUD.

Are animal models of addiction useful?

BACKGROUND

Pre-clinical research involving non-human animals has made important contributions to our understanding of risk factors for addiction, neuroadaptations that follow chronic drug exposure and to the development of some efficacious pharmacotherapies for addiction. Despite these contributions, we argue that animal models of addiction have impeded progress in our understanding of addiction and its treatment in humans.

ARGUMENT

First, the majority of pharmacological treatments that were initially developed using animal models have failed to prove effective for the treatment of addiction in humans, resulting in a huge waste of resources. Secondly, we demonstrate that prevailing animal models that portray addiction as a disorder of compulsion and habit cannot be reconciled with observations that psychoactive drug use in humans is a goal-directed operant behaviour that remains under the control of its consequences, even in people who are addicted. Thirdly, addiction may be a uniquely human phenomenon that is dependent on language, which necessarily limits the validity of animal models. Finally, we argue that addicted brains must be understood as one component of broader networks of symptoms and environmental and social factors that are impossible to model in laboratory animals.

CONCLUSIONS

A case can be made that animal models of addiction have not served us well in understanding and treating addiction in humans. It is important to reconsider some widely held beliefs about the nature of addictive behaviour in humans that have arisen from the zeal to translate observations of laboratory animals.

Adolescent and Parent Knowledge, Attitudes, and Perceptions of Harm of Household Controlled Medications

Introduction: Adolescents learn knowledge, attitudes, and behaviors from their parents, yet little is known about how these attributes are associated with management of household controlled prescription medications. We aimed to assess adolescent and parent: 1) knowledge and attitudes regarding household controlled medications, including previous healthcare counseling; 2) perceptions of harm of medication misuse and diversion; and 3) potential associations of these attributes with household management. Methods: This was a cross-sectional study with paired data using brief, online, confidential surveys of adolescents and parents via an adolescent medicine clinic associated with a large academic center. Eligible adolescents were aged 12-18 years old with at least one controlled prescription medication in the home. Data collection and analysis occured in 2017-2018. Results: Of the 243 adolescent-parent dyads, many adolescents and parents had: low knowledge (15%; 6%), risky attitudes (31%; 32%), received healthcare counseling on safe management of controlled medications (30%; 96%), and low perceived harm of adolescent diversion (39%; 49%). Parents practicing unsafe household management were 2.4 (95% CI = 1.3, 4.3) times as likely to have risky attitudes. Adolescents with families practicing unsafe medication management were 3.7 (95% CI = 1.1, 10.4) times as likely to have low perceptions of harm from diversion. Conclusions: Many adolescents and parents have low knowledge, risky attitudes, and low perceptions of harm of adolescent diversion, some of which are associated with unsafe household medication management. Providers should aim to utilize interventions to improve these attributes for adolescents and parents to enhance safe household medication management.

Social Interaction With an Alcohol-Intoxicated or Cocaine-Injected Peer Selectively Alters Social Behaviors and Drinking in Adolescent Male and Female Rats

BACKGROUND

Drinking alcohol is facilitated by social interactions with peers, especially during adolescence. The importance of peer social influences during adolescence on alcohol and substance use has recently received more attention. We have shown that social interaction with an alcohol-intoxicated peer influences adolescent alcohol drinking differently in male and female rats using the demonstrator-observer paradigm. The present set of experiments analyzed the social interaction session to determine changes in social behaviors and subsequent alcohol drinking in adolescent male and female rats.

METHODS

Specifically, in Experiment 1, we determined whether specific social behaviors were altered during interaction with an alcohol-intoxicated demonstrator administered 1.5 g/kg ethanol (EtOH) and assessed changes in EtOH intake in adolescent observers. Experiment 2 examined changes in voluntary saccharin consumption to determine whether social interaction with an alcohol-intoxicated demonstrator administered 1.5 g/kg EtOH altered consumption of a palatable solution. In Experiment 3, we administered saline, and a low (5 mg/kg) or high (20 mg/kg) dose of cocaine to the demonstrator and assessed changes in the adolescent observers to determine whether social interaction with a "drugged" peer altered social behaviors and voluntary EtOH intake.

RESULTS

We showed that social interaction with an alcohol-intoxicated demonstrator administered 1.5 g/kg EtOH (i) decreased social play and increased social investigation and social contact in adolescent male and female observers, (ii) did not alter nonsocial behaviors, (iii) did not alter saccharin consumption, and (iv) increased voluntary EtOH intake in adolescent female but not male observers. When the peer was injected with cocaine, (i) social play was dose-dependently decreased, (ii) there were no changes in other social or nonsocial behaviors, and (iii) voluntary EtOH intake in adolescent male and female observers was unaffected.

CONCLUSIONS

The present results are consistent and extend our previous work, showing that social interaction with an alcohol-intoxicated peer selectively alters social behaviors and alcohol drinking in adolescent rats. Females appear to be more sensitive to the elevating effects of social interaction on voluntary EtOH consumption.

Aspirational Brand Choice and Underage Alcohol Use

OBJECTIVE

Marketing aims to foster brand allegiance, and alcohol is a heavily marketed commodity. We hypothesize that exposed youth who are able to identify an aspirational alcohol brand will be at higher risk for underage drinking.

METHOD

U.S. youth ages 15-20 (N = 2,012; 51% female) were surveyed twice in 2011-2013. Aspirational brand was assessed by asking, "If you could drink any brand you want, what is the name of the brand of alcohol you would choose?" Multivariable logistic regression tested associations between having an aspirational brand at baseline and onset of ever, binge (≥6 drinks/occasion), and hazardous drinking (Alcohol Use Disorders Identification Test-Consumption ≥ 4).

RESULTS

Baseline ever, binge, and hazardous drinking prevalence was 55%, 26%, and 19%, respectively; 47% reported having an aspirational brand, of whom 20% were nondrinkers. Top five reported brands were Budweiser, Smirnoff, Corona, Jack Daniels, and Bacardi, all heavily advertised brands. Older age, male gender, sensation seeking, and peer/parent drinking were associated with having an aspirational brand. After we controlled for these confounders, having an aspirational brand was independently associated cross-sectionally with greater risk of ever, binge, and hazardous drinking (adjusted odds ratio = 4.47, 95% CI [3.33, 6.00], 4.84 [3.41, 6.86], and 5.46 [3.63, 8.23], respectively) and longitudinally with initiation of binge and hazardous drinking (1.80 [1.19, 2.73] and 2.02 [1.33, 3.06], respectively).

CONCLUSIONS

Having an aspirational alcohol brand is both common and independently associated with subsequent underage alcohol use and misuse. Further studies examining how youth interact with and are affected by branded advertising are critical to guide development of effective education and policy interventions.

Mediation analysis with zero-inflated substance use outcomes: Challenges and recommendations

Mediating mechanisms are important components of substance use research, as many substance use interventions work by targeting mediating variables. One issue that is common in substance use research is the presence of many responses of zero in a count variable that is the primary outcome of interest, such as number of drinks per week or number of substances used in the past month. The goal of this paper is to highlight the unique challenges that substance use researchers face when conducting mediation analysis with a zero-inflated count outcome. In this paper, we first describe the models that are commonly used for zero-inflated count data, and when it is appropriate to use them. We then describe general mediation analysis and summarize the small body of work that has focused on mediation for count and zero-inflated count outcomes. We identify the main issue of computing the mediated effect when outcomes are zero-inflated, namely, that the path leading to the zero-inflated count outcome (or mediator) is modeled in two parts. We then provide two examples of mediation models with different conclusions that have zero-inflated count outcomes using adolescent substance use data and define the issues that arise when assessing mediation for each. Finally, we describe the directions in which we must target future methodological research to create accessible solutions for handling mediation with zero-inflated count data in substance use research.

Perceptions of Alcohol Advertising Vary Based on Psychological Characteristics

BACKGROUND

The alcohol industry recognizes children and pregnant women as population sub-groups vulnerable to the effects of alcohol marketing. Research indicates that heavy alcohol users are also potentially vulnerable to alcohol marketing. The purpose of the current study is to determine if sub-groups defined by psychological characteristics should be classified as potentially vulnerable as well.

METHODS

College students (n = 326) from two northeast schools were recruited to complete a survey containing questions on demographics, alcohol use, and psychological characteristics (alcohol expectancies, alcohol dependence, sensation seeking traits, and past delinquent behaviors). Additionally, after viewing each of five alcohol ads (4 television and 1 magazine), participants answered questions about their perceptions of alcohol consumption, responsible drinking, excessive drinking, and appeal of the ads. Main effects were assessed using hierarchical linear modeling, with adjustment for age, sex, race, ethnicity, and AUDIT score.

RESULTS

Alcohol expectancies (p < .001), particularly the social and physical pleasure and social expressiveness sub-scales, and sensation seeking traits (p = .002) were positively associated with alcohol ad appeal. Alcohol dependence symptoms, specifically impaired control and tolerance, were positively associated with perceptions of responsible drinking (p = .035), even though mean perceived number of drinks consumed met the definition of binge drinking.

CONCLUSIONS

Individuals with positive alcohol expectancies, sensation seeking traits, and alcohol dependence may be vulnerable to alcohol advertising and marketing. Because alcohol advertising often contains content that can serve as a cue or reinforce to drink, specific regulations may be needed to prevent alcohol-related harm from occurring in these sub-populations.

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

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

Reciprocal relations between positive alcohol expectancies and peer use on adolescent drinking: An accelerated autoregressive cross-lagged model using the NCANDA sample

Positive alcohol expectancies (PAE) and associating with drinking peers are reliable predictors of adolescent alcohol use. Knowledge of when and for whom these risk factors are most influential could enhance intervention effectiveness. Reciprocal relations between PAE and adolescent and peer alcohol use were examined between the ages of 13 and 18 in a sample (N = 566; 50% female) from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), as well as sex differences in these associations. Associating with drinking peers prospectively predicted more frequent alcohol use for both sexes, although peer socialization was evident earlier for girls compared with boys. Higher PAE influenced later drinking in mid-adolescence, from age 14 to 16, for boys only. PAE influenced peer group selection for both sexes, although the influence was evident earlier in boys than girls. The relative impact of environmental risk factors for problematic alcohol use may vary over time and across developmental periods. These results suggest that prevention and treatment efforts for adolescent drinking can be improved by targeting age-appropriate risk factors. Early adolescent interventions may be best served by minimizing involvement with drinking peers and correcting normative beliefs of peer use. Among adolescent girls, early interventions focused on reducing peer influence may be most effective. Prevention and treatment programs aimed at addressing PAE would likely prove more effective for boys in mid- to late adolescence. (PsycINFO Database Record

Development and testing of the Youth Alcohol Norms Survey (YANS) instrument to measure youth alcohol norms and psychosocial influences

OBJECTIVES

This study aimed to develop and validate an online instrument to: (1) identify common alcohol-related social influences, norms and beliefs among adolescents; (2) clarify the process and pathways through which proalcohol norms are transmitted to adolescents; (3) describe the characteristics of social connections that contribute to the transmission of alcohol norms; and (4) identify the influence of alcohol marketing on adolescent norm development.

SETTING

The online Youth Alcohol Norms Survey (YANS) was administered in secondary schools in Western Australia PARTICIPANTS: Using a 2-week test-retest format, the YANS was administered to secondary school students (n=481, age=13-17 years, female 309, 64.2%).

PRIMARY AND SECONDARY OUTCOME MEASURES

The development of the YANS was guided by social cognitive theory and comprised a systematic multistage process including evaluation of content and face validity. A 2-week test-retest format was employed. Exploratory factor analysis was conducted to determine the underlying factor structure of the instrument. Test-retest reliability was examined using intraclass correlation coefficient (ICC) and Cohen's kappa.

RESULTS

A five-factor structure with meaningful components and robust factorial loads was identified, and the five factors were labelled as 'individual attitudes and beliefs', 'peer and community identity', 'sibling influences', 'school and community connectedness' and 'injunctive norms', respectively. The instrument demonstrated stability across the test-retest procedure (ICC=0.68-0.88, Cohen's kappa coefficient=0.69) for most variables.

CONCLUSIONS

The results support the reliability and factorial validity of this instrument. The YANS presents a promising tool, which enables comprehensive assessment of reciprocal individual, behavioural and environmental factors that influence alcohol-related norms among adolescents.

Even in early childhood offspring alcohol expectancies correspond to parental drinking

BACKGROUND

Research has found that children as young as preschoolers have an idea about the valence (positive vs. negative) and activation (arousal vs. sedation) of emotional change when adults drink alcohol. The development of alcohol expectancies at such a young age may be due to observed parental alcohol use.

METHODS

Three measures of alcohol use (frequency, quantity and binge drinking) assessed among 115 fathers and 149 mothers were correlated with four alcohol expectancy factors (crossing valence and activation) of their offspring, aged three to six (70 boys and 82 girls).

RESULTS

For both arousal and sedation expectancies and across alcohol use measures of both fathers and mothers, the greater parental alcohol use was, the higher their sons' negative and the lower positive alcohol expectancies were. For negative expectancies (particularly sedation, i.e., drinking when feeling sad or depressed), there was a stronger and more consistent association with paternal than with maternal drinking. For daughters, there was no consistent association between any expectancy factor and any parental drinking behavior.

CONCLUSIONS

Already among preschoolers, parental drinking was found to be correlated with their sons' alcohol expectancies in the sense that they may observe and associate positive emotional consequences (feeling joyful, happy, calm, relaxed etc.) with moderate parental drinking and negative emotional consequences (feeling angry, nervous, sad, depressed etc.) with excessive drinking. This may be important for prevention, as expectancies have been found to be predominant predictors of early alcohol initiation and development of risky drinking in adolescence and beyond.

Early Initiation of Substance Use as an Indicator of Problematic Substance Use Among Young Men Who Have Sex with Men (YMSM)

BACKGROUND AND OBJECTIVES

Much research has documented that young men who have sex with men (YMSM) are at higher risk for substance use-related problems. This study examined the age of substance use initiation and it's relationship to current substance use-related problems among substance-using YMSM.

DESIGN AND METHODS

A cross-sectional survey of 191 YMSM (aged 18 to 29) with recent histories of prescription drug misuse was conducted in Philadelphia in 2012-13. Participants were surveyed about age of initiation of cigarette smoking, alcohol use to the point of intoxication, marijuana, prescription, and illicit drugs, and about alternate modes of prescription drug administration. The severity of participants' current substance use related problems was measured using the Drug Abuse Screening Test (DAST-10).

RESULTS

Mean age of initiation was 14.6 years for cigarette smoking, 15.3 years for alcohol use to the point of intoxication, 15.2 years for marijuana, 16.8 years for prescription drugs, and 17.9 years for illicit drugs. Use of 2 or more substances by the age of 15 was reported by 56% of the participants. Odds of substance-related problems were significantly greater among those who reported earlier initiation of alcohol, prescription drugs, or polysubstance use. Odds of prescription drug misuse via altered routes of administration were significantly greater among participants with earlier onset of alcohol, marijuana, prescription, illicit drugs, or polysubstance use.

DISCUSSION AND CONCLUSIONS

This study demonstrates that earlier initiation of substance use is associated with higher risk of substance-related problems among substance-using YMSM. Early interventions addressing substance use initiation could benefit this population.

Postintervention Effects of Click City® : Alcohol on Changing Etiological Mechanisms Related to the Onset of Heavy Drinking

INTRODUCTION

Alcohol consumption, including heavy drinking, is the fourth leading preventable cause of death in the United States. Youth who engage in heavy drinking are likely to experience a number of problems associated with their use. In 2015, U.S. prevalence of heavy drinking was 17% among 12th graders. These data suggest a clear need for conducting alcohol prevention activities among youth.

METHOD

We designed the Click City®: Alcohol program for 7th graders, with a booster in 8th grade. We conducted an efficacy trial in 25 schools in three counties in Oregon. Schools were randomized to either the Click City: Alcohol ( n = 12) or Usual Curriculum condition ( n = 13). We present the results of a short-term evaluation, assessing change in outcomes from baseline to 1 week following the intervention among students in Click City: Alcohol schools versus those in Usual Curriculum schools.

RESULTS

Students who used the Click City: Alcohol program significantly decreased their intentions to drink heavily in the future, as compared with students in the Usual Curriculum control condition, although the effect size was small. Changes in the targeted mechanisms were in the expected direction and were significant for all but one mechanism, with moderate effect sizes.

CONCLUSION

Our short-term findings provide preliminary support for the efficacy of the Click City: Alcohol program to change adolescents' intentions to engage in heavy drinking. If the results are maintained over time, the program has the potential to prevent the onset of heavy drinking among teens and reduce the negative consequences associated with heavy drinking, including neurological and other health consequences.

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

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

Factor Structure of the Brief Comprehensive Effects of Alcohol Scale in Adolescents

Alcohol use among adolescents is a public health concern; therefore, it is important that studies that examine factors associated with adolescent drinking behaviors utilize measures that are well-validated for use with this population. The current study examined the factor structure and convergent validity of the Brief Comprehensive Effects of Alcohol scale, a measure of alcohol outcome expectancies and evaluations of expected outcomes, among adolescents ( N = 1,074; 50% girls; M_age = 15.96 years, SD = 1.13, range = 13-18; 74% White) drawn from three independent studies ( n_{site 1} = 594; n_{site 2} = 97; and n_{site 3} = 383). Results yielded support for a four-factor structure for alcohol expectancies and two-factor structure for valuations. Moreover, the factor structure was partially or fully invariant across gender, age, and site. Thus, findings are similar, yet unique, to those identified in college samples. The convergent validity of the modified measure was supported, suggesting that the Brief Comprehensive Effects of Alcohol scale may be useful for assessing adolescents' beliefs about alcohol.

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

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

Commentary on Rossow et al. (2016): Early days yet in the cycle from peer to parent drinking as influences on adolescent alcohol involvement

Rossow et al. ’s systematic review highlights the fact that we know less than we thought about the role of parent drinking in the etiology of teen drinking. Further research is needed to clarify both the aspects of parent drinking that impact later drinking by adolescent offspring as well as the mediators and moderators of this relation.

Positive Outcome Expectancy Mediates the Relationship Between Peer Influence and Internet Gaming Addiction Among Adolescents in Taiwan

The present study examined the role of positive outcome expectancy in the relationship between peer/parental influence and Internet gaming addiction (IGA) among adolescents in Taiwan. Two thousand, one hundred and four junior high students completed the Chen Internet Addiction Scale for IGA, Parental Influence for IGA, peer influence for IGA, and Positive Outcome Expectancy of Internet Gaming Questionnaire. Results showed that the three types of peer influences (positive attitudes toward Internet gaming, frequency of Internet game use, and invitation to play) and positive outcome expectancy were significantly and positively correlated with IGA. Moreover, peer influence was also positively correlated with positive outcome expectancy. On the other hand, positive outcome expectancy and parental influences had a low correlation. Structural equation modeling analysis revealed that positive outcome expectancy did not mediate the relationship between either type of parental influences and IGA, and only the parent's invitation to play Internet games directly predicted IGA severity. However, peers' positive attitude or the frequency of peers' Internet game use positively predicted IGA and was fully mediated through positive outcome expectancy of Internet gaming. In addition, the frequency of peers' invitation to play Internet games directly and indirectly predicted IGA severity through a partial mediation of positive outcome expectancy of Internet gaming. The overall fit of the model was adequate and was able to explain 25.0 percent of the variance. The findings provide evidence in illuminating the role of peer influences and positive outcome expectancy of Internet gaming in the process of why adolescents may develop IGA.

Variations in parental monitoring and predictions of adolescent prescription opioid and stimulant misuse

OBJECTIVE

This study examined relations between adolescents' family structures, social ties, and drug-related attitudes, and their misuse of prescription opioids and stimulants. Different relationships were anticipated for the substances based on prior research highlighting varying motivations for their use.

METHOD

Based on an earlier model of adolescent substance misuse, two path analytic models were tested using data from 12 to 17 year olds in the 2012 U.S. National Survey on Drug Use and Health (NSDUH: N=17,399).

RESULTS

Female respondents reported higher levels of parental warmth, as did youth from wealthier families. Greater parental monitoring was reported by adolescents from wealthier and intact families. Parental monitoring and warmth predicted adolescents' social ties and individual differences associated with drug use, and both variables predicted prescription opioid and stimulant misuse. Contrary to previous research, for adolescents aged 12 to 14, high levels of parental monitoring, while positively associated with attitudes and social ties, also predicted higher rates of prescription stimulant misuse when combined with low levels of parental warmth. Results were cross-validated with data from the 2011 NSDUH.

CONCLUSIONS

Analyses highlighted the importance of understanding and differentiating the underlying factors associated with adolescent prescription stimulant and opioid misuse, and the role of parental behaviors in prevention.

Alcohol expectancies in young children and how this relates to parental alcohol use

According to the cognitive model of intergenerational transference, modeling of alcohol use is an indirect process in which parental drinking shapes alcohol expectancies of children, which in turn are associated with later alcohol use in adolescents. The present study examined whether parental alcohol use was related to alcohol expectancies and experimentation with alcohol use in young children. A community sample of 240 children aged 8.02 (SD=1.13) participated. Alcohol expectancies were assessed by means of the Berkeley Puppet Interview. Children reported consistently and reliably on the positive and negative consequences of alcohol use among adults. Their positive and negative expectancies were equally strong. Compared to younger children, older children had more negative and less positive expectancies. For girls, more paternal alcohol use was associated with less negative alcohol expectancies. For older children, more alcohol use of the mother was related to less positive expectancies, while more alcohol use of the father was related to more positive expectancies. The present study showed that young children already have clear ideas about the positive and negative consequences alcohol can have among adults, which can be captured with the Berkeley Puppet Interview. These expectancies are partly associated with alcohol use of their parents.

Personality and Alcohol Expectancies Discriminate Alcohol Consumption Patterns in Female College Students

AIMS

To characterize patterns of alcohol use in a sample of Argentinean female college students according to personality traits and alcohol expectancies.

METHODS

Data from 298 female college students (M age = 18.27 years; SD = 1.37 years) from the city of Cordoba, Argentina were analysed using multinomial regression.

RESULTS

Three drinking categories were identified, abstainers, moderate drinkers and regular drinkers with heavy episodic drinking, and these were differentiated by three personality traits [extraversion, disinhibition (DIS) and experience seeking (ES)] and three alcohol expectancies dimensions (sociability, risk/aggression and negative mood). Regular drinkers with heavy episodic drinking and moderate drinkers had, compared to abstainers, higher scores in extroversion and alcohol expectancies for social facilitation, and lower scores in alcohol expectancies for risk and aggression. Regular drinkers with heavy episodic drinking exhibited, compared to moderate drinkers, higher scores in ES, DIS, extroversion, alcohol expectancies for social facilitation and negative mood alcohol expectancies; as well as lower scores in risk and aggression alcohol expectancies.

CONCLUSION

College women in Argentina with problematic alcohol drinking can be distinguished from those drinking moderately.

Peer influences on alcohol expectancies in early adolescence: a study of concurrent and prospective predictors in Taiwan

The effects of peers on three domains of alcohol expectancies through early adolescence were prospectively examined over 2 years. Information on pubertal development, parental drinking, peer characteristics, network structure, alcohol expectancies, and alcohol consumption was assessed in a three-wave longitudinal study of 779 6th graders (~12 years of age) randomly selected from northern Taiwan. Complex survey regression analyses, stratified by drinking experience in 6th grade, were performed to identify predictors of two positive (i.e., enhanced social behaviors and relaxation/tension reduction) and one negative alcohol expectancies (i.e., cognitive/behavioral deterioration) in 7th grade. The results showed that the effects of peer influence on adolescents' alcohol expectancies varied by prior drinking experiences and by expectancy domains. For the alcohol naive, recent exposure to peer drinking was significantly associated with positive and negative alcohol expectancies in grade 7, and this association was moderated by advanced pubertal development (ESBlate puberty: ßwt=0.55; ESBearly puberty: ßwt=-0.40; PRTRlate puberty: ßwt=0.01; PRTRearly puberty: ßwt=1.22; CBD late puberty: ßwt=-0.84; CBDearly puberty: ßwt=0.56). For the alcohol experienced, neither peer drinking nor pubertal development showed any significant links with alcohol expectancies. Occupying a bridge position was slightly linked with negative expectancy (ßwt=0.25). Concurrent drinking serves as a strong predictor for the endorsed alcohol expectancy in both groups, particularly for the domain of enhanced social behaviors. If these effects are confirmed, knowledge of the effect of interplay between peer factors and pubertal development on alcohol expectancies in early adolescence can provide effective targets in prevention programs.

Alcohol and marijuana use in middle school: comparing solitary and social-only users

PURPOSE

Middle school students with a history of solitary substance use are at elevated risk for substance problems by young adulthood. Understanding how these students differ from social-only users on substance use behaviors and consequences, normative beliefs, social influences, and attitudes can inform efforts to reduce solitary use and its related negative consequences.

METHODS

Sixth- to seventh-grade students completed an in-school survey. We compared those with a history of solitary versus social-only alcohol use (n = 202 and n = 616, respectively) and marijuana use (n = 92 and n = 208, respectively) on a range of substance use-related characteristics.

RESULTS

Any solitary use was reported by 25% of lifetime alcohol users and 31% of lifetime marijuana users. Those with a history of solitary use of either substance were more likely to hold positive expectancies about their use but also reported more negative consequences during the past year. Solitary users tended to have greater exposure to substance-using peers and more difficulty resisting offers to use. Compared with social-only drinkers, those with a history of solitary drinking perceived that more of their peers were alcohol users. Significant group differences were not found on negative outcome expectancies or attempts to cut down on substance use.

CONCLUSIONS

Solitary use is an important, yet, overlooked problem among middle school students who have just begun drinking or using marijuana. Results suggest that positive expectancies, peer influences, resistance self-efficacy, and normative beliefs may be important areas to target in reducing solitary use and the risk it poses for problematic use in young adulthood.

How important are positive and negative outcome expectancies in the treatment of addiction: a narrative review of the literature

Purpose

– The purpose of this paper is to review the substance misuse literature on how outcome expectancies are measured, how they are related with the level of use and other factors as well as their role into treatment and recovery.

Design/methodology/approach

– A narrative review of the literature for all major substances of abuse was undertaken.

Findings

– Existing measurement tools are substance specific. Most research has been in the field of alcohol, and involved students or light and moderate drinkers. Positive expectancies have been found to be related to initiation and level of alcohol, nicotine and cannabis use and also to be modifiable with repeated cue exposure. Negative expectancies have been found to be associated with prevention of smoking, positive changes in drinking and positive effect on treatment outcome for alcohol.

Research limitations/implications

– Both positive and negative outcome expectancies have been found to predict development of substance misuse and recovery from it respectively, but cross-substance comparisons are hindered by lack of appropriate measures.

Originality/value

– The concept of outcome expectancies is present in several theories of addiction. To date there has been no comprehensive review of the extent to which different types of expectancy play a role in different substances and their treatment.

Parental socialization and children's susceptibility to alcohol use initiation

OBJECTIVE

This study examined relations between children's susceptibility to alcohol use initiation and parents' alcohol-specific beliefs, attitudes, and practices and whether these relations vary by parental alcohol use.

METHOD

The sample comprised 1,050 pairs of mothers or mother surrogates and their third-grade children (51.8% female) recruited for a 4-year intervention trial. Families were recruited from school districts located primarily in North Carolina; the school districts provided permission for study recruitment materials to be distributed to families but were not otherwise involved in the research. Data are from the baseline cross-sectional telephone interviews conducted with the mothers and children. Children's susceptibility to alcohol use initiation is based on child reports, and parental alcohol-specific beliefs, attitudes, and practices are based on maternal reports.

RESULTS

All parental alcohol socialization attributes were statistically significantly associated as hypothesized with child susceptibility to alcohol use initiation. In the final full model, the mother's disapproving attitude about child sipping and the interaction between mother-child communication and parental alcohol use frequency were uniquely significantly associated with child susceptibility. Talking with the child about harmful consequences of alcohol use was associated with reduced child susceptibility in families where parents drank alcohol more frequently but had no relationship with child susceptibility in families where parents drank infrequently.

CONCLUSIONS

The normative interactions that parents have with their elementary school children may inhibit or facilitate children's susceptibility to alcohol use. To the extent that child susceptibility leads to early onset of use, prevention programs directed at parents to reduce child susceptibility are indicated.

A influência dos amigos no consumo de drogas entre adolescentes

Objetivou-se avaliar a relação entre variáveis associadas aos amigos e o uso de álcool, tabaco e drogas ilícitas em 965 adolescentes de 50 escolas públicas de Jacareí e Diadema, São Paulo, Brasil. Foi utilizado o Drug Use Screening Inventory para a coleta de dados. Ter amigos que usam substâncias, que têm problemas com a lei, que roubaram/danificaram algo, que vendem drogas, que levam drogas a festas e que ficam entediados quando não bebem em festas aumentou progressivamente o risco de os adolescentes usarem álcool, tabaco e drogas ilícitas. Esse resultado mostra a importância de se avaliar o consumo dessas substâncias separadamente, já que o consumo concomitante de álcool e de tabaco parece ser mais grave do que o consumo isolado de um deles.

Family Structure and Adolescent Alcohol Use Problems: Extending Popular Explanations to American Indians

Competing explanations of the relationship between family structure and alcohol use problems are examined using a sample of American Indian adolescents from the National Longitudinal Study of Adolescent Health. Living in a single-parent family is found to be a marker for the unequal distribution of stress exposure and parental alcohol use, but the effects of other family structures like non-parent families and the presence of under 21-year-old extended family or non-family members emerge or remain as risk or protective factors for alcohol use problems after a consideration of SES, family processes, peer socialization, and social stress. In particular, a non-parent family structure that has not been considered in prior research emerged as a protective family structure for American Indian adolescent alcohol use problems.

Design of an instrument to measure alcohol-related psychosocial influences in the development of norms among 13-year-old to 17-year-old adolescents

INTRODUCTION

Harmful drinking among young people is common in Australia and many other countries. Social norms and their influence on adolescents' alcohol consumption behaviours have received much research attention in recent years. However, there is limited understanding of how social norms related to alcohol are developed and transmitted across social networks and a specific tool that measures these constructs has yet to be developed. This paper outlines the rationale and protocol for the design and validation of a multidimensional survey instrument which measures the development and transmission pathways of alcohol-related norms among adolescents. A longer term aim is to apply the instrument in a respondent-driven sampling study with a large adolescent cohort.

METHODS AND ANALYSIS

Social Cognitive Theory (SCT) and relevant literature will guide the design of the online survey instrument. Feedback from a practitioner-based stakeholder committee, academic expert panel reviews, focus groups and interviews with adolescents aged 13-17 years in Perth, Western Australia (WA) will serve to ascertain content and face validity. A test-retest will be conducted using a purposive sample of students (n=400) at secondary schools in Perth. The instrument's psychometric properties will be analysed, including exploratory factor analyses, discriminant validity, internal consistency and test-retest reliability.

ETHICS AND DISSEMINATION

The results of this research will provide public health researchers and practitioners with a comprehensive standardised instrument to explore the characteristics of individual-level and community-level social influences and norms associated with use of alcohol by adolescents and the routes through which these norms are transmitted. The data collected by the instrument is anticipated to inform the design of youth specific interventions with the potential to reduce alcohol-related harms. The Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The study has received approval from the Curtin University Human Research Ethics Committee.

Underage drinking: prevalence and risk factors associated with drinking experiences among Argentinean children

The aim of this study was to describe the prevalence and predictors of alcohol drinking behavior in children. Data were obtained from 367 children, aged 8-12 years (M = 10.44 years, SD = 1.21 years; 61.9% female) from the city of Córdoba, Argentina. Several scales were used to assess risk factors, including personality traits, alcohol expectancy (i.e., beliefs about the consequences of using alcohol), and perceived peer alcohol use, for alcohol drinking and alcohol drinking experiences. Hierarchical regression analysis was used to determine the contribution of multiple risk factors to the quantity of alcohol consumed. The results showed that 58% of the children had tasted alcohol, and approximately one-third drank alcohol again after the first drinking experience. Twelve-year-old children had a significantly higher prevalence of tasting and drinking alcohol and a significantly greater frequency and quantity of alcohol consumed than younger children. Eighty percent of the children who liked alcohol during their first drinking experience reported that they drank alcohol again. Among the children who did not like alcohol during their first drinking experience, only 31% drank alcohol again. Underage drinking usually occurred under adult supervision in family settings when parents or other relatives allowed them to drink or were aware of their children's drinking. The hierarchical regression analysis showed that being older and male, having more peers that drink alcohol, having higher levels of extroversion, and having alcohol expectancy for social facilitation increased the risk for greater alcohol use. The final model explained 33% of the total variance.

Association of contextual factors with drug use and binge drinking among White, Native American, and Mixed-Race adolescents in the general population

Large-scale surveys have shown elevated risk for many indicators of substance abuse among Native American and Mixed-Race adolescents compared to other minority groups in the United States. This study examined underlying contextual factors associated with substance abuse among a nationally representative sample of White, Native American, and Mixed-Race adolescents 12-17 years of age, using combined datasets from the National Survey on Drug Use and Health (NSDUH 2006-2009, N = 46,675, 48.77 % female). Native American adolescents displayed the highest rate of past-month binge drinking and past-year illicit drug use (14.06 and 30.91 %, respectively). Results of a logistic regression that included seven predictors of social bonding, individual views of substance use, and delinquent peer affiliations showed that friendships with delinquent peers and negative views of substance use were associated significantly with both substance abuse outcomes among White and Mixed-Race adolescents and, to a lesser extent, Native American adolescents. The association of parental disapproval with binge drinking was stronger for White than for Native American adolescents. Greater attention to specific measures reflecting racial groups' contextual and historical differences may be needed to delineate mechanisms that discourage substance abuse among at-risk minority adolescent populations.

Racial/ethnic differences in the influence of cultural values, alcohol resistance self-efficacy, and alcohol expectancies on risk for alcohol initiation

Prior research has reported racial/ethnic differences in the early initiation of alcohol use, suggesting that cultural values that are central to specific racial/ethnic groups may be influencing these differences. This 1-year longitudinal study examines associations between two types of cultural values, parental respect (honor for one's parents) and familism (connectedness with family), both measured at baseline, and subsequent alcohol initiation in a sample of 6,054 (approximately 49% male, 57% Hispanic, 22% Asian, 18% non-Hispanic White, and 4% non-Hispanic Black) middle school students in Southern California. We tested whether the associations of cultural values with alcohol initiation could be explained by baseline measures of alcohol resistance self-efficacy (RSE) and alcohol expectancies. We also explored whether these pathways differed by race/ethnicity. In the full sample, adolescents with higher parental respect were less likely to initiate alcohol use, an association that was partially explained by higher RSE and fewer positive alcohol expectancies. Familism was not significantly related to alcohol initiation. Comparing racial/ethnic groups, higher parental respect was protective against alcohol initiation for Whites and Asians, but not Blacks or Hispanics. There were no racial/ethnic differences in the association between familism and alcohol initiation. Results suggest that cultural values are important factors in the decision to use alcohol and these values appear to operate in part, by influencing alcohol positive expectancies and RSE. Interventions that focus on maintaining strong cultural values and building strong bonds between adolescents and their families may help reduce the risk of alcohol initiation.

Voluntary After-School Alcohol and Drug Programs for Middle School Youth : If You Build It Right, They Will Come

Few after-school programs target alcohol and other drug (AOD) use because it is difficult to encourage a diverse group of youth to voluntarily attend. The current study describes attendance at a voluntary after-school program called CHOICE, which targeted AOD use among middle school students. Over 4,000 students across eight schools completed surveys and 15% participated in CHOICE. Analyses indicated that there were some differences between CHOICE participants and non-participants. For example, African American and multiethnic students were more likely to attend. Past month alcohol users were more likely to initially attend, and marijuana users were more likely to continue attendance. Thus, CHOICE reached students of different racial/ethnic groups and attracted higher risk youth who may not typically obtain prevention services.

The Anticipated Effects of Alcohol Scale: development and psychometric evaluation of a novel assessment tool for measuring alcohol expectancies

Alcohol expectancy (AEs) research has enhanced our understanding of how anticipated alcohol effects confer risk for heavy drinking and alcohol-related problems. However, extant AE measures have limitations within 1 or more of the following areas: assessing a comprehensive range of effects, specifying the hypothetical number of drinks consumed, assessing AEs by limb of the blood alcohol curve (BAC), and/or not having undergone psychometric evaluation. Building upon the strengths of existing measures, we employed conceptual and statistical advances in measurement development to create the novel, psychometrically sound Anticipated Effects of Alcohol Scale (AEAS). Unique to this study, pilot data ensured that the AEAS comprised a comprehensive sampling of effects that varied in valence (positive/negative) and arousal (low/high) and were identified as plausible outcomes of drinking. The AEAS specified the number of drinks individuals imagined consuming (adjusted for sex) and the hypothetical drinking episode length (2 hr). AEs were also assessed separately by BAC limb. For validation purposes, the AEAS was included in several survey studies of young adults (ages 18-30). The validity argument for the proposed interpretation of AEAS test scores was based upon the following: (a) exploratory and confirmatory factor analyses (N = 546) identified a 22-item, 4-factor internal structure, categorizing alcohol effects into quadrants (high/low arousal crossed with positive/negative valence); (b) scalar measurement invariance was established for BAC limb, sex, and binge drinking status; (c) convergence/divergence was observed with alternative AEs measures and mood; and (d) test-criterion relationships were observed with several alcohol-related outcomes. The reliability argument was based on test-retest and internal consistency coefficients.

Substance use initiation: the role of simultaneous polysubstance use

INTRODUCTION AND AIMS

Simultaneous polysubstance use (SPU) is a common phenomenon, yet little is known about its role in substance use initiation.

DESIGN AND METHODS

In the present study, 226 cannabis users completed structured interviews about their substance use history. For each substance ever used, participants provided details of their age of first use, their use in the preceding 30 days and whether they co-administered any other licit or illicit substances the first time they used the substance.

RESULTS

For most illicit substances [powder cocaine, crack, amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA; ecstasy), heroin, opium, gamma-hydroxybutyric acid (GHB), ketamine, psilocybin (magic mushrooms), mescaline, phencyclidine (PCP), peyote and inhalants], results showed that a clear majority of participants (≥75%) reported SPU during their first-ever use of the substance. While SPU was less common on occasions of first use of alcohol, tobacco and cannabis, a high proportion of SPU on occasions of first use of 'harder' drugs could be accounted for by the co-use of alcohol, tobacco and/or cannabis.

DISCUSSION AND CONCLUSIONS

Such findings raise the possibility that specific alcohol, tobacco and/or cannabis use episodes might directly contribute to the initiation of new substance use. Understanding the role of SPU on occasions of first use might help better identify risk factors for substance use progression and improve intervention efforts.

Path of socialization and cognitive factors' effects on adolescents' alcohol use in Taiwan

OBJECTIVES

The purpose of this study was to explore the direct and indirect effects of alcohol-related socialization factors and cognitive factors on adolescent alcohol use in a country with a low prevalence of drinking.

METHODS

Data were obtained from the 2006 phase of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project, at which time the study participants were in grade nine (aged 14-15 years). Data from 1940 participants were analyzed. The main study variables included the current alcohol use of each adolescent, alcohol expectations, alcohol refusal efficacy, alcohol use among parents and peers, attitudes of the parents toward underage drinking, and peer encouragement of drinking. Path analysis was conducted to examine whether parental and peer socialization factors had direct effects on adolescent alcohol use, or whether they acted indirectly via cognitive factors.

RESULTS

Among the participants, 19.54% had used alcohol in the previous month. Path analysis demonstrated that father, mother and peer alcohol use directly influenced alcohol use in adolescents. Attitudes of mothers toward underage drinking, peer drinking and peer encouragement of drinking had indirect effects on adolescent alcohol use that were mediated by cognitive factors.

CONCLUSIONS

This study demonstrated that alcohol-related socialization factors could directly influence adolescent drinking behavior and had indirect effects on alcohol use that were mediated by cognitive factors partially. Parents and peers play important roles in preventing adolescent alcohol use. Establishing appropriate alcohol expectations and strengthening alcohol refusal skills could aid in decreasing alcohol use in adolescents.

Differential relationships of family drinking with alcohol expectancy among urban school children

Background

Positive alcohol outcome expectancy has consistently been linked with problematic drinking, but there is little population-based evidence on its role on early stages of drinking in childhood. The present study seeks to understand the extent to which drinking of family members is differentially associated with the endorsement of alcohol expectancy in late childhood.

Methods

A representative sample of 4th and 6th graders (N = 2455) drawn from 28 public schools in an urban region of Taiwan completed a self-administered paper-and-pencil questionnaire. Each student provided information on alcohol expectancy, drinking experiences, and individual and family attributes. Complex survey analyses were performed to evaluate the relationship, with stratification by children's alcohol drinking history.

Results

An estimated 29% of the 4^th graders and 43% of the 6^th graders had initiated alcohol consumption (over 40% of them had drank on three or more occasions). Alcohol drinking-related differences appear in both the endorsement and the correlates of alcohol expectancy. Positive alcohol expectancy was strongly associated with family drinking, particularly the dimension of "enhanced social behaviors"; negative alcohol expectancy was inversely associated with drinking frequency. Among alcohol naïve children, significant connections appear between paternal drinking and three dimensions of positive alcohol expectancy (i.e., enhanced social behaviors:β_wt = 0.15, promoting relaxation or tension reduction:β_wt = 0.18, and global positive transformation:β_wt = 0.22).

Conclusions

Individual tailored strategies that address family influences on alcohol expectancy may be needed in prevention programs targeting drinking behaviors in children.