Alcohol-specific rules, personality and adolescents' alcohol use: a longitudinal person-environment study

Alcohol norms and alcohol intake among high school students

AIMS

To analyse whether parental alcohol norms were associated with the alcohol intake of high school students and whether this association persisted across different levels of alcohol intake in school and trustful communication with parents.

METHODS

This was a cross-sectional study among 70,544 high school students (mean age 18 years) participating in the Danish National Youth Study 2014. We examined the associations between parental alcohol norms and individual alcohol intake as the number of drinks at the most recent school party and the frequency of binge drinking in the last 30 days using negative binomial regression. We then performed joint analyses of parental alcohol norms and alcohol intake at school level, and parental alcohol norms and trustful communication with parents.

RESULTS

The mean intake of alcohol at the most recent school party was 9.9 units of alcohol for boys and 7.6 units of alcohol for girls. A total of 36.2% of boys and 24.7% of girls were binge drinking frequently (more than four occasions in the last month). Lenient parental alcohol norms and a low level of trustful communication with parents were associated with a higher intake at the most recent school party and with the frequency of binge drinking. Joint analyses showed that these associations persisted across different levels of school level alcohol intake and levels of trustful communication with parents.

CONCLUSIONS

Among high school students, parental alcohol norms were strongly associated with alcohol intake and consistently so across different levels of school level alcohol intake and level of trustful communication with parents. This indicates that the role of parents in preventing excessive drinking is important, even in older adolescents.

Gender differences in the supply of alcohol to adolescent daughters and sons

Background: Parents are the main supplier of alcohol to children but it is not known whether mothers and fathers equally contribute to the supply of alcohol to their female and male children as these children transition to adulthood.Objectives: i) to determine whether the gender of the parent is associated with the gender of the adolescent offspring when alcohol is supplied and ii) whether the gender of the parent supplying is associated with gender differences in adolescent binge drinking and alcohol related harms.Methods: Longitudinal cohort of 1,927 (males = 1052) Australian adolescents (mean age 12.9 years), recruited in 2010/11 from schools in Australia and surveyed annually for six years. We assessed the association between adolescent and parent gender related to subsequent adolescent drinking, binge drinking (>4 standard drinks), and alcohol-related harms.Results: At mean age of 12.9 years about one in ten children report parental supply of alcohol which increases to about four in ten children by 17.8 years. Mothers consistently more often supply their daughters with alcohol than their sons, [Wave 5 OR 1.77 (1.53,2.05)], while mothers less often supply sons than their daughters, [Wave 5 OR 0.82 (0.71,0.95)]. Mothers' supply of alcohol to daughters predicts substantially increased odds of daughters binge drinking, [OR 1.67 (1.10,2.53)] and experiencing alcohol related harms, [OR 1.65 (1.10,2.48)].Conclusion: There is a need to involve both mothers and fathers and to equally target female and male children in programs to reduce the harmful consequences of parental supply of alcohol to their children.

Exploratory and confirmatory factor analysis of the parental rules toward adolescent drinking questionnaire: Two factors are better than the original one

The parental rules toward drinking questionnaire (PRQ; Van der Vorst et al., 2005) assesses strictness toward adolescent drinking situations. The aim of the current study was to address a gap in the literature on the psychometric testing and evaluation of the factor structure of the PRQ. The current sample consisted of Dutch adolescents (N = 2922) who participated in a randomized control trial with three intervention groups (parent, student, and parent + student) and a control. PRQ and frequency of alcohol use (past month and year) were measured at baseline (T1) and 12 months later (T2). Results from Exploratory and Confirmatory Factor Analyses revealed two reliable factors: (a) rules about normative drinking situations and (b) rules about non-normative drinking situations (both αs ≥ 0.88). Regression analyses conducted to examine the prospective effects of the interventions revealed that both parent conditions predicted increases in strictness toward normative drinking situations relative to the control condition, while only the parent + student condition affected the original PRQ (single factor). Further, the normative subscale predicted increases in drinking (past month and year), as did the original PRQ. Significant effects with the normative subscale indicate that rules toward these drinking situations are ones that account for the effects in the original PRQ, and that the original PRQ can mask effects. The results illustrate that the PRQ is multidimensional. The effects of the normative subscale suggest that intervention efforts should focus on preventing drinking situations that parents normally permit their adolescents to engage in.

The association between parental supply of alcohol and supply from other sources to young people: a prospective cohort

AIMS

Despite legal age limits set for alcohol consumption, parents are one of the main suppliers of alcohol to underage minors. Although supply from non-parental sources has been found to be associated with greater risk of harm compared with parental supply, the association between parental supply and supply from other sources is unclear. This study investigated the associations between parental supply of sips and whole serves of alcohol on subsequent other supply, conditional on current supply from non-parental sources.

METHODS

Data from the Australian Parental Supply of Alcohol Longitudinal Study cohort of adolescents was used. A cohort of 1927 Australian children recruited in grade 7 (mean age 12.9 years) was surveyed annually from 2010 to 2016 (94%, n = 1821 included for analyses). The primary outcome was alcohol exposure from other sources ('other supply'), including alcohol supply from other adults, friends, siblings, or self-supply, compared with adolescents reporting no supply from these sources. Analyses were conducted using random intercept logistic regression (to account for within-respondent correlation).

RESULTS

Parental supply of alcohol alone was associated with increased odds of receiving alcohol from other non-parental sources in subsequent years (OR: 1.99; 95% CI: 1.65-2.39) after adjusting for confounders. Increased odds of subsequent other supply were associated with current parental supply of sips (OR: 1.92; 95% CI: 1.56-2.36) and whole drinks (OR: 2.76; 95% CI: 1.85-4.11).

CONCLUSIONS

Parental supply of alcohol appears to increase the risk of subsequent supply of alcohol from other sources in certain contexts.

Parental alcohol-specific rules effectively reduce adolescents' tobacco and cannabis use: A longitudinal study

AIMS

The current study aimed to longitudinally examine the direct and indirect effects (via alcohol use) of parental alcohol-specific rule-setting on adolescent tobacco and cannabis use. Based on the gateway hypothesis, we expected parental alcohol-specific rules to affect adolescent tobacco and cannabis use through adolescent alcohol use.

DESIGN AND PARTICIPANTS

A longitudinal design including three waves and 906 Dutch adolescents (Mage = 13.51 years, SD = 0.60) was used to apply zero-inflated Poisson models (ZIP).

MEASUREMENTS

Self-report questionnaires measured adolescents' perceived rules about alcohol at T1, cigarette use at T1 and T3 (frequency of life-time and current smoking), cannabis use at T1/T3 (frequency of yearly and monthly use) and frequency of monthly alcohol use at T1/T2.

FINDINGS

Stricter alcohol-specific rules at T1 predicted lower incidence and prevalence rates of cigarette (life-time: β = -0.20, p < .00; current: β = -0.21, p = .04) and cannabis use (monthly: β = -0.43, p = .02; yearly: β = -0.28, p = .19) two years later (T3). This direct effect was no longer significant when alcohol use at T1 was controlled for. Moreover, a significant indirect effect of alcohol-specific rules at T1 on tobacco and cannabis use T3 via monthly alcohol use T2 was found.

CONCLUSIONS

The current study demonstrated that strict rules regarding alcohol may not only reduce alcohol but subsequently also other substance use such as tobacco and cannabis. Thus, interventions targeting the prevention of alcohol use, which appears to serve as a gateway, also affects the involvement in other substances.

The overall effect of parental supply of alcohol across adolescence on alcohol-related harms in early adulthood-a prospective cohort study

BACKGROUND AND AIMS

Recent research suggests that parental supply of alcohol is associated with more risky drinking and alcohol-related harm among adolescents. However, the overall effect of parental supply throughout adolescence remains unclear, because parental supply of alcohol varies during adolescence. Due to the complexity of longitudinal data, standard analytical methods can be biased. This study examined the effect of parental supply of alcohol on alcohol-related outcomes in early adulthood using robust methods to minimize risk of bias.

DESIGN

Prospective longitudinal cohort study.

SETTING

Australia PARTICIPANTS: A cohort of school students (n = 1906) recruited in the first year of secondary school (average age 12.9 years) from Australian schools in 2010-11, interviewed annually for 7 years.

MEASUREMENTS

The exposure variable was self-reported parental supply of alcohol (including sips/whole drinks) during 5 years of adolescence (waves 1-5). Outcome variables were self-reported binge drinking, alcohol-related harm and symptoms of alcohol use disorder, measured in the two waves after the exposure period (waves 6-7). To reduce risk of bias, we used targeted maximum likelihood estimation to assess the (counterfactual) effect of parental supply of alcohol in all five waves versus no supply on alcohol-related outcomes.

FINDINGS

Parental supply of alcohol throughout adolescence saw greater risk of binge drinking [risk ratios (RR) = 1.53; 95% confidence interval (CI) = 1.27-1.84] and alcohol-related harms (RR = 1.44; 95% CI = 1.22-1.69) in the year following the exposure period compared with no supply in adolescence. Earlier initiation of parental supply also increased risk of binge drinking (RR = 1.10; 95% CI = 1.05-1.14), and any alcohol-related harm (RR = 1.09; 95% CI = 1.05-1.13) for each year earlier parental supply began compared with later (or no) initiation.

CONCLUSIONS

Adolescents whose parents supply them with alcohol appear to have an increased risk of alcohol-related harm compared with adolescents whose parents do not supply them with alcohol. The risk appears to increase with earlier initiation of supply.

Adolescent Alcohol Use Trajectories: Risk Factors and Adult Outcomes

OBJECTIVES

Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be important predictors of later harms, including alcohol use disorder (AUD). Previous conceptualizations of these trajectories lacked adjustment for known confounders of adolescent drinking, which we aimed to address by modeling dynamic changes in drinking throughout adolescence while adjusting for covariates.

METHODS

Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over 5 annual follow-ups (mean age = 13.9 until 17.8 years). Regression models were used to determine whether child, parent, and peer factors at baseline (mean age = 12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD at the final follow-up (mean age = 18.8 years).

RESULTS

We identified 4 classes: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Having more alcohol-specific household rules reduced risk of early-onset heavy drinking compared with late-onset moderate drinking (relative risk ratio: 0.31; 99.5% confidence interval [CI]: 0.11-0.83), whereas having more substance-using peers increased this risk (relative risk ratio: 3.43; 99.5% CI: 2.10-5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (odds ratio: 7.68; 99.5% CI: 2.41-24.47).

CONCLUSIONS

Our study provides evidence that parenting factors and peer influences in early adolescence should be considered to reduce risk of later alcohol-related harm. Early initiation and heavy alcohol use throughout adolescence are associated with increased risk of alcohol-related harm compared with recommended maximum levels of consumption (late-onset, moderate drinking).

Interplay Between Sensation Seeking and Parental Rules in the Emergence of Heavy Episodic Drinking

This study examined the parallel mediational processes between sensation seeking and parental rules on alcohol, in the emergence of heavy episodic drinking (HED) in adolescents. Data were drawn from a U.K. clustered randomized control trial (control arm only, N ≈ 6,300, M_age at baseline = 12.5). Using parallel process latent growth curve analysis, stricter parental rules at baseline were found to be associated with greater declines in sensation seeking over time and a lower risk of HED at follow-up (+33 months). Higher initial levels of sensation seeking predicted a faster relaxation of parental rules and a greater risk of HED. By maintaining strict rules about alcohol, parents may promote a positive reduction in sensation seeking and a lower risk of HED.

Parental supply of alcohol as a predictor of adolescent alcohol consumption patterns: A prospective cohort

BACKGROUND

Recent research has not supported the idea that parental supply of alcohol to adolescents prevents later alcohol-related harm. Yet the specific role of parental supply in shaping patterns of drinking over time remains unclear. This study investigated the role of parental supply of alcohol in patterns of drinking across adolescence, and assessed whether that role remained consistent over time.

METHOD

Using a longitudinal cohort of 1927 adolescents (mean age 12.9 years), recruited in 2010 and 2011 from schools across Australia and followed up annually until 2016, we assessed three outcomes using mixed-effect negative binomial regression: frequency of consumption, typical quantity consumed, and overall alcohol consumption in the year (frequency * quantity). Child, parental, familial, and peer confounders of adolescent alcohol consumption were measured and adjusted for in the analyses.

FINDINGS

Parental supply was associated with greater overall consumption in earlier adolescence: Grade 7-8 (incidence rate ratio [IRR]: 3.61; 95% CI: 2.55, 5.12; no supply IRR: 1.00), Grade 8-9 (IRR: 4.84; 95% CI: 3.66, 6.39; no supply IRR: 1.44) and Grade 9-10 (IRR: 8.33; 95% CI: 6.28, 11.05; no supply IRR: 4.75). Alcohol consumption continued to increase in later adolescence regardless of whether parental supply occurred.

CONCLUSIONS

Parental supply of alcohol was associated with increased alcohol consumption by their children during early adolescence. While parental supply appears to have less impact on drinking in later adolescence, there was no evidence to suggest it is protective. Parents should be advised to avoid supplying children with alcohol, particularly in early adolescence.

Parental drinking as context for parental socialization of adolescent alcohol use

INTRODUCTION

While alcohol-specific parenting practices have demonstrated unique effects on adolescent substance use, their efficacy in the context of parental drinking levels has not been studied. This study assessed the influence of three alcohol-specific parenting practices (rules, punishment, communication) on adolescent alcohol use, and the degree to which those associations varied by parents' own drinking.

METHODS

We conducted logistic regression analyses among US adolescents (N = 1023; 52% female; 12% Hispanic; 76% Caucasian, 5% Black, 8% mixed race, 11% other race/ethnicity; mean age at enrollment = 12.2 years) to examine the relationship between alcohol-specific parenting practices and the odds of ever having experienced two drinking milestones, having a full drink of alcohol and a heavy drinking episode, and whether parental drinking levels moderated those associations.

RESULTS

Strict rules for drinking, higher levels of cautionary communication messages, and punishment for drinking were associated with lower odds of alcohol use. Witnessing parent drinking increased the risk for both alcohol outcomes. Furthermore, parental drinking modified the influence of parental cautionary messages on alcohol use such that the effect was particularly salient for those youth who witnessed and whose parents reported higher levels of alcohol use.

CONCLUSIONS

Family-based preventive interventions should include skills training in alcohol-specific parenting practices with emphasis on reducing parental alcohol use particularly when children are present.

Bidirectional Relationships between Alcohol-Specific Parental Socialization Behaviors and Adolescent Alcohol Misuse

BACKGROUND

Although numerous studies have examined parental influence on adolescent alcohol misuse, few have examined how adolescents impact parental behavior or the reciprocal nature of parent-adolescent behavior relative to alcohol misuse.

OBJECTIVES

This study assessed bidirectional relationships between adolescent alcohol misuse and three alcohol-specific parenting behaviors (substance-specific monitoring, permissive communication messages about alcohol, and cautionary communication messages about alcohol).

METHODS

Data were from 1,645 parent-adolescent dyads drawn from a longitudinal study spanning grades 6-10. A multivariate latent curve model with structured residuals was used to test study hypotheses.

RESULTS

One marginally significant result emerged (increased alcohol misuse leads to greater substance-specific monitoring) after accounting for underlying developmental processes.

CONCLUSIONS

Though practical implications are limited based on the results of the study, further directions for research regarding study design and measurement are provided to more fully examine dynamic processes between parents and adolescents relative to alcohol use.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

A systematic review of combined student- and parent-based programs to prevent alcohol and other drug use among adolescents

ISSUES

Alcohol and other drug use among adolescents is a serious concern, and effective prevention is critical. Research indicates that expanding school-based prevention programs to include parenting components could increase prevention outcomes. This paper aims to identify and describe existing combined student- and parent-based programs for the prevention of alcohol and other drug use to evaluate the efficacy of existing programs.

APPROACH

The PsycINFO, Medline, Central Register of Controlled trials and Cochrane databases were searched in April 2015 and additional articles were obtained from reference lists. Studies were included if they evaluated a combined universal intervention for students (aged 11-18 years old) and their parents designed to prevent alcohol and/or other drug use, and were delivered in a school-based setting. Risk of bias was assessed by two independent reviewers. Because of the heterogeneity of the included studies, it was not possible to conduct a meta-analysis and a qualitative description of the studies was provided.

KEY FINDINGS

From a total of 1654 screened papers, 22 research papers met inclusion criteria, which included 13 trials of 10 programs. Of these, nine programs demonstrated significant intervention effects in terms of delaying or reducing adolescent alcohol and/or other drug use in at least one trial.

CONCLUSION

This is the first review of combined student- and parent-based interventions to prevent and reduce alcohol and other drug use. Whilst existing combined student- and parent-based programs have shown promising results, key gaps in the literature have been identified and are discussed in the context of the development of future prevention programs. [Newton NC, Champion KE, Slade T, Chapman C, Stapinski L, Koning I, Tonks Z, Teesson M. A systematic review of combined student- and parent-based programs to prevent alcohol and other drug use among adolescents. Drug Alcohol Rev 2017;36:337-351].

A school-based programme for tobacco and alcohol prevention in special education: effectiveness of the modified 'healthy school and drugs' intervention and moderation by school subtype

AIMS

To test the effectiveness of the Healthy School and Drugs (HSD) programme on tobacco and alcohol use in Dutch secondary special education (SE) schools, and whether this depends upon subtypes of SE schools and the level of implementation.

DESIGN

In a quasi-experimental design with baseline and post-treatment follow-up, 363 students were allocated arbitrarily or depending on teacher motivation to either intervention condition (n = 205) or usual curriculum (n = 158).

SETTING

Thirteen secondary SE schools spread throughout the Netherlands.

PARTICIPANTS

Participants were recruited during the autumn of 2013 from three school subtypes: SE for adolescents with intellectual/physical disabilities (SEI; n = 13), behavioural/emotional difficulties (SEB; n = 136) and learning disabilities/developmental disorders (SEL; n = 214).

MEASUREMENTS

Self-reported life-time smoking prevalence and life-time drinking frequency as outcomes, and school subtype (SEL/SEB) and implementation fidelity (high/low) as moderators.

FINDINGS

No significant differences were found at follow-up in life-time smoking [odds ratio (OR) = 1.52; 95% confidence interval (CI) = 0.74-3.12] and drinking frequency (d = 0.01; 95% CI = -0.16 to 0.18). Interaction analyses revealed adverse effects in SEB students for alcohol use (d = 0.43; 95% CI = 0.16-0.69). Effect on tobacco refusal self-efficacy was moderated positively by implementation fidelity (d = 0.35; 95% CI = 0.07-0.63).

CONCLUSION

The Healthy School and Drugs programme adapted for secondary special education in the Netherlands lacked clear evidence for effects on all outcomes. This pilot study suggests further that, within special education, substance use interventions may need to be targeted at school subtypes, as these may have harmful effects among students with behavioural difficulties. Finally, limited evidence was found that programme effectiveness may depend upon implementation fidelity.

Parental supply of alcohol and alcohol consumption in adolescence: prospective cohort study

BACKGROUND

Parents are a major supplier of alcohol to adolescents, yet there is limited research examining the impact of this on adolescent alcohol use. This study investigates associations between parental supply of alcohol, supply from other sources, and adolescent drinking, adjusting for child, parent, family and peer variables.

METHOD

A cohort of 1927 adolescents was surveyed annually from 2010 to 2014. Measures include: consumption of whole drinks; binge drinking (>4 standard drinks on any occasion); parental supply of alcohol; supply from other sources; child, parent, family and peer covariates.

RESULTS

After adjustment, adolescents supplied alcohol by parents had higher odds of drinking whole beverages [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.33-2.45] than those not supplied by parents. However, parental supply was not associated with bingeing, and those supplied alcohol by parents typically consumed fewer drinks per occasion (incidence rate ratio 0.86, 95% CI 0.77-0.96) than adolescents supplied only from other sources. Adolescents obtaining alcohol from non-parental sources had increased odds of drinking whole beverages (OR 2.53, 95% CI 1.86-3.45) and bingeing (OR 3.51, 95% CI 2.53-4.87).

CONCLUSIONS

Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase children's drinking.

Home-based alcohol prevention program for parents and children: A randomized controlled trial

Objective To evaluate the effectiveness of a home-based alcohol prevention program to delay initiation of alcohol use in children. Methods In 2011, a total of 1349 sixth-grade children (M=12.15, SD=0.47) and their mothers who could read and write Dutch were recruited from primary schools in the northern part of the Netherlands. They participated in a cluster randomized controlled trial with two conditions; (1) intervention group (5 modules which families received by mail every 4weeks over 5months), (2) control group (a factsheet information brochure). An independent statistician allocated the schools to the conditions (allocation ratio (1:1)). Participants and data-analyst were blind to randomization. The primary outcome was alcohol initiation. Results Of the participants, 680 were randomized to the intervention and 669 to the control condition. In the intervention condition (N=540) 5.4% of the children drank alcohol compared to 7.1% in the control condition (N=601). The difference was not significant (OR=.99, 95% CI=.96-1.02, p=52). Conclusion The present study showed no effects of 'In control: No alcohol!' on alcohol initiation. A critical evaluation of program design and content, and future studies in different target groups, are suggested. The trial is registered at trialregister.nl, number NTR2474.

Cross-sectional study on parental pro-drinking practices and adolescent alcohol drinking in Hong Kong

OBJECTIVES

To investigate the association between parental pro-drinking practices (PPDPs) and alcohol drinking in Hong Kong Chinese adolescents.

DESIGN

A cross-sectional study.

SETTING

4 randomly selected secondary schools in Hong Kong.

PARTICIPANTS

1738 students (mean age 14.6 years ± 2.0, boys 67.8%).

MAIN OUTCOME MEASURES

Drinking status, drinking intention and exposure to 9 PPDPs (eg, seeing parents drunk, helping parents buy alcohol, encouraged to drink by parents) were reported by students. Logistic regression was used to compute adjusted ORs (AORs) of drinking and intention to drink by each PPDP and the number of PPDPs (0, 1-2, 3-4, 5 or above), adjusting for sociodemographic characteristics, parental drinking and school clustering.

RESULTS

Nearly half (48.6%) of the students were ever-drinkers, 16.2% drank monthly (at least once per month) and 40.3% intended to drink in the next 12 months. Most PPDPs were significantly associated with ever drinking (AORs 1.40-6.20), monthly drinking (AORs 1.12-8.20) and intention to drink (AORs 1.40-5.02). Both ever and monthly drinking were most strongly associated with parental training of drinking capacity (ability to drink more without getting drunk) with AORs of 6.20 and 8.20 (both p<0.001), respectively. Adolescent drinking intention was most strongly associated with parental encouragement of drinking and training of drinking capacity with AORs of 3.19 and 5.02 (both p<0.001), respectively.

CONCLUSIONS

Exposure to PPDPs was associated with ever drinking, monthly drinking and drinking intention in Hong Kong Chinese adolescents. More studies, especially prospective studies, should be conducted to confirm these results, followed by interventional studies.

A multidimensional model of mothers' perceptions of parent alcohol socialization and adolescent alcohol misuse

We assessed a multidimensional model of parent alcohol socialization in which key socialization factors were considered simultaneously to identify combinations of factors that increase or decrease risk for development of adolescent alcohol misuse. Of interest was the interplay between putative risk and protective factors, such as whether the typically detrimental effects on youth drinking of parenting practices tolerant of some adolescent alcohol use are mitigated by an effective overall approach to parenting and parental modeling of modest alcohol use. The sample included 1,530 adolescents and their mothers; adolescents' mean age was 13.0 (SD = .99) at the initial assessment. Latent profile analysis was conducted of mothers' reports of their attitude toward teen drinking, alcohol-specific parenting practices, parental alcohol use and problem use, and overall approach to parenting. The profiles were used to predict trajectories of adolescent alcohol misuse from early to middle adolescence. Four profiles were identified: 2 profiles reflected conservative alcohol-specific parenting practices and 2 reflected alcohol-tolerant practices, all in the context of other attributes. Alcohol misuse accelerated more rapidly from Grade 6 through 10 in the 2 alcohol-tolerant compared with conservative profiles. Results suggest that maternal tolerance of some youth alcohol use, even in the presence of dimensions of an effective parenting style and low parental alcohol use and problem use, is not an effective strategy for reducing risky adolescent alcohol use. (PsycINFO Database Record

Identifying binge drinkers based on parenting dimensions and alcohol-specific parenting practices: building classifiers on adolescent-parent paired data

BACKGROUND

Most Dutch adolescents aged 16 to 18 engage in binge drinking. Previous studies have investigated how parenting dimensions and alcohol-specific parenting practices are related to adolescent alcohol consumption. Mixed results have been obtained on both dimensions and practices, highlighting the complexity of untangling alcohol-related factors. The aim of this study was to investigate (1) whether parents' reports of parenting dimensions and alcohol-specific parenting practices, adolescents' perceptions of these dimensions and practices, or a combination are most informative to identify binge drinkers, and (2) which of these parenting dimensions and alcohol-specific parenting practices are most informative to identify binge drinkers.

METHODS

Survey data of 499 adolescent-parent dyads were collected. The computational technique of data mining was used to allow for a data driven exploration of nonlinear relationships. Specifically, a binary classification task, using an alternating decision tree, was conducted and measures regarding the performance of the classifiers are reported after a 10-fold cross-validation.

RESULTS

Depending on the parenting dimension or practice, parents' reports correctly identified the drinking behaviour of 55.8% (using psychological control) up to 70.2% (using rules) of adolescents. Adolescents' perceptions were best at identifying binge drinkers whereas parents' perceptions were best at identifying non-binge drinkers.

CONCLUSIONS

Of the parenting dimensions and practices, rules are particularly informative in understanding drinking behaviour. Adolescents' perceptions and parents' reports are complementary as they can help identifying binge drinkers and non-binge drinkers respectively, indicating that surveying specific aspects of adolescent-parent dynamics can improve our understanding of complex addictive behaviours.

Brief Family Based Intervention for Substance Abusing Adolescents

Research has shown that a lack of parental involvement in their children's activities predicts initiation and escalation of substance use. Parental monitoring and supervision, parent-child communication including communication regarding beliefs and disapproval of substance use, positive parenting, and family management strategies, have been shown to protect against adolescent substance abuse and related problems. Family and parenting approaches to preventing and intervening on adolescent substance abuse have received support in the literature. This article discusses the theoretical foundations as well as the application of the Family Check-up, a brief, family-based intervention for adolescent substance use.

Emergence of sex differences in the development of substance use and abuse during adolescence

Substance use and abuse begin during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse. Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use.

Parental Awareness of Substance Use Among Adolescents in a Junior High School Sample

There is a lack of studies assessing parental awareness of adolescent alcohol, cigarette, and drug use in the general adolescent population. A total of 1,426 adolescents aged 14 to 16, and their parents, answered questions about adolescent substance use annually during junior high school. Sensitivity for parental report of adolescent substance use was low: 5.6% to 26% for drunkenness, 14.3% to 20.6% for cigarettes, and 4.9% to 12% for illicit drugs. Higher age and higher frequency of use were positively associated with parental awareness of drunkenness and cigarette use. Female sex was associated with higher parental awareness of drunkenness. Higher school performance was negatively associated with parental awareness of drunkenness in Grade 9 and with cigarette use in Grades 8 to 9. Parental awareness of adolescent drunkenness, and cigarette and illicit drug use in the general population is low. Factors of importance for parental awareness are identified.

Providing alcohol for underage youth: what messages should we be sending parents?

OBJECTIVE

There have been conflicting findings in the literature concerning the risks to adolescents when parents provide them with alcohol. Studies have examined various ways in which parents directly affect adolescent alcohol consumption through provision (e.g., parental offers, parental allowance/supervision, parental presence while drinking, and parental supply). This review synthesizes findings on the direct ways parental provision can influence a child's alcohol consumption and related problems in an effort to provide parents with science-based guidance. We describe potential mechanisms of the relationship between these parental influences and adolescent problems, suggest future directions for research, and discuss implications for parents.

METHOD

Twenty-two studies (a mix of cross-sectional and longitudinal) that empirically examined the association between parental provision and adolescent drinking outcomes were reviewed.

RESULTS

Parental provision was generally associated with increased adolescent alcohol use and, in some instances, increased heavy episodic drinking as well as higher rates of alcohol-related problems. Data in support of the view that parental provision serves as a protective factor in the face of other risk factors were equivocal.

CONCLUSIONS

The nature and extent of the risks associated with parental provision, and the potential mechanisms underlying this association, are complex issues. Although more rigorous studies with longitudinal designs are needed, parents should be aware of potential risks associated with providing adolescents with alcohol and a place to drink. It is recommended that parents discourage drinking until adolescents reach legal age.

Parental rules, parent and peer attachment, and adolescent drinking behaviors

Family factors have been widely implicated in the development of adolescent drinking behaviors. These include parental attachment and parental rules concerning drinking behaviors. Moreover, throughout adolescence attachment to parents gives way to attachment to peers, and parental rules about alcohol use become less strict. The present study examined the relationship between parental and peer attachment, parental rules on drinking and alcohol use in a large sample (n = 1,724) of adolescents in the United Kingdom. Controlling for school grade (proxy for age), sex and the non-independence of respondents (clustering at school level) results showed that scores on a parental rules on drinking questionnaire were a significant statistical predictor when comparing moderate drinkers and abstainers, as well as moderate drinkers and problematic drinkers. Scores on both attachment scales were also significant, but only in the comparison between moderate and problematic drinkers, with lower attachment to parents and higher attachment to peers associated with problematic drinking.

Alcohol drinking and pro-drinking practices in parents of Hong Kong adolescents

AIMS

We investigated the prevalence of various parental pro-drinking practices and its association with parental drinking status.

METHODS

A school-based survey was completed by 2200 students (mean age 14.8, SD 2.0; boys 51.4%) from 4 randomly selected secondary schools in Hong Kong. Students reported whether they had ever experienced each of nine parental pro-drinking practices (PPDPs).

RESULTS

Overall, 67.5% of students reported at least one PPDP, but the prevalence was much higher if both parents were drinkers (89.0%) compared with non-drinkers (38.8%). The adjusted odds ratio (AOR) (95% CI) of experiencing at least one PPDP was 6.79 (4.98, 9.26) if either parent drank and 15.71 (10.50, 23.50) if both drank compared with none (P for trend <0.001). Compared with non-drinking, the AORs (95% CI) of experiencing at least one PPDP for occasional drinking and frequent drinking were 6.72 (5.03, 8.98) and 18.11 (9.88, 33.18) in fathers (P for trend <0.001), and 7.33 (5.15, 10.44) and 5.33 (1.98, 14.45) in mothers.

CONCLUSION

The prevalence of PPDPs was generally low in non-drinking parents, but increased dramatically with the number of drinking parents and the frequency of paternal drinking.

Reported maternal styles and substance use: a cross-sectional study among educated Albanian young adults

The study explored a predictive model of substance use including perceived maternal parenting style, age and gender. Participants were 347 Albanian young adults (144 males and 203 females) aged 18 to 28 years. They completed the Parental Authority Questionnaire and the Adolescent Alcohol and Drug Involvement Scale. Gender, perceived authoritative maternal style, and age predicted a proportion of substance use involvement. Gender and perceived authoritative maternal style also predicted the proportion of young people at risk for substance use or abuse. Implications of the findings and limitations of the study are discussed.

Alcohol-specific parenting as a mechanism of parental drinking and alcohol use disorder risk on adolescent alcohol use onset

OBJECTIVE

The primary aim of the current study was to examine three dimensions of alcohol-specific parenting (anti-alcohol parenting strategies, parental legitimacy in regulating adolescent drinking, and parental disclosure of negative alcohol experiences) as mechanisms in the prospective relations between parental drinking and alcohol use disorder (recovered, current, and never diagnosed) and adolescent alcohol use initiation.

METHOD

Participants were from an ongoing longitudinal study of the intergenerational transmission of alcoholism. Structural equation modeling was used to test a maternal model (n = 268 adolescents and their mothers) and a paternal model (n = 204 adolescents and their fathers) of alcohol-specific parenting.

RESULTS

Results indicated that higher levels of drinking among mothers and current alcohol use disorder among fathers were related to more frequent parental disclosure of personal negative experiences with alcohol. Maternal disclosure of negative alcohol experiences mediated the effect of maternal drinking on adolescent onset of alcohol use such that more disclosure predicted a greater likelihood of adolescent drinking initiation at follow-up over and above general parenting. In addition, currently alcoholic mothers were perceived as having less legitimate authority to regulate adolescent drinking, and low levels of legitimacy among fathers was predictive of drinking onset among adolescents.

CONCLUSIONS

Alcohol-specific parenting is a distinct and influential predictor of adolescent alcohol use initiation that is partially shaped by parents' own drinking experiences. Moreover, parental conversations about their own personal experiences with alcohol may not represent a form of parent-child communication about drinking that deters adolescent drinking.

Preventing adolescent alcohol use: effects of a two-year quasi-experimental community intervention intensifying formal and informal control

PURPOSE

To determine the effect on adolescent alcohol use of a community intervention combining intensified formal control (restricting retail supply) and informal control (restricting social supply). Intervention effects on intermediate intervention goals were investigated. Analyses for different age groups were performed.

METHODS

A longitudinal quasi-experimental design (baseline at 2008, plus two yearly post-measurements) was used, including one intervention and one matched-comparison community in The Netherlands. We assessed outcomes by observing 1,368 Dutch adolescents aged 13-15 years at baseline. Main dependent variables were weekly drinking status and progression into drunkenness among weekly drinkers. Additional dependent variables were formal control intermediate intervention goals (frequency of alcohol purchases and perceived ease of purchasing alcohol) and informal control intermediate intervention goals (frequency of alcohol-specific rules and parental alcohol supply).

RESULTS

Survival analyses showed no significant reduction in the risk of drinking weekly for adolescents in the intervention region; however, the risk of progressing into drunkenness was reduced by 15% (p = .04) for adolescents drinking weekly. No intervention effects on the intermediate intervention goals were found among 14- and 15-year-olds. The intervention had a positive effect on two of four intermediate intervention goals (i.e., parental alcohol supply and alcohol-specific rules) among 13-year-olds.

CONCLUSIONS

A combined formal and informal community intervention package is associated with a reduced risk of progressing into drunkenness among drinking adolescents. Interventions focusing on discouraging drinking below a certain age might cause a greater increase in the frequency of purchasing alcohol once reaching this age.

Mediational relations of substance use risk profiles, alcohol-related outcomes, and drinking motives among young adolescents in the Netherlands

AIM

To examine the mediation by drinking motives of the association between personality traits (negative thinking, anxiety sensitivity, impulsivity, and sensation seeking) and alcohol frequency, binge drinking, and alcohol-related problems using a sample of students (n=3053) aged between 13 and 15, who reported lifetime use of alcohol.

METHOD

Structural equation modeling was used to examine the relationship between personality traits and alcohol-related outcomes. The Model Indirect approach was used to examine the hypothesized mediation by drinking motives of the association between personality traits and alcohol-related outcomes.

RESULTS

In this study among young adolescents, coping motives, social motives and enhancement motives played a prominent mediating role between personality and the alcohol outcomes. Multi-group analyses revealed that the role of drinking motives in the relation between personality and alcohol outcomes were largely similar between the sexes, though there were some differences found for binge drinking. More specifically, for young males, enhancement motives seems to play a more prominent mediation role between personality and binge drinking, while for young females, coping motives play a more mediating role between personality and binge drinking. Few mediation associations were found for conformity motives, and no relationships were found between anxiety sensitivity and drinking motives.

DISCUSSION

Already in early adolescence, personality traits are found to be associated with drinking motives, which in turn are related to alcohol use. This study provides indications that it is important to intervene in early adolescence with interventions focusing on personality traits in combination with drinking motives.

Evaluation of a Swedish version of the Strengthening Families Programme

BACKGROUND

Adolescents' alcohol consumption is a public health concern in Sweden as well as in many other countries. Underage drinking is associated with increased risks of alcohol-related injuries, risky sexual behaviours and dependence later in life. Different strategies have been used in the effort to prevent this behaviour, and to postpone the onset of alcohol. The Strengthening Families Programme 10-14 (SFP 10-14) from the USA has been highlighted as one of the more effective prevention programmes. The aim of the present article was to evaluate the effectiveness of a culturally adapted Swedish version of the SFP 10-14.

METHODS

This was a cluster randomized controlled trial including 587 sixth-grade students (age 12) and their parents in 19 elementary schools in Stockholm. Schools were randomly assigned to either control (9 schools, 216 students) or to the family skills training intervention (10 schools, 371 students). The SFP Swedish version consisted of two parts with seven and five sessions, respectively, held separately for youths and parents except two joint family sessions. Measures of students' self-reported episodes of drunkenness, smoking, illicit drug use and other norm-breaking behaviours were collected at baseline (March 2003) and at three subsequent yearly surveys. Data were analysed using multilevel models with an intention-to-treat approach.

RESULTS

No preventive effects were found for smoking, alcohol and illicit drug use and other norm-breaking behaviours, nor did moderators affect the outcome.

CONCLUSION

The Swedish version of the SFP 10-14 was not effective in preventing youths' substance use in a Swedish context.

Adolescent alcohol use reflects community-level alcohol consumption irrespective of parental drinking

PURPOSE

Risk factors for adolescent alcohol use are typically conceptualized at the individual level, and school- and community-level risk factors have received little attention. Based on the theoretical understanding of youth alcohol consumption as a reflection of community social practice, we analyzed whether adolescent drunkenness was related to community-level adult alcohol use (AAC), when taking individual and school-level risk factors for drunkenness into account. Furthermore, we investigated whether the association between community-level AAC and adolescent drunkenness was attenuated after inclusion of parental drinking.

METHODS

We used data from three sources: data about adolescent drunkenness from the Health Behavior in School-Aged Children 2010 survey (N = 2,911; 13- to 15-year-olds nested in 175 school classes and 51 schools); data about community-level AAC derived from the Danish National Health Survey 2010 (177,639 participants); and data on school-level variables from Health Behavior in School-Aged Children School Leader Survey 2010. We performed multilevel logistic regression analysis with data from students nested within school classes and schools.

RESULTS

Overall, 33.5% of students had been drunk twice or more. High community-level AAC was significantly associated with adolescent drunkenness (odds ratio [95% confidence interval], 1.94 [1.21-3.11]). Parental drinking was strongly related to adolescent drunkenness but did not attenuate the relationship between community-level AAC and adolescent drunkenness. We found no association between adolescent drunkenness and school-level variables (youth friendly environment, alcohol education, and exposure to alcohol outlets).

CONCLUSIONS

Adolescent drunkenness was associated with community-level AAC and was not explained by parental drinking.

Alcohol-specific parenting, adolescent alcohol use and the mediating effect of adolescent alcohol-related cognitions

OBJECTIVES

Previous research indicated that alcohol-specific parenting is an important precursor of adolescent alcohol use, but failed to define the underlying mechanism. Based on social cognitive theory, alcohol-related cognitions such as alcohol refusal self-efficacy and alcohol-related expectancies were hypothesised to mediate this link.

DESIGN

A cross-sectional survey included 1349 mothers and their sixth grade (11-12 years old) adolescent offspring. Structural equation modelling was employed to test the association between alcohol-specific parenting and adolescent alcohol use, mediated by adolescent alcohol-related cognitions.

MAIN OUTCOME MEASURES

Adolescent alcohol use, drinking refusal self-efficacy and alcohol expectancies.

RESULTS

The associations between frequency of communication, maternal alcohol use and adolescent alcohol use were mediated by negative alcohol-related expectancies. The associations between quality of communication, rules and disclosure and adolescent alcohol use were mediated by self-efficacy.

CONCLUSIONS

The present study provides a first indication that the underlying mechanism of the association between the most important alcohol-specific parenting practices and adolescent alcohol use can be contributed to the mediating effect of alcohol-refusal self-efficacy.

The impact of parenting styles on adolescent alcohol use: the TRAILS study

AIMS

To investigate the influence of parenting styles (overprotection, emotional warmth, and rejection) in early adolescence on regular alcohol use in late adolescence.

METHODS

We analyzed data from the first three waves (mean ages: 11.09, 13.56, and 16.27 years, respectively) of a population-based prospective cohort study of 2,230 adolescents, conducted between 2001 and 2007. Adolescents reported on parental overprotection, emotional warmth, and rejection (T1). Regular alcohol use was defined as six and seven glasses or more a week for girls and boys, respectively. We further assessed family socioeconomic status, parental divorce, parental alcohol use, educational level of the adolescent, and alcohol use at baseline.

RESULTS

Parental overprotection had the strongest relationship to regular alcohol use: adolescents who perceived more parental overprotection were at increased risk of developing regular alcohol use, even after adjustment for several confounders. Rejection was not related to adolescents' alcohol use and, after adjustment for the other variables, neither was emotional warmth.

CONCLUSION

Overprotective parenting is a determinant of future regular adolescent alcohol use and therefore health professionals should pay particular attention to those adolescents who have overprotective parents. The role of adolescent characteristics in the relationship between overprotection and alcohol use deserves further study.

Parenting practices and adolescent risk behavior: rules on smoking and drinking also predict cannabis use and early sexual debut

Previous research has provided considerable support for idea that increased parental support and control are strong determinants of lower prevalence levels of adolescent risk behavior. Much less is known on the association between specific parenting practices, such as concrete rules with respect to smoking and drinking and adolescent risk behavior. The present paper examined whether such concrete parental rules (1) have an effect on the targeted behaviors and (2) predict other, frequently co-occurring, risk behaviors (i.e., cannabis use and early sexual intercourse). These hypotheses were tested in a nationally representative sample of 12- to 16-year-old adolescents in the Netherlands. We found that both types of rules were associated with a lower prevalence of the targeted behaviors (i.e., smoking and drinking). In addition, independent of adolescent smoking and drinking behaviors, parental rules on smoking predicted a lower prevalence of cannabis use and early sexual intercourse, and parental rules on alcohol use also predicted a lower prevalence of early sexual intercourse. This study showed that concrete parental rule setting is more strongly related to lower levels of risk behaviors in adolescents compared to the more general parenting practices (i.e., support and control). Additionally, the effects of such rules do not only apply to the targeted behavior but extend to related behaviors as well. These findings are relevant to the public health domain and suggest that a single intervention program that addresses a limited number of concrete parenting practices, in combination with traditional support and control practices, may be effective in reducing risk behaviors in adolescence.

Differential impact of a Dutch alcohol prevention program targeting adolescents and parents separately and simultaneously: low self-control and lenient parenting at baseline predict effectiveness

To test whether baseline levels of the factors accountable for the impact of the Prevention of Alcohol use in Students (PAS) intervention (self-control, perceived rules about alcohol and parental attitudes about alcohol), moderate the effect of the intervention. A cluster randomized trial including 3,490 Dutch early adolescents (M age=12.66, SD=.49) and their parents randomized over four conditions: 1) parent intervention, 2) student intervention, 3) combined intervention and 4) control group. Moderators at baseline were used to examine the differential effects of the interventions on onset of (heavy) weekly drinking at 34-month follow-up. The combined intervention was only effective in preventing weekly drinking among those adolescents who reported to have lower self-control and more lenient parents at baseline. No differential effect was found for the onset of heavy weekly drinking. No moderating roles of self-control and lenient parenting were found for the separate student and parent interventions regarding the onset of drinking. The combined intervention is more effective among adolescents with low-self control and lenient parents at baseline, both factors that were a specific target of the intervention. The relevance of targeting self-control in adolescents and restrictive parenting is underlined.

The moderating effect of alcohol-specific parental rule-setting on the relation between the dopamine D2 receptor gene (DRD2), the μ-opioid receptor gene (OPRM1) and alcohol use in young adolescents

AIMS

The main aim of the study was to test the moderating effect of two genetic polymorphisms, one in the dopamine D2 receptor gene (DRD2) and one in the mu-opioid receptor gene (OPRM1), on the link between parental rule-setting and adolescent alcohol use.

METHODS

A total of 214 adolescents (M(age )=13.7, 44.9% male) provided saliva samples and completed survey items describing alcohol use and parental rule-setting.

RESULTS

Findings indicated that alcohol-specific parental rule-setting was more robustly associated with alcohol use for adolescents with the DRD2 A1 risk allele and for those with the OPRM1 G-allele.

CONCLUSION

This study replicates the interaction between parental rule-setting and the DRD2 risk allele on adolescent alcohol use and extends the literature by demonstrating the moderating effects of the OPRM1 risk allele on the link between parental rule-setting and adolescent alcohol use.

Bidirectional influences between parents and children in smoking behavior: a longitudinal full-family model

BACKGROUND

The present study investigated longitudinal associations and bidirectional influences between family members in smoking behavior using a longitudinal full-family design. Family systems provide a powerful social context in which modeling and imitation take place. In current literature, however, bidirectional associations between parents and children in smoking behavior are seldom considered.

METHODS

Participants were 426 families, including mothers, fathers, and 2 adolescent children. Associations were assessed over 5 waves with yearly intervals using a cross-lagged model in structural equation modeling.

RESULTS

Findings demonstrate that families resemble an interactive system affording smoking contagion across family members. Results suggest that associations between parents and children are bidirectional, that is, parental smoking behavior influences adolescent smoking behavior and adolescent smoking behavior influences parental smoking behavior. There is insufficient evidence to conclude that longitudinal associations between family members are generally bidirectional, as only unidirectional longitudinal associations were found between between siblings and partners.

CONCLUSIONS

The present study extends previous research on the intergenerational transmission of smoking behavior by demonstrating bidirectional influences between parents and children in smoking behavior. Moreover, the present study suggests that family members may be susceptible to adjust their smoking behavior across time in response to smoking behavior within the family.

Results of the 'in control: no alcohol!' pilot study

More than 50% of Dutch 12-year olds already started drinking. Since it is known that delaying the onset of alcohol use results in a lower risk of alcohol-related problems, the recently developed 'In control: No alcohol!' prevention program is targeted at elementary school children and their mothers. In this pilot study, the success of program implementation and impact of the program on quality of alcohol-specific communication, rules and monitoring were evaluated, using a randomized controlled design. A total of 108 children (11-12 years) and their mothers participated in the prevention program, while the control group consisted of 105 dyads. Families participating in the experimental condition showed an increase in frequency of alcohol-specific communication and 75% of the dyads reported that they took part in at least 3 of 5 magazines, suggesting implementation was successful. The program led to an increase in quality of communication but only for those dyads in which mothers' alcohol use was above average. The program led parents to set up a non-drinking contract with their children and to monitor their children more closely. Results are promising but need to be replicated in a larger longitudinal study.

The role of academic motivation in high school students' current and lifetime alcohol consumption: adopting a self-determination theory perspective

OBJECTIVE

The current study investigated the relationship between different types of academic motives-specifically, intrinsic motivation, introjected regulation, and external regulation-and high school students' current and lifetime alcohol consumption.

METHOD

One thousand sixty-seven high school students completed measures of academic motivation, other school-related factors, and lifetime and current alcohol consumption.

RESULTS

Using structural equation modeling, different types of motivation and school-related factors were differentially related to student drinking. Specifically, intrinsic motivation was negatively related to lifetime and current alcohol consumption. External regulation, on the other hand, was positively associated with current drinking. Grade point average was the only school-related factor related to student alcohol use.

CONCLUSIONS

These findings suggest that motivation is an important construct to consider in predicting students' alcohol use, even when other more commonly studied educational variables are considered. In addition, it supports the adoption of a motivation framework that considers different types of motivation in understanding the relationship between academic motivation and alcohol use. Suggestions for incorporating the self-determination model of motivation into studies of alcohol and substance use, as well as potential impacts on intervention efforts, are discussed. In particular, it may be important to foster only certain types of motivation, rather than all types of academically-focused motives, in efforts to deter alcohol use.

The moderating role of working memory capacity and alcohol-specific rule-setting on the relation between approach tendencies and alcohol use in young adolescents

BACKGROUND

Dual process models of alcohol addiction propose that the transition from normative alcohol consumption to heavy drinking is the result of an imbalance in interplay between relatively impulsive or automatic and reflective or controlled processes. The current study examines whether impulsive and reflective processes are also detectable in a sample of adolescents with limited alcohol use.

METHODS

Specifically, we tested the interaction between alcohol approach tendencies and 2 types of reflective processes, working memory capacity (WMC) and alcohol-specific rule-setting, on changes in alcohol use of 238 young adolescents (mean age: 13.82 years). Gender differences in these associations were also explored.

RESULTS

Results showed that WMC did not moderate the relation between approach tendencies and subsequent alcohol use, whereas rule-setting did, with stronger associations between approach tendencies and alcohol use for male adolescents reporting more permissive parents than male adolescents with parents enforcing stricter rules involving alcohol use. Associations between approach tendencies and subsequent alcohol use did not emerge for female adolescents.

CONCLUSIONS

Results indicate that even in a sample of adolescents with limited drinking experience, automatic processes are positively associated with alcohol use for male adolescents that are not motivated by parents to control their drinking.

Parents' rules about underage drinking: a qualitative study of why parents let teens drink

Results from a qualitative study with parents about underage drinking are presented. Semistructured interviews (n = 44) were conducted with parents of teens to investigate whether and why parents permit underage drinking. Parents had three primary reasons for allowing underage drinking: deliberate, spontaneous, and harm reduction. Deliberate reasons included passing on knowledge about drinking responsibly and appreciating alcohol. Parents also spontaneously decided to let their teen drink. Some of these spontaneous situations involved feeling pressure from other adults to let their teen drink. Another reason was a desire to reduce potential harm. Parents feared that forbidding underage drinking would harm their relationship with their teen and potentially lead to drunk driving. Prevention efforts aimed at parents should take into account parents' motivations to let teens drink.

The influence of alcohol-specific communication on adolescent alcohol use and alcohol-related consequences

Alcohol-specific communication, a direct conversation between an adult and an adolescent regarding alcohol use, contains messages about alcohol relayed from the adult to the child. The current study examined the construct of alcohol-specific communication and the effect of messages on adolescent alcohol use and alcohol-related consequences. Parent-adolescent dyads were assessed biannually for 3 years (grades 9-11 at wave 6) to examine these relations in a large longitudinal study of adolescents initially in grades 6 through 8. An exploratory factor analysis identified two factors among alcohol-specific communication items, permissive messages and negative alcohol messages. Results showed previous level of adolescent alcohol use moderated the relation between permissive messages and alcohol use outcomes. Plotting of these interactions showed greater alcohol use and consequences with increasing permissive messages in adolescents with higher versus lower levels of previous alcohol use. Results suggest that parental messages regarding alcohol use may impact adolescent alcohol use beyond the effect of general parenting style and parental alcohol use.

The interplay of loneliness and depressive symptoms across adolescence: exploring the role of personality traits

Based on current theories of depression, reciprocal links between loneliness and depressive symptoms are expected to occur. However, longitudinal studies on adolescent samples are scarce and have yielded conflicting results. The present five-wave longitudinal study from mid- to late adolescence (N=428, M age at T1=15.22 years; 47% female) examined the direction of effect between loneliness and depressive symptoms, using cross-lagged path analysis. In addition, the robustness of these prospective associations was tested by examining the role of the Big Five personality traits (i.e., extraversion, conscientiousness, agreeableness, neuroticism, and openness) as explaining factors and moderators. Results indicated that loneliness and depressive symptoms influenced one another reciprocally, and these reciprocal associations were not attributable to their mutual overlap with personality traits. In addition, neuroticism was found to be a moderator, in that the bidirectional effects between loneliness and depressive symptoms were only found in adolescents high in neuroticism. Practical implications are discussed, and suggestions for future research are outlined.

Effectiveness of the home-based alcohol prevention program "In control: no alcohol!": study protocol of a randomized controlled trial

BACKGROUND

In the Netherlands, children start to drink at an early age; of the Dutch 12-year olds, 40% reports lifetime alcohol use, while 9.7% reports last-month drinking. Starting to drink at an early age puts youth at risk of developing several alcohol-related problems later in life. Recently, a home-based prevention program called "In control: No alcohol!" was developed to delay the age of alcohol onset in children. The main aim of this project is to conduct a Randomized Controlled Trial (RCT) to evaluate the effectiveness of the program.

METHODS/DESIGN

The prevention program will be tested with an RCT among mothers and their 6 grade primary school children (11-12 years old), randomly assigned to the prevention or control condition. The program consists of five printed magazines and an activity book designed to improve parental alcohol-specific socialization. Parent-child dyads in the control group receive a factsheet information brochure, which is the standard alcohol brochure of the Trimbos Institute (the Netherlands Institute for Mental Health and Addiction).Outcome measures are initiation of alcohol use (have been drinking at least one glass of alcohol), alcohol-specific parenting, susceptibility to drinking alcohol, alcohol expectancies, self-efficacy, and frequency and intensity of child alcohol use. Questionnaires will be administered online on secured Internet webpages, with personal login codes for both mothers and children. Mothers and children in both the experimental and control condition will be surveyed at baseline and after 6, 12, and 18 months (follow-ups).

DISCUSSION

The present study protocol presents the design of an RCT evaluating the effectiveness of the home-based "In control: No alcohol!" program for 6 grade primary school children (11-12 years old). It is hypothesized that children in the prevention condition will be less likely to have their first glass of alcohol, compared to the control condition. When the prevention appears to be effective, it can easily and relatively quickly be implemented as a standard alcohol prevention program on a large scale.

TRIAL REGISTRATION

Nederlands Trial Register NTR2564.

Making sense of alcohol experiences: young adolescents' accounts of alcohol-related critical incidents

OBJECTIVE

This study explores how alcohol use is incorporated in the lives of young adolescents in the Netherlands. To this end, critical incidents involving alcohol use situations are analyzed. Special attention is paid to the consequences associated with alcohol use, the role of the parents, and the way adolescents evaluate incidents and link them to behavioral intentions.

METHOD

Data were collected in 45 interviews using the critical incident technique. Participants were asked to mention salient alcohol-related incidents, which they had either experienced or observed. The participants were 45 adolescents, aged 15 and 16, who were recruited at high schools.

RESULTS

A total of 145 incidents were described. Many different, mostly adverse, consequences were associated with the incidents. Parents only played a minor role: they were not always aware of incidents, and if they were, they often did not take them seriously. Two tendencies were found in adolescents' sense making of incidents: the tendency to link adverse consequences to positive overall experiences, and the tendency to not translate negative overall experiences into lower drinking intentions.

CONCLUSION

The study shows that alcohol is already deeply rooted in the lives of adolescents. The role of parents appears to be problematic. Furthermore, the study underlines the complexity of the problem of adolescent alcohol use. If their own negative experiences and first-hand observations do not substantially lead to lower drinking intentions, it does not seem plausible that alcohol information and education materials focusing on consequences will.