Socioeconomic differences in alcohol-specific parenting practices and adolescents' drinking patterns

Standard Versus Family-Based Screening, Brief Intervention, and Referral to Treatment for Adolescent Substance Use in Primary Care: Protocol for a Multisite Randomized Effectiveness Trial

BACKGROUND

Screening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite the recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning. There is urgent need to investigate the value of systematically incorporating caregivers in SBIRT-A procedures.

OBJECTIVE

This randomized effectiveness trial will advance research and scope on SBIRT-A in primary care by conducting a head-to-head test of 2 conceptually grounded, evidence-informed approaches: a standard adolescent-only approach (SBIRT-A-Standard) versus a more expansive family-based approach (SBIRT-A-Family). The SBIRT-A-Family approach enhances the procedures of the SBIRT-A-Standard approach by screening for AOD risk with both adolescents and caregivers; leveraging multidomain, multireporter AOD risk and protection data to inform case identification and risk categorization; and directly involving caregivers in brief intervention and referral to treatment activities.

METHODS

The study will include 2300 adolescents (aged 12-17 y) and their caregivers attending 1 of 3 hospital-affiliated pediatric settings serving diverse patient populations in major urban areas. Study recruitment, screening, randomization, and all SBIRT-A activities will occur during a single pediatric visit. SBIRT-A procedures will be delivered digitally on handheld tablets using patient-facing and provider-facing programming. Primary outcomes (AOD use, co-occurring behavior problems, and parent-adolescent communication about AOD use) and secondary outcomes (adolescent quality of life, adolescent risk factors, and therapy attendance) will be assessed at screening and initial assessment and 3-, 6-, 9-, and 12-month follow-ups. The study is well powered to conduct all planned main and moderator (age, sex, race, ethnicity, and youth AOD risk status) analyses.

RESULTS

This study will be conducted over a 5-year period. Provider training was initiated in year 1 (December 2023). Participant recruitment and follow-up data collection began in year 2 (March 2024). We expect the results from this study to be published in early 2027.

CONCLUSIONS

SBIRT-A is widely endorsed but currently underused in pediatric primary care settings, and questions remain about optimal approaches and overall effectiveness. In particular, referral to treatment procedures in primary care remains virtually untested among youth. In addition, whereas research strongly supports involving families in interventions for adolescent AOD, SBIRT-A effectiveness trial testing approaches that actively engage family members in primary care are absent. This trial is designed to help fill these research gaps to inform the critical health decision of whether and how to include caregivers in SBIRT-A activities conducted in pediatric primary care.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05964010; https://www.clinicaltrials.gov/study/NCT05964010.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/54486.

Problematic familial alcohol use and adolescent outcomes: Do associations differ by parental education?

Aim: To investigate the associations between problematic familial alcohol use and adolescent subjective health, binge drinking, relationships with parents, school performance, and future orientation, and to study whether these associations differ in relation to parental education. Methods: Cross-sectional data from the Stockholm School Survey (SSS) collected among students in the 9th and 11th grades in 2018 and in 2020 were used (n = 19,415). Subjective health, parent-youth relationships, and school performance were coded as continuous variables; binge drinking and future orientation were coded as binary variables. Familial drinking included three categories: problematic; don't know/missing; and not problematic. Parental university education distinguished between adolescents with two, one, or no university-educated parent(s). Control variables included gender, grade, family structure, migration background, parental unemployment, and survey year. Linear and binary logistic regression analyses were performed. Results: Problematic familial alcohol use was associated with worsened subjective health, a higher likelihood of engaging in binge drinking, worse relationships with parents, and a higher likelihood of having a pessimistic future orientation, even when adjusting for all control variables. Having less than two university-educated parents was associated with a higher likelihood of reporting problematic familial alcohol use. Parental university education moderated the association between problematic familial alcohol use and binge drinking as this relationship was stronger for adolescents with no and one university-educated parent(s). Conclusions: Adolescents with problematic familial alcohol use fared worse with regards to all studied outcomes, except for school performance. Parental university education only moderated the association between problematic familial alcohol use and binge drinking. However, since problematic familial alcohol use was more common among adolescents with less than two university-educated parents, we argue that at the group level, this category may be more negatively affected by alcohol abuse in the family. Policy interventions could benefit from having a socioeconomic perspective on how children are affected by alcohol's harms to others.

The moderating effects of alcohol use with and without parent permission on alcohol risk communication in early adolescence

The frequency of parental alcohol risk communication (ARC) is considered an integral component of socializing youth about alcohol, but the literature offers mixed findings on whether such communication is protective. Early adolescents' prior drinking experiences may moderate the effectiveness of ARC, but evidence for such an interaction is inconsistent. One limitation of this work considering prior drinking experience is that it has not distinguished drinking with versus without parental permission. Parents are one of the earliest sources of information about alcohol use and many parents view allowing adolescents to drink alcohol with permission as a harm reduction strategy, despite some work suggesting the opposite effect. Using a random effects multilevel regression, we tested the unique moderating effects of drinking with and without parental permission on the prospective association between alcohol risk communication and later drinking without parental permission. Adolescent and parent dyads completed 3 annual assessments (first assessment mean age = 12.6, 52% girls, 76% White/non-Hispanic). Results supported a three-way interaction. There was a modest protective effect of parental ARC on later adolescent drinking, but only for adolescents who had prior experience drinking both with and without parental permission. For all other combinations of prior drinking experience, parental communication was not prospectively related to later drinking. These results help clarify the mixed literature on alcohol communication and suggests that ARC may help reduce some of the risk associated with allowing youth to drink alcohol but only for youth who also have experience with alcohol outside of parental supervision.

Is adolescent multiple risk behaviour associated with reduced socioeconomic status in young adulthood and do those with low socioeconomic backgrounds experience greater negative impact? Findings from two UK birth cohort studies

BACKGROUND

Adolescent multiple risk behaviour (MRB) is associated with negative outcomes such as police arrests, unemployment and premature mortality and morbidity. What is unknown is whether MRB is associated with socioeconomic status (SES) in adulthood. We test whether adolescent MRB is associated with socioeconomic status (SES) in young adulthood and whether it is moderated by early life SES variables.

METHODS

Prospective cohort studies; British Cohort Study 1970 (BCS70) and Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991-1992, were used and two comparable MRB variables were derived. Logistic regression was used to determine the association between MRB and young adult SES. The moderating effect of three early life SES variables was assessed using logistic regression models with and without interaction parameters. Evidence to support the presence of moderation was determined by likelihood ratio tests ≤p = 0.05. Multiple imputation was used to account for missing data.

RESULTS

Adolescents had a median of two risk behaviours in BCS70 and three in ALSPAC. Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response relationship, with each additional risk behaviour resulting in reduced odds of university degree attainment. MRB was associated occupational status at age 34 in BCS70 (OR 0.86 95% CI: 0.82, 0.90). In BCS70, there was evidence that maternal education (p = 0.03), parental occupational status (p = 0.009) and household income (p = 0.03) moderated the effect of adolescent MRB on young adult SES in that the negative effect of MRB is stronger for those with low socioeconomic backgrounds. No evidence of moderation was found in the ALSPAC cohort.

CONCLUSIONS

Adolescence appears to be a critical time in the life course to address risk behaviours, due to the likelihood that behaviours established here may have effects in adulthood. Intervening on adolescent MRB could improve later SES outcomes and thus affect health outcomes later in life. Evidence for a moderation effect in the BCS70 but not ALSPAC suggests that more detailed measures should be investigated to capture the nuance of contemporary young adult SES.

Parental Perceptions About Alcohol Use for Their Adolescent with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

Alcohol use can worsen attention-deficit/hyperactivity disorder (ADHD) symptoms, interfere with treatment, and worsen outcomes. Our objective was to describe parental perceptions of alcohol use for their adolescents with ADHD.

METHODS

Parents of adolescents with ADHD completed an online survey about perceptions of adolescent alcohol use for adolescents with ADHD. We described the level of parental concern about the impacts of alcohol use on their adolescent's functioning. We assessed whether specific covariates were associated with the level of parental concern.

RESULTS

Of 290 parents who completed the survey, 96.5% were women, and 66.1% had an educational attainment of college degree or higher. Most adolescents (75.4%) took ADHD medication, and 59.9% had comorbid anxiety or depression. Almost one-third (30.3%) of parents perceived that their adolescent was more likely to use alcohol because of ADHD, whereas 34.8% of parents disagreed with this and 34.8% of parents were neutral. Parents who suspected their adolescent regularly used alcohol were less likely to report concern about the impact of alcohol on their adolescent's school performance or ADHD medication effectiveness compared with parents who did not suspect regular adolescent alcohol use. Almost half of the parents (48.5%) did not report discussing the impact of alcohol use on ADHD with their adolescent.

CONCLUSION

Many parents of adolescents with ADHD do not understand the unique risks of alcohol use for their adolescents. In addition, if alcohol use harm is not obvious, parents may not perceive there to be concerns about alcohol use on functioning. Parental education about alcohol use and ADHD is needed.

Socio-economic differences in factors associated with alcohol use among adolescents in Slovenia: a cross-sectional study

OBJECTIVES

This paper aims to investigate the association of parental, friends, and personal factors with the risk of alcohol use in a sample of Slovenian adolescents, and whether these associations differ by socio-economic status of the school area (SES).

METHODS

The survey involved 2946 students of 44 Slovenian primary schools in the school year 2010/2011. The association between sociodemographic characteristics, parental alcohol use and permissiveness to drink, parental monitoring, perception of friends' alcohol use, beliefs towards alcohol, self-esteem and refusal skills, and the probability of recent alcohol use was evaluated through multiple multilevel logistic regression analysis.

RESULTS

Parental alcohol use, parental permissiveness to drink alcohol, low parental monitoring, perception of friends' alcohol use, positive beliefs towards alcohol use, and low refusal skills were significantly associated with the risk of alcohol use. Parental drinking and permissive attitudes were stronger correlates of alcohol use among adolescents of middle and low SES schools, while friends' alcohol use and personal factors among adolescents of high SES schools.

CONCLUSIONS

Alcohol prevention programs should be tailored to school socio-economic environment taking into account friends and personal determinants among high SES, and parental factors among low SES school students.

Prevention of alcohol use in older teens: A randomized trial of an online family prevention program

This study examines effects of a randomized controlled trial for an online, family-based prevention program for older teens, Smart Choices 4 Teens, on alcohol use and related outcomes. Families (N = 411; teen age M = 16.4, SD = 0.5) were randomly assigned to the intervention or control condition in 2014-2015. Both intent to treat (ITT) and dosage models were conducted. ITT models: At the 6-month follow-up, teens in the experimental condition reported fewer friends who had been drunk, and parents in the experimental group reported more communication about social host laws. At the 12-month follow-up, parents in the experimental condition reported consuming fewer drinks than parents in the control group. Dosage models: At the 6-month follow-up, dosage was inversely related to teen drinking in the past 6 months or 30 days, frequency of teen drinking during the past 6 months and 30 days, drinks consumed by teens over the past 6 months, teen drunkenness and binge-drinking during the past 30 days, teen reported communication about safe drinking and positively related to parent and teen reported communication about social host laws. At 12 months, dosage was inversely related to teen alcohol use, frequency of teen drinking over the past 30 days, drinks consumed by teens over the past 6 months and 30 days, and teen drunkenness over the past 6 months. Results suggest that Smart Choices 4 Teens is beneficial for families. Dissemination and implementation strategies that motivate completion of program content will improve outcomes related to older teens' alcohol use. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Tobacco and Alcohol Use Among Youth in Low and Middle Income Countries: A Multi-Country Analysis on the Influence of Structural and Micro-Level Factors

BACKGROUND

The transition from adolescence to adulthood is a critical life phase as it is during this period that substance use and disorders typically emerge and escalate. Globally, few studies have examined the prevalence and correlates of alcohol and tobacco use among youth (ages 15-24). This study seeks to bridge this gap by assessing the influence of structural and micro-level factors on tobacco and alcohol use among youth in Low- and Middle-income countries (LMICs).

METHODS

Data are drawn from the Multiple Indicator Cluster Surveys (MICS) conducted in 29 countries or regions in Eastern Europe, Latin America, Asia and Africa between 2010 and 2015. Analyses focus on lifetime prevalence and age of onset for tobacco and alcohol use.

RESULTS

Descriptive analyses highlight regional variations in the prevalence and age of onset of tobacco and alcohol use: tobacco use is more concentrated among youth in Eastern Europe but alcohol use is generalized across the regions. Using multi-level analyses, we find statistically significant main effects for age, gender, educational attainment, rural residence, marital status and exposure to mass media on tobacco and alcohol use outcomes as well as interaction effects for age, gender and education on tobacco and alcohol use outcomes. Conclusions/importance: These findings highlight the need for structural interventions to control tobacco social marketing, and for gender considerations in tobacco and alcohol use prevention programs and policies.

Parental drinking in Australia: Does the age of children in the home matter?

INTRODUCTION AND AIMS

Parental role modelling of alcohol use is known to influence alcohol consumption in adolescence and in later life. This study aimed to assess relationships between parental status, child age and alcohol consumption, which have not been well documented.

DESIGN AND METHODS

Data were sourced from the 2013 Australian National Drug Strategy Household Survey. Analyses were conducted for 25-55 year olds (n = 11 591) by parental status, gender and age of youngest child in the household, controlling for socio-demographic factors.

RESULTS

Parents were less likely than non-parents to exceed the alcohol guideline for increased lifetime risk (18.2% vs. 24.2%) and short-term risk: at least weekly (14.2% vs. 21.2%); and at least monthly (27.5% vs. 35.9%). Fathers were just as likely to exceed the guidelines for lifetime risk as other men, but those with children aged 0-2, were less likely to exceed the guideline for short-term risk. Women were least likely to exceed the guideline for lifetime risk if they had children aged 0-2, 6-11 or 15 years and over, or the guideline for short-term risk, if they had children aged 0-2, or 15 years and over in the household. Parents were more likely to report drinking in the home.

DISCUSSION AND CONCLUSIONS

Parents were less likely to exceed alcohol guidelines than non-parents, especially mothers whose youngest child was an infant or in high school or older. Consistent with population rates in men, fathers were more likely to exceed alcohol guidelines than mothers, and this excess consumption warrants public health attention.

Effectiveness of a selective alcohol prevention program targeting personality risk factors: Results of interaction analyses

AIM

To explore whether specific groups of adolescents (i.e., scoring high on personality risk traits, having a lower education level, or being male) benefit more from the Preventure intervention with regard to curbing their drinking behaviour.

DESIGN

A clustered randomized controlled trial, with participants randomly assigned to a 2-session coping skills intervention or a control no-intervention condition.

SETTING

Fifteen secondary schools throughout The Netherlands; 7 schools in the intervention and 8 schools in the control condition.

PARTICIPANTS

699 adolescents aged 13-15; 343 allocated to the intervention and 356 to the control condition; with drinking experience and elevated scores in either negative thinking, anxiety sensitivity, impulsivity or sensation seeking.

MEASUREMENTS

Differential effectiveness of the Preventure program was examined for the personality traits group, education level and gender on past-month binge drinking (main outcome), binge frequency, alcohol use, alcohol frequency and problem drinking, at 12months post-intervention.

INTERVENTION AND COMPARATOR

Preventure is a selective school-based alcohol prevention programme targeting personality risk factors. The comparator was a no-intervention control.

FINDINGS

Intervention effects were moderated by the personality traits group and by education level. More specifically, significant intervention effects were found on reducing alcohol use within the anxiety sensitivity group (OR=2.14, CI=1.40, 3.29) and reducing binge drinking (OR=1.76, CI=1.38, 2.24) and binge drinking frequency (β=0.24, p=0.04) within the sensation seeking group at 12months post-intervention. Also, lower educated young adolescents reduced binge drinking (OR=1.47, CI=1.14, 1.88), binge drinking frequency (β=0.25, p=0.04), alcohol use (OR=1.32, CI=1.06, 1.65) and alcohol use frequency (β=0.47, p=0.01), but not those in the higher education group. Post hoc latent-growth analyses revealed significant effects on the development of binge drinking (β=-0.19, p=0.02) and binge drinking frequency (β=-0.10, p=0.03) within the SS personality trait.

CONCLUSIONS

The alcohol selective prevention program Preventure appears to have effect on the prevalence of binge drinking and alcohol use among specific groups in young adolescents in the Netherlands, particularly the SS personality trait and lower educated adolescents.

New evidence about the "dark side" of social cohesion in promoting binge drinking among adolescents

Adolescence is characterized by heightened susceptibility to peer influence, which makes adolescents vulnerable to initiating or maintaining risky habits such as heavy drinking. The aim of the study was to investigate the association of social capital with longitudinal changes in the frequency of binge drinking among adolescents at public and private high schools in the city of Diamantina, Brazil. This longitudinal study used two waves of data collected when the adolescents were 12 and 13 years old. At the baseline assessment in 2013 a classroom survey was carried out with a representative sample of 588 students. In 2014, a follow-up survey was carried out with the same adolescents when they were aged 13 years. The Alcohol Use Disorder Identification Test-C (AUDIT C) was employed for the evaluation of alcohol intake. Our predictor variables included sociodemographic and economic characteristics (gender, type of school, mother's education, family income) and Social Capital. For evaluation of social capital, we used the Social Capital Questionnaire for Adolescent Students (SCQ-AS). Descriptive and bivariate analyzes were performed (p <0.05). The log-binomial model was used to calculate prevalence ratios (PR) and 95% confidence intervals. The two-tailed p value was set at <0.05. The prevalence of binge drinking in 2013 was 23.1% and in 2014 the prevalence had risen to 30.1%. Gender (PR 1.48; 95% CI 0.87–2.52) and socioeconomic status (type of school and mother’s education) were not associated with the increase in the frequency of binge drinking. However, higher social capital was significantly associated with an increase in binge drinking by students. Adolescents who reported that they had an increase in social cohesion in the community/neighborhood subscale were 3.4 times more likely (95%CI 1.96–6.10) to binge drink themselves. Our results provide new evidence about the “dark side” of social cohesion in promoting binge drinking among adolescents.

Adolescent drinking-a touch of social class?

AIMS

To estimate whether parental socio-economic status (SES) is associated with adolescent drinking, and the degree to which a possible association may be accounted for by various parental factors.

DESIGN AND SETTING

Cross-sectional Norwegian school survey from 2006 (response rate: 86%).

PARTICIPANTS

Students aged 13-14 years (n = 5797), 15-16 years (n = 6613) and 17-18 years (n = 5351), of whom 51% were girls.

MEASUREMENTS

Parents' education was our main SES indicator, and we distinguished between low (7%) and middle/high (93%) educational level. The outcomes comprised past-year drinking and intoxication. We also applied measures on general parenting, parents' alcohol-related permissiveness and parental intoxication. The main analyses were conducted using Poisson regression.

FINDINGS

Parents' education had no statistically significant impact on alcohol use among the 17-18-year-olds, while 13-16-year-olds with low educated parents had an elevated relative risk (RR) of both drinking [RR = 1.21, 95% confidence interval (CI) = 1.13-1.29] and intoxication (RR = 1.32, 95% CI = 1.21-1.44). The RRs became statistically insignificant when including all the parental factors as covariates in the regression models. Among adolescents who had consumed alcohol, low parental education was related to more frequent drinking (RR = 1.24, 95% CI = 1.11-1.38) and intoxication episodes (RR = 1.42, 95% CI = 1.22-1.66). Again, the RRs became statistically insignificant when we accounted for all the parental factors. This pattern was replicated when we applied an alternative indicator for low parental SES.

CONCLUSIONS

Adolescent drinking in Norway appears to be related inversely to parents' social standing. The elevated risk of low socio-economic status vanishes when general parenting, alcohol-related parental permissiveness and parents' drinking are accounted for.

Parenting approaches, family functionality, and internet addiction among Hong Kong adolescents

Background

Internet addiction (IA) among adolescents has become a global health problem, and public awareness of it is increasing. Many IA risk factors relate to parents and the family environment. This study examined the relationship between IA and parenting approaches and family functionality.

Methods

A cross-sectional study was conducted with 2021 secondary students to identify the prevalence of IA and to explore the association between adolescent IA and familial variables, including parents’ marital status, family income, family conflict, family functionality, and parenting approaches.

Results

The results revealed that 25.3 % of the adolescent respondents exhibited IA, and logistic regression positively predicted the IA of adolescents from divorced families, low-income families, families in which family conflict existed, and severely dysfunctional families. Interestingly, adolescents with restricted Internet use were almost 1.9 times more likely to have IA than those whose use was not restricted.

Conclusions

Internet addiction is common among Chinese adolescents in Hong Kong, and family-based prevention strategies should be aligned with the risk factors of IA.

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.

Effects of a Web-Based Computer-Tailored Game to Reduce Binge Drinking Among Dutch Adolescents: A Cluster Randomized Controlled Trial

Background

Binge drinking among Dutch adolescents is among the highest in Europe. Few interventions so far have focused on adolescents aged 15 to 19 years. Because binge drinking increases significantly during those years, it is important to develop binge drinking prevention programs for this group. Web-based computer-tailored interventions can be an effective tool for reducing this behavior in adolescents. Embedding the computer-tailored intervention in a serious game may make it more attractive to adolescents.

Objective

The aim was to assess whether a Web-based computer-tailored intervention is effective in reducing binge drinking in Dutch adolescents aged 15 to 19 years. Secondary outcomes were reduction in excessive drinking and overall consumption during the previous week. Personal characteristics associated with program adherence were also investigated.

Methods

A cluster randomized controlled trial was conducted among 34 Dutch schools. Each school was randomized into either an experimental (n=1622) or a control (n=1027) condition. Baseline assessment took place in January and February 2014. At baseline, demographic variables and alcohol use were assessed. Follow-up assessment of alcohol use took place 4 months later (May and June 2014). After the baseline assessment, participants in the experimental condition started with the intervention consisting of a game about alcohol in which computer-tailored feedback regarding motivational characteristics was embedded. Participants in the control condition only received the baseline questionnaire. Both groups received the 4-month follow-up questionnaire. Effects of the intervention were assessed using logistic regression mixed models analyses for binge and excessive drinking and linear regression mixed models analyses for weekly consumption. Factors associated with intervention adherence in the experimental condition were explored by means of a linear regression model.

Results

In total, 2649 adolescents participated in the baseline assessment. At follow-up, 824 (31.11%) adolescents returned. The intervention was effective in reducing binge drinking among adolescents aged 15 years (P=.03) and those aged 16 years when they participated in at least 2 intervention sessions (P=.04). Interaction effects between excessive drinking and educational level (P=.08) and between weekly consumption and age (P=.09) were found; however, in-depth analyses revealed no significant subgroup effects for both interaction effects. Additional analyses revealed that prolonged use of the intervention was associated with stronger effects for binge drinking. Yet, overall adherence to the intervention was low. Analyses revealed that being Protestant, female, younger, a nonbinge drinker, and having a higher educational background were associated with adherence.

Conclusions

The intervention was effective for adolescents aged 15 and 16 years concerning binge drinking. Prevention messages may be more effective for those at the start of their drinking career, whereas other methods may be needed for those with a longer history of alcohol consumption. Despite using game elements, intervention completion was low.

Trial Registration

Dutch Trial Register: NTR4048; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4048 (Archived by WebCite® at http://www.webcitation.org/6eSJD3FiY)

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.

Relationship Satisfaction and Communication Among Urban Minority HIV-Positive and HIV-Negative Mothers: The Influence on Daughter's Alcohol Use

Family relationships influence children's beliefs and behaviors. This work examined qualities associated with communication about alcohol among 176 mothers and the influence of this communication on daughters' alcohol use. Path analyses by maternal HIV status indicated significant differences. Relationship satisfaction was associated with self-efficacy for both HIV-positive (β = 0.545, p < .001) and HIV-negative (β = 0.557, p < .001) mothers. Maternal self-efficacy was associated with communication for both HIV-positive (β = 0.364, p < .01) and HIV-negative (β = 0.310, p < .05) mothers; maternal attitudes toward alcohol use were associated with communication among HIV-negative mothers (β = 0.20, p < .05). Relationship satisfaction was indirectly related to daughter's alcohol use in HIV-positive dyads (β = 0.153, p < .05). In families with interfamilial and environmental stressors, investing in the mother-daughter relationship, in part by discussing issues related to alcohol use, is protective in nature.

Mediation and moderation effects of an in-home family intervention: the "in control: no alcohol!" pilot study

The aim of this study was to examine the effect of a theory-based in-home family intervention (In control: No alcohol!) on adolescent alcohol cognitions via its putative mediators using a randomized controlled design. In the South Holland region of the Netherlands, a total of 213 children (11-12 years) and their mothers were randomly assigned to the prevention program (108 dyads) and the control condition (105 dyads). Mediation effects were analyzed using pretest and two follow-up measurements (5 and 12 months after baseline). A path model was estimated (using Mplus) to examine the effect of the intervention on the putative mediators (frequency- and quality of mother-child communication, rules about alcohol, establishing a nondrinking agreement, and parental monitoring of the child's whereabouts). Outcomes were adolescents' perceived harmfulness of drinking and intention to drink. Multigroup analyses were performed to examine potential differences across gender. The program led to an increase in frequency of alcohol-specific communication, nondrinking agreements, and parental monitoring. Moreover, adolescents in the experimental condition perceived drinking to be more harmful and had less intention to drink compared to adolescents in the control condition. The effect of the program on adolescent alcohol cognitions was significantly mediated through having more frequent conversations about alcohol, yet only among boys. Although results on actual drinking need to be added, findings indicate that this relatively inexpensive, easy-to-administer home intervention is promising.

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.

Web-based interventions to decrease alcohol use in adolescents: a Delphi study about increasing effectiveness and reducing drop-out

BACKGROUND

Web-based computer-tailored (CT) interventions have a high potential to reach a large number of people and effectively change health risk behaviors and their determinants. However, effect studies show small and variable effect sizes, and these interventions also suffer from high drop-out. In this study we explored how Web-based CT interventions can be used effectively to reduce binge drinking in 16- to 18-year-old adolescents.

METHOD

A three-round Delphi study was conducted. We invited experts to identify strategies to be used in Web-based CT interventions that can effectively decrease binge drinking in adolescents and to rate these strategies by importance. We asked to discriminate between interventions targeted for adolescents and those targeted for parents. Furthermore, we asked experts to suggest strategies for reducing drop-out and to indicate their importance.

RESULTS

Important strategies mentioned by the experts were: encouraging parents to set appropriate rules, encouraging consistent communication, and training refusal skills among adolescents. Concerning the reduction of drop-out from Web-based CT interventions experts came up with suggestions involving the content of the intervention (e.g., relevant material, use of language, tailored messages) but also involving the use of reminders and incentives.

CONCLUSIONS

The results of this explorative study provide useful strategies to increase effectiveness and decrease drop-out in future interventions.

Correlates of pro-drinking practices in drinking parents of adolescents in Hong Kong

Introduction and Aims

Parental alcohol-related practices are important risk factors of adolescent drinking, but little is known about the factors associated with these parental pro-drinking practices (PPDPs). We investigated the correlates of 9 PPDPs in drinking parents of adolescents in Hong Kong.

Methods

A total of 2200 students (age 14.8±2.0; boys 63.2%) participated in a school-based cross-sectional survey in 2012. Analysis was restricted to 1087 (61.8%) students with at least 1 drinking parent as PPDPs were much more common in these families. Logistic regression was used to identify correlates of each PPDP.

Results

Among 1087 students, the prevalence of PPDPs ranged from 8.2% for training drinking capacity to 65.7% for seeing parents drink. Only 14.8% of students had not experienced any of these practices. More frequent maternal drinking predicted parental training of drinking capacity. Older age predicted helping parents buy alcohol and parental encouragement of drinking. Adolescent girls were more likely to have received parental training of drinking capacity than boys. Higher perceived family affluence was associated with hearing parents saying benefits of drinking, and helping parents open bottle and pour alcohol.

Conclusions

PPDPs were associated with parental drinking frequency and various socio-demographic factors. These results have implications on alcohol control programmes involving parents to tailor messages for reducing PPDPs based on the characteristics of adolescents and parents.

Substance use outcomes in the Healthy School and Drugs program: results from a latent growth curve approach

AIM

To assess the effectiveness of the Healthy School and Drugs (HSD) program for secondary schools on the development of substance use among Dutch early adolescents and to explore whether boys, adolescents of lower educational backgrounds, or adolescents high on personality risk traits, would benefit more from the HSD program than others.

DESIGN

Randomized clustered trial with two intervention conditions (i.e., lessons and integral) among a general population of adolescents in the Netherlands.

PARTICIPANTS

A total of 3784 students of 23 Dutch secondary schools.

MEASUREMENTS

Structured digital questionnaires were administered pre-intervention and at 8, 20, and 32months follow-ups. The outcome measure was the rate of change in substance use across follow-ups. Differential effectiveness of the HSD program was examined for sex, educational level, and personality traits.

FINDINGS

Our results show no HSD intervention effects on the development of substance use. Sex, education level, and personality characteristics of the participants did not moderate the intervention effects.

CONCLUSION

The absence of effects of the Healthy School and Drugs program on the development of substance use indicates that the program should be renewed and redeveloped.

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.

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.

Risk moderation of a parent and student preventive alcohol intervention by adolescent and family factors: a cluster randomized trial

OBJECTIVE

To examine risk moderation of an alcohol intervention targeting parents and adolescents.

DESIGN

A cluster randomized trial including 2937 Dutch early adolescents (m=12.68years, SD=0.51) and their parents randomized over four conditions: parent intervention, student intervention, combined parent-student intervention, and control group.

SETTING

152 classes of 19 high schools in The Netherlands (2006).

METHOD

Moderators at baseline (adolescent: gender, educational level and externalizing behavior; parent: educational level and heavy alcohol use) were used to examine the differential effects of the interventions on onset of (heavy) weekly drinking at 22-month follow-up.

RESULTS

The combined intervention effectively delayed the onset of weekly drinking in the general population of adolescents, and was particularly effective in delaying the onset of heavy weekly drinking in a higher-risk subsample of adolescents (i.e. those attending lower levels of education and reporting higher levels of externalizing behavior).

CONCLUSION

Present and previous results have established the combined intervention to be universally effective in postponing weekly alcohol use among Dutch adolescents, with an added effect on postponing heavy weekly drinking in high risk subgroups. Therefore, implementation of this intervention in the general population of schools in The Netherlands is advised.

TRIAL REGISTRATION

NTR649.

Influence of parental alcohol-related attitudes, behavior and parenting styles on alcohol use in late and very late adolescence

Parents influence adolescent drinking behavior, but to what extent does this association diminish with age, however? The cross-sectional data was drawn from the Scania drug use survey 2007, consisting of 4,828 secondary education students in the 9th and 11th grade. The age- and gender-adjusted findings indicate that having parents who are consenting to alcohol use (OR 1.4), having been provided with alcohol by one's parents (OR 1.8), having parents with an authoritarian (OR 1.5) or neglectful (OR 2.1) parenting style, and having parents who both have a university degree (OR 1.3) were factors significantly associated with monthly heavy episodic drinking. These findings lead to the conclusion that parenting styles as well as parental attitudes and behaviors are important throughout the high school years. Thus, prevention targeting parents should emphasize both these domains.

What are other parents saying? Perceived parental communication norms and the relationship between alcohol-specific parental communication and college student drinking

This study examined parents' normative perceptions of other college parents' alcohol-specific communication, and how parents' perceived communication norms and alcohol-specific communication relate to student drinking outcomes. A sample of 457 student-parent dyads were recruited from a midsize university. Students completed Web-based assessments of alcohol-related attitudes and behaviors. Parents completed alcohol-specific measures of communication norms and parent-child communication, including communication content (i.e., targeted communication) and frequency of communication. Results indicated that parents overestimated how much other parents talked to their college students about the frequency and quantity of alcohol use, but underestimated how often parents initiated conversations about alcohol. In a path model, perceived communication norms positively predicted both targeted communication and frequency of communication. Perceived communication norms and targeted communication negatively predicted students' attitude toward alcohol use. In contrast, more frequent communication predicted students holding more approving attitudes toward alcohol. The relationship between parents' perceived communication norms and students' drinking behaviors was mediated by the parental communication variables and student attitudes. Tests of indirect effects were undertaken to examine meditational processes. The findings underscore relations involving parental perceived communication norms and parents' own alcohol communication and their children's drinking outcomes. The complex relationships of different types of parental communication and student outcomes warrant further research.

Determinants of binge drinking in a permissive environment: focus group interviews with Dutch adolescents and parents

Background

Compared to other European countries, the Netherlands score among the highest of binge drinking rates of 16 to 18 year old adolescents. Dutch adolescents aged 16 are legally allowed to buy and consume low strength alcoholic beverages. This study focused on determinants of binge drinking in such a permissive environment from the perspectives of adolescents and parents.

Methods

Focus group interviews were conducted with adolescents aged 16 to 18 (N = 83), and parents of adolescents from this age group (N = 24). Data was analysed using thematic analyses methods.

Results

Most reasons adolescents mentioned for drinking were to relax, increase a good mood and to be social. Also peers around them influenced and increased adolescents’ drinking. Comparing adolescents and parental statements about their perspectives how alcohol use is handled and accepted by the parents we found that generally, those perspectives match. Parents as well as adolescents stated that alcohol use is accepted by parents. However, when looking at essential details, like the acceptable amounts that children may consume, the perspectives differ enormously. Adolescents think their parents accept any amount of drinking as long as they do not get drunk, whereas parents reported acceptable limits of 1 or 2 glasses every two weeks. Parents further indicated that they felt unsupported by the Dutch policies and regulations of alcohol use. Most of them were in favour of an increase of the legal purchasing age to 18 years.

Conclusions

Parents and adolescents should both be targeted in interventions to reduce alcohol use among adolescents. In particular, communication between parents and children should be improved, in order to avoid misconceptions about acceptable alcohol use. Further, adolescents should be supported to handle difficult social situations with peers where they feel obliged to drink. Additionally, revisions of policies towards a less permissive standpoint are advised to support parents and to impede availability of alcoholic beverages for adolescents/children younger than 18 years.

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.

How parents of adolescents store and monitor alcohol in the home

In this study, we explored how and where parents store alcohol in the home, and how they monitor this stored alcohol. In-depth, semi-structured interviews were conducted with parents of youths, aged 15-18 years, in northern California. We found that parents typically stored alcohol in unsecured locations easily accessible to adolescents. Parental monitoring of alcohol included counting or marking bottles and hiding alcohol. However, parents reported that they relied primarily on their memory and intuition to monitor alcohol and admitted that they would not notice if small amounts of alcohol disappeared.

Binge drinking among Brazilian students: a gradient of association with socioeconomic status in five geo-economic regions

BACKGROUND

Socioeconomic status (SES) may be directly associated with binge drinking (BD) and country inequality. The aims of this study were to describe the characteristics of BD among high school students in Brazil and the association of BD with students' socioeconomic status in the five different Brazilian macro-regions.

METHODS

A national cross sectional survey was carried out using a multistage probabilistic sample of 17,297 high school students aged 14-18 years drawn from 789 public and private schools in each of the 27 Brazilian state capitals. Self-report data about BD behaviors and SES were analyzed via weighted logistic regressions and a funnel plot.

RESULTS

Almost 32% of the students engaged in BD in the past-year. Being in the highest SES stratum doubled the risk of BD among students in all five Brazilian macro-regions. There was a gradient in the association between past-year BD and socioeconomic status: as SES increased; the chance of having recently engaged in BD also increased. In Brazilian capitals as a whole, being a boy versus being a girl (adjusted odds ratio - aOR=1.40 [95%CI 1.26; 1.58]), being older (aOR=1.47 [95%CI 1.40; 1.55]) and attending private versus public schools (aOR=1.39 [95%CI 1.18; 1.62]) were associated with greater risk for BD.

CONCLUSIONS

Contrary to what is observed in developed countries, students living in Brazilian capitals may be at an increased risk of BD when they belong to the highest socioeconomic status. There might be similar associations between high SES and BD among adolescents growing up in other emerging economies.

The influence of paternal and maternal drinking patterns within two-partner families on the initiation and development of adolescent drinking

As it is still unclear to what extent parental drinking is a predictor of children's alcohol use, we tested the association of specific paternal and maternal drinking patterns with both initiation and development of adolescent alcohol use. Longitudinal data (four annual measurements) of parent-child dyads (N=2319) have been used. Parental drinking patterns have been identified using latent class analysis. The association of parental drinking patterns with the initiation and development of 12-15 year olds' drinking have been examined with latent growth curve modeling. Only two out of six parental drinking patterns were related to adolescent drinking. That is, having a heavy drinking father or two heavy episodic drinking parents particularly predicts early and heavier adolescent drinking. When controlled for parenting behaviors and background variables, such as adolescent gender, age and socioeconomic status (SES), these findings remained significant. Interaction analyses revealed that the influence of parental heavy (episodic) drinking differs across gender and is especially strong among adolescents with lower SES. Thus, parental heavy (episodic) drinking, and not so much the frequency of drinking, predicts the initiation and development of alcohol consumption in their offspring. Parents and professionals must be aware that parental heavy drinking affects their offspring, particularly adolescents with lower SES, resulting in earlier and heavier drinking among this high-risk group.

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.

Parents as a resource: communication quality affects the relationship between adolescents' internet use and loneliness

The authors examined the influence of parent-adolescent communication quality, as perceived by the adolescents, on the link between adolescents' Internet use and loneliness, controlling for perceived family support in general terms. Adolescents (N = 216, M(age) = 15.80 years) provided data on Internet use, loneliness, Internet-related parent-adolescent communication, and perceived family support. Moderated regression analyses showed that Internet-related communication quality determined whether more extensive Internet use was associated with more loneliness. This moderation effect remained significant when perceived family support in general terms was controlled for. Gender and age of the participants did not influence the findings. Implications for successful Internet-related parenting strategies are discussed.

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.

Parental alcohol-specific rules and alcohol use from early adolescence to young adulthood

BACKGROUND

  Several studies stress the importance of alcohol-specific rules during adolescence to prevent them from drinking early and heavily. However, most studies have short follow-up periods and do not cover the relevant developmental period in which direct parental control diminishes and adolescent alcohol use increases. The current study aimed to provide a developmental perspective on the link between alcohol-specific rules and alcohol use from early adolescence until early adulthood in the Netherlands.

METHODS

  The sample consisted of 428 Dutch families including fathers, mothers and adolescents from 2 age groups (13 and 15 years old) at Time 1 (T1), who have been surveyed annually for 6 years. To address the effect of alcohol-specific rules on adolescent alcohol use over time, a latent growth curve analytic approach with time-varying covariates was employed.

RESULTS

  Over time, adolescent alcohol use increased, whereas alcohol-specific rules decreased. Most importantly, however, the lagged paths of alcohol-specific rules consistently predicted subsequent alcohol use across the 6 assessments for both younger and older siblings. Thus, strict alcohol-specific rules at a certain point in time were related to a lower intensity of adolescent alcohol use a year later.

CONCLUSIONS

  Although parents turn somewhat less strict in alcohol-specific rules over time, and adolescent alcohol use increases over time, the specific rules parents set remain important in restraining the alcohol use of their adolescent offspring. Thus, parents should and can feel confident about their parenting capabilities, and they should maintain being strict to prevent their offspring from drinking.