Predicting substance use behavior among South African adolescents: The role of leisure experiences across time

Exploring EEG resting state as a function of boredom proneness in pre-adolescents and adolescents

Boredom is a prominent experience commonly reported in school settings and associated with poor academic achievement. Little is known, however, about the age-related trajectory of boredom. Here we examined self-reported ratings of boredom in a cross-sectional sample of 8 to 15-year olds (n = 185) as a function of resting state EEG. Results indicated that reports of boredom in school rose as a function of age. Resting state EEG showed a decrease in theta power with age perhaps reflective of increased control. While no effects were evident in beta and alpha bands, we did observe an interaction between boredom and age for frontal asymmetry such that for those higher in boredom, the asymmetry increased with age. Finally, for theta to beta ratios there were main effects of age (i.e., a decrease in theta/beta ratio with age) and boredom such that those higher in boredom had higher theta/beta ratios over frontal and central brain areas. The results are discussed in the context of prior work on school-related boredom and provide several important avenues for further research.

Associations Between Trait Boredom and Frequency of Cannabis, Alcohol, and Tobacco Use in College Students

Objective

Boredom is a common emotion associated with substance use in college students - a group already at risk for substance misuse. The purpose of this study is to understand how two types of trait boredom (susceptibility and proneness) in college students are associated with frequency of cannabis, alcohol, and tobacco use.

Method

Data were collected from an online survey completed by a sample of undergraduate students (N = 414, Mage = 19.55, 84.5% female; 64.3% White) enrolled at a large public university in the northwest. Multivariate logistic regression was used to evaluate the association between trait boredom and frequency of cannabis, alcohol, and tobacco use after controlling for age, sex, and race.

Results

Boredom susceptibility was a significant predictor of annual, monthly, and weekly cannabis and alcohol use, but only annual and monthly tobacco use. Boredom proneness was only a significant predictor for monthly alcohol use.

Conclusions

Findings were generally consistent across types of substances and frequency of use for boredom susceptibility, indicating students higher in susceptibility, rather than proneness, are a subgroup to target prevention interventions to alleviate boredom and subsequent maladaptive coping mechanisms.

Engagement in types of activities and frequency of alcohol use in a national sample of United States adolescents

OBJECTIVE

Adolescents with fewer sources of environmental reinforcement may be at risk for alcohol use. Behavioral economic theories posit that engagement in some activities may facilitate alcohol use, whereas other activities may be incompatible with use and reduce likelihood of alcohol use. It is unclear which types of activities may facilitate or may be incompatible with alcohol use in adolescence. Using a national sample of adolescents, the current study examined differences in engagement with types of activities that may be incompatible with alcohol use, compared among adolescents who endorsed alcohol use, and adolescents who did not.

METHOD

Data from the 2019 Monitoring the Future (MTF) study (N = 4626) were analyzed. Potentially incompatible and facilitating activities, and alcohol-involved activities were identified from pre-existing survey measures. Confirmatory factor analysis, measurement invariance, and structural equation modeling were used to examine patterns in activity engagement among those who endorsed alcohol use and those who did not.

RESULTS

Participants who did not endorse alcohol use reported higher engagement in activities that may be incompatible with alcohol use, including enjoyment from school and going to the mall (p < .001). Participants who endorsed alcohol use reported higher engagement in activities that may facilitate alcohol use (p < .001), such as spending time with friends and attending parties. Facilitating activities (β = 0.15, p < .001) and alcohol-involved activities (β = 0.70, p < .001) were positively associated with alcohol use frequency. Observed effect sizes were small in magnitude for all findings.

CONCLUSIONS

The findings support the premise of behavioral economic theory, suggesting some activities may serve as protective factors against alcohol use frequency while other activities may facilitate alcohol use among adolescents. National surveys may consider adding specific measure of activity engagement to identify activities that may be incompatible with alcohol use among adolescents.

How Is Leisure Related to Wellbeing and to Substance Use? The Probable Key Role of Autonomy and Supervision

The present research is based on a large and representative national survey and intends to analyse the correlation of several leisure activities with risk, and with health and well-being outcomes. This work is part of the Health Behaviour in School-aged Children (HBSC) study, a collaborative WHO international study that aims to explore the school-aged children behaviour regarding health and risk behaviours in their life contexts. Participants were 8215 Portuguese adolescents, randomly chosen from those attending the 6th, 8th, 10th and 12th grades in 2018. The sample included 52.7% of girls and the mean age was 14.36 years old. Descriptive and comparative analyses were performed (ANOVAS and Chi-Square). The results of the present study suggested that several leisure activities, namely sports and social engagement activities (politic involvement and participation, religious activities, scouting and volunteer work), are associated with the adolescents' well-being and life satisfaction. However, these types of activities can also be associated with an increase in substance use. However, some activities are also associated with risky behaviour. Identifying activities that promote well-being in young people can be important for professionals, families and public policies.

Older and Wiser? Age-related Change in State and Trait Boredom During Adolescence and Associations with Neural Correlates of Self-regulation

Purpose

The purpose of the current study was to examine age-related change in state and trait boredom in 12- to 17-year-old adolescents and test whether neurophysiological correlates of self-regulation relate to boredom during adolescence in the same way that has been found in adults.

Methods

Eighty-nine 12- to 17-year-old adolescents participated. Three types of trait boredom were measured: boredom proneness, leisure boredom, and boredom susceptibility. State boredom was also measured after completing a boredom induction task while EEG was recorded. Slopes in frontal alpha asymmetry (FAA) were extracted from the EEG as a measure of approach (leftward shifts) or avoidance (rightward shifts).

Results

A curvilinear relationship between age and boredom proneness and age and boredom susceptibility was observed, indicating trait boredom rises and falls across adolescence. State boredom, by contrast, increased linearly with age. Slopes in FAA inversely related only to boredom proneness, indicating higher levels of this type of trait boredom related to an avoidant response as a state of boredom ensues.

Conclusion

We suggest the rise and fall of trait boredom across adolescence may be due to changes in person-environment fit during middle adolescence, whereas state boredom may increase with age due to improvements in attentional processes that mundane lab tasks do not satisfactorily engage. The link between FAA and only one type of trait boredom indicates self-regulatory processes and boredom are not yet strongly coupled in adolescence. Implications for prevention of negative behavioral health outcomes associated with high levels of trait boredom are discussed.

Patient perceptions of facilitators and barriers to reducing hazardous alcohol use among people living with HIV in East Africa

BACKGROUND

Hazardous alcohol use among people living with HIV is associated with poor outcomes and increased morbidity and mortality. Understanding the hazardous drinking experiences of people living with HIV is needed to reduce their alcohol use.

METHODS

We conducted 60 interviews among people living with HIV in East Africa with hazardous drinking histories. Interviews and Alcohol Use Disorder Identification Test (AUDIT) scores were conducted 41 - 60 months after their baseline assessment of alcohol use to identify facilitators and barriers to reduced alcohol use over time.

RESULTS

People living with HIV who stopped or reduced hazardous drinking were primarily motivated by their HIV condition and desire for longevity. Facilitators of reduced drinking included health care workers' recommendations to reduce drinking (despite little counseling and no referrals) and social support. In those continuing to drink at hazardous levels, barriers to reduced drinking were stress, social environment, alcohol accessibility and alcohol dependency.

CONCLUSIONS

Interventions that capacity-build professional and lay health care workers with the skills and resources to decrease problematic alcohol use, along with alcohol cessation in peer support structures, should be explored.

Boredom is the root of all evil-or is it? A psychometric network approach to individual differences in behavioural responses to boredom

Functional accounts of boredom propose that boredom serves as an impartial signal to change something about the current situation, which should give rise to adaptive and maladaptive behaviour alike. This seemingly contrasts with research on boredom proneness, which has overwhelmingly shown associations with maladaptive behaviour. To shed light on this discrepancy, we disentangled boredom proneness from individual differences in (i) the urge to avoid and escape boredom and (ii) adaptive and maladaptive ways of dealing with boredom by developing corresponding trait scales. In a study with N = 636 participants, psychometric network modelling revealed tight associations between boredom proneness and less adaptive and (especially) more maladaptive ways of dealing with boredom. However, its associations with the urge to avoid and escape boredom were rather weak. Importantly, a higher urge to avoid and escape boredom was linked not only to more maladaptive but also to more adaptive ways of dealing with boredom. This pattern of results was robust across various specific behaviours that have previously been linked to boredom. Our findings provide novel evidence for functional accounts of boredom from an individual difference perspective, cautioning against a shallow view of boredom as being associated with purely maladaptive behaviour.

Leisure Satisfaction, Personality, and Psychosexual Adjustment Among College Students: A Latent Profile Analysis

Although the factors influencing sexual health have been explored by researchers, the impact of leisure and personality on psychosexual adjustment and the interaction of these two factors remain unknown. This study investigated the relationship between leisure satisfaction and psychosexual adjustment based on the compensation theory and the social learning theory. The differences in psychosexual adjustment across different personality types were also explored. Finally, we examined the interaction between personality and leisure satisfaction based on the personal-environment fit models. The participants in this study were 1,161 college students. The results supported all the hypotheses proposed. There was a significant positive correlation between leisure satisfaction and psychosexual adjustment. Participants of four personality types (the overcontrolled, high-moderate, low-moderate, and resilient groups) had different performance in psychosexual adjustment. The resilient group had the highest scores, while the overcontrolled group had the lowest scores. The results suggest that there is an interaction between personality and leisure satisfaction. Our research could enrich the research contents of leisure and personality and provide a practical basis for the improvement of college students in psychosexual adjustment.

Boredom Proneness Predicts Self-Assessed Decision Errors in Sports but Is Unrelated to Risk Taking in General

Introduction: Boredom proneness is linked to poor self-regulation, leading to poor decision making and/or increased risk taking. These links have not yet been investigated in the domain of sports and exercise. However, poor decisions or excessive risk behavior would be highly detrimental to sporting performance and, in some cases, even cause physical harm. Here, we address this gap by assessing if boredom proneness is linked to general risk taking, sport-specific risk taking, and to regrets about sports-specific decision errors with respect to acting too risky or too passively. Methods: N = 936 athletes (27.6 ± 9.0 years, 89.6% men): n = 330 Climbers (31.8 ± 10.7 years, 82.4% men), n = 83 Snowboarders (29.9 ± 8.3 years, 79.5% men), and n = 523 Esports athletes (24.6 ± 6.3 years, 95.8% men) completed the Short Boredom Proneness Scale (SBPS), along with measures for objective risk taking (Balloon Analogue Risk Task; BART), subjective risk taking (general willingness to take risks), as well as assessments for sport-specific risk taking and regrets for sports-specific decision errors (taking too many risks, failing to act at all). In the two extreme sports samples (i.e., climbers and snowboarders), we additionally assessed self-selected outcome certainty in a hypothetical sports-specific scenario where an error would result in physical harm. Results: A series of multiple regression analyses revealed that boredom proneness was unrelated to objective and subjective general risk taking, but a significant predictor of sport-specific risk taking and higher risk taking in the sports scenario (climbers and snowboarders only). Most importantly, boredom proneness predicted regrets for taking too many risks and being too passive. Exploratory post-hoc analyses further indicated that boredom proneness in extreme sports athletes was lower than in esports athletes. Higher boredom proneness was significantly related to lower skill levels across all kinds of sport. Discussion: Across three athlete samples, boredom proneness was unrelated to general risk taking but significantly related to poorer decision making, as indicated by regrets about acting too risky and too passively, as well as demanding a significantly lower safety threshold to make a risky sports-specific choice. While at odds with the often-reported link between boredom proneness and risk taking, these results are consistent with the conceptualization of boredom proneness as a maladaptive self-regulatory disposition that leads to noisy decision making in sports. In addition, we provide preliminary evidence that boredom proneness covaries with self-selection into specific types of sports and might also stand in the way of skill acquisition in sports.

Contribution of Leisure Context, Motivation and Experience to the Frequency of Participation in Structured Leisure Activities among Adolescents

Leisure time is considered an important context for adolescent development. The purpose of this article is to investigate what contributes to the frequency of adolescents' participation in structured leisure activities (SLA). Participants were aged 14-21 years (M = 18.87, SD = 1.23) and 44.8% of participants were female. Hierarchical regression analyses were conducted. Results indicate that boys and adolescents who perceive the context of participation in SLA as safe, are externally or intrinsically motivated, and perceive that participation has contributed to their identity development and experiences of initiative, as well as their experiences of stress, are more likely to participate frequently in SLA. On the other hand, these findings indicate that girls and adolescents who are unmotivated to participate in SLA and who experience negative peer influences while participating in SLA are less likely to frequently participate in SLA. It can be concluded that it is important to think much more broadly than just the setting of the activities themselves when promoting young people's participation in SLA. Some of the features of SLA that promote positive youth development are presented in this paper.

“Alcohol is life, it’s part of us”: Examining the Everyday Experiences of Alcohol Use in Botswana

Efforts to control and regulate alcohol has recently gained steam in Botswana. Inspired by a public health perspective, the government of Botswana has recently increased the alcohol tax levy, reduced the hours of operation for bars and increased penalties for alcohol-related offences to control alcohol-related harm. While these reforms have been central to policymaking, and caused some controversy, not much is known about the everyday experiences of alcohol consumers in Botswana. Drawing from semi-structured interviews (n = 40) collected amongst drinkers over a five-year period, this paper examines the everyday use of alcohol in Botswana. The analysis demonstrates that alcohol use constitutes an important part of leisure and night-time economy (NTE) activities in Botswana. It is a functional social activity that is used by people to take time away from the routines and pressures of daily life. More importantly, it is pleasurable to people, enhances sociability, and partaken as a form of transaction between men and women in bars. There is need for policy makers to consider the embodied experiences of alcohol use when designing alcohol interventions in Botswana.

Leisure Boredom, Timing of Sexual Debut, and Co-Occurring Behaviors among South African Adolescents

Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an underexplored correlate of sexual behavior that is associated with many adolescent health outcomes. We investigated if and how individual differences in leisure boredom may be associated with timing of sexual debut, and whether individuals engage in safe or risky behaviors at debut. Survival analysis, logistic regression, and Poisson regression were applied to eight-wave longitudinal data obtained from 3,088 South African adolescents (baseline M_age = 13.9 years) to examine associations between leisure boredom and cumulative hazard of sexual debut across adolescence, odds of co-occurring sexual behaviors, and incidence rate of co-occurring sexual risk behaviors at debut. Higher levels of leisure boredom were associated with elevated hazard cumulatively across adolescence. Higher levels of leisure boredom were also associated with lower odds of safe sex and higher odds of substance use during sex and transactional sex at sexual debut, but not casual sex or condom non-use at sexual debut. Although odds of singular risk behaviors were lower for girls than for boys, the association between leisure boredom and the number of risk behaviors at sexual debut was stronger for girls than boys. Higher trait leisure boredom was associated with elevated hazard of sexual debut, greater likelihood that risky behaviors accompanied sexual debut, and greater number of co-occurring risky behaviors at sexual debut. Results support leisure boredom as a potential target for preventing sexual risk behavior among South African adolescents.

Boredom in Adolescence: Validation of the Italian Version of the Multidimensional State Boredom Scale (MSBS) in Adolescents

Boredom in adolescence is often underestimated, although it may be the sign of a profound unease or be associated with psychological disorders. Given the complexity of the construct of boredom and its increasing prevalence among adolescents in recent years, the present study aimed to validate the factorial structure of the Italian version of the Multidimensional State Boredom Scale (MSBS) in adolescents using a cross-validation approach. The study involved 272 students (33.8% males, 66.2% females) aged 14–19 (M = 15.9, SD = 1.38) living in northern and central Italy. In addition to the MSBS, the Symptoms Checklist 90-R (SCL 90-R) and the Children’s Depression Inventory (CDI) were administered. Exploratory and confirmatory factor analyses validated a 23-item structure of the MSBS, comprising five correlated factors. The tool showed a good internal consistency for these factors and a good convergent and factor validity. The MSBS consequently seems a valid and reliable method for assessing boredom in adolescence. The cut-off for the total score that could pinpoint cases posing a potential clinical risk was 88. A weak correlation was found between the total level of boredom and the daily Internet usage, while no relationship emerged between boredom and age, gender, and grades. Since excessive levels of boredom may conceal a general unease that could develop into structured psychological disorders, the value of the MSBS lies in enabling us to identify in advance adolescents at potential clinical risk.

Boredom by Sensation-Seeking Interactions During Adolescence: Associations with Substance Use, Externalizing Behavior, and Internalizing Symptoms in a US National Sample

During adolescence, sensation seeking is linked to several adverse outcomes including substance use, risk taking, and psychopathology. Recent empirical interest in the construct of boredom has revealed that some similar associations may exist for boredom during adolescence. Both boredom and sensation seeking peak during adolescence, and yet, research on boredom and its interaction with sensation seeking are limited. In a multi-cohort, US nationally representative sample of 8th and 10th grade students from the monitoring the future study, latent-moderated structural equation modeling was used to estimate the association of boredom, sensation seeking, and their interaction, to substance use, externalizing behavior, and depressive affect. Moderation by gender was also tested. Boredom and sensation seeking were both significantly associated with most dependent variables. Significant interaction effects were found wherein individuals high on both boredom and sensation seeking reported the highest levels of depressive affect and externalizing behavior. There were no significant interaction effects for substance use indices. Gender moderation was found for depressive affect. The results of this study demonstrate the generalizability of boredom associations and the significance of boredom by sensation-seeking interactions across multiple mental health domains during adolescence. Prevention efforts that attend to both boredom and sensation seeking may be particularly effective for promoting mental health and preventing externalizing behavior.

More Bored Today Than Yesterday? National Trends in Adolescent Boredom From 2008 to 2017

PURPOSE

Boredom is an accepted part of adolescence. Developmental and contextual factors are likely to conspire to increase boredom during adolescence, which, in turn, relates to health risk behaviors. However, literature is lacking in the developmental course of boredom across adolescence as well as historical variation in boredom. The present study used multicohort nationally representative samples of U.S. secondary school students to identify historical trends and grade level differences in boredom overall and by sex.

METHODS

The present study includes 8th, 10th, and 12th graders from 2008 to 2017 who completed the Monitoring the Future self-report survey (n = 106,784). Joinpoint was used to identify historical trends in boredom and linear regression to identify grade level differences.

RESULTS

Boredom increased historically both across and within grades with girls generally demonstrating greater increases than boys. Across grade, boredom appears to peak in 10th grade for boys and decrease across grade for girls.

CONCLUSIONS

Study findings indicate boredom has been increasing among adolescents over the past several years, with greater increases among girls. Increases may be concomitant with recent increases in mental health difficulties, suggesting that the overarching psychosocial profile of U.S. adolescents is becoming less optimal. Findings also suggest boredom peaks in 10th grade overall although when analyzing separately by sex, girls' boredom declines from 8th to 12th grade. It is clear that boredom is a worthy target for intervention both in clinical and prevention contexts.

Using the Short Form of the MSBS to Assess State Boredom Among Adolescents: Psychometric Evidence by Applying Item Response Theory

The Multidimensional State Boredom Scale (MSBS) is widely used, but evidence regarding its psychometric properties among adolescents is lacking. In particular, the functioning of the scale across genders is unknown. As a result, we used item response theory (IRT) to investigate gender invariance of the Short Form of the MSBS (MSBS-SF) among adolescents. Four hundred and sixty-six Italian high school students (51% male; M = 16.7, SD = 1.44) were recruited. A confirmatory factor analysis demonstrated the unidimensionality of the scale, and IRT analyses indicated that the scale was sufficiently informative. Differential item functioning (DIF) across genders showed that only one item had DIF that was both nonuniform and small in size. Additionally, relationships with negative/positive urgency and present/future-oriented time perspectives were found. Overall, this study offers evidence that the MSBS-SF is a valuable and useful scale for measuring state boredom among male and female adolescents.

Highlighting the Role of Cognitive and Brain Reserve in the Substance use Disorder Field

BACKGROUND

Cognitive reserve (CR) refers to the ability of an individual to cope with brain pathology remaining free of cognitive symptoms. This protective factor has been related to compensatory and more efficient brain mechanisms involved in resisting brain damage. For its part, Brain reserve (BR) refers to individual differences in the structural properties of the brain which could also make us more resilient to suffer from neurodegenerative and mental diseases.

OBJECTIVE

This review summarizes how this construct, mainly mediated by educational level, occupational attainment, physical and mental activity, as well as successful social relationships, has gained scientific attention in the last years with regard to diseases, such as neurodegenerative diseases, stroke or traumatic brain injury. Nevertheless, although CR has been studied in a large number of disorders, few researches have addressed the role of this concept in drug addiction.

METHODS

We provide a selective overview of recent literature about the role of CR and BR in preventing substance use onset. Likewise, we will also discuss how variables involved in CR (healthy leisure, social support or job-related activities, among others) could be trained and included as complementary activities of substance use disorder treatments.

RESULTS

Evidence about this topic suggests a preventive role of CR and BR on drug use onset and when drug addiction is established, these factors led to less severe addiction-related problems, as well as better treatment outcomes.

CONCLUSION

CR and BR are variables not taken yet into account in drug addiction. However, they could give us a valuable information about people at risk, as well as patient's prognosis.

Clonidine Increases the Likelihood That Abstinence Can Withstand Unstructured Time in Buprenorphine-maintained Outpatients

OBJECTIVE

In a clinical trial examining daily clonidine as an adjunct to buprenorphine treatment for opioid dependence, we found that clonidine increased opioid abstinence and decoupled stress from craving. From a personalized-medicine perspective, the next step is to identify people for whom clonidine would be beneficial. To that end, using data from the same clinical trial, we examined the associations of daily-life activities with treatment success.

METHODS

Outpatients (N = 118) received clonidine (0.3 mg/d) or placebo during 18 weeks of buprenorphine treatment. Participants carried a smartphone that randomly prompted them 4 times per day to report their moods and activities. Using generalized linear mixed models, we assessed the likelihoods of different types of daily activity as a function of clonidine versus placebo, days of longest continuous opioid abstinence, and their interaction.

RESULTS

Participants in the buprenorphine-only (buprenorphine plus placebo) control group who engaged in more responsibilities (work and child/elder care) had longer streaks of abstinence, whereas those who engaged in more unstructured-time activities had shorter streaks of abstinence. Conversely, for participants in the buprenorphine-plus-clonidine group, longer streaks of abstinence were associated with higher frequencies of activities associated with "unstructured" time.

CONCLUSIONS

The study replicates findings that engaging in responsibilities is related to positive treatment outcomes in standard opioid agonist therapy. The pattern of results also suggests that clonidine helped participants engage in unstructured-time activities with less risk of craving or use than they might otherwise have had.

Perception of freedom in leisure among substance users and nonusers

Abstract The aim of this study was to verify that substance use among adolescents would be linked to perceptions of freedom in leisure. It was selected for convenience sampling 186 adolescents at Projeto Quixote in a public school in Guarulhos. It used as questionnaire Data Sociodemographic and Leisure, The Leisure Diagnostic Battery, version B (PLL) to measure Perceived Freedom in Leisure and Drug Use Screening Inventory for classification of substance use, all self-administered. Based on 165 reviews analyzed, the frequency of use of ecstasy and marijuana in the last month were related to higher rates of PLL. The number of substances used in the last month had no significant effect. These data suggest specific components of leisure related to the frequency of substance use, such as perceived control and need at leisure.

Girls Just Want to Know Where to Have Fun: Preventing Substance Use Initiation in an Under-Resourced Community in South Africa Through HealthWise

This study examined how the perception of the availability of leisure opportunities may prevent substance use initiation through HealthWise, a school-based program focused on reducing risky behavior. In this study, we specifically focused on whether HealthWise increased student perceptions of leisure opportunities between 8th grade and 10th grade (N = 5610) in an under-resourced community in South Africa. Path analyses were used to test hypotheses. Given gender differences in substance use patterns, societal norms, and leisure opportunities in under-resourced communities, such as the townships of Cape Town, South Africa, it was especially important to examine associations within each gender. Results suggested that HealthWise directly reduced the likelihood of initiating alcohol and cigarette use and increased the amount of perceived leisure opportunities among girls but not boys. Perceived leisure opportunities mediated the effect of HealthWise on reducing the initiation of alcohol and cigarette use directly, and marijuana use indirectly, among girls but not boys. This is the first study to demonstrate how experimentally targeting leisure through an intervention can increase perceived leisure opportunities and thereby prevent early substance use initiation for a specific population. The importance of considering the context of gender, age, and location is discussed.

Exercise in the Treatment of Youth Substance Use Disorders: Review and Recommendations

Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth.

"I cannot stand the boredom." Binge drinking expectancies in adolescence

INTRODUCTION

The main aim of this study is to improve our knowledge on binge drinking behavior in adolescents. In particular, we tested a model of predictors of binge drinking focusing on boredom proneness; we also examined the predictive and mediating role of drinking expectancies on binge drinking.

METHODS

A questionnaire designed to assess current drinking behavior, such as binge drinking, drinking expectancies and boredom proneness, was administered to 721 Italian adolescents (61% females) aged between 13 and 19 years (M = 15.98, SD = 1.61).

RESULTS

Structural equation modeling confirmed the evidence on drinking expectancies as predicted by boredom proneness and as predictive of adolescents' binge drinking. Interestingly, disinhibition and relief from pain seem to play a more important mediating role between boredom and alcohol outcome. Conversely, no mediation was found for interpersonal and social confidence expectancies on binge drinking.

CONCLUSIONS

In general, the results suggest that preventative interventions on alcohol misuse should focus on personality traits and underlying drinking expectancies.

Trajectories of adolescent substance use development and the influence of healthy leisure: A growth mixture modeling approach

Considerable heterogeneity exists in adolescent substance use development. To most effectively prevent use, distinct trajectories of use must be identified as well as differential associations with predictors of use, such as leisure experience. The current study used a person-centered approach to identify distinct substance use trajectories and how leisure is associated with trajectory classes. Data came from a larger efficacy trial of 2.249 South African high school students who reported substance use at any time across 8 waves. Growth mixture modeling was used to identify developmental trajectories of substance use and the influence of healthy leisure. Results identified three increasing and one stable substance use trajectory and subjective healthy leisure served to protect against use. This study is the first of its kind to focus on a sample of South African adolescents and serves to develop a richer understanding of substance use development and the role of healthy leisure.

A qualitative study of methamphetamine initiation in Cape Town, South Africa

BACKGROUND

Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals' initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa.

METHODS

In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes.

RESULTS

On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered "trendy", which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town.

CONCLUSION

The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for community-level interventions to address the availability and perceived normality of methamphetamine use, and to provide young people opportunities for recreation. On an individual level, addressing mental health and misconceptions about the dangers and benefits of methamphetamine could ameliorate willingness for initiation. Potential points of intervention include mass media campaigns and school-based interventions to raise awareness of the physical and social impacts of methamphetamine, and structural interventions to create safer neighborhoods, provide opportunities for employment and recreation, and expand mental health services to improve emotional health and coping skills.

Boredom Prone or Nothing to Do? Distinguishing Between State and Trait Leisure Boredom and its Association with Substance Use in South African Adolescents

Reducing adolescent substance use is important in South Africa, a developing nation with increasing adolescent substance use, lack of leisure/recreation opportunities, and high rates of adolescent discretionary time. Previous research suggests leisure boredom and adolescent substance use co-occur in this setting. Using longitudinal data from 2,580 SA adolescents as they progressed from the 8^th to 11^th grade, the current study disentangles the associations of trait and state leisure boredom with substance use, and examines how ability to restructure boring situations moderates those associations. On average, individuals with higher trait boredom used more substances, and on occasions when state boredom was high, the prototypical adolescent used more substances. Although restructuring did not moderate these associations, greater ability was associated with lower substance use independent of leisure boredom. Findings illustrated the importance of considering how trait and state aspects of leisure may contribute to adolescents' risk behavior and addressed through preventive intervention.

The Dynamic Association between Healthy Leisure and Substance Use in South African Adolescents: A State and Trait Perspective

South Africa has an increasing adolescent substance use problem, lack of leisure opportunities and resources, and high adolescent discretionary time. How aspects of leisure relate to adolescent substance use is not well understood. Little research has been conducted on the leisure behaviors and experiences of South African adolescents, if and how those behaviors are associated with substance use, and ecological influences on those associations. By applying multi-level models to longitudinal data obtained from youth living in high-risk contexts, this research examines the association between state and trait healthy leisure and adolescent substance use and how perceived parental over-control moderates those associations. Results indicate healthy leisure protects against substance use at state and trait levels, provides empirical support that risk behavior can be addressed through leisure-based interventions, and emphasizes the importance of both short- and long-term processes when considering the context-dependent nature of adolescents' leisure experiences.

Was Bob Seger Right? Relation Between Boredom in Leisure and [Risky] Sex

This article examines the association between boredom in leisure and risky sexual behaviors among South African youth (N = 1695) using longitudinal data. We hypothesized that youth who were higher on boredom in leisure at the end of ninth grade would be more likely to report engaging in risky sexual behaviors at the beginning of tenth grade. Chi-square results indicate youth, especially male youth who experience high levels of leisure boredom in ninth grade, are more likely to engage in risky sexual behaviors in tenth grade. These findings have implications for prevention programs that aim to delay sexual initiation, reduce sexual risk behaviors, and decrease the transmission of HIV and AIDS. The findings support the need for additional research on how the reduction of leisure boredom may be a potential target for reducing sexual risk among youth.

Public commitment, resistance to advertising, and leisure promotion in a school-based drug abuse prevention program: a component dismantling study

The objective of the present study was to examine the contribution of three intervention components (public commitment, resistance to advertising, and leisure promotion) on alcohol and protective variables in a school-based substance use prevention program. Participants included 480 Spanish students aged from 14 to 16 who received the Saluda prevention program in one of the following five experimental conditions: complete program, program minus public commitment, program minus resistance to advertising, program minus leisure promotion, and a waiting-list control. The students completed self-report surveys at pretest, posttest, and 6-month follow-up assessments. When excluding the healthy leisure promotion component, the Saluda program showed no loss of efficacy neither on alcohol use nor on other substance-related variables, while public commitment and resistance to advertising improved the aforementioned program's efficacy.