Affective and personality risk and cognitive mediators of initial adolescent alcohol use

Multi-dimensional predictors of first drinking initiation and regular drinking onset in adolescence: A prospective longitudinal study

Early adolescent drinking onset is linked to myriad negative consequences. Using the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) baseline to year 8 data, this study (1) leveraged best subsets selection and Cox Proportional Hazards regressions to identify the most robust predictors of adolescent first and regular drinking onset, and (2) examined the clinical utility of drinking onset in forecasting later binge drinking and withdrawal effects. Baseline predictors included youth psychodevelopmental characteristics, cognition, brain structure, family, peer, and neighborhood domains. Participants (N=538) were alcohol-naïve at baseline. The strongest predictors of first and regular drinking onset were positive alcohol expectancies (Hazard Ratios [HRs]=1.67-1.87), easy home alcohol access (HRs=1.62-1.67), more parental solicitation (e.g., inquiring about activities; HRs=1.72-1.76), and less parental control and knowledge (HRs=.72-.73). Robust linear regressions showed earlier first and regular drinking onset predicted earlier transition into binge and regular binge drinking (βs=0.57-0.95). Zero-inflated Poisson regressions revealed that delayed first and regular drinking increased the likelihood (Incidence Rate Ratios [IRR]=1.62 and IRR=1.29, respectively) of never experiencing withdrawal. Findings identified behavioral and environmental factors predicting temporal paths to youthful drinking, dissociated first from regular drinking initiation, and revealed adverse sequelae of younger drinking initiation, supporting efforts to delay drinking onset.

Sensation Seeking and Adolescent Drinking: Do Protective Behavioral Strategies Lower Risk?

Using a cross-sectional design, we examined protective behavioral strategies (PBS) as a moderator of the relationship between sensation seeking and hazardous drinking and alcohol-related consequences among high school seniors (N = 212). Hierarchical regression analyses indicated sensation seeking was a significant predictor of binge drinking (β = .65, p < .001), pre-partying (β = .71, p < .001), gaming (β = .75, p < .001), and alcohol-related consequences (β = .69, p < .001). Further, PBS moderated these relationships such that among high sensation seeking adolescents, PBS use was associated with better outcomes, including lower levels of binge drinking (β = -.37, p < .01), pre-partying (β = -.44, p < .01), gaming (β = -.31, p < .05), and alcohol-related consequences (β = -.53, p < .001). We discuss counseling implications, including assessment and harm reduction strategies focusing on PBS to reduce hazardous drinking among high sensation seeking adolescents.

Facilitating Change in Drinking Cognitions and Behaviors Among Three Immigrant Generations of Latinx Youth Through a School-Based Intervention: Findings From a Multi-Site Clinical Trial

Latinx youth experience disparities in the availability of and participation in evidence-based interventions to reduce hazardous alcohol use. The aim of this secondary data analysis was to examine whether Project Options, a brief, evidence-based alcohol use intervention was beneficial for Latinx participants. A total of 331 first-, second-, and third-generation immigrant Latina and Latino youth who participated in a multi-site, hybrid effectiveness/efficacy clinical trial of the intervention were selected for analyses. Mixed-effects growth models tested changes in drinking cognitions (i.e., perception of peer drinking, intention to drink next month, alcohol use and cessation expectancies) and behaviors (i.e., number of past-month drinking days, average number of drinks per occasion, and maximum number of drinks per occasion) across three time points (i.e., baseline, 4-weeks, and 12-weeks). Consistent with prior Project Options studies, participants with more drinking experience reported greater decreases in perception of peer drinking, intentions to drink next month, and all drinking behaviors than those with less experience. While no changes were observed in expectancies, first-generation participants endorsed lower positive use expectancies than second- and third-generation youth as well as more favorable cessation expectancies than third-generation teens. In concert with prior studies demonstrating the intervention's success in recruitment and retention of Latinx participants, results suggest that Project Options might be a promising school-based intervention for Latinx youth. This intervention has the potential to reach adolescents who might otherwise not participate in traditional programming and help decrease disparities in availability of evidence-based practices for Latinx youth.

Alcohol Expectancies Moderate the Association Between School Connectedness and Alcohol Consumption

BACKGROUND

In this study, we investigate the moderated association of school connectedness and alcohol expectancies with adolescent drinking.

METHODS

Two large community samples were obtained with 2 repeated attempted censuses of all students attending a large suburban school district. Participants completed a self-administered questionnaire that assessed substance use, alcohol expectancies, and school connectedness. We used logistic regression analyses on the training sample and confirmed with Bayesian test intervals with the test sample.

RESULTS

Party related alcohol expectancies and school connectedness interacted in their explanatory association with recent drinking and binging, such that school connectedness had a protective association only for youth with lower positive expectancies. These findings were the result of pre-planned exploratory analysis, which were confirmed with out-of-sample test data.

CONCLUSIONS

The potential benefits for student health behaviors resulting from improved school connectedness may be dependent on at least one dimension of alcohol expectancies, at the individual level.

The protective effect of psychological suzhi on the relationship between school climate and alcohol use among Chinese adolescents

Background: There issome research on school climate impact on adolescent alcohol use in the Western social context; however, there is no research on school climate impact on adolescent alcohol use in China. This study aimed to explore the effect of school climate on Chinese adolescents' alcohol use, and the moderating role of psychological suzhi between them. Methods: A total of 801 adolescents (45.8% boys, 14.96±1.66 years) completed self-reports on school climate, psychological suzhi, and alcohol use. Results: Moderation analyses revealed that both school climate and psychological suzhi significantly negatively predicted adolescents' alcohol use, and the interaction of school climate and psychological suzhi significantly positively predicted adolescents' alcohol use. Moreover, the effect of school climate on adolescents' alcohol use was stronger for low psychological suzhi adolescents than high psychological suzhi adolescents. Conclusions: We can build good school climate by formulating of national level legal and regulations and good social norms, and use mature interventions or cultivation strategies to improve adolescents' psychological suzhi in order to better play its role in protection.

Longitudinal association between social anxiety disorder and incident alcohol use disorder: results from two national samples of US adults

This study assessed the association between subclinical social fears and a 12-month diagnosis of Social Anxiety Disorder (SAD) at baseline and the risk of incident Alcohol Use Disorder (AUD) at follow-up, compared to those without subclinical social fears and a 12-month diagnosis of SAD. We performed an individual participant meta-analysis based on data from two national longitudinal surveys. Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) was conducted in 2001-2002 in a sample of 43,093 adults and Wave 2 was conducted in 2004-2005 in 34,653 of the original respondents. Wave 1 of the National Comorbidity Survey was conducted in 1990-1992 in a sample of 8098 respondents and Wave 2 was conducted in 2001-2002 in 5001 of the original respondents. Binary logistic regression analyses were performed independently in each study and then the effect estimates were combined using random-effects meta-analysis. Neither subclinical social fears nor 12-month SAD at baseline were associated with incident AUD at follow-up. These findings conflict with reports of previous studies that a diagnosis of SAD is a risk factor for AUD in adults, and suggest that subclinical social fears are not associated with differential risk of incident AUD.

Perceptions of Alcohol Advertising Vary Based on Psychological Characteristics

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Reasons for Testing Mediation in the Absence of an Intervention Effect: A Research Imperative in Prevention and Intervention Research

OBJECTIVE

Mediation models are used in prevention and intervention research to assess the mechanisms by which interventions influence outcomes. However, researchers may not investigate mediators in the absence of intervention effects on the primary outcome variable. There is emerging evidence that in some situations, tests of mediated effects can be statistically significant when the total intervention effect is not statistically significant. In addition, there are important conceptual and practical reasons for investigating mediation when the intervention effect is nonsignificant.

METHOD

This article discusses the conditions under which mediation may be present when an intervention effect does not have a statistically significant effect and why mediation should always be considered important.

RESULTS

Mediation may be present in the following conditions: when the total and mediated effects are equal in value, when the mediated and direct effects have opposing signs, when mediated effects are equal across single and multiple-mediator models, and when specific mediated effects have opposing signs. Mediation should be conducted in every study because it provides the opportunity to test known and replicable mediators, to use mediators as an intervention manipulation check, and to address action and conceptual theory in intervention models.

CONCLUSIONS

Mediators are central to intervention programs, and mediators should be investigated for the valuable information they provide about the success or failure of interventions.

A GABRA2 polymorphism improves a model for prediction of drinking initiation

BACKGROUND

Survival analysis was used to explore the addition of a single nucleotide polymorphism (SNP) and covariates (sex, interview age, and ancestry) on a previously published model's ability to predict onset of drinking. A SNP variant of rs279871, in the chromosome 4 gene encoding gamma-aminobutyric acid receptor (GABRA2), was selected due to its associations with alcoholism in young adults and with behaviors that increased risk for early drinking.

METHODS

A subsample of 674 adolescents (ages 14-17) participating in the Collaborative Study on the Genetics of Alcoholism (COGA) was examined using a previously derived Cox proportional hazards model containing: 1) number of non-drinking related conduct disorder (CD) symptoms, 2) membership in a high-risk alcohol-dependent (AD) family, 3) most best friends drank (MBFD), 4) Achenbach Youth Self Report (YSR) externalizing score, and 5) YSR social problems score. The above covariates along with the SNP variant of GABRA2, rs279871, were added to this model. Five new prototype models were examined. The most parsimonious model was chosen based on likelihood ratio tests and model fit statistics.

RESULTS

The final model contained four of the five original predictors (YSR social problems score was no longer significant and hence dropped from subsequent models), the three covariates, and a recessive GABRA2 rs279871 TT genotype (two copies of the high-risk allele containing thymine). The model indicated that adolescents with the high-risk TT genotype were more likely to begin drinking than those without this genotype.

CONCLUSIONS

The joint effect of the gene (rs279871 TT genotype) and environment (MBFD) on adolescent alcohol initiation is additive, but not interactive, after controlling for behavior problems (CD and YSR externalizing score). This suggests that the impact of the high-risk TT genotype on the onset of drinking is affected by controlling for peer drinking and does not include genotype-by-environment interactions.

Risk Factors for Substance Misuse and Adolescents' Symptoms of Depression

PURPOSE

Depressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse.

METHODS

The study used data from a place-randomized trial of the Promoting School-Community-University Partnerships to Enhance Resilience model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey, and social network data from 636 adolescents followed from sixth through ninth grades.

RESULTS

When adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts.

CONCLUSIONS

The Promoting School-Community-University Partnerships to Enhance Resilience interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse.

Impulsive sensation seeking, binge drinking, and alcohol-related consequences: Do protective behavioral strategies help high risk adolescents?

This study examined protective behavioral strategies (PBS) as a moderator of the relationship between impulsive sensation seeking and binge drinking and alcohol-related consequences in a sample of high school seniors (N=346). Hierarchical regression analyses indicated that impulsive sensation seeking was a significant predictor of binge drinking and alcohol-related consequences and that PBS moderated these relationships. Specifically, manner of drinking moderated the relationships such that among students with high impulsive sensation seeking, those using strategies related to how they drink (e.g. avoiding rapid and excessive drinking) reported lower levels of binge drinking and alcohol-related consequences than those using fewer of these strategies. Clinical implications are discussed including using personality-targeted interventions that equip high impulsive sensation seeking adolescents with specific strategies to reduce binge drinking and alcohol-related consequences.

Early onset mood disorders and first alcohol use in the general population

BACKGROUND

Mood disorders and alcohol use are common in the general population and often occur together. This study explored how early onset mood disorders relate to age of first alcohol use in the Australian general population.

METHODS

Discrete time survival analysis modelled the odds of first alcohol use among those with, versus without, an early onset DSM-IV mood disorders (major depression, dysthymia or bipolar disorder). Data came from the 2007 Australian National Survey of Mental Health and Wellbeing (N=8841).

RESULTS

Early onset mood disorders as an overall class were not significantly related to the odds of first alcohol use in any given year. On examining the different types of mood disorders individually early onset bipolar disorder was a significant predictor of first alcohol use. The analysis then looked at interactions with time and found that after the age of 14 years the presence of an early onset mood disorder significantly increased the odds of first alcohol use by 32%.

LIMITATIONS

Retrospective recall was used to determine age of onset data which is subject to known biases and replication is recommended in some subgroup analysis due to smaller sample sizes.

CONCLUSIONS

Mood disorders, particularly bipolar disorder, act as unique risk factors for first alcohol use in the general population and show significant interactions with developmental timing. The findings point to the potential utility of prevention programs that target alcohol use and mood disorders together from early adolescence.

Marijuana use/cessation expectancies and marijuana use in college students

BACKGROUND

Research suggests that marijuana expectancies are associated with problematic marijuana use; however, these marijuana-related cognitions remain relatively understudied.

OBJECTIVE

This study examined marijuana-related decision-making among college students by exploring the relationships among marijuana expectancies and marijuana use variables.

METHOD

College students (N = 357) endorsing lifetime marijuana use completed an online survey on marijuana use expectancies, marijuana cessation expectancies, marijuana use, and future marijuana use intentions. A simple regression framework was used to test the effect of each type of expectancies on marijuana outcome; a hierarchical regression framework tested the unique predictive validity when both types were entered into the same model.

RESULTS

Both marijuana use expectancies and marijuana cessation expectancies independently predicted a number of marijuana use variables. Additionally, marijuana use expectancies and marijuana cessation expectancies contributed significant unique variance to the prediction of marijuana use.

CONCLUSIONS

It is important to consider both use expectancies and cessation expectancies, as these two domains of marijuana-related cognitions appear to act independently, rather than as opposite ends of the same construct. Longitudinal studies are needed to further examine how these factors interact to influence marijuana use and problems over time.

Gender Differences in the Effect of Depressive Symptoms on Prospective Alcohol Expectancies, Coping Motives, and Alcohol Outcomes in the First Year of College

Problematic alcohol use and risk for dependence peak during late adolescence, particularly among first-year college students. Although students matriculating into college with depressive symptoms experience elevated risk for alcohol problems, few studies have examined the intervening mechanisms of risk. In this study, we examined depressed mood at college entry on prospective alcohol expectancies, drinking motives, and alcohol outcomes during the first year of college, adjusting for pre-college factors. Participants (N = 614; 59% female, 33% non-White) were incoming college students from three universities who completed online self-report surveys prior to matriculating into college and at the end of their first year in college. We utilized path analysis to test our hypotheses. In women, the path that linked depressive symptoms to consequences was primarily attributable to the effect of pre-college drinking to cope on drinking to cope in college, which in turn was associated with alcohol consequences. In men, the effect of depressive symptoms on alcohol consequences in college was independent of pre-college and college factors, thus indicating the need for research that identifies mechanisms of risk in males. Interventions that address coping deficits and motivations for drinking may be particularly beneficial for depressed adolescent females during this high-risk developmental period.

The Developmental Relationship Between Depressive Symptoms in Adolescence and Harmful Drinking in Emerging Adulthood: The Role of Peers and Parents

Depressive symptoms have been linked to the development of harmful drinking in adolescence but it remains unclear to what extent this effect continues into emerging adulthood. Deviant peers represent a risk factor while parental monitoring is a protective factor for harmful drinking. The study explored the relationship between depressive symptoms and harmful drinking between early adolescence and emerging adulthood. We also assessed to what extent this relationship is mediated by the influence of deviant peers and whether parental monitoring weakens this process. The sample consisted of 2964 adolescents (64 % females) from the Avon Longitudinal Study of Parents and Children study assessed between the ages of 14 and 19. Using structural equation modelling, we found that affiliation with deviant peers mediated the association between depressive symptoms and harmful drinking after adjustment for socio-demographic variables, parental drinking and depression, teenager's sex, conduct problems as well as drinking and depressive symptoms in early adolescence. We also found that parental control and solicitation reduced the influence of deviant peers on harmful drinking. The results indicate that prevention programs should offer adolescents training for peer resistance training and monitoring skills training for parents may have a long-term effect at weakening peer influences on harmful drinking.

Prevalence and correlates of sipping alcohol in a prospective middle school sample

Research documents an association between early use of alcohol and adverse outcomes. Most studies on drinking initiation exclude sipping or confound sips with consumption of a full drink. However, even a few sips of alcohol can constitute a meaningful experience for naïve drinkers. Prior research with this project indicated that sipping before middle school predicted subsequent adverse outcomes (at high-school entry), even controlling for child externalizing and sensation seeking and parent alcohol use. The present study extends our prior work by examining the correlates of early sipping and sipping onset. The sample was comprised of 1,023 6th, 7th, and 8th graders (52% female; 24% non-White, and 12% Hispanic). Participants completed Web-based surveys on 5 occasions over the course of 2 years. The prevalence of sipping at Wave 1 was 37%, with 29% of never-sippers initiating sipping within 2 years. Sipping was associated with stronger alcohol-related cognitions and low school engagement as well as contextual influences in the peer, sibling, and parent domains. Sipping onset among never-sippers was prospectively predicted by sensation seeking and problem behavior as well as parental and sibling influences. More important, mere availability of alcohol was a strong correlate both concurrently and prospectively. Further analyses demonstrated that youth who sipped alcohol with parental permission had a lower profile of risk and healthier relationships with parents as compared with youth who reported unsanctioned sipping. Findings point to the importance of considering fine-grained early drinking behavior and call for further attention to sipping in research on initiation of alcohol use.

The mediating role of deviant peers on the link between depressed mood and harmful drinking

PURPOSE

One's peer group can have a strong impact on depressed mood and harmful drinking in adolescence. It remains unclear whether affiliation with deviant peers explains the link between these traits. Our study aims to (1) explore the developmental relationship between harmful drinking and depressed mood in adolescence and (2) establish to which extent affiliation with deviant peers explains this relationship.

METHODS

A total of 4,863 adolescents from the Avon Longitudinal Study of Parents and Children were assessed between the ages of 14 and 16 years. Harmful drinking was established using age-appropriate measures: the Semi-Structured Assessment for the Genetics of Alcoholism in mid-adolescence (age, 14 years) and the Alcohol Use Disorders Identification Test in late adolescence (age, 16 years). Depressed mood was measured by the Short Mood and Feelings Questionnaire at both ages. Affiliation with deviant peers was assessed at the age of 15 years.

RESULTS

Harmful drinking at the age of 14 years predicted depressed mood 2 years later. This association was explained by affiliation with deviant peers and remained present even after adjustment for earlier depressed mood. Depressed mood at the age of 14 years predicted harmful drinking at the age of 16 years via affiliation with deviant peers; however, this indirect effect disappeared when adjusting for adolescents' earlier harmful alcohol use (age, 14 years). No gender differences were observed.

CONCLUSIONS

Adolescents who engage in early harmful drinking and subsequently become affiliated with a deviant peer group may be at particular risk of later depressed mood.

A test of the efficacy of a brief, web-based personalized feedback intervention to reduce drinking among 9th grade students

Alcohol use increases substantially during the transition from middle school to high school. This study tested a brief, web-based personalized feedback program aimed at reducing risk factors for drinking, alcohol use, and alcohol-related consequences among 9th grade students. At a 3-month follow-up, students in the intervention group showed positive results relative to those in the control group on variables associated with reduced risk, including positive alcohol expectancies and positive beliefs about alcohol. Students in the intervention group also reported a reduction in drinking frequency and alcohol-related consequences relative to those in the control group. There were, however, no differences in normative beliefs regarding peer drinking or quantity of weekly drinking between the two groups. Results indicate that a brief, web-based personalized normative feedback program delivered in the school setting is a promising approach to reducing alcohol use and the associated consequences among 9th grade students.

Risky cognitions associated with adolescent alcohol misuse: moral disengagement, alcohol expectancies and perceived self-regulatory efficacy

AIM

To examine the longitudinal associations between moral disengagement, alcohol related expectancies, perceived self-regulatory efficacy and alcohol use amongst adolescents.

DESIGN AND PARTICIPANTS

A total of 367 students (mean age=13.1, SD=0.51; 65% male) from five schools across Sydney, Australia took part in this longitudinal study. Participants completed a self-report questionnaire at four time points across an 18 month period which assessed their alcohol use, levels of moral disengagement, alcohol related expectancies and perceived self-regulatory efficacy to resist peer pressure to engage in transgressive behaviours.

RESULTS

Over time, rates of binge drinking in the past three months significantly increased, but rates of drinking any alcohol in the past three months remained stable. As hypothesised, all three cognitions were independently and consistently associated with adolescent alcohol use and binge drinking over time, with the exception of perceived self-regulatory efficacy which was not associated with an increased risk of drinking any alcohol in the past three months when controlling for moral disengagement, alcohol expectancies, gender and age.

CONCLUSIONS

The current study is the first study to longitudinally map three distinct cognitive factors associated with adolescent alcohol use. Considering the alarming number of adolescents drinking at levels that place them at risk of significant harm, this study has provided important implications about cognitive factors that can be targeted to increase the accuracy of assessment and efficacy of prevention for alcohol misuse amongst adolescents.

Puberty and adolescence as a time of vulnerability to stressors that alter neurobehavioral processes

Puberty and adolescence are major life transitions during which an individual's physiology and behavior changes from that of a juvenile to that of an adult. Here we review studies documenting the effects of stressors during pubertal and adolescent development on the adult brain and behavior. The experience of complex or compound stressors during puberty/adolescence generally increases stress reactivity, increases anxiety and depression, and decreases cognitive performance in adulthood. These behavioral changes correlate with decreased hippocampal volumes and alterations in neural plasticity. Moreover, stressful experiences during puberty disrupt behavioral responses to gonadal hormones both in sexual performance and on cognition and emotionality. These behavioral changes correlate with altered estrogen receptor densities in some estrogen-concentrating brain areas, suggesting a remodeling of the brain's response to hormones. A hypothesis is presented that activation of the immune system results in chronic neuroinflammation that may mediate the alterations of hormone-modulated behaviors in adulthood.

The impact of adolescent binge drinking and sustained abstinence on affective state

BACKGROUND

While it is clear that affect is negatively impacted by heavy drinking in adulthood and that it improves with abstinence, little is known about effects of heavy drinking on mood during adolescence.

METHODS

This study examined negative mood states among 2 groups of 16- to 18-year-old high school students; youth with a history of recent heavy episodic drinking (HED; n = 39) and comparison youth with limited lifetime drinking experience (CON; n = 26). Affect was assessed at 3 time points during a 4- to 6-week period of monitored abstinence using the Hamilton Rating Scales for Anxiety and Depression; self-reports were obtained with the state portion of the State-Trait Anxiety Inventory, and experience sampling of current affect was assessed via daily text messages sent at randomly determined times in the morning, afternoon, and evening.

RESULTS

Youth with a recent history of HED reported more negative affect compared with nondrinking youth during early stages of abstinence (days since last HED at assessment 1: M = 6.46; SD = 5.06); however, differences in affect were not observed after 4 to 6 weeks of abstinence. Sex differences were evident, with HED girls reporting greater depression and anxiety than HED male peers. Although not significant, response patterns indicated that boys may experience faster resolution of negative emotional states than girls with sustained abstinence.

CONCLUSIONS

Findings suggest that high-dose drinking is associated with elevated negative affect for adolescents and that negative mood states may take longer to resolve for girls than for boys following heavy drinking episodes. Future research clarifying naturally occurring changes in affective response during early and sustained abstinence is necessary for improving programs designed to promote adolescent decision-making and to reduce risk for relapse.

A model to determine the likely age of an adolescent's first drink of alcohol

OBJECTIVE

With the use of a new cohort of adolescent subjects, predictors from the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) interview and the Achenbach Youth Self Report (YSR) were combined to model age of first drink (AFD).

METHODS

Subjects consisted of 820 adolescents (ages 14-17) drawn from the current phase of the Collaborative Study on the Genetics of Alcoholism. Three Cox proportional hazards models were considered. Model 1 contained SSAGA variables equivalent to AFD predictors from our previous study: interview age, family history of alcohol dependence, and number of conduct disorder symptoms. Model 2 incorporated 2 additional SSAGA questions (best friends drink and smoked a cigarette before a reported AFD) plus 8 YSR-derived scale scores. Model 3 was a reduced version of model 2, retaining only significant predictors.

RESULTS

Model 2 was a significant improvement over model 1. Model 3 was the best and the most parsimonious of the 3 with respect to likelihood ratio and Wald χ(2) tests and retained only 5 variables from model 2. Included variables were the following: (1) best friends drink, (2) membership in a high-risk alcohol dependence family, (3) number of conduct disorder symptoms, (4) YSR externalizing score, and (5) YSR social problems score.

CONCLUSIONS

Adding variables to those from our original study improved our ability to model the likely age of alcohol initiation. In addition to the SSAGA, the YSR appears to have utility as a research tool to predict the age of alcohol initiation.

Sensation seeking as risk factor for suicidal ideation and suicide attempts in adolescence

BACKGROUND

High sensation seeking in adolescence is associated with engagement in risk-taking behaviors, especially substance use. Although depressed adolescents are prone to increased risk-taking, and suicidal behavior can be considered within the spectrum of risk-taking behaviors, the relationships between sensation seeking, depression, and suicidal behavior have not been explored.

METHODS

A self-report questionnaire assessing sensation seeking, depression, substance use problems, and suicidal ideation and suicide attempts was completed by 9th- through 12th-grade students (n=2189) in six New York State high-schools from 2002 through 2004. Logistic regression analyses were conducted to examine main and interaction effects between sensation seeking and the four clinical variables.

RESULTS

High sensation seeking was positively associated with depressive symptoms and substance use problems. The main effects of sensation seeking on suicidal ideation and suicide attempts remained significant after controlling for depression and substance use. The association between sensation seeking and suicide attempts was moderated by substance use problems.

LIMITATIONS

The schools were suburban and predominantly white, limiting the generalizability of the results. Other mental disorders with potential implications for sensation seeking and for suicidal behavior, such as bipolar disorders, were not assessed.

CONCLUSIONS

The finding that sensation seeking makes an independent contribution to the risk of suicidal ideation and attempts is consistent with findings in literature on novelty seeking and impulsivity. The associations between sensation seeking, depressive symptoms and suicidal behavior may be compatible with the presence of an underlying temperamental dysregulation. Screening for sensation seeking may contribute to the reduction of adolescent suicide risk.

I (should) need a cigarette: adolescent social anxiety and cigarette smoking

BACKGROUND

Approximately half of high school students in the USA have used tobacco. Social anxiety can put adolescents at increased risk for smoking.

PURPOSE

This study aims to determine whether adolescents high in trait social anxiety report more cigarette use and greater urge to smoke before, during, and after friend interactions than do teens low in trait social anxiety.

METHODS

Four hundred two students who reported smoking more than once during high school were assessed approximately every 30 min during up to 84-day monitoring sessions.

RESULTS

Controlling for momentary anxiety, high socially anxious teens were equally or less likely to smoke, but more likely to report urge to smoke, surrounding friend interactions than low socially anxious teens.

CONCLUSIONS

Although high socially anxious adolescents do not smoke more than low socially anxious peers, they may believe that they should need a cigarette in anxiety-provoking situations. Such urges may later develop into smoking behaviors.

The theory of planned behavior: precursors of marijuana use in early adolescence?

BACKGROUND

Precursors of marijuana use in early adolescence are largely unknown because studies generally focus on marijuana use among older adolescents or adults.

METHODS

In this study, we examined precursors of marijuana use in a sample of 1023 Dutch early adolescents (aged 11-14 at Time 1) who were never-marijuana user at baseline, by applying a 3-wave longitudinal design. The theory of planned behavior (TPB) was used as a theoretical framework and posits that marijuana-specific cognitions (i.e., positive and negative expectancies, evaluative attitude, social approval, and self-efficacy) are antecedents of marijuana use and that this relationship is mediated by the intention to start using marijuana.

RESULTS

In accordance with these premises, our results indicated that evaluative attitude, social approval, and self-efficacy at Time 1 are related to marijuana use at Time 3 (20 months follow-up) via the intention to start using marijuana at Time 2 (8 months follow-up). More specifically, the structural equation models showed that more positive marijuana attitudes, more approval from the social environment, and lower self-efficacy were related to marijuana use initiation through a stronger intention to start using marijuana.

CONCLUSION

This outcome is important for prevention efforts in that our results underline the importance of weakening adolescents' positive attitudes toward marijuana, decrease social approval of marijuana use, and stimulating the development of early adolescents' refusal skills with respect to marijuana use.

Self-medication or social learning? A comparison of models to predict early adolescent drinking

The current study examined the effects of social anxiety, depressive symptoms, and alcohol expectancies of social behavior change on alcohol involvement to determine whether the self-medication and/or social learning models predicted drinking behavior in a sample of over 400 eighth grade students. Middle school students completed confidential surveys that assessed current alcohol use and expectancies as well as negative affectivity including social anxiety and depressive symptoms. Consistent with the self-medication hypothesis, depressive symptoms predicted more frequent and heavier alcohol use as well as solitary drinking. The social learning model was supported by a negative association between social anxiety and quantity/frequency of drinking and less drinking at parties, and a positive association between alcohol expectancies and all drinking outcomes. Additionally, social anxiety moderated the association between expectancies and alcohol use. These findings suggest that self-medication and social learning processes may both play a role in predicting early adolescent alcohol use and the contexts in which youths drink.

Thinking and drinking: alcohol-related cognitions across stages of adolescent alcohol involvement

Alcohol-related cognitions, particularly expectancies for drinking and nondrinking and motives for nondrinking, are involved in the initiation, maintenance, and cessation of alcohol use and are hypothesized to play key roles in adolescent decision making. This study explored (a) the relationships between alcohol use expectancies, nondrinking expectancies, and nondrinking motives; (b) the roles of these cognitions across hypothesized developmental stages of adolescent alcohol use; and (c) the relationships between these cognitions and recent or intended future changes in drinking behavior in a cross-sectional sample. Surveys assessing alcohol use behaviors and attitudes were administered to 1,648 high school students. Heavier drinkers reported more positive alcohol use expectancies and fewer nondrinking motives than did lighter drinkers or nondrinkers; however, nondrinking expectancies only differed between nondrinkers and rare drinkers and all subsequent drinking classes. Alcohol use expectancies, nondrinking expectancies, and nondrinking motives differentiated students who recently initiated alcohol from those who had not, while nondrinking expectancies and nondrinking motives differentiated binge-drinking students who had made recent efforts to reduce/stop their drinking from those who had not. Intentions to initiate or reduce drinking in the coming month were also associated with these alcohol-related cognitions. Drinking and nondrinking expectancies and motives for not drinking may play critical roles in decisions to alter alcohol-use behavior during adolescence. Future exploration of temporal relationships between changes in alcohol-related cognitions and behavioral decision making will be useful in the refinement of effective prevention and intervention strategies.

To drink or not to drink: motives and expectancies for use and nonuse in adolescence

Drinking motives have a prominent role in cognitive models of adolescent and adult alcohol decision-making (Cooper, Russell, Skinner, & Windle, 1992; Cooper, 1994). The complementary construct of motivation not to drink has received less attention (Epler, Sher & Piasecki, 2009). We examined how abstinence motives interacted with drinking motives and alcohol expectancies to predict alcohol consumption in samples of US high school students (N>2500). Nondrinking motives predicted lower rates of lifetime and current alcohol use. Motives not to drink interacted with specific drinking motives, like social and coping motives, and alcohol expectancies to predict certain aspects of drinking behavior. For example, motives not to drink had the greatest impact on youth with weaker social motivations. Findings highlight the distinction between motives not to drink and other alcohol-related cognitions in predicting adolescent alcohol consumption. This work not only supports the utility of this construct in developing models of youth alcohol-related decision-making but also has implications for prevention programming.

A Mixture IRT Analysis of Risky Youth Behavior

The study reported in this manuscript used a mixture item response model with data from the Youth Risk Behavior Survey 2009 (N = 16,410) to identify subtypes of adolescents at-risk for engaging in unhealthy behaviors, and to find individual survey items that were most effective at identifying such students within each subtype. The goal of the manuscript is twofold: (1) To demonstrate the utility of the mixture item response theory model for identifying subgroups in the population and for highlighting the use of group specific item response parameters and (2) To identify typologies of adolescents based on their propensity for engaging in sexually and substance use risky behaviors. Results indicate that four classes of youth exist in the population, with differences in risky sexual behaviors and substance use. The first group had a greater propensity to engage in risky sexual behavior, while group 2 was more likely to smoke tobacco and drink alcohol. Group 3 was the most likely to use other substances, such as marijuana, methamphetamine, and other mind altering drugs, and group 4 had the lowest propensity for engaging in any of the sexual or substance use behaviors included in the survey. Finally, individual items were identified for each group that can be most effective at identifying individuals at greatest risk. Further proposed directions of research and the contribution of this analysis to the existing literature are discussed.