Sports participation moderates the risk of family-specific negative life events on alcohol use among adolescents: Evidence from the longitudinal MyLife study

Negative life events (NLE) have been associated with increased alcohol use (AU) during adolescence. However, whether this risk association may be modified by leisure activities such as sports participation (SP) remains poorly understood. This study examined whether accumulated family-specific NLE in particular were associated with greater AU, and if so, whether SP moderated this association to reduce AU among high-NLE adolescents. We examined five annual assessments from a nationwide cohort of 3,422 Norwegian adolescents (13-15 year-olds; 55.3 % girls at baseline) who participated in the MyLife study. At each assessment, adolescents reported their AU on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C), the number of family-specific NLE in the past 12 months, SP days in the past 30 days, and multiple sociodemographic and individual-level characteristics (covariates). Changes over time in AU as a function of NLE, SP, and their interaction (NLExSP) were examined with a set of partially nested growth curve models. AU increased non-linearly over time in all models. The fully adjusted best-fitting model showed significant NLExSP interactions (estimate = -0.013, 95% CI [-0.02, -0.006]), such that the initial AUDIT-C scores were lower for high-NLE adolescents with high SP and greater for high-NLE adolescents with low SP. Further, linear increases in AU over time were marginally steeper for high-NLE adolescents with high SP (NLExSPxTime estimate = 0.034, 95% CI [-0.0002, 0.007]). Thus, SP appeared to have a protective role in reducing AU for high-NLE youth primarily during middle school years. Prevention efforts thus may utilize organized sports for youth facing family-specific NLE as a resource early on.

Examining within-person associations between alcohol and cannabis use and hooking up among adolescents and young adults in the United States

OBJECTIVE

This study examined daily associations between alcohol use, cannabis use, and simultaneous alcohol and cannabis/marijuana (SAM) use with the likelihood of hooking up (uncommitted sexual encounter that may or may not include intercourse).

METHOD

We used a longitudinal measurement burst ecological momentary assessment (EMA) design with 3-week EMA bursts with daily measurements repeated quarterly across 12 months. 1,009 (57 % female, Mean age = 20.00 [SD = 3.21]) Texan adolescents and young adults ages 15-25 participated in the study. Mixed effects logistic regression models were estimated using maximum likelihood estimation to evaluate the associations between substance use and hooking up.

RESULTS

Within-person results indicated that participants were more likely to hook up on days with alcohol use and on days with cannabis use, but not on days with SAM use. Participants were also more likely to hook up on drinking days with higher-than-usual alcohol use. Between-person results indicated that participants who used alcohol more often or cannabis more often on average were more likely to hook up, and participants who tended to drink more on drinking days were more likely to hook up.

CONCLUSIONS

Given the significant daily-level associations between alcohol and cannabis use and hooking up behavior, public health initiatives should focus on developing interventions to reduce alcohol and cannabis use and promote safer hooking up behavior among adolescents and young adults.

The role of psychosocial factors and biological sex on rural Thai adolescents' drinking intention and behaviours: A structural equation model

AIMS

To examine the contributions of psychosocial factors (attitude towards drinking, perceived drinking norms [PDNs], perceived behavioural control [PBC]), and biological sex on drinking intention and behaviours among rural Thai adolescents.

DESIGN

A cross-sectional study design.

METHODS

In 2022, stratified by sex and grade, we randomly selected 474 rural Thai adolescents (Mage  = 14.5 years; SD = 0.92; 50.6% male) from eight public district schools in Chiang Mai Province, Thailand, to complete a self-administered questionnaire. Structural equation modelling with the weighted least square mean and variance adjusted was used for data analysis.

RESULTS

All adolescents' psychosocial factors contributed significantly to the prediction of drinking intention, which subsequently influenced their drinking onset, current drinking and binge drinking pattern in the past 30 days. PDNs emerged as the strongest psychosocial predictor of drinking intention, followed by PBC. Rural adolescents' drinking intention significantly mediated the relationship between all psychosocial factors and drinking behaviours either fully or partially. The path coefficient between drinking attitude and drinking intention was significantly different between males and females.

CONCLUSION

Different from previous studies focus on adolescents' drinking attitude, rural Thai adolescents' PDNs play a significant role on their drinking intention and subsequently their drinking onset and patterns. This nuanced understanding supports a paradigm shift to target adolescents' perceived drinking norms as a means to delay their drinking onset and problematic drinking behaviours.

IMPACT

Higher levels of perceived drinking norms significantly led to the increase in drinking intention among adolescents. Minimizing adolescents' perceptions of favourable drinking norms and promoting their capacity to resist drinking, especially due to peer pressure, are recommended for nursing roles as essential components of health education campaigns and future efforts to prevent underage drinking.

PATIENT OR PUBLIC CONTRIBUTION

In this study, there was no public or patient involvement.

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

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

Parental monitoring, family conflict, and adolescent alcohol use: A longitudinal latent class analysis

This study examined relationships among parental monitoring, family conflict, and subgroups of adolescent alcohol use identified through longitudinal latent class analyses (LLCA). Differences in these subgroups across sex and race/ethnicity were also examined. The present study used data (N = 4,067; 51% male, 49% female) collected during a longitudinal study in which adolescents completed questionnaires each semester for seven semesters, beginning in spring of their freshman year of high school until spring of their senior year. LLCA demonstrated three classes of drinking over time (low, increasing, and moderate use). The majority of adolescents were increasing-use drinkers. Moderate drinkers were more likely to be male than female; nondrinkers were most likely to be African American; and increasing-use drinkers were more likely to be Mexican American. Adolescents who received less maternal monitoring and experienced more family conflict were more likely to be identified in the class of moderate alcohol use compared to nonuse. These results highlight the importance of encouraging parental monitoring and decreasing family conflict to reduce the likelihood of adolescent alcohol use throughout the high school years (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Predictors of Sexual Intimate Partner Violence Perpetration Among Men: A Prospective Analysis

Research demonstrates that both peer socialization and underage drinking play a significant role in teen dating violence. However, less is known about the lasting effects of these risk factors on boys' ability to form healthy romantic relationships as they get older. The present study examined whether boys who perceived their peers would respect them more for having sex and those who engaged in past year heavy alcohol use would be more likely to perpetrate sexual intimate partner violence (IPV) in young adulthood compared to boys who did not endorse perceived peer approval for sex or report past year heavy drinking. Analyses were conducted using a sample of boys (n = 1,189) from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health (Add Health). A logistic regression was conducted to assess the relationship between perceived peer approval to have sex and heavy alcohol use at Wave I and sexual IPV at Wave III, after adjusting for demographic factors and other correlates of sexual IPV at Wave I, including age, race/ethnicity, sexual initiation in adolescence, parental attachment, annual family income, and neighborhood poverty. Boys who believed they would gain peer respect by having sex and boys who reported getting drunk in the last 12 months, regardless of how often, were significantly more likely to report sexual IPV in young adulthood compared to boys who did not endorse either of these factors. Targeting boys' perceived peer norms regarding sexual activity and heavy alcohol use may therefore be especially important for preventing sexual IPV later in life.

Risk-taking behaviors in adolescent men who have sex with men (MSM): An association between homophobic victimization and alcohol consumption

Objective

The aim of this study was to determine whether homophobic victimization was associated with alcohol consumption and riding with an intoxicated driver or driving a car while under the influence of alcohol or drugs among adolescent men who have sex with men (MSM).

Methods

Cross-sectional analysis used baseline data from a national HIV prevention trial (NCT03167606) for adolescent MSM aged 13–18 years (N = 747). Multivariable logistic regression models assessed associations between homophobic victimization (independent variable) and alcohol-related outcomes (dependent variables), controlling for age, parents’ education level, sexual orientation, health literacy, race, and ethnicity.

Results

Most participants (87%) reported at least one form of homophobic victimization in their lifetime, with verbal insults being the most frequently reported (82%). In the bivariate analysis, alcohol consumption and riding with an intoxicated driver or driving a car while under the influence were associated with many forms of victimization. Exposure to at least one form of victimization was associated with increased odds of alcohol consumption (OR: 2.31; 95% CI: 1.38–3.87) and riding with an intoxicated driver or driving a car while under the influence (OR: 2.25; 95% CI: 1.26–4.00), after controlling for covariates.

Conclusion

Increased risk of alcohol consumption and risky alcohol-related behaviors were found among adolescent MSM who experienced homophobic victimization. Interventions should address homophobic victimization and its impact on adolescent MSM, as well as disentangling motivations for underage drinking, riding with an intoxicated driver or driving a car while under the influence.

Lifetime Alcohol Use Influences the Association Between Future-Oriented Thought and White Matter Microstructure in Adolescents

AIMS

Future orientation, or the ability to plan ahead and anticipate consequences, is a capacity that develops during adolescence, yet its underlying neurobiology is unknown. Previous independent reports suggest that reduced future orientation and altered white matter microstructure are associated with greater alcohol use in adolescents; however, these effects have not been studied in conjunction. This study investigated the association between future orientation and white matter microstructure as a function of lifetime alcohol use.

METHODS

Seventy-seven adolescents (46 female; 15-21 years of age) underwent diffusion weighted imaging (DWI) and completed a fifteen-item Future Orientation Questionnaire. Regression analyses assessed the association between self-reported lifetime alcohol use and future orientation, and the association between future orientation and white matter microstructure, as a function of lifetime alcohol use.

RESULTS

Adolescents with more lifetime alcohol use demonstrated lower future orientation. Voxel-wise DWI analyses revealed two regions, bilateral posterior corona radiata (PCR), where greater future orientation was associated with lower mean diffusivity in those with little or no history of alcohol use; however, this association was diminished with increasing rates of lifetime alcohol use.

CONCLUSIONS

These findings replicate reports of reduced future orientation as a function of greater lifetime alcohol use and demonstrate an association between future orientation and white matter microstructure, in the PCR, a region containing afferent and efferent fibers connecting the cortex to the brain stem, which depends upon lifetime alcohol use. These findings provide novel information regarding the underlying neurobiology of future-oriented thought and how it relates to alcohol use.

Peer influence in adolescent drinking behavior: A meta-analysis of stochastic actor-based modeling studies

Objectives

To measure the effects of peer influence and peer selection on drinking behavior in adolescence through a rigorous statistical approach designed to unravel these interrelated processes.

Methods

We conducted systematic searches of electronic databases, thesis collections and conference proceedings to identify studies that used longitudinal network design and stochastic actor-oriented modeling to analyze drinking behavior in adolescents. Parameter estimates collected from individual studies were analyzed using multilevel random-effects models.

Results

We identified 26 articles eligible for meta-analysis. Meta-analyses for different specifications of the peer influence effect were conducted separately. The peer influence effect was positive for every specification: for average similarity (avSim) mean log odds ratio was 1.27 with 95% confidence interval [0.04; 2.49]; for total similarity (totSim) 0.46 (95% CI = [0.44; 0.48]), and for average alter (avAlt) 0.70 (95% CI = [-0.01; 1.41]). The peer selection effect (simX) was also positive: 0.46 (95% CI = [0.28; 0.63]). Conversion log odds ratio values to Cohen’s d gives estimates from 0.25 to 0.70, which is considered as medium to large effect.

Conclusions

Advances in methodology for social network analysis have made it possible to accurately estimate peer influence effects free from peer selection effects. More research is necessary to clarify the roles of age, gender, and individual susceptibility on the changing behavior of adolescents under the influence of their peers. Understanding the effects of peer influence should inform practitioners and policy makers to design and deliver more effective prevention programs.

Prospective Association of Digital Media Use with Alcohol Use Initiation and Progression Among Adolescents

BACKGROUND

Although adolescents commonly use digital media and consume alcohol , longitudinal evidence of the association between these behaviors is scant. This study examined the association between the frequency of digital media use and the subsequent initiation or progression of alcohol use. We also examined whether these associations were moderated by gender and race/ethnicity.

METHODS

The study included 2,473 adolescents from a prospective cohort in the Los Angeles, CA area who were surveyed in fall 2015 (11th grade, baseline for the current study) and every 6 months through the end of high school (Spring 2017, 12th grade). At baseline, youth self-reported the total number of 14 digital media activities (e.g., checking social media, streaming music/videos, texting) they engaged in at a high frequency (i.e., many times a day) over the past week. Scores ranged from 0 (i.e., no reported high-frequency digital media use) to 14 (i.e., reported engagement in all 14 digital media activities at a high frequency). Self-report measures of ever using alcohol, number of days of alcohol use in the past 30 days (0 to 30), binge drinking (yes/no), and covariates (i.e., demographics and measures of behavioral health and other substance use) were assessed at each time point.

RESULTS

Among respondents who at baseline reported never using alcohol (n = 1,214), high-frequency engagement in each additional digital media activity was associated with 4% higher odds of initiating alcohol use (aOR = 1.04, 95% CI: 1.01 to 1.07) across follow-up. Among respondents who at baseline reported ever using alcohol (n = 1,259), baseline high-frequency engagement in each additional digital media activity was associated at follow-up with 3% more days of alcohol use in the past 30 days (aIRR = 1.03, 95% CI: 1.00 to 1.06). Digital media use and binge drinking were not statistically significantly associated at follow-up. There was no evidence of moderation by gender or race/ethnicity.

CONCLUSIONS

Digital media use frequency was modestly associated with increased risk of initiation and progression of alcohol use in adolescence. Additional research is needed to determine potential mechanisms for these associations.

Social facilitation of alcohol subjective effects in adolescents: Associations with subsequent alcohol use

RATIONALE

Laboratory research in adults indicates that alcohol-related subjective effects are enhanced under some social conditions. However, it is unknown whether this "social facilitation" of alcohol effects occurs in adolescents and is associated with alcohol use in the natural ecology.

OBJECTIVES

We examined associations of social facilitation of alcohol-related subjective effects with subsequent alcohol use among a relatively high-risk group of adolescents who reported drinking alcohol both with friends and alone.

METHODS

Los Angeles high school students from a prospective study (N = 142; 51% female; 10th graders) completed a baseline survey that assessed alcohol-related "positive" and "negative" subjective effects in two contexts: social (alcohol with friends) and solitary (alcohol alone); social facilitation was calculated as the difference between social and solitary. Students then completed five semi-annual surveys spanning 30 months (2014-2017) assessing 30-day alcohol use (days used, number of drinks, binge drinking).

RESULTS

Greater social facilitation of positive effects was significantly associated with greater number of alcohol use days (RR [95% CI] = 1.48 [1.19, 1.82]; p < .001), greater number of drinks (RR [95% CI] = 1.38 [1.14, 1.66]; p = .001), and greater odds of binge drinking (OR [95% CI] = 1.75 [1.20, 2.57]; p = .004). Similar associations were found with social positive effects. There were no significant associations between solitary positive effects-or any negative effects-and alcohol use outcomes.

CONCLUSIONS

Social facilitation can be measured outside of the laboratory. Relatively high-risk drinking adolescents who are more susceptible to the social facilitation of subjective alcohol effects are more likely to use more alcohol and binge drink.

Effects of Polygenic Risk and Perceived Friends' Drinking and Disruptive Behavior on Development of Alcohol Use Across Adolescence

OBJECTIVE

Developmental theory posits interacting individual and contextual factors that contribute to alcohol use across adolescence. Despite the well-documented salience of peer environmental influences on adolescent drinking, it is not known whether peer environments moderate polygenic risks for trajectories of alcohol use. The current theoretically based investigation aimed to test developmental gene-environment interaction (G×E) effects across adolescence.

METHOD

Latent growth curve models tested interactive associations of polygenic risk scores and adolescents' perceived friend drinking and disruptive behavior with adolescents' initial level of alcohol use frequency at age 16 years old and change in alcohol frequency from ages 16 to 20. The sample comprised 8,941 White adolescents (49% female) from Great Britain within the Avon Longitudinal Study of Parents and Children (ALSPAC).

RESULTS

Greater polygenic risk was associated with more frequent initial drinking as well as escalations in drinking frequency over the subsequent 5 years in latent growth curve models. Contrary to study hypotheses, no significant G×E effects were identified after controlling for confounding main and interaction effects.

CONCLUSIONS

Adolescents at heightened genetic risk may accelerate their alcohol use across adolescence, although not significantly more so in the presence of these alcohol-promoting peer environments. Future well-powered, theoretically driven replication efforts are needed to examine generalizability of these findings across diverse samples.

A trait-like propensity to experience internalizing symptoms is associated with problem alcohol involvement across adulthood, but not adolescence

There are stable between-person differences in an internalizing "trait," or the propensity to experience symptoms of internalizing disorders, such as social anxiety, generalized anxiety disorder, and depression. Trait internalizing may serve as a marker of heightened risk for problem alcohol outcomes (such as heavier drinking, binge drinking, or alcohol dependence). However, prior research on the association between internalizing symptoms and alcohol outcomes has been largely mixed in adolescence, with more consistent support for an association during adulthood. It may be that trait internalizing is only associated with problem alcohol outcomes in adulthood, after individuals have gained experience with alcohol. Some evidence suggested that these effects may be stronger for women than men. We used data from a community sample (n = 790) interviewed during adolescence (ages 14-16) and again at ages 21, 24, 27, 30, 33, and 39. Using generalized estimating equations, we tested the association between trait internalizing and alcohol outcomes during both adolescence and adulthood, and tested whether adult trait internalizing mediated the association between adolescent trait internalizing and adult alcohol outcomes. Trait internalizing in adulthood (but not adolescence) was associated with more frequent alcohol use, binge drinking and symptoms of alcohol use disorders, and mediated the effects of adolescent trait internalizing on alcohol outcomes. We observed no moderation by gender or change in these associations over time. Understanding the developmental pathways of trait internalizing may provide further insights into preventing the emergence of problem alcohol use behavior during adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

"It's business as usual": adolescents perspectives on the ban of alcohol sachets towards reduction in under age alcohol use in Malawi

BACKGROUND

Alcohol contributes to poor health, social and economic outcomes among adolescents. In Malawi, alcohol consumption among young people significantly increased after the introduction of alcohol sachets. A government ban on the sale of alcohol sachets affected in 2012 aimed to reduce prevalence of alcohol among users. We explored adolescents perceptions regarding the effectiveness of the ban towards reducing alcohol consumption among the under aged in the country.

METHODS

Using a descriptive phenomenological school-based approach, we recruited 44 school-going adolescents, 15-17 year olds using snow ball sampling and conducted 12 individual semi-structured interviews and four group discussions differentiated by sex. We sought a waiver from College of Medicine Ethics Committee (COMREC) to obtain verbal consent from adolescents. All interviews and discussions were digitally recorded and simultaneously transcribed and translated verbatim into English. Data management and analysis was done manually using thematic approach.

RESULTS

Aggressive packaging, and marketing tendencies and lack of restrictive measures in Malawi have rendered the ban ineffective through increased affordability and availability to different income population groups and the underage. Results indicate that even though adolescents perceive the ban as a significant step towards reducing under age alcohol use, personality and drinking motives precede any interventions. Adolescents emphasized on strong personality as a significant factor for reduced alcohol intake or abstinence.

CONCLUSIONS

We recommend strict alcohol policy and enforcement regarding packaging, pricing, positive role modelling by parents and enhanced adolescent personality development through schools and families.

Characterizing profiles of polysubstance use among high school students in Baltimore, Maryland: A latent class analysis

BACKGROUND

Adolescent drug use has long term health consequences, like substance use disorders and psychiatric illnesses. Proximal health risks, especially for overdose, are amplified when multiple substances are combined. Existing literature on polysubstance use among adolescents has largely focused on alcohol, tobacco, and marijuana, but has largely excluded other drugs like opioids. Understanding how adolescents combine illicit drugs is essential for intervening to prevent poor health outcomes.

METHODS

We aimed to explore patterns of lifetime polysubstance use among adolescents in Baltimore City. We used data on 9th-12th graders recruited to participate in the 2017 local Baltimore Youth Risk Behavior Survey who reported any lifetime drug use (n = 387; 60 % female, 77 % non-Hispanic Black). We then conducted a latent class analysis using 10 indicators of lifetime drug and alcohol use. After selecting the class model, we tested for associations between the class profiles and race, sex, school grade, and lifetime injection drug use.

RESULTS

We identified three profiles of lifetime polysubstance use in our sample: alcohol and marijuana (68.6 % of sample), polysubstance (22.0 %), and alcohol/pain medication/inhalant use (9.4 %). Members of the polysubstance use class were more likely to be male and to report injection drug use.

CONCLUSIONS

Understanding broader patterns of drug use beyond alcohol, tobacco and marijuana among adolescents is a crucial step towards preventing adverse drug and health-related outcomes later in life. More research is needed to characterize the full health impact of youth polysubstance use patterns and related risk behaviors like injection drug use.

Externalising pathways to alcohol-related problems in emerging adulthood

BACKGROUND

Both 'early-onset persistent' and 'adolescent-onset' conduct problems (CPs) are associated with alcohol-related problems in emerging adulthood. The escalation of early CPs into criminal behaviour and heavy alcohol consumption prior to emerging adulthood are both likely to be important pathways.

METHODS

Data were analysed from 3,038 young people in a UK birth cohort, the Avon Longitudinal Study of Parents and Children. The exposure was developmental trajectories of CPs ('low', 'childhood-limited', 'adolescent-onset' and 'early-onset persistent') between ages 4 and 13 years. The mediator was latent classes representing heavy alcohol consumption and/ or criminal behaviour at age 15 years. For the outcome, a quadratic latent growth curve was estimated to capture nonlinear change in alcohol-related problems between ages 18 and 23 years.

RESULTS

Those with 'early-onset persistent' [b(95% CI) = 1.16 (0.17, 2.14)] and 'adolescent-onset' CPs [b(95% CI) = 1.31 (0.17, 2.45)] had higher levels of alcohol-related problems at age 18 years compared to those with 'low' CPs', but there was little evidence of an association with alcohol-related problems after age 19 years. There was evidence for an indirect effect of 'early-onset persistent' CPs [b(95% CI) = 1.12 (0.52, 1.72)] on alcohol-related problems at age 18 years via the latent classes of alcohol and criminal behaviour in adolescence. This was not found for 'adolescent-onset' CPs [b(95% CI) = 0.35 (-0.36, 1.07)].

CONCLUSIONS

Strong associations exist between early CPs, adolescent alcohol consumption and criminal behaviour and alcohol-related problems at age 18 years. Associations between early CPs and alcohol-related problems weakened considerably across emerging adulthood.

The effects of adolescent alcohol exposure on learning and related neurobiology in humans and rodents

Adolescent alcohol use is a widespread problem in the United States. In both humans and rodents, alcohol can impair learning and memory processes mediated by forebrain areas such as the prefrontal cortex (PFC) and hippocampus (HC). Adolescence is a period in which alcohol use often begins, and it is also a time that can be uniquely sensitive to the detrimental effects of alcohol. Exposure to alcohol during adolescence can cause persisting alterations in PFC and HC neurobiology that are linked to cognitive impairments, including changes in neurogenesis, inflammation, and various neurotransmitter systems in rodent models. Consistent with this, chronic adolescent alcohol exposure can cause PFC-dependent learning impairments that persist into adulthood. Deficits in adult HC-dependent learning after adolescent alcohol exposure have also been reported, but these findings are less consistent. Overall, evidence summarized in this review indicates that adolescent exposure to alcohol can produce long-term detrimental effects on forebrain-dependent cognitive processes.

The effect of sensation seeking on alcohol use among middle school students: a latent state-trait analysis

BACKGROUND

Sensation seeking has been implicated as a major risk factor for underage alcohol use, however little research into this personality trait has been conducted among children.

OBJECTIVE

The current study examined if sensation seeking presents as a state or trait in children, and if the state or trait predicted future alcohol use.

METHODS

A latent state-trait (LST) analysis was conducted among 552 individuals (54.3% female; age range 8-13; mean age 9.3) to determine the state or trait-based aspects of sensation seeking, and if this state or trait predicted future alcohol use. Sensation seeking behavior and lifetime alcohol use were assessed at four time points using two previously validated measures.

RESULTS

Between 49.4% and 95.3% of individual differences in sensation seeking could be attributed to a stable underlying sensation seeking trait. Further, logistic regression of the stable trait of sensation seeking predicted future alcohol use. A one unit increase in the latent trait increased the odds a student would try alcohol by 7.83 times (95% CI = 1.49-41.11, p = .015). Standardized regression coefficients revealed that an increase of one standard deviation in the latent trait of sensation seeking increased the odds of experimentation with alcohol by 1.29 times (95% CI = 1.11-1.49, p = .001).

CONCLUSION

Findings suggest sensation seeking presents as a stable trait during childhood, which can cause children to seek out a novel or exciting behaviors such as alcohol use. Future substance use interventions may need to account for the influence of the underlying trait.

Pathways Linking Childhood Physical Abuse to Alcohol Misuse in Adolescent Boys and Girls: A Prospective Cohort Study From Rio de Janeiro, Brazil

OBJECTIVE

The purpose of this study was to identify if childhood physical abuse is a risk factor for adolescent alcohol misuse and the specific pathways linking childhood physical abuse and alcohol misuse in boys and girls.

METHOD

The study enrolled 785 students from the baseline and first wave of a prospective cohort study developed at six high schools in Rio de Janeiro, Brazil. The Childhood Trauma Questionnaire (CTQ), Conflict Tactics Scale-Form R (CTS-1), and Alcohol Use Disorders Identification Test (AUDIT) were used to identify childhood and adolescence physical abuse and alcohol misuse, respectively. Multigroup path analysis was performed to explore the postulated pathways between the exposures and outcomes.

RESULTS

Childhood physical abuse was a significant risk factor for alcohol misuse in adolescence for both sexes. Among girls, childhood physical abuse increased the risk of adolescent revictimization and school delay, which were mediators between childhood physical abuse and alcohol misuse. Among boys, childhood physical abuse has a direct effect on increasing the risk of alcohol misuse. School delay was also a mediator from more social determinants to alcohol misuse in both sexes, whereas not living with the mother in adolescence mediated such effects only among boys.

CONCLUSIONS

Childhood physical abuse increases the risk of alcohol misuse in adolescence through different pathways in boys and girls. Strategies aimed at reducing alcohol misuse and other mental health problems in adolescence should incorporate such specificities.

Effect of alcohol use on the adolescent brain and behavior

Adolescence is a particularly vulnerable neurodevelopmental period marked by high rates of engagement with risky alcohol use. This review summarizes the cognitive and neural consequences following alcohol use during adolescence from longitudinal design studies in humans and animals. Findings from human adolescent studies suggest that binge drinking and heavy alcohol use is associated with poorer cognitive functioning on a broad range of neuropsychological assessments, including learning, memory, visuospatial functioning, psychomotor speed, attention, executive functioning, and impulsivity. Alcohol use during adolescence is associated with accelerated decreases in gray matter and attenuated increases in white matter volume, and aberrant neural activity during executive functioning, attentional control, and reward sensitivity tasks, when compared to non-drinking adolescents. Animal studies in rodents and non-human primates have replicated human findings, and suggest cognitive and neural consequences of adolescent alcohol use may persist into adulthood. Novel rodent studies demonstrate that adolescent alcohol use may increase reward responsiveness of the dopamine system to alcohol later in life, as well as disrupt adolescent neurogenesis, potentially through neuroinflammation, with long-lasting neural and behavioral effects into adulthood. Larger longitudinal human cognitive and neuroimaging studies with more diverse samples are currently underway which will improve understanding of the impact of polysubstance use, as well as the interactive effects of substance use, physical and mental health, and demographic factors on cognition and neurodevelopment.

Alcohol Marketing and Adolescent and Young Adult Alcohol Use Behaviors: A Systematic Review of Cross-Sectional Studies

OBJECTIVE

This article provides a systematic review of cross-sectional research examining associations between exposure to alcohol marketing and alcohol use behaviors among adolescents and young adults.

METHOD

Literature searches of eight electronic databases were carried out in February 2017. Searches were not limited by date, language, country, or peer-review status. After abstract and full-text screening for eligibility and study quality, 38 studies that examined the relationship between alcohol marketing and alcohol use behaviors were selected for inclusion.

RESULTS

Across alcohol use outcomes, various types of marketing exposure, and different media sources, our findings suggest that cross-sectional evidence indicating a positive relationship between alcohol marketing exposure and alcohol use behaviors among adolescents and young adults was greater than negative or null evidence. In other words, cross-sectional evidence supported that alcohol marketing exposure was associated with young peoples' alcohol use behaviors. In general, relationships for alcohol promotion (e.g., alcohol-sponsored events) and owning alcohol-related merchandise exposures were more consistently positive than for other advertising exposures. These positive associations were observed across the past four decades, in countries across continents, and with small and large samples.

CONCLUSIONS

Despite issues of measurement and construct clarity within this body of literature, this review suggests that exposure to alcohol industry marketing may be important for understanding and reducing young peoples' alcohol use behavior. Future policies aimed at regulating alcohol marketing to a greater extent may have important short- and long-term public health implications for reducing underage or problematic alcohol use among youth.

The Relationship Between Exposure to Alcohol Marketing and Underage Drinking Is Causal

OBJECTIVE

This article summarizes the findings of narrative and systematic literature reviews focused on the relationship between exposure to alcohol marketing and youth drinking, viewed in context of criteria for causality. We also consider the implications of this proposition for alcohol policy and public health.

METHOD

Our descriptive synthesis of findings is from 11 narrative and systematic reviews using the nine Bradford Hill causality criteria: (a) strength of association, (b) consistency, (c) specificity of association, (d) temporality, (e) biological gradient, (f) biological plausibility, (g) coherence, (h) experimental evidence, and (i) analogy.

RESULTS

Evidence of causality for all nine of the Bradford Hill criteria was found across the review articles commissioned for this supplement and in other previously published reviews. In some reviews, multiple Bradford Hill criteria were met. The reviews document that a substantial amount of empirical research has been conducted in a variety of countries using different but complementary research designs.

CONCLUSIONS

The research literature available today is consistent with the judgment that the association between alcohol marketing and drinking among young persons is causal.

Disentangling the role of social cognition processes at early steps of alcohol abuse: The influence of affective theory of mind

Excessive alcohol use among adolescents has become a pressing challenge among Western societies. Accordingly, one of the current research objectives is to identify the processes associated with this harmful habit. Although numerous studies have underlined the role of executive and motivational processes, few have explored emotional and interpersonal abilities at early steps of alcohol abuse. The present study evaluated the role of two social cognition processes, namely theory of mind (ability to infer others' mental states at cognitive and affective levels) and empathy (ability to understand others' feelings at cognitive and affective levels) in adolescents' alcohol consumption. Two hundred and two adolescents (13-20 years old) performed a behavioral task evaluating theory of mind and filled in questionnaires measuring personal data, empathy, alcohol consumption (alcohol abuse and specific binge drinking), as well as depressive and anxiety symptoms. Findings showed that cognitive and affective empathy were negatively associated with alcohol consumption in youth whereas affective theory of mind was related to specific binge drinking. Importantly, affective theory of mind predicted binge drinking in adolescents, even after controlling for age, gender, and education level. These results emphasized the role of social cognition in early alcohol abuse and showed that, beyond inhibition, interpersonal abilities might precipitate excessive drinking in youth.

Examining the internalizing pathway to substance use frequency in 10 cultural groups

Use of alcohol, tobacco, and drugs (i.e., substance use) is a leading cause of global health burden for 10-to-24-year-olds, according to the World Health Organization's index of number of years of life lost, leading international health organizations to prioritize the prevention of substance use before it escalates in adolescence. Pathways defined by childhood externalizing symptoms and internalizing symptoms identify precursors to frequent substance use toward which interventions can be directed. However, these pathways are rarely examined beyond the United States and Europe. We investigated these pathways in our sample of 1083 children from 10 cultural groups followed from ages 8-14. We found that age-10 externalizing symptoms predicted more frequent mother-reported age-13 and self-reported age-14 substance use. We also found that a depressive pathway, marked by behavioral inhibition at age 8 and subsequent elevation in depressive symptoms across ages 8-12 predicted more frequent substance use at age 13 and 14. Additionally, we found a combined externalizing and internalizing pathway, wherein elevated age-9 depressive symptoms predicted elevated externalizing symptoms at age-10 which predicted greater peer support for use at age-12, which led to more frequent substance use at age-13 and -14. These pathways remained significant within the cultural groups we studied, even after controlling for differences in substance use frequency across groups. Additionally, cultures with greater opportunities for substance use at age-12 had more frequent adolescent substance use at age-13. These findings highlight the importance of disaggregating between- and within-culture effects in identifying the etiology of early adolescent substance use.

Adolescent Social Norms and Alcohol Use: Separating Between- and Within-Person Associations to Test Reciprocal Determinism

Despite perceived drinking norms being robust predictors of adolescent alcohol use, few studies have assessed the development of perceived norms across adolescence and processes accounting for the strong associations between perceived norms and drinking. Using reciprocal determinism as a theoretical basis for understanding the development of adolescent drinking norms, this study examined reciprocal associations across nine waves of data spanning early to late adolescence. Bivariate latent curve models with structured residuals demonstrated consistent within-person reciprocal associations between descriptive and injunctive norms and alcohol use after accounting for growth in norms and alcohol use. Results suggest the need for developmentally informed intervention efforts targeting perceived drinking norms during early and middle adolescence.

School and town factors associated with risky alcohol consumption among Catalan adolescents

Risky alcohol consumption among adolescents has health and social consequences. Evidence identifying the school context that determines alcohol consumption among rural and urban adolescents is lacking. This study aimed to describe the contextual school and town factors determining risky alcohol consumption among rural and urban 10th-grade adolescents (15-17 years old) from Catalonia (northeastern Spain). The study had a cross-sectional design. Cluster sampling with the class as the sampling unit was used, and a total of 1268 10th-grade adolescents from Catalonia nested in 26 high schools participated in the study. A computerized and self-administrated questionnaire was used to collect individual variables. Contextual variables were collected from the Catalan police registers, geocoded sources, and governmental internet databases, and by aggregation of answers from the self-administrated questionnaire. The prevalence of risky alcohol consumption was calculated, and a multilevel Poisson regression analysis with robust variance was conducted with data from adolescents nested within high schools. The results show that risky alcohol consumption is higher among rural adolescents (59.3%) than among urban youth (51.1%) (p < 0.005). Positive expectancies, drunkenness of siblings and friends, and most of the variables indicating accessibility are associated with risky alcohol consumption at the individual level. At the contextual level, the sports center rate and the high school's percentage of risky student alcohol consumption are strongly associated with individual risky alcohol consumption. The town environment (rural or urban), the unemployment rate, and the number of pubs and nightclubs lost their significance after adjustment by the individual and mediating variables. In conclusion, individual factors, such as the influence of drinking patterns of siblings and friends, and more alcohol access opportunities, are associated with adolescents' risky alcohol consumption. The associated contextual factors are the sports center rate and the percentage of risky classmate alcohol consumers. Interventions targeting adolescents should focus at community and high school levels, trying to reduce adolescents' accessibility to alcohol.

Relational Peer Victimization Interacts With Depression Severity to Predict the Timing of Alcohol Use Initiation in Adolescent Girls

BACKGROUND

Peer victimization is consistently linked to adolescents' alcohol use. However, the relative influence of relational and physical peer victimization on alcohol use, and timing of drinking initiation, is not well understood. In this study, we evaluate the impact of both relational and physical peer victimization on adolescent girls' alcohol use initiation, and the extent to which depression severity moderates these associations.

METHODS

Participants were 2,125 girls in the Pittsburgh Girls Study, a longitudinal community-based study. Participants reported experiences of relational and physical peer victimization, depression severity, and alcohol use each year from ages 10 to 17. Cox proportional hazards (PH) regression analyses predicting the timing of first drink were conducted in 2 stages, testing for main effects of peer victimization in Model 1 and moderation by depression severity in Model 2.

RESULTS

Analyses were split at age 14 to adjust for PH violations. Model 1 results supported a main effect for relational (Hazards ratio [HR] = 1.83, CI: 1.46 to 2.28 ≤ age 13; HR = 1.23, CI: 1.05 to 1.45 ≥ age 14) but not physical victimization on timing of alcohol use onset (HR = 1.10, CI: 0.88 to 1.39). Model 2 results show that depression severity moderates the association between relational victimization and alcohol use initiation: the association between relational victimization and early alcohol use onset was stronger for lower depression severity (-1 SD HR = 2.38, CI: 1.68 to 3.39 ≤ age 13; -1 SD HR = 1.48, CI: 1.10 to 1.52 ≥ age 14).

CONCLUSIONS

Results demonstrate that relational (and not physical) victimization predicts earlier drinking among adolescent girls. Relational peer victimization conferred greater risk for alcohol use initiation when depression severity was lower, whereas girls with high depression severity engaged in early alcohol use regardless of peer victimization. Results suggest that interventions focused on relational peer victimization may have spillover effects for delaying girls' alcohol use initiation, particularly in early adolescence, when this association is most robust.

Does the social context of early alcohol use affect alcohol-related harms in adulthood? Findings from a national birth cohort

Internationally, laws on the provision of alcohol commonly exempt that provided by parents and/or consumed in private premises. Whether these exemptions mitigate alcohol-related harms, as has been posited, is unclear. We used data from 10,968 individuals (5216 women) from the 1970 British Birth Cohort Study. Exposures, self-reported at 16-years of age, were consumption of alcohol with specific people (including parents, siblings and friends) and acquisition from different places (including their own home). The outcomes, self-reported at 30-years of age, were high alcohol consumption (>14 units of alcohol in the last week), and screening positive for a possible alcohol problem using the cutting down, being annoyed by criticism, feeling guilty, and eye-openers (CAGE) questionnaire. At 30-years of age, 32.1% of study members consumed >14 units in the last week and 14.3% screened positive on the CAGE questionnaire. Neither consuming alcohol with parents nor the acquisition of alcohol from home was associated with later high consumption or alcohol problems. There was a suggestion, however, that drinking with other teenagers was related to an increased risk of both outcomes (consumption: 1.32 (1.16, 1.51); alcohol problems: 1.27 (1.01, 1.58), as was acquisition from an off-license (consumption: 1.23 (0.99, 1.51); alcohol problems: 1.49 (1.17, 1.90). This study strengthens the evidence that alcohol consumption with parents, or acquisition from home, does not protect against later alcohol-related harms.

Variations by sex and age in the association between alcohol use and depressed mood among Thai adolescents

BACKGROUND

Alcohol is associated with depression among adolescents, but variations in the association by age and sex are relatively unexplored. This study aims to assess variations in the association between alcohol consumption and depressed mood among adolescents by age and sex.

METHODS

We analyzed data from a school-based survey of 38,186 students in junior high school (Year 7 and 9) and senior high school (Year 11). The mean age of the participants was 15.2 (SD = 1.9) years. We used multivariate logistic regression to measure the association between self-reported alcohol drinking (past-year, past-month, and binge-drinking) and history of depressed mood for two weeks or more during the past year. We stratified the analyses by school level (as proxy for age group) and sex of the respondent.

RESULTS

Approximately 1% of students in surveyed schools refused to answer the questionnaires and fewer than 5% of all questionnaires were invalid. Prevalence of depressed mood was 13.2%. Prevalence of past-year alcohol drinking was 41.0% among those with depressed mood vs. 24.6% among those with no depressed mood (Adj OR = 1.78, 95% CI = 1.60, 1.98). The association was strongest among girls in junior high school (Adj OR = 2.38, 95% CI = 2.03, 2.79) and weakest among boys in senior high school (Adj OR = 1.19, 95% CI = 0.99, 1.42).

CONCLUSION

Associations between alcohol drinking and depressed mood were particularly strong among junior high school girls. Youth mental health and alcohol programs should consider prioritizing this sub-group accordingly.

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

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

Sources of Social Influence on Adolescents' Alcohol Use

The present research examines social influences on self-reported frequency of drunkenness in a longitudinal sample of 1,439 adolescents (46% female, 90% White, mean age = 14 at baseline) with social network measures from friends, romantic partners, and romantic partners' friends. We build on past research by addressing multiple mechanisms of social influence-peers' frequency of drunkenness, alcohol-related attitudes, and unstructured socializing-across relationship types. Adolescents' drunkenness frequency increased when their friends' and partners' friends' drunkenness frequency increased and when their romantic partners' positive alcohol-related attitudes increased. Furthermore, the association between unstructured socializing and frequency of drunkenness was stronger for older than younger adolescents. Results advance understanding of the social transmission of alcohol use in adolescence and inform intervention efforts.

Boundary violations and adolescent drinking: Observational evidence that symbolic boundaries moderate social influence

Scholars of social influence can benefit from attending to symbolic boundaries. A common and influential way to understand symbolic boundaries is as widely shared understandings of what types of behaviors, tastes, and opinions are appropriate for different kinds of people. Scholars following this understanding have mostly focused on how people judge others and how symbolic boundaries align with and thus reproduce social differences. Although this work has been impressive, I argue that it might miss important ways in which symbolic boundaries become effective in everyday social life. I therefore develop an understanding of how symbolic boundaries affect people's ideas and decisions about themselves and their own behavior. Based on this, I argue that focusing on boundary violations-that is, what happens if people express opinions or enact behavior that contravenes what is considered (in)appropriate for people like them-might offer an important way to understand how symbolic boundaries initiate and shape cultural and social change. Using data from Add Health, I demonstrate the utility of this line of argument and show that boundary violations play an important role in channeling social influence. Conservative/Evangelical Protestants and to a lesser degree Catholics, but not Mainline Protestants are highly influenced by the drinking of co-religionists. I consider the implications for cultural sociology.

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.

Alcohol use in late adolescence and early adulthood: The role of generalized anxiety disorder and drinking to cope motives

BACKGROUND

The relationship between anxiety and alcohol use is unclear, and moderating factors, such as drinking to cope (DTC) motives, may explain mixed findings.

METHODS

Using the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined associations between generalized anxiety disorder (GAD) at age 18 and frequent drinking, frequent bingeing, hazardous drinking, and harmful drinking at ages 18 (unadjusted n = 3462) and 21 (unadjusted n = 2076), in a sample of late adolescent drinkers. Analyses were adjusted for sociodemographic, parental, and adolescent confounders. We also examined whether DTC motives influenced the strength and direction of associations between GAD and alcohol use.

RESULTS

GAD was positively associated with all alcohol outcomes at baseline (unadjusted OR (95% CI): frequent drinking 1.40 (1.02-1.91); frequent bingeing 1.40 (0.96-2.04); hazardous drinking 1.44 (1.08-1.92); harmful drinking 1.98 (1.22-3.23)). GAD increased the odds of harmful drinking at age 21 (unadjusted OR 1.72, 95% CI 1.09-2.73), but there was no clear evidence of a longitudinal relationship between GAD and the other alcohol use outcomes. There was no clear evidence of a GAD x DTC interaction on alcohol use at ages 18 or 21. Findings were consistent across various multiply imputed datasets.

CONCLUSIONS

In adolescence, GAD symptoms are associated with frequent drinking, frequent bingeing, hazardous drinking, and harmful drinking. In early adulthood, associations remain for harmful drinking only. DTC motives do not appear to moderate the relationship at either age.

Familism, sibling relationship qualities, and sibling sex constellation as predictors of alcohol use among Mexican-origin adolescents

Sibling relationship qualities and traditional family values (i.e., familism) are contextual factors relevant for early substance use risk among Mexican-origin adolescents. Yet limited research has examined whether familism moderates the effects of sibling relationship features on alcohol use. The present study examined whether familism enhanced or reduced the effects of sibling intimacy, negativity, and sibling deviance on later alcohol use, also testing whether sibling sex constellation (sisters, brothers, mixed) modified the patterns of influence. We analyzed two waves of data (N = 404) from the California Families Project, a longitudinal study of Mexican-origin youth. Using zero-inflated Poisson models, we examined unique and intersecting prospective influences of age 14 sibling contexts and familism on the likelihood of and degree of engagement in alcohol use at age 16. Results indicated a complex interplay of sibling features, familism values, and alcohol use patterns. Familism moderated the effects of sibling intimacy on later alcohol use patterns. For those with lower familism, increasing intimacy was associated with higher probability of any use, but decreasing degree of use (especially for brother pairs and sister pairs). Among those with higher familism, increasing intimacy predicted reduced probability of any use, but increases in the degree of use (for sister and mixed pairs). More sibling negativity was related to reduced alcohol use probability for brothers, and increased alcohol use in mixed sibling pairs. Sibling deviance was associated with greater age 16 alcohol use. This study highlights cultural considerations for including siblings in substance use prevention programs for Mexican-origin youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Identifying trajectories of alcohol use in a sample of secondary school students in Ontario and Alberta: longitudinal evidence from the COMPASS study

INTRODUCTION

Despite evidence indicating a rapid progression in use of alcohol during adolescence, little is known about the ways patterns of drinking develop over time. This study investigated patterns of alcohol use within a cohort of youth in Ontario and Alberta and the probability of changes between patterns.

METHODS

The sample consists of two-year linked longitudinal data (school year 2013/14 to 2014/15) from 19 492 students in Grades 9 to 12 in 89 secondary schools across Ontario and Alberta, Canada, who participated in the COMPASS study. The latent class analysis used two self-reported items about the frequency of drinking (measured as none, monthly, weekly, or daily use) and the frequency of binge drinking (measured as none, less than or once a month, 2-4 times a month, or more than once week) to characterize patterns of alcohol use. The effects of gender, ethnicity and cannabis and cigarette use on alcohol use patterns were examined.

RESULTS

The study identified four drinking patterns: non-drinker, periodic drinker (reported monthly drinking and no binge drinking), low-risk drinker (reported monthly drinking and limited binge drinking) and high-risk regular drinker (reported drinking 1-3 times a week and binge drinking 2-4 times a month). Non-drinker was the most prevalent pattern at baseline (55.1%) and follow-up (39.1%). Periodic drinkers had the highest likelihood of an increase in alcohol consumption, with 40% moving to the low-risk pattern. A notable proportion of participants returned to a lower severity pattern or transitioning out of drinking.

CONCLUSION

There are four distinct youth alcohol-use patterns. The high probability of transitioning to drinking during the secondary school years suggests the need for preventive interventions in earlier stages of use, before drinking becomes habitual.

Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults

BACKGROUND

Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

METHODS

Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

RESULTS

We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

CONCLUSIONS

Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

A longitudinal investigation of racial discrimination, drinking to cope, and alcohol-related problems among underage Asian American college students

Few studies have investigated alcohol-related problems among Asian American college students, perhaps because of the model minority myth, or the false stereotype that Asian Americans are academically and economically successful and thus do not experience significant physical or mental health problems. However, drinking patterns among Asian Americans are complex and there is evidence that alcohol use may be increasing among Asian American college students. One potential risk factor for alcohol-related problems among Asian American college students is racial discrimination. Although past research has revealed a link between experiences of racial discrimination and alcohol use, few studies have examined the psychological processes underlying this association. Furthermore, only a few studies have examined the association between discrimination and alcohol-related problems using longitudinal designs. The present study longitudinally examined the direct and indirect effect of discrimination on alcohol-related problems through the frequency in which they engaged in drinking to cope within a sample of 311 underage Asian American college students. Controlling for alcohol use and baseline alcohol-related problems, Wave 2 drinking-to-cope motives were directly associated with Wave 3 (1 year later) alcohol-related problems. Wave 1 discrimination was indirectly associated with Wave 3 alcohol-related problems through drinking to cope. These findings have important implications for the prevention of alcohol-related problems among an understudied group, Asian American college students. They highlight the necessity of considering how sociocultural factors such as racism contribute to alcohol-related problems as well as examining how psychological processes such as drinking to cope put certain students at increased risk. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Socio-Ecological Influences on Adolescent (Aged 10-17) Alcohol Use and Unhealthy Eating Behaviours: A Systematic Review and Synthesis of Qualitative Studies

Excess body weight and risky alcohol consumption are two of the greatest contributors to global disease. Alcohol use contributes directly and indirectly to weight gain. Health behaviours cluster in adolescence and track to adulthood. This review identified and synthesised qualitative research to provide insight into common underlying factors influencing alcohol use and unhealthy eating behaviours amongst young people aged 10–17. Sixty two studies met inclusion criteria. Twenty eight studies focused on alcohol; 34 focused on eating behaviours. Informed by principles of thematic analysis and meta-ethnography, analysis yielded five themes: (1) use of alcohol and unhealthy food to overcome personal problems; (2) unhealthy eating and alcohol use as fun experiences; (3) food, but not alcohol, choices are based on taste; (4) control and restraint; and (5) demonstrating identity through alcohol and food choices. Young people faced pressure, reinforced by industry, to eat and drink in very specific ways, with clear social consequences if their attitudes or behaviour were deemed unacceptable. No qualitative studies were identified with an explicit and concurrent focus on adolescent eating behaviours and alcohol consumption. Further exploratory work is needed to examine the links between food and alcohol in young people’s emotional, social and cultural lives.

Peer influence in adolescent drinking behaviour: a protocol for systematic review and meta-analysis of stochastic actor-based modeling studies

INTRODUCTION

Alcohol consumption is a considerable public health problem that is especially harmful to young people. To develop effective prevention programmes targeted at adolescents, it is important to understand the social mechanisms triggering alcohol consumption. Among such mechanisms, peer influence plays an important role. The effects of peer influence are very difficult to evaluate because of the entanglement with social selection, that is, a tendency of people to befriend others with similar behaviour. The recently developed stochastic actor-oriented models (SAOM) approach is designed to disentangle social influence from social selection. The aim of this study is to conduct a systematic review and meta-analysis of studies employing SAOM methodology to evaluate the effects of social influence on adolescent drinking behaviour.

METHODS AND ANALYSIS

In order to analyse the co-evolution of alcohol consumption and adolescent friendship networks, we will collect articles that use SAOM methodology through systematic electronic searches in Web of Science, Scopus, PubMed, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials), EBSCOhost (MEDLINE, SocINDEX, Academic Source, ERIC), ProQuest (ProQuest Dissertations and Theses Global), PsycINFO (PsycNET), Excerpta Medica database (Embase) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). We will collect the literature from academic journals, dissertations/theses, reports and conference materials. Three reviewers will retrieve and independently assess potentially relevant material in terms of whether they comply with prespecified criteria. Subsequently, we will summarise the results of the studies in a systematic review. If a sufficient number of studies can be found, SAOM quantitative results will be extracted and meta-analysed. The project will go from 1 December 2018 to 1 December 2019.

ETHICS AND DISSEMINATION

Ethical approval will not be required as our work is based on published studies. A list of all the studies included in this work will be available for review. We plan dissemination in a peer-reviewed international scientific journal and through conference presentations. Our review will highlight the peer effect of peers in adolescent drinking behaviour and provide guidance for developing effective prevention and intervention programmes. We expect it to be informative for policy and practice, decision-making as well as for further research in public health and sociology of adolescents.

PROSPERO REGISTRATION NUMBER

CRD42019119836.

Long-term Associations Between Substance Use-Related Media Exposure, Descriptive Norms, and Alcohol Use from Adolescence to Young Adulthood

Adolescents and young adults in the United States are constantly exposed to substance-related media and advertising content. The current study seeks to explore, developmentally, how exposure to substance-related media content influences both normative beliefs about peer alcohol use and individual alcohol use. Youth (N = 4'840; 50.6% female) were followed for ten years from age 12 to 22. Auto-regressive latent trajectory with structured residual (ALT-SR) models were used to explore within-person reciprocal associations between substance-related media content, descriptive norms, and alcohol use. Results indicated that' across adolescence and young adulthood, exposure to substance-related media content was associated with increased alcohol use via perceived alcohol norms. The pathway from media exposure to alcohol use was mediated by increased perceived norms for adolescents only. With screen time increasing over the last decade, it is important to invest resources into real-time interventions that address substance-related social media content as it relates to misperceived norms and to begin these interventions in early adolescence.

Alcohol Use by Youth

Alcohol use continues to be problematic for youth and young adults in the United States. Understanding of neurobiology and neuroplasticity continues to highlight the potential adverse impact of underage drinking on the developing brain. This policy statement provides the position of the American Academy of Pediatrics on the issue of alcohol and is supported by an accompanying technical report.

Trends in binge drinking and alcohol abstention among adolescents in the US, 2002-2016

BACKGROUND

Binge drinking accounts for several adverse health, social, legal, and academic outcomes among adolescents. Understanding trends and correlates of binge drinking and alcohol abstention has important implications for policy and programs and was the aim of this study. The current study examined trends in adolescent binge drinking and alcohol abstention by age, gender, and race/ethnicity over a 15-year period.

METHODS

Respondents between the ages of 12 and 17 years who participated in the National Survey on Drug Use and Health (NSDUH) between 2002 and 2016 were included in the sample of 258,309. Measures included binge drinking, alcohol abstention, and co-morbid factors (e.g., marijuana, other illicit drugs), and demographic factors.

RESULTS

Logistic regression analyses were conducted to examine the significance of trend changes by sub-groups while controlling for co-morbid and demographic factors. Findings indicated that binge drinking decreased substantially among adolescents in the US over the last 15 years. This decrease was shown among all age, gender, and racial/ethnic groups. In 2002, Year 1 of the study, 26% of 17-year-olds reported past-month binge drinking; in 2016, past-month binge drinking dropped to 12%. Findings also indicated comparable increases in the proportion of youth reporting abstention from alcohol consumption across all subgroups. Black youth reported substantially lower levels of binge alcohol use and higher levels of abstention, although the gap between Black, Hispanic and White youth narrowed substantially between 2002 and 2016.

CONCLUSION

Study findings are consistent with those of other research showing declines in problem alcohol- use behavior among youth.

Classes of drinking motives among American Indian youth drinkers

Research exploring American Indian (AI) youth drinking motives and their relation to negative outcomes is critical due to higher rates of alcohol use and early exposure to intoxication in the population. The purpose of this study is to explore classes of drinking motives as they relate to heavy episodic drinking, perceived discrimination, religious importance, ethnic identity, and ethnic pride. This study is part of an ongoing epidemiologic and etiologic investigation of substance use among AI youth drinkers living on or near reservations (n = 1,934, Mage = 15.31). A latent class analysis (LCA) was conducted to discern latent classes of drinking motives. Once latent classes were identified, differences in perceived discrimination, ethnic pride, ethnic identity, religious importance, and heavy episodic drinking were tested. A 2-class solution provided the best overall model fit to the data. The higher coping and enhancement motive class was associated with significantly greater heavy episodic drinking, perceived discrimination, and ethnic identity compared with the low motive class. Further, the class structure did not differ between 7th and 8th graders and 9th-12th graders. Results indicate that among AI youth, the class with strong motives to drink for coping or enhancement had higher ethnic identity, greater risk of heavy episodic drinking, and greater perceived discrimination compared with the class with low motives. Future research should examine additional factors and stressors that may be associated with these classes of drinking motives and are unique to the AI population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Selection and Socialization Influences on Adolescent Alcohol Use: The Individual and Joint Contexts of Neighborhood Disadvantage and Population Density

Background: Neighborhood disadvantage (ND) and population density (PD) are two community characteristics contextualizing friends' influence on adolescent alcohol use. However, these community characteristics are rarely examined for potential joint contributions, although it is possible that the way friends are selected or influence alcohol use are shaped by both ND and PD. In addition, prior studies examining ND or PD contexts on friend influence rarely discern between socialization and selection. Objectives: The current study examined how selection and socialization influences on adolescent alcohol use are shaped by unique and joint contexts of ND and PD. Methods: Adolescents from Waves I and II of the National Longitudinal Study of Adolescent and Adult Health (Add Health) were included in three models assessing friends' socialization of alcohol us initiation and binge drinking, and selection of drinking friends. ND and PD were tested for mediation and moderation individually and jointly. Results: Results indicated that socialization of drinking initiation was stronger in high ND contexts, and that continued binge drinking was stronger in low ND contexts. PD indirectly influenced socialization of initiation and binge drinking maintenance via a negative association with number of drinking friends. PD and ND jointly influenced the association between initial binge drinking and next-year selection of drinking friends, such that selection was stronger within areas related to lower levels of drinking friends. Conclusions/Importance: Current results indicate that PD and ND shape friends' influence on alcohol use in unique ways. These must be accounted for to better understand bidirectional effects of friend influence.

With a little help from my friends? A longitudinal look at the role of peers versus friends on adolescent alcohol use

INTRODUCTION

Alcohol is the most commonly used substance by South African adolescents. Social norms play a key role in alcohol use, although distinctions are not always made between descriptive and injunctive norms and peer proximity. Additionally, little research identifies factors attenuating social norms, peer proximity, and alcohol use, such as one's ability to resist peer influence.

METHODS

The current study investigates the relationship between adolescent alcohol use in 9th Grade and descriptive peer and injunctive friend norms in 8th grade, the moderating role of resistance to peer influence, and sex differences. Data were from South African students (N = 3592; M_age = 14) participating in the HealthWise South Africa implementation quality trial.

RESULTS

Path model results indicated injunctive friend norms, but not peer norms, influenced alcohol use. Resistance to peer influence did not moderate relationships and group comparisons found no sex differences.

CONCLUSION

Findings suggest social proximity shapes influences of alcohol use. Despite a differing cultural context, findings were consistent with those from the United States, indicating social proximity is relevant cross-culturally.

Substance Use and School Characteristics in Lesbian, Gay, Bisexual, and Heterosexual High School Students

BACKGROUND

Tobacco, alcohol, and illicit drug use among lesbian, gay, and bisexual (LGB) high school students as well as related environment and school-level risk and protective factors were examined.

METHODS

Data was acquired from the 2015 CDC's Youth Behavior Risk Survey for Kentucky (N = 2577). Prevalence of substance use was calculated for all high school respondents by reported sexual orientation. Multivariate analyses estimated the relationship between school and environmental-level factors (eg, having an adult to talk to) and tobacco, alcohol, and illicit drug use via logistic regressions. Sexual orientation, gender, age, and race/ethnicity were covariates.

RESULTS

LGB students used tobacco, alcohol, and illicit drugs more frequently than their heterosexual counterparts. More LGB teens report facing school risk factors (eg, 37% LGB vs 20% heterosexual bullied at school, p ≤ .001; 17% LGB vs 5% heterosexual ever threatened or injured at school, p < .001; 13% LGB vs 7% heterosexual involved in a school fight, p = .001). Adjusting for school related risk factors, having an adult to talk to was associated with a reduced likelihood of daily smoking (adjusted odds ratio [aOR]: 0.43; 95% confidence interval [CI]: 0.26-0.73), past 30-day alcohol use (aOR: 0.71; 95% CI: 0.50-0.95), and ever marijuana use (aOR: 0.71; 95% CI: 0.50-1.00).

CONCLUSION

Innovative strategies are needed to create safe, supportive school environments. These strategies are particularly needed in predominately rural states like Kentucky.

Accelerated alcohol use across adolescence predicts early adult symptoms of alcohol use disorder via reward-related neural function

BACKGROUND

Alcohol use is commonly initiated during adolescence, with earlier onset known to increase the risk for alcohol use disorder (AUD). Altered function in neural reward circuitry is thought to increase the risk for AUD. To test the hypothesis that adolescent alcohol misuse primes the brain for alcohol-related psychopathology in early adulthood, we examined whether adolescent alcohol consumption rates predicted reward responsivity in the ventral striatum (VS), and in turn, AUD symptoms in adulthood.

METHODS

A total of 139 low income, racially diverse urban males reported on their alcohol use at ages 11, 12, 15, and 17; completed self-reports of personality, psychiatric interviews, and a functional magnetic resonance imaging (fMRI) scan at age 20; and completed a psychiatric interview at age 22. We measured adolescent alcohol use trajectories using latent growth curve modeling and measured neural responses to monetary reward using a VS region of interest. We tested indirect effects of adolescent alcohol use on AUD symptoms at age 22 via VS reward-related reactivity at age 20.

RESULTS

Greater acceleration in adolescent alcohol use predicted increased VS response during reward anticipation at age 20. VS reactivity to reward anticipation at age 20 predicted AUD symptoms at age 22, over and above concurrent symptoms. Accelerated adolescent alcohol use predicted AUD symptoms in early adulthood via greater VS reactivity to reward anticipation.

CONCLUSIONS

Prospective findings support a pathway through which adolescent alcohol use increases the risk for AUD in early adulthood by impacting reward-related neural functioning. These results highlight increased VS reward-related reactivity as a biomarker for AUD vulnerability.

Internalizing and Externalizing Problem Behavior: a Test of a Latent Variable Interaction Predicting a Two-Part Growth Model of Adolescent Substance Use

Externalizing symptoms robustly predict adolescent substance use (SU); however, findings regarding internalizing symptoms have been mixed, suggesting that there may be important moderators of the relationship between internalizing problems and SU. The present study used a longitudinal community sample (N = 387, 55% female, 83% White) to test whether externalizing symptoms moderated the relationship between internalizing symptoms and trajectories of alcohol and marijuana use from early (age 11-12 years old) to late (age 18-19 years old) adolescence. Two-part latent growth models were used to distinguish trajectories of probability of use from trajectories of amount of use among users. Results suggested that externalizing symptoms moderated the association between internalizing symptoms and probability of alcohol, but not marijuana use. The highest probability of alcohol use was observed at high levels of externalizing symptoms and low levels of internalizing symptoms. A negative protective effect of internalizing symptoms on probability of alcohol use was strongest in early adolescence for youth high on externalizing symptoms. Although moderation was not supported for amount of use among users, both domains of symptomology were associated with amount of alcohol and marijuana use as first-order effects. High levels of externalizing symptoms and low levels of internalizing symptoms were associated with high levels of amount of use among users. These findings suggest that developmental models of substance use that incorporate internalizing symptomology should consider the context of externalizing problems and distinguish probability and amount of use.