Initiation and persistence of alcohol use in United States Black, Hispanic, and White male and female youth

Genetic and environmental influence on alcohol intent and alcohol sips among U.S. children-Effects across sex, race, and ethnicity

INTRODUCTION

Alcohol intent (the susceptibility to initiating alcohol use) and alcohol sips (the initiation of alcohol) in youth are a multifactorial puzzle with many components. This research aims to examine the connection between genetic and environmental factors across sex, race and ethnicity.

METHODS

Data was obtained from the twin hub of the Adolescent Brain Cognitive Development (ABCD) study at baseline (2016-2018). Variance component models were conducted to dissect the additive genetic (A), common (C) and unique environmental (E) effects on alcohol traits. The proportion of the total alcohol phenotypic variation attributable to additive genetic factors is reported as heritability (h2).

RESULTS

The sample (n = 1,772) included an approximately equal male-female distribution. The 886 same-sex twin pairs were 60.4% dizygotic (DZ), 39.6% monozygotic (MZ), 65.4% non-Hispanic Whites, 13.9% non-Hispanic Blacks, 10.8% of Hispanics with a mean age of 121.2 months. Overall, genetic predisposition was moderate for alcohol intent (h2 = 28%, p = .006) and low for alcohol initiation (h2 = 4%, p = 0.83). Hispanics (h2 = 53%, p < .0001) and Blacks (h2 = 48%, p < .0001) demonstrated higher alcohol intent due to additive genetic factors than Whites (h2 = 34%, p < .0001). Common environmental factors explained more variation in alcohol sips in females (c2 = 63%, p = .001) than in males (c2 = 55%, p = .003). Unique environmental factors largely attributed to alcohol intent, while common environmental factors explained the substantial variation in alcohol initiation.

CONCLUSION

Sex and racial/ethnic disparities in genetic and environmental risk factors for susceptibility to alcohol initiation can lead to significant health disparities. Certain populations may be at greater risk for alcohol use due to their genetic and ecological factors at an early age.

The indirect effects of self-regulation on the association of social support with increased protective drinking behavior and decreased alcohol problems in a predominantly Hispanic college student sample

BACKGROUND

Research suggests that self-regulation, which refers to one's ability to manage a behavior, and social support are related to alcohol use. Other research suggests that social support may serve as a precursor to self-regulation and health-promoting behaviors. We examined whether self-regulation has an indirect effect on the association between social support and both protective drinking behaviors and alcohol problems.

METHODS

A random sample of students at a Hispanic Serving Institution completed an online survey, which included sociodemographic questions, the Multidimensional Perceived Social Support Scale, the Short Self-Regulation Questionnaire, the Protective Behavioral Strategies (PBS) Scale, and the Rutgers Alcohol Problem Index. Undergraduate students (n = 192) who reported drinking in the last month were included in the analysis. A path analysis using Mplus8 was conducted to investigate the relationships among social support, self-regulation, PBS, and alcohol-related problems.

RESULTS

The sample was mostly female (58.9) and of Hispanic ethnicity (89.6). Analyses showed that social support had a significant positive association with PBS and a significant negative association with alcohol-related problems. When self-regulation was added to the models, these associations were no longer significant, and self-regulation had a significant indirect effect on the relationship between social support and both PBS and alcohol-related problems.

CONCLUSIONS

The results of the current cross-sectional study suggest that a viable hypothesis in future longitudinal studies is that self-regulation is a mechanism by which social support increases PBS and reduces alcohol problems. Future research should assess longitudinally both the mediating effects of self-regulation between social support and drinking outcomes and potential moderators, such as ethnicity.

Sociocultural influences on alcohol expectancies in early adolescence: Findings from the ABCD study

OBJECTIVE

Alcohol expectancies (AE) during early adolescence predict early alcohol use initiation and problem drinking both cross-sectionally and prospectively well into adulthood. Yet, our understanding of the sociocultural factors associated with AE during this development period remains limited. This study examines associations between AE and sociocultural factors across various domains (i.e., individual, family, peer, school, community, and culture) in a demographically diverse sample of 10- to 14-year-old youth in the Adolescent Brain Cognitive Development Study (ABCD Study).

METHOD

This cross-sectional study used 2-year follow-up data from the ABCD Release 3.0 for N = 5,322 early adolescents (Mage = 12 years [SD = 0.6]; 47% male). Approximately 60% identified as non-Hispanic/Latinx White, 17% as Hispanic/Latinx, 11% as non-Hispanic/Latinx Black, 2% as non-Hispanic/Latinx Asian, and 11% as mixed/other race-ethnicity. Separate models for positive and negative AE outcomes were conducted using linear mixed-effect models while controlling for demographic covariates.

RESULTS

Positive AE were most strongly associated with familism, followed by other peer, school, community, and cultural level factors. Negative AE were most strongly associated with the peer-level factor of relational victimization and the individual-level factor of negative life events, followed by other peer, school, and community-level factors.

CONCLUSION

The present findings reveal the potential constellation of sociocultural factors that may serve as targets for modifying AE during the middle school years. Study results also underscore the need for future research that integrates cultural factors into our understanding of alcohol use risk and resilience during early adolescence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Does polygenic risk for substance-related traits predict ages of onset and progression of symptoms?

BACKGROUND AND AIMS

Genetic risk can influence disease progression. We measured the impact of genetic risk for substance use disorders (SUDs) on substance use onset and progression of symptoms.

DESIGN, SETTING, PARTICIPANTS

Using findings from genome-wide association studies (GWASs) of alcohol use disorder (AUD), opioid use disorder (OUD) and smoking trajectory (SMK) as discovery samples, we calculated polygenic risk scores (PRSs) in a deeply phenotyped independent target sample. Participants in the target sample were recruited from 2000 to 2020 from US inpatient or outpatient settings or through advertisements and comprised 5692 European-ancestry individuals (EUR) (56.2% male) and 4918 African-ancestry individuals (AFR) (54.9% male).

MEASUREMENTS

This study measured age of first substance use, regular use, reported problems and dependence diagnosis and progression from regular use to onset of problems and dependence for alcohol, opioids and smoking. We examined the contribution of PRS to each milestone and progression measure.

FINDINGS

EUR and males reported an earlier onset and shorter progression times than AFR and females, respectively. Among EUR, higher AUD PRS predicted earlier onset and more rapid progression to alcohol-related milestones (P < 0.001). Although the AUD PRS was a stronger moderator of problem onset among females (P = 0.017), it was more predictive of the progression to problems among males (P = 0.005). OUD and SMK PRS in EUR also predicted earlier onset of the respective milestones (P < 0.001). Among AFR, where power is lower due to the smaller discovery sample, AUD PRS predicted age of regular alcohol use (P = 0.039) and dependence (P = 0.001) and progression from regular use to diagnosis (P = 0.045), while SMK PRS predicted earlier age of initiation (P = 0.036).

CONCLUSIONS

Genetic risk for SUDs appears to predict substance use milestones and symptom progression among European-ancestry individuals and, to a lesser extent, African-ancestry individuals.

The role of adolescent social relationships in promoting alcohol resistance: Interrupting the intergenerational transmission of alcohol misuse

Genetic factors contribute to the intergenerational transmission of alcohol misuse, but not all individuals at high genetic risk develop problems. The present study examined adolescent relationships with parents, peers, and romantic partners as predictors of realized resistance, defined as high biological risk for disorder combined with a healthy outcome, to alcohol initiation, heavy episodic drinking, and alcohol use disorder (AUD). Data were from the Collaborative Study on the Genetics of Alcoholism (N = 1,858; 49.9% female; mean age at baseline = 13.91 years). Genetic risk, indexed using family history density and polygenic risk scores for alcohol problems and AUD, was used to define alcohol resistance. Adolescent predictors included parent-child relationship quality, parental monitoring, peer drinking, romantic partner drinking, and social competence. There was little support for the hypothesis that social relationship factors would promote alcohol resistance, with the exception that higher father-child relationship quality was associated with higher resistance to alcohol initiation (β ^ = - 0.19 , 95% CI = -0.35, -0.03). Unexpectedly, social competence was associated with lower resistance to heavy episodic drinking (β ^ = 0.10 , 95% CI = 0.01, 0.20). This pattern of largely null effects underscores how little is known about resistance processes among those at high genetic risk for AUD.

Prevalence of adolescent's risk behaviors at age 11 and 15: data from the 2004 Pelotas birth cohort

PURPOSE

The objective of this study was to investigate the prevalence of the following risk behaviors: cigarette, electronic cigarette, alcohol, substance and sexual experimentation and delinquent behavior at age 15, stratified by sex and socioeconomic position. We also investigated the prevalence of cigarette and alcohol experimentation at age 11 and the persistence and cumulative incidence of these behaviors between 11 to 15 age.

METHODS

Cohort study. We included 3,491 11-year-old and 1,949 15-year-old adolescents from the 2004 Pelotas Birth Cohort. All outcomes were identified via confidential questionnaires and were analyzed as binary variables.

RESULTS

At age 11, we found a male preponderance of cigarette experimentation. At age 15, alcohol experimentation, cigarette experimentation and substance experimentation had a female preponderance; and cigarette experimentation and sexual experimentation were more prevalent in individuals belonging to low socioeconomic position. We found high rates of cumulative incidence of 'alcohol experimentation' in male and in female adolescents; and high rates of persistence of alcohol experimentation both in male and female.

CONCLUSIONS

Further research should clarify causal paths of high prevalence of risk behaviors during adolescence and its increase in female adolescents.

Medical Cannabis Laws and Adolescent Alcohol Use Initiation

Background

The effects of medical cannabis laws (MCLs) on adolescent alcohol use remains unclear. Previous literature investigates alcohol consumption rather than alcohol initiation among adolescents, and does not examine the effect by sociodemographic characteristics and state-level dispensary status. We used population representative, state-level data to examine the relationship between MCLs and adolescent alcohol initiation.

Methods

Data for this study were derived from the Youth Risk Behavior Survey (YRBS), a nationally representative, cross-sectional school-based survey administered by the Centers for Disease Control (CDC) in odd-numbered years from 1991 to 2015. We used a difference-in-difference model to assess pre and post effects of state MCL enactment on adolescent alcohol use initiation. Logistic regression analyses assessed associations between MCLs and varying ages of initiation. We further stratified our results by race/ethnicity, gender, and dispensary status.

Results

Results from adjusted logistic regression models showed higher odds of initiating alcohol among adolescents in states without MCLs when compared to adolescents in states with MCLs (OR 1.37, [95% CI = 1.29, 1.44]). This effect was consistent across age, race/ethnicity, and gender groups. Reductions in self-report of alcohol initiation were also consistently found in multiple age strata (9-10, 11-12, and 13-14), though this finding did not reach conventional levels of statistical detection in all race/ethnicities.

Conclusions

Our findings support a substitutive effect, suggesting that adolescents in states with MCLs, as opposed to states without MCLs, may substitute cannabis for alcohol. Considering the evolving landscape of medical cannabis laws and the proliferation of state-level legalization laws, further research into the effects of such policies, such as adult-use cannabis laws, is warranted to further elucidate their effects on adolescent substance use.

Ethnic/Racial Differences in Alcohol Use: Does Drinking Refusal Self-Efficacy Matter?

Introduction: College students-including those of Hispanic backgrounds-are at risk for hazardous drinking. Research has shown robust group differences between Hispanic and White individuals in alcohol use outcomes. The ability to resist alcohol consumption can be leveraged to reduce hazardous drinking; however, little research has examined Hispanic-White differences and whether drinking refusal self-efficacy accounts for group differences in hazardous drinking. Considering Hispanic individuals make up the largest ethnic/racial minority group in the United States, it is important to identify malleable psychological factors that prevent and reduce drinking problems. Method: Hispanic and White college students at two predominantly White institutions (N = 389; 58.6% women, M_age= 20.22) completed measures assessing drinking refusal self-efficacy, hazardous drinking, and negative drinking consequences. Results: Hispanic students reported lower levels of hazardous drinking, alcohol-related problems, and drinking refusal self-efficacy than White students. Drinking refusal self-efficacy was found to partially explain Hispanic-White differences in the levels of hazardous drinking and drinking-related problems. Specifically, drinking refusal self-efficacy was associated with alcohol use outcomes only among White students and not Hispanic students. Conclusion: The correspondence between drinking refusal self-efficacy and actual behaviors to turn down drinks, ethnic/racial distinctiveness in ratings of self-efficacy and cultural orientations, and situational contexts that surround drinking should be examined in future research.

Trajectories of early alcohol use milestones: Interrelations among initiation and progression

BACKGROUND

Alcohol use shows age-graded patterning, with normative use progressing through characteristic milestones of escalating use or severity. Despite some knowledge about the timing of milestone attainment and sequencing across milestones, there is a gap in our understanding of the earliest stages of use. This study characterizes the timing, sequencing, and speed of progression through milestones beginning with the first sip of alcohol.

METHODS

Sixth through eighth graders (N = 1023; 52% female; 76% White; M = 12.23 years old) completed web surveys through the end of high school. Participants reported on alcohol experiences including the first sip, full drink, consumption of 3+ drinks/occasion (heavy drinking), being drunk, and experiencing acute consequences, from which milestone age and speed of progression (duration) were calculated. Milestone prevalence, sequencing, and timing were characterized, and associations between age of attainment and speed of progression were examined. We also examined whether milestone timing and progression varied by sex and racial/ethnic group.

RESULTS

Overall, milestones followed the expected ordering with the exception of heavy drinking (3+ drinks/occasion) and being drunk, which appear to index similar experiences. An earlier age of attainment was associated with an increased likelihood of attaining each of the milestones. In contrast, once a milestone was achieved, there was reduced risk of initiation of subsequent adjacent milestones for individuals with an earlier first sip and full drink, and earlier initiation was associated with a longer duration to subsequent milestones. Girls were more likely to attain all milestones than boys, but there was no sex difference in the age of attainment. In contrast, Hispanic youth reported earlier ages of initiation than White non-Hispanic youth, but the likelihood of attainment did not vary by race/ethnicity. Rapid progression was observed in females but did not vary by race/ethnicity.

DISCUSSION

Risks associated with early drinking are complex, with little support for normative ordering of milestones beyond the first sip. Although early drinking is associated with an increased risk of subsequent drinking, it does not appear to place the drinker on an accelerated course to heavier use. A nuanced understanding of risks associated with milestone timing may inform intervention efforts.

The impact of an alcohol policy change on developmental trajectories of youth alcohol use: examination of a natural experiment in Canada

OBJECTIVES

In 2015, the Liquor Control Board of Ontario (LCBO) authorized sale of alcohol in some Ontario grocery stores. This research evaluates the impact of the new policy on alcohol use patterns of youth in a quasi-experimental setting with two control groups.

METHODS

The sample consists of 2267 grade 9 students attending 60 secondary schools across Ontario (n = 56) and Alberta (n = 4), who provided 4-year linked longitudinal data (2013-2014 to 2016-2017) in the COMPASS study. The study used the frequency of drinking and the frequency of binge drinking to characterize alcohol use behaviours.

RESULTS

Latent transition analysis found four statuses of alcohol use: abstainer, periodic drinker, low-risk drinker, and high-risk regular drinker. The new policy had no negative impact among periodic and low-risk drinkers, but the risk of transitioning from the abstainer (lowest risk status) to high-risk regular drinker (highest risk status) among the exposed cohort was 1.71 times greater post-policy than pre-policy change, compared with those of Ontario-unexposed (0.50) and Alberta-unexposed cohorts (1.00). The probability of sustaining high-risk drinking among the exposed cohort increased by a factor of 1.76, compared with 1.13-fold and 0.89-fold among the Ontario-unexposed and Alberta-unexposed cohorts, respectively.

CONCLUSION

Youth are more likely to transition from abstinence to high-risk regular drinking, and high-risk regular drinkers are more likely to maintain their behaviours in the jurisdictions exposed to the latest change in LCBO policy authorizing grocery stores to sell alcohol. When formulating policy interventions, youth access to alcohol should be considered in order to reduce their harmful alcohol consumption.

Exploring how Family and Neighborhood Stressors Influence Genetic Risk for Adolescent Conduct Problems and Alcohol Use

Previous research suggests that genetic risk factors may predispose to conduct problems and alcohol use in adolescence. Whether genetic risk factors interact with social contexts has not been well characterized among African American adolescents. Data came from a subsample of the Genes, Environment, and Neighborhood Initiative study comprising 501 African American adolescents, including 151 lifetime drinkers (56% female, mean age = 16.3, SD = 1.4). Genetic risk was assessed with polygenic risk scores for alcohol dependence. Analyses explored interactions between genetic risk and self-reported alcohol use, conduct problems, life stressors, and other covariates. The effects of two gene-environment interactions (G × E) were tested in the sample of alcohol exposed adolescents; one on conduct problems and the other on alcohol use. There were significant associations between polygenic risk for alcohol dependence and conduct problems. A significant G × E interaction showed the impact of genetic risk on conduct problems was stronger under conditions of high exposure to family and neighborhood stressors. Among this sample of African American adolescents, genetic risk for alcohol dependence was not directly associated with alcohol use but was related to more conduct problems. Further, the effect of genetic risk interacted with stressors from the family and neighborhood, so that the effect of genetic risk on conduct problems was stronger for individuals who reported greater stressors.

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.

The Influence of Parental Support and Community Belonging on Socioeconomic Status and Adolescent Substance Use over Time

Background. Despite a growing trend in community-based research, studies investigating the influence of multi-level community factors on individual-level outcomes remain relatively sparse. Objective. The current study aimed to extend this literature by investigating the association between community disadvantage measured at the community level, and adolescents' substance use over time. Additionally, this study also investigated the influence of parental support and community belonging on this association. Methods. Data were drawn from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health data set. Using a multi-level modeling approach, we tested the association between community disadvantage and substance use during adolescence. Second, to determine if this association held longitudinally, we examined the influence of community disadvantage on substance use over time, into young adulthood. Lastly, we tested the moderating effects of parental support and community belonging on the association between community disadvantage and substance use during adolescence and young adulthood. Results. Findings suggested that individuals experiencing the greatest disadvantage were less likely to engage in substance use in comparison to those experiencing the greatest advantage. Conclusions/Importance. Differential effects of parental support and community belonging on community disadvantage and substance use were also found. Implications of these findings are discussed.

Black-white disparities in alcohol consumption trends among women in the United States, 1990-2015

Alcohol consumption has more adverse consequences among African American women than among white women. Yet little is known about trends in alcohol consumption among African American women. Using the National Survey on Drug Use and Health, we examined trends in alcohol consumption among African American (n = 4,079) and white (n = 17,512) women, 1990-2015. We calculated population prevalence and used the Cochrane-Armitage test to examine trends, controlling for sociodemographic factors. In adjusted analyses, binge consumption increased for African American and white women; not consuming alcohol decreased among African Americans (all p < 0.05). Results highlight the need for culturally sensitive prevention and intervention strategies.

Childhood Trauma and Two Stages of Alcohol Use in African American and European American Women: Findings from a Female Twin Sample

The current investigation assessed for moderating effects of childhood trauma on genetic and environmental contributions to timing of alcohol use initiation and alcohol use disorder in African American (AA) and European American (EA) women. Data were drawn from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a longitudinal female twin study. Childhood trauma was defined alternately as child maltreatment and more broadly to include other events (e.g., witnessing violence). Phenotypic associations between childhood trauma and alcohol outcomes were estimated using logistic regression analyses. Twin modeling was conducted to test for moderating effects of childhood trauma on the contributions of genetic and environmental factors to timing of initiation and alcohol use disorder. Under both definitions, childhood trauma was associated with early initiation (relative risk ratios: 1.90, 1.72) and alcohol use disorder (odds ratios: 1.92, 1.76). Yet gene by environment effects were observed only for child maltreatment and timing of initiation in EA women, with heritable influences less prominent in those who had experienced child maltreatment (0.35, 95% CI: 0.05-0.66 vs. 0.52, 95% CI: 0.30-0.73). We found more similarities than differences in the association of childhood trauma with alcohol outcomes across racial/ethnic groups, trauma type, and stages of alcohol use. However, findings suggest that the relative contribution of genetic factors to alcohol outcomes differs by childhood maltreatment history in EA women specifically in the earliest stage of alcohol use.

Developmental considerations in survival models as applied to substance use research

Survival analysis is a class of models that are ideal for evaluating questions of timing of events, which makes them well-suited for modeling the development of a process such as initiation of substance use, development of addiction, or post-treatment recovery. The focus of this review paper is to demonstrate how survival models operate in a broader developmental framework and to offer guidance on selecting the appropriate model on the basis of the research question at hand. We provide a basic overview of survival models and then identify several key issues, explain how they pertain to research in the addiction field, and describe studies that utilize survival models to address questions about timing. We discuss the importance of carefully selecting the metric and origin of the time scale that corresponds to developmental process under investigation and we describe types of censoring/truncation. We describe the value of modeling covariates as time-invariant versus time-varying, and make the distinction between time-varying covariates and time-varying effects of covariates. We also explain how to test for substantive differences due to the timing of the assessment of the predictor. We finish the paper with a presentation of relatively novel extensions of survival models, including models that integrate standard statistical mediational analysis with discrete-time survival analysis, models that simultaneously consider order and timing of multiple events, and models that involve joint modeling of longitudinal and survival data. We also present our own substantive examples of various models in an Appendix containing annotated syntax and output.

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.

Racial discrimination and alcohol use and negative drinking consequences among Black Americans: a meta-analytical review

BACKGROUND AND AIMS

Findings of the association between racial discrimination and alcohol use and related consequences are inconsistent, and the role of potential moderators in the association is largely unknown. This meta-analysis aimed to synthesize the discrimination-alcohol literature among Black Americans, estimate the magnitude of associations and explore differences as a function of sample characteristics.

METHODS

Empirical studies reporting the association of racial discrimination with alcohol-related behaviors in an all-black sample were identified via systematic literature search. A random-effects meta-analysis was conducted using 33 effect sizes extracted from 27 studies, all of which used US samples (n = 26 894).

RESULTS

Significant positive associations were found for racial discrimination with alcohol consumption [k = 9, confidence interval (CI) = 0.08, 0.17, I²  = 49%, r = 0.12], heavy/binge drinking (k = 12, CI = 0.02, 0.10), I²  = 27%, r = 0.06), at-risk drinking (k = 4, CI = 0.06, 0.23, I²  = 0%, r = 0.14) and negative drinking consequences (k = 5, CI = 0.09, 0.25, I²  = 94%, r = 0.25), but not with alcohol use disorder (k = 3, CI = -0.01, 0.20, I²  = 90%, r = 0.10). Only alcohol consumption and negative drinking consequences showed significant between-study heterogeneity and had a sufficient quantity of studies for moderation analysis (i.e., 4 or more studies). The positive association of racial discrimination with negative drinking consequences was stronger among younger samples; the association with alcohol consumption did not differ by age or proportion of men.

CONCLUSIONS

Experiences of racial discrimination are associated with diverse alcohol-related behaviors among Black Americans, with a stronger association with problematic alcohol use, particularly among younger individuals.

Patterns of adolescent tobacco and alcohol use as predictors of illicit and prescription drug abuse in minority young adults

The present longitudinal study examined the relationship between patterns of cigarette smoking and alcohol use during adolescence and illicit drug abuse (DA) and prescription drug abuse (PDA) in early adulthood. The sample consisted of 984 predominantly minority young adults (57% women) who completed (a) six annual surveys as adolescents attending New York City public schools (grades 7 through 12) and (b) a follow-up telephone interview as young adults (mean age = 23). Findings from a series of latent growth models indicated that growth in cigarette smoking and alcohol use during adolescence each independently predicted DA in adulthood. Baseline levels of alcohol use in 7th grade also predicted DA in adulthood. Growth in alcohol consumption during adolescence predicted PDA in young adulthood. Results indicate that an escalation during adolescence in the use of substances that are legal for adults (cigarettes and alcohol) contributes to greater DA and PDA in young adulthood. One implication of these findings is that interventions that can prevent cigarette smoking and alcohol use during adolescence may also reduce DA and PDA in young adults.

Evaluating a Method to Estimate Mediation Effects With Discrete-Time Survival Outcomes

The utility of evaluating mediation effects spans across research domains. The model facilitates investigation of underlying mechanisms of event timing and, as such, has the potential to help strengthen etiological research and inform intervention work that incorporates the evaluation of mediating variables. In order for the analyses to be maximally useful however, it is critical to employ methodology appropriate for the data under investigation. The purpose of this paper is to evaluate a regression-based approach to estimating mediation effects with discrete-time survival outcomes. We empirically evaluate the performance of the discrete-time survival mediation model in a statistical simulation study, and demonstrate that results are functionally equivalent to estimates garnered from a potential-outcomes framework. Simulation results indicate that parameter estimates of mediation in the model were statistically accurate and precise across the range of examined conditions. Type 1 error rates were also tolerable in the conditions studied. Adequate power to detect effects in the model, with binary X and continuous M variables, required effect sizes of the mediation paths to be medium or large. Possible extensions of the model are also considered.

Negative life events and incident alcohol use disorders among ethnic minorities

The association of negative life events (NLEs) with incident alcohol use disorders (AUDs) was examined among Blacks, Hispanics, and Whites in the second wave of the National Comorbidity Survey (NCS) among 3,679 participants without AUDs at the first wave. The number of past-year NLEs at NCS-2 was higher for Black than White participants, but the rates of incident AUDs did not differ by racial/ethnic group (14.2% among all participants). Past-year NLEs were associated with increased odds of incident AUDs for Whites and Hispanics but not Blacks. The implications of racial/ethnic differences in life events and AUDs are discussed.

Longitudinal Reciprocal Associations Between Anxiety, Depression, and Alcohol Use in Adolescent Girls

BACKGROUND

Depression, anxiety, and alcohol misuse predict adverse social, academic, and emotional outcomes, and their relations to one another increase during adolescence-particularly in girls. However, evidence on the directions of these relations is mixed. Longitudinal models of internalizing problem-alcohol use links may identify promising prevention targets. Accordingly, we examined reciprocal associations between anxiety severity and alcohol use, as well as between depression severity and alcohol use, in adolescent girls.

METHODS

Data were drawn from a population-based longitudinal study of female adolescents. The current sample comprised 2,100 participants (57.1% Black, 42.9% White) assessed annually between ages 13 and 17. Girls self-reported depression severity, anxiety severity, and frequency of alcohol use (consumption of ≥1 full drink) in the past year. Primary caregivers reported on socioeconomic and neighborhood factors; these were included with race, early puberty, and conduct problems (youth-report) as covariates. Anxiety and depression severity were included within a single cross-lagged panel model, along with alcohol use, to isolate their independent and reciprocal links to drinking behavior.

RESULTS

Higher depression severity modestly predicted increased likelihood of subsequent alcohol use from ages 13 to 17. However, inconsistent relations emerged for the reverse pathway: Alcohol use modestly predicted decreased depression severity at ages 14 and 16; associations were nonsignificant in other lagged associations. Anxiety severity and alcohol use were not consistently associated.

CONCLUSIONS

Results highlight the key role of depression, relative to anxiety, in predicting later alcohol use. Future studies may examine whether depression prevention programs yield secondary reductions in alcohol use in adolescent girls.

Moderation of the effects of discrimination-induced affective responses on health outcomes

OBJECTIVE

The goal of the study was to examine differential mediation of long-term effects of discrimination on health behaviour and health status by internalising (anxiety and depression) and externalising (hostility and anger), and to explore moderation of these effects, specifically, by the presence of support networks and coping tendencies.

DESIGN

The current analyses employed structural equation modelling of five waves of data from Black female participants of the Family and Community Health Study over 11 years (M age 37-48).

MAIN OUTCOMES MEASURES

The main outcome variables were health status and alcohol use (frequency and problematic consumption).

RESULTS

Perceived racial discrimination was associated with increases in internalising and externalising. In addition, internalising reactions to discrimination were associated with deterioration in health status and increases in problematic drinking; externalising reactions were associated with increases in frequency of drinking. These relations were attenuated by availability of support networks, and exacerbated by use of avoidance coping.

CONCLUSION

The current study (a) replicated previous research suggesting that two different types of affective reactions mediate the relations between perceived racial discrimination and physical health status vs. health-impairing behaviours: internalising and externalising, and (b) revealed moderation of these effects by coping mechanisms.

The relationship between childhood trauma and alcohol use initiation in Black and White adolescent girls: considering socioeconomic status and neighborhood factors

PURPOSE

To assess whether the higher prevalence of childhood trauma exposure but lower prevalence of alcohol use in Black vs. White adolescent girls reflects a lower magnitude of association between trauma and alcohol use initiation in Black girls; and additionally, whether low socioeconomic status (SES) and neighborhood factors account in part for the link between trauma and early alcohol use.

METHODS

Data were drawn from annual interviews conducted with an urban sample of girls and their primary caregivers from ages 5-8 (baseline) through age 17 (n = 2068, 57.7% Black, 42.3% White). Cox proportional hazards regression analyses using race and childhood trauma to predict alcohol use initiation were conducted in two stages, with SES and neighborhood factors added in the second stage.

RESULTS

Childhood trauma was more prevalent (29.0 vs. 17.5%) and alcohol use initiation less prevalent (37.7 vs. 54.4%) in Black vs. White girls, but we found no evidence for differences in liability conferred by trauma. However, significant changes in hazards ratios (HRs) from the unadjusted to adjusted models were observed for Black race (HR = 0.57, CI 0.50-0.65 to HR = 0.66, CI 0.54-0.80) and childhood trauma (HR = 1.70, CI 1.46-1.99 to HR = 1.34, CI 1.05-1.71).

CONCLUSIONS

Findings indicate that childhood trauma is an equally potent risk factor for early drinking onset for Black and White girls; the risk for early alcohol use in Black girls who have experienced traumatic events should not be underestimated. Results further indicate that low SES and neighborhood factors contribute to the associations of childhood trauma and race with alcohol use initiation.

Trends in typologies of concurrent alcohol, marijuana, and cigarette use among US adolescents: An ecological examination by sex and race/ethnicity

Substance use during adolescence is a public health concern due to associated physical and behavioral health consequences. Such consequences are amplified among concurrent substance users. Although sex and racial/ethnic differences in single-substance use have been observed, the current literature is inconclusive as to whether differences exist in the prevalence of concurrent use. The current study used data from the 2011-2014 National Survey on Drug Use and Health to examine typologies (single and concurrent patterns) of alcohol, marijuana, and cigarette use among current adolescent users age 12-18 by sex and race/ethnicity. Participants were 14,667 White, Hispanic, African American, Asian, and Native American adolescents. The most common typology was alcohol only, followed by concurrent use of alcohol and marijuana. Weighted prevalence estimates indicated that adolescent females were more likely to be current users of alcohol only, whereas male adolescents were more likely to belong to all other typologies. Compared to Whites, racial/ethnic minorities had larger proportions of marijuana only users and were generally less likely than or equally likely to be concurrent users. One exception was for African American adolescents, who were more likely to be alcohol and marijuana users than their White counterparts. Results suggest that concurrent substance use is common among U.S. adolescents, making up over 40% of past-month use, but typologies of use vary by sex and race/ethnicity. Preventive interventions should consider all typologies of use rather than only single substance exposures and address patterns of use that are most pertinent to adolescents based on sex and race/ethnicity.

Age of initiation and substance use progression: A multivariate latent growth analysis

An individual's age at first substance use may be associated with their risk for progression toward heavier substance involvement. To our knowledge, however, no studies within nationally representative samples have examined the relation between the timing of initiation and progression in use of multiple substances. The present study employed a sample of 9,421 participants from the National Longitudinal Study of Adolescent to Adult Health who reported on their ages of tobacco, alcohol, and cannabis initiation; frequency of tobacco, alcohol, and cannabis use; and quantity of tobacco and alcohol use across 4 waves. We fit latent growth models to examine (a) associations between the age of initiation and initial status and rate of change in substance involvement, and (b) the degree to which the timing of first substance use accounted for differences in trajectories. There were significant relations between all ages of initiation and rates of change in tobacco (βs = -0.21 to -0.31, ps < .01) and alcohol use frequency (βs = 0.14 to 0.31, ps < .001), age of cannabis initiation and rate of change in tobacco use quantity (β = 0.23, p < .01), and age of tobacco initiation and rate of change in cannabis use frequency (β = -0.14, p < .01). After adjusting for age of initiation, significant associations were observed between trajectories for tobacco and alcohol (r = .43, p < .0001) and alcohol and cannabis (r = .20, p < .05). Results highlight differences in within- and cross-substance relations between the age of initiation and rate of change in use across substances. They suggest that differences in substance use trajectories are partly accounted for by age at first use. (PsycINFO Database Record

Parental Influences on Heavy Episodic Drinking Development in the Transition to Early Adulthood

PURPOSE

The purpose of this study was to examine how parental relationship quality (communication frequency, time spent together, and closeness) during early adulthood is related to heavy episodic drinking (HED) during this developmental period and whether effects vary according to age, youth sex, or parent sex.

METHODS

National data from the Panel Study of Income Dynamics-Transition to Adulthood Study were analyzed. Youth participated in up to four interviews (2005, 2007, 2009, and 2011; n = 1,320-1,489) between ages 18-25 years. At each wave, respondents reported past-year HED and their communication frequency, time spent, and closeness with each parent (items combined into an index). We tested differences in parental effects by age, parent sex, and youth sex using multigroup latent curve models.

RESULTS

Paternal relationship quality was negatively associated with HED for both males and females at each age; associations did not vary by respondent age or sex (odds ratio [OR] = .73, 95% confidence interval [CI]: .63-.85). Maternal relationship quality was significantly negatively associated with HED at ages 18-19 years among both sexes equally (OR = .50, 95% CI: .41-.61). Although protective associations continued until the age of 25 years for males, they weakened and became nonsignificant at ages 20-25 years for females (OR = .87, 95% CI: .72-1.04). Findings were robust to inclusion of multiple covariates associated with both parenting and alcohol use.

CONCLUSIONS

Having close, communicative parental relationships seems protective against HED in early adulthood, although for females maternal effects appear limited to late adolescence. Programs to improve relationship quality between young adults and their parents may help curb problematic drinking during this vulnerable period.

The moderating effect of neighborhood sense of community on predictors of substance use among Hispanic urban youth

Hispanic adolescents represent a disproportionate number of youth living in urban communities. These youth confront significant social problems that increase their likelihood for substance use. However, youth that have a greater neighborhood sense of community are postulated, through empowerment theory, to be less influenced by negative environmental experiences and less inclined to engage in drug and alcohol use. We examine the moderating effect neighborhood SOC has on predictors of substance use among Hispanic (N = 538) urban youth in low- (n = 246) and high-conflict homes (n = 292). Using logistic regression analysis and a plotting technique to examine interaction effects, we explore these relationships and provide recommendations for practice and prevention.

Parental divorce and initiation of alcohol use in early adolescence

Parental divorce/separation is among the most commonly endorsed adverse childhood events. It has been shown to increase subsequent risk of alcohol dependence and problems across adolescence and early adulthood, but its influence on early stages of alcohol involvement has only recently been explored. In the present study, we examined whether time to first full drink was accelerated among youth who experienced parental divorce/separation. To determine specificity of risk, models controlled for perceived stress as well as family history of alcoholism, current parental drinking, and internalizing and externalizing problems. Developmental specificity in terms of timing of both parental divorce and first drink was also examined. Participants were 931 middle-school students (488 girls, 443 boys) who were enrolled in a prospective study on drinking initiation and progression (52% female; 23% non-White, 11% Hispanic). Students indicated whether and at what age they had consumed a full drink of alcohol. Parental divorce/separation was coded from a parent-reported life-events inventory and was grouped based on age experienced (ages 0-5, ages 6-9, age 10+). Cox proportional hazard models showed increased risk for onset of drinking as a function of divorce/separation, even controlling for stress, parental alcohol involvement, and psychopathology. There was no evidence for developmental specificity of the divorce/separation effect based on when it occurred nor in timing of first drink. However, the effect of parental divorce/separation on initiation was magnified at higher levels of parental drinking. Given the rates of parental divorce/separation and its association with increased risk of early drinking, investigation of the mechanisms underlying this link is clearly warranted. (PsycINFO Database Record

Similarities and differences in alcohol trajectories: Testing the catch-up effect among biracial black subgroups

Using National Longitudinal Study of Adolescent and Adult Health (Add Health) data, we examine the alcohol-use trajectories of monoracial Black youth and biracial Black-White, Black-Hispanic, and Black-American Indian youth to assess how their trajectories differ from the alcohol-use trajectories of White youth over time. The sample consists of 9421 adolescents and young adults who self-identified as White, Black, Black-American Indian, Black-Hispanic, or Black-White. Study hypotheses are tested using latent growth curve modeling. Results indicate that a catch-up effect exists, but only for Black-American Indians whose alcohol-use rates approach the higher rates of Whites at age 29. Black-American Indians face particularly high risk of problematic drinking over the life course. Additional research is needed to understand causal factors of alcohol-use among biracial individuals particularly Black-American Indians who may be at higher risk for alcohol misuse.

Progression from First Drink, First Intoxication, and Regular Drinking to Alcohol Use Disorder: A Comparison of African American and European American Youth

BACKGROUND

Differences between African Americans (AAs) and European Americans (EAs) in the prevalence and age at onset of alcohol use and alcohol use disorder (AUD) have been documented, but distinctions in the timing of early stage transitions and contribution of various psychiatric and psychosocial risk factors to the progression from initiation to AUD have yet to be investigated. The current study characterized progression from alcohol use initiation-defined alternatively as first drink, first intoxication, and regular drinking onset-to AUD in AA and EA youth.

METHODS

Psychiatric interviews were administered via telephone to 1,461 participants (56% AA, 44% EA) in a high-risk family study (50.3% female, mean age = 17.6 [SD = 3.8]). Cox proportional hazards regression analyses were conducted separately for the AA and EA subsamples to predict DSM-5 AUD as a function of age at alcohol use initiation, with age at first drink, age at first intoxication, and age at regular drinking onset as the point of origin in separate models.

RESULTS

Across race/ethnicity, regardless of how it was measured, early alcohol use initiation predicted AUD, but hazard ratios (HRs) were lowest for first drink. Regular smoking and social anxiety disorder were significant predictors in both racial/ethnic groups, but associations with conduct disorder (all 3 models: HR range = 2.07 to 4.15) and major depressive disorder (regular drinking: HR = 4.51, confidence interval [CI]: 1.60 to 12.69 for AUD onset ≥ age 20) were specific to AAs. Posttraumatic stress disorder (HR = 5.38, CI: 1.44 to 20.08) and generalized anxiety disorder (HR = 7.35, CI: 2.31 to 23.34 for AUD onset ≤ age 17) were strongly associated with progression from regular drinking to AUD exclusively in EAs.

CONCLUSIONS

Early alcohol use initiation is a marker of risk for AUD in both AA and EA youth, but the contributions of various psychiatric risk factors to the development of AUD are not universal across racial/ethnic groups.

Self-Reported Emotion Reactivity Among Early-Adolescent Girls: Evidence for Convergent and Discriminant Validity in an Urban Community Sample

Emotion reactivity, measured via the self-report Emotion Reactivity Scale (ERS), has shown unique associations with different forms of psychopathology and suicidal thoughts and behaviors; however, this limited body of research has been conducted among adults and older adolescents of predominantly White/European ethnic backgrounds. The present study investigated the validity of ERS scores for measuring emotion reactivity among an urban community sample of middle-school-age girls. Participants (N = 93, ages 11-15, 76% African-American, 18% Latina) completed the ERS and measures of emotion coping, internalizing problems, proactive and reactive aggression, negative life events, and lifetime suicidal ideation and substance use. As hypothesized, ERS scores were significantly associated with internalizing problems, poor emotion coping, negative life events, reactive aggression, and suicidal ideation (evidence for convergent validity), but showed little to no association with proactive aggression or lifetime substance use (evidence for discriminant validity). A series of logistic regressions were conducted to further explore the associations among internalizing problems, emotion reactivity, and suicidal ideation. With depressive symptoms included in the model, emotion reactivity was no longer uniquely predictive of lifetime suicidal ideation, nor did it serve as a moderator of other associations. In conjunction with previous research, these findings offer further support for the construct validity and research utility of the ERS as a self-report measure of emotion reactivity in adolescents.

The prospective association between sipping alcohol by the sixth grade and later substance use

OBJECTIVE

Although there is a clear association between early use of alcohol and short- and long-term adverse outcomes, it is unclear whether consumption of minor amounts of alcohol (less than a full drink) at a young age is prognostic of risk behaviors in later adolescence.

METHOD

Data were taken from 561 students enrolled in an ongoing prospective web-based study on alcohol initiation and progression (55% female; 25% White non-Hispanic). Based on a combination of monthly and semiannual surveys, we coded whether participants sipped alcohol before sixth grade and examined associations between early sipping and alcohol consumption by fall of ninth grade, as well as other indices of problem behavior. Participants also reported on the context of the first sipping event.

RESULTS

The prevalence of sipping alcohol by fall of sixth grade was 29.5%. Most participants indicated that their first sip took place at their own home, and the primary source of alcohol was an adult, usually a parent. Youth who sipped alcohol by sixth grade had significantly greater odds of consuming a full drink, getting drunk, and drinking heavily by ninth grade than nonsippers. These associations held even when we controlled for temperamental, behavioral, and environmental factors that contribute to proneness for problem behavior, which suggests that sipping is not simply a marker of underlying risk.

CONCLUSIONS

Our findings that early sipping is associated with elevated odds of risky behaviors at high school entry dispute the idea of sipping as a protective factor. Offering even just a sip of alcohol may undermine messages about the unacceptability of alcohol consumption for youth.

Alcohol consumption among adolescents: attitudes, behaviors and associated factors

The scope of this paper is to assess the attitudes and behaviors regarding alcohol use and analyze associated factors among schoolchildren in public schools of Campina Grande in the state of Paraíba. A cross-sectional study was carried out involving 574 adolescents, with the application of a semi-structured questionnaire. The chi-square test and Fisher's exact test were used (5% level of significance). Among the adolescents 54.5% had drunk alcohol and 6.7% of them were heavy drinkers. The majority of them drank alcohol between 11 and 14 years of age (42.8%); 26.3% of the adolescents purchased alcoholic beverages; and beer was the most drink most consumed (43.8%). The risk of alcohol drinking was higher between 16 and 19 years of age (OR = 4.44; p < 0.001), among those without religious affiliation (OR = 4.36; p = 0.002), among those who worked (OR = 2.13; p = 0.012) and among those who had a fair to poor relationship with their father (OR = 2.18; p = 0.010). The results of this study underscore the complexity of this issue and the need to pay particular attention to the adolescent population. Public policies alone are not sufficient. Support from family, school and society is essential to curtail early alcohol use and its consequences.

Perceived Discrimination and Heavy Episodic Drinking Among African-American Youth: Differences by Age and Reason for Discrimination

PURPOSE

The purpose of this study was to examine whether associations between perceived discrimination and heavy episodic drinking (HED) vary by age and by discrimination type (e.g., racial, age, physical appearance) among African-American youth.

METHODS

National data from the Panel Study of Income Dynamics Transition to Adulthood Study were analyzed. Youth participated in up to four interviews (2005, 2007, 2009, 2011; n = 657) between ages 18 and 25 years. Respondents reported past-year engagement in HED (four or more drinks for females, five or more drinks for males) and frequency of discriminatory acts experienced (e.g., receiving poor service, being treated with less courtesy). Categorical latent growth curve models, including perceived discrimination types (racial, age, and physical appearance) as a time-varying predictors of HED, were run. Controls for gender, birth cohort, living arrangement in adolescence, familial wealth, parental alcohol use, and college attendance were explored.

RESULTS

The average HED trajectory was curvilinear (increasing followed by flattening), whereas perceived discrimination remained flat with age. In models including controls, odds of HED were significantly higher than average around ages 20-21 years with greater frequency of perceived racial discrimination; associations were not significant at other ages. Discrimination attributed to age or physical appearance was not associated with HED at any age.

CONCLUSIONS

Perceived racial discrimination may be a particularly salient risk factor for HED around the ages of transition to legal access to alcohol among African-American youth. Interventions to reduce discrimination or its impact could be targeted before this transition to ameliorate the negative outcomes associated with HED.

Developmental Relations Between Alcohol and Aggressive Behavior Among Adolescents: Neighborhood and Sociodemographic Correlates

Throughout adolescence, alcohol consumption and aggressive behaviors are associated with multiple problematic outcomes. Few studies have examined neighborhood-level predictors and individual and family-level sociodemographic variables to describe longitudinal trajectories of these problem behaviors. Therefore, this study investigated the unique contributions of neighborhood and sociodemographic factors in the shared development of aggressive behaviors and drinking in adolescents. We analyzed alcohol consumption frequency and frequency of aggressive behaviors using parallel process latent growth curve models with demographic indicators and neighborhood constructs as predictors. At all ages, alcohol use and aggression positively covaried. Male gender was associated with both aggressive episodes and alcohol use at age 12. African American ethnicity was associated with higher levels of early aggression. Higher neighborhood income was associated with lower levels of early aggression. Findings lend support to current efforts to curb early initiation of alcohol use and aggression.

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.

Asian American problem drinking trajectories during the transition to adulthood: ethnic drinking cultures and neighborhood contexts

OBJECTIVES

We aimed to identify problem drinking trajectories and their predictors among Asian Americans transitioning from adolescence to adulthood. We considered cultural and socioeconomic contextual factors, specifically ethnic drinking cultures, neighborhood socioeconomic status, and neighborhood coethnic density, to identify subgroups at high risk for developing problematic drinking trajectories.

METHODS

We used a sample of 1333 Asian Americans from 4 waves of the National Longitudinal Study of Adolescent to Adult Health (1994-2008) in growth mixture models to identify trajectory classes of frequent heavy episodic drinking and drunkenness. We fitted multinomial logistic regression models to identify predictors of trajectory class membership.

RESULTS

Two dimensions of ethnic drinking culture-drinking prevalence and detrimental drinking pattern in the country of origin-were predictive of problematic heavy episodic drinking and drunkenness trajectories. Higher neighborhood socioeconomic status in adolescence was predictive of the trajectory class indicating increasing frequency of drunkenness. Neighborhood coethnic density was not predictive of trajectory class membership.

CONCLUSIONS

Drinking cultures in the country of origin may have enduring effects on drinking among Asian Americans. Further research on ethnic drinking cultures in the United States is warranted for prevention and intervention.

Bicultural stress, identity formation, and alcohol expectancies and misuse in Hispanic adolescents: a developmental approach

Hispanic immigrant youth engage in increased health risk behaviors, such as alcohol misuse, due in part to being confronted with acculturative stress in addition to facing major normative developmental challenges, such as identity consolidation (Berry et al. in Appl Psychol 55:303-332, 2006). Using a developmental psychopathology framework, in the present study we examined the effect of bicultural stress on alcohol misuse among immigrated Hispanic adolescents, indirectly through trajectories of identity formation and alcohol expectancies. Our sample consisted of 302 recently immigrated Hispanic adolescents (53 % male; Mage = 14.5 at baseline) who were interviewed every 6 months for 3 years. Bivariate growth curve modeling was used to examine the influence of initial early bicultural stress on later alcohol misuse via change in identity development (i.e., coherence and confusion) and subsequent growth in cognitive alcohol expectancies. Findings revealed that initial levels and growth of identity coherence were not significantly associated with either bicultural stress or tension reduction (TR) alcohol expectancies. Multiple mediation analyses indicated that the effect of bicultural stress at time 1 on the frequency of being drunk at time 6 was mediated via high initial levels of identity confusion, followed by growth in risky TR expectancies (T4-T6). A developmental approach to the genesis of alcohol use problems in immigrant youth is discussed.

Testing demographic differences for alcohol use initiation among adolescents for the decisional balance and situational temptation prevention inventories

Alcohol use by middle school-aged students is a public health concern because of the numerous adverse social, health and psychological outcomes. Prevention programs attempt to intervene before alcohol use begins. A tailored, computer-delivered program for the prevention of alcohol use and a series of new transtheoretical model measures were developed, including decisional balance (Pros and Cons) of alcohol use and Situational Temptations to Try Alcohol. This study investigated if there were any demographic differences on these measures in a sample of 6th grade middle school students from 20 schools (N=4151) at baseline. Three factorial analysis of variance tests were conducted to explore the impact of race (whites vs. non-whites), ethnicity (Hispanics vs. Non-Hispanics) and gender (males vs. females). A significant two-way interaction effect was found between gender and ethnicity for Pros of Alcohol Use. A significant three-way interaction effect was found between gender, race and ethnicity for Cons of Alcohol Use. Main effects were found for the three demographic factors for Situational Temptations to Try Alcohol. However, the effect sizes for the interaction effects and main effects were very small (all below η(2)=.01), suggesting that race/ethnicity and gender alone may not be highly influential factors in the Decisional Balance for the Prevention of Alcohol and Situational Temptations to Try Alcohol in adolescence. The implications for these results and alcohol use prevention among this group are discussed.

Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled Youth Risk Behavior Surveys

OBJECTIVES

We examined sexual orientation disparities in cancer-related risk behaviors among adolescents.

METHODS

We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys. We classified youths with any same-sex orientation as sexual minority and the remainder as heterosexual. We compared the groups on risk behaviors and stratified by gender, age (< 15 years and > 14 years), and race/ethnicity.

RESULTS

Sexual minorities (7.6% of the sample) reported more risk behaviors than heterosexuals for all 12 behaviors (mean = 5.3 vs 3.8; P < .001) and for each risk behavior: odds ratios (ORs) ranged from 1.3 (95% confidence interval [CI] = 1.2, 1.4) to 4.0 (95% CI = 3.6, 4.7), except for a diet low in fruit and vegetables (OR = 0.7; 95% CI = 0.5, 0.8). We found sexual orientation disparities in analyses by gender, followed by age, and then race/ethnicity; they persisted in analyses by gender, age, and race/ethnicity, although findings were nuanced.

CONCLUSIONS

Data on cancer risk, morbidity, and mortality by sexual orientation are needed to track the potential but unknown burden of cancer among sexual minorities.

White and black adolescent females differ in profiles and longitudinal patterns of alcohol, cigarette, and marijuana use

Emerging research suggests that white youth are more likely to show continuity of alcohol use in the year after drinking onset, compared with black youth. Little is known, however, regarding racial differences in year-to-year continuity of alcohol, cigarette, and marijuana use during adolescence, particularly among females, who are at greater risk for certain substance-related harm than males. This study used latent class/transition analysis to identify profiles of past year alcohol, cigarette, and marijuana use at ages 13-17 in a community sample of 1076 adolescent females (57% black, 43% white). Three profiles of past year substance use were identified in separate analyses by race: "no use," "alcohol only," and "polydrug use." Although similar labels describe the profiles, the probability of endorsing use of a particular substance for a given profile differed by race, precluding direct comparison. Latent transition analyses of five annual waves covering ages 13-17 indicated that an intermittent pattern of use (e.g., use in one year, but not the next) was relatively low at all ages among white girls, but among black girls, an intermittent pattern of use began to decline at age 15. Among black girls, conduct problems at age 12 predicted substance using profiles at age 13, whereas among white girls, intentions to use alcohol and cigarettes at age 12 predicted substance using profiles at age 13. Racial differences in girls' substance use profiles suggest the potential utility of culturally tailored interventions that focus on differences in risk for specific substances and relatively distinct early patterns of use.

Racial differences in type of alcoholic beverage consumed during adolescence in the Pittsburgh Girls Study

BACKGROUND

White, compared with Black, adolescents have higher rates of alcohol use and show more rapid increases in alcohol use. Racial differences in type of alcohol beverage (i.e., beer, wine, and liquor) consumed by youth have received scant attention, and little is known regarding changes in type of alcohol beverage consumed during adolescence, when experimentation may transition to more regular use.

METHODS

This study used repeated measures latent class analysis to identify distinct profiles that represent change in type of alcohol beverage consumed across ages 11 to 18 and to examine predictors (e.g., caretaker alcohol use, perceived peer alcohol use, ease in accessing alcohol, perceived neighborhood risk indicated by witnessing drug dealing), most of which were measured at ages 11 to 12, of alcohol use profiles in the Pittsburgh Girls Study (n = 2,171; 57% Black, 43% White), a community sample with annual follow-ups.

RESULTS

Among Black girls, 2 profiles were identified: Low Use (76%), and Alcohol Use involving primarily liquor starting around age 15 (24%). Among White girls, 4 profiles were identified: Wine sippers (11%); a Low Use profile with low probability of drinking until age 18, when use of beer and liquor increased (52%); an Increasing Use profile with increased probability of drinking beer and liquor starting at age 15 (23%); and a High Alcohol Use profile, starting with use of wine, then shifting to use primarily of beer and liquor after age 13 (14%). Separate risk factor analyses conducted by race indicated similar predictors for Black and White girls: perceived ease in accessing alcohol, witnessing neighborhood drug dealing, and perceived peer alcohol use were each associated with heavier drinking profiles.

CONCLUSIONS

Longitudinal profiles of type of alcoholic beverages, within and across racial groups, can guide the tailoring of interventions to address developmentally salient turning points in alcohol use for specific subgroups of girls.