Prospective differential prediction of adolescent alcohol use and problem use: examining the mechanisms of effect

Influence of Early Onset of Alcohol Use on the Development of Adolescent Alcohol Problems: a Longitudinal Binational Study

This study examined cross-national similarities in a developmental model linking early age of alcohol use onset to frequent drinking and heavy drinking and alcohol problems 1 and 2 years later in a binational sample of 13-year-old students from two states: Washington State, USA and Victoria, Australia (N = 1833). A range of individual, family, school, and peer influences was included in analyses to investigate their unique and shared contribution to development of early and more serious forms of alcohol use and harms from misuse. Data were collected annually over a 3-year period from ages 13 to 15. Analyses were conducted using multiple-group structural equation modeling. For both states, early use of alcohol predicted frequent drinking, which predicted alcohol problems. Family protective influences had neither direct effects on heavy drinking nor effects on alcohol harm in either state, whereas school protection directly reduced the risk of heavy drinking in both states. Exposure to antisocial peers and siblings predicted a higher likelihood of heavy drinking and alcohol harm for students in both Washington and Victoria. Implications for the prevention of adolescent alcohol problems are discussed.

Social and Individual-Level Predictors of Alcohol Use Initiation and Escalation: Replicating and Extending Tests of Differential Effects

OBJECTIVE

Although alcohol use is considered a developmental phenomenon, there is a relative dearth of studies disaggregating predictors of alcohol use initiation versus early escalation of drinking. One perspective that has emerged is that social levels of influence may be relevant for the initiation of drinking, whereas individual levels of influence may be relevant for the early escalation in level of drinking among initiators, which we refer to as the specificity hypothesis.

METHOD

A sample of alcohol-naive youth (n = 944; mean age = 12.16 years, SD = 0.96) was prospectively assessed for 3 years, spanning six waves of data collection.

RESULTS

Both social (parental conflict, perceived prevalence of peer drinking) and individual-level (higher sensation seeking) variables uniquely predicted increases in the likelihood of alcohol initiation. Likewise, both social (perceived descriptive norms of peer drinking) and individual-level (lower school grades, higher sensation seeking) variables uniquely predicted escalation in level of drinking among initiators (although only marginally for sensation seeking).

CONCLUSIONS

Overall, there was little support for the specificity hypothesis. Our findings suggest that to assume that social and individual-level processes differentially predict drinking outcomes may be a false dichotomy. Theoretical work may benefit from drawing from developmental models emphasizing the interplay between individual and environmental factors in the prediction of the early development of drinking. The emergence of drinking behaviors is likely to result from a developmental cascade of interacting variables that make the ontogeny of drinking unlikely to emerge from a single class of variables.

Polygenic Risk, Personality Dimensions, and Adolescent Alcohol Use Problems: A Longitudinal Study

OBJECTIVE

Alcohol use problems are common during adolescence and can predict serious negative outcomes in adulthood, including substance dependence and psychopathology. The current study examines the notion that alcohol use problems are driven by polygenic influences and that genetic influences may indirectly affect alcohol use problems through multiple pathways of risk, including variations in personality.

METHOD

We used a genome-wide approach to examine associations between genetic risk for alcohol use problems, personality dimensions, and adolescent alcohol use problems in two separate longitudinal population-based samples, the Finnish Twin Cohort (FinnTwin12) and the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants were 1,035 young adults from FinnTwin12 and 3,160 adolescents from ALSPAC. Polygenic risk scores (PRS) were calculated for ALSPAC using genome-wide association results (on alcohol dependence symptoms as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) from FinnTwin12. A parallel multiple mediator model was tested to examine whether the association between PRS and alcohol use problems assessed at age 16 could be explained by variations in personality dimensions assessed at age 13, including sensation seeking and negative emotionality.

RESULTS

PRS were marginally predictive of age 16 alcohol use problems; this association was partially mediated by sensation seeking. Polygenic variation underlying risk for alcohol use problems may directly influence the effects of sensation seeking, which in turn influence the development of alcohol use problems in later adolescence.

CONCLUSIONS

These findings contribute to the increasing evidence regarding the salience of sensation seeking during early adolescence as a potential constituent in the risk pathway underlying the development of alcohol use problems.

Gender and Direction of Effect of Alcohol Problems and Internalizing Symptoms in a Longitudinal Sample of College Students

BACKGROUND

Alcohol problems and internalizing symptoms are consistently found to be associated but how they relate to each other is unclear.

OBJECTIVE

The present study aimed to address limitations in the literature of comorbidity of alcohol problems and internalizing symptoms by investigating the direction of effect between the phenotypes and possible gender differences in college students.

METHOD

We utilized data from a large longitudinal study of college students from the United States (N = 2607). Three waves of questionnaire-based data were collected over the first two years of college (in 2011-2013). Cross-lagged models were applied to examine the possible direction of effect of internalizing symptoms and alcohol problems. Possible effects of gender were investigated using multigroup modeling.

RESULTS

There were significant correlations between alcohol problems and internalizing symptoms. A direction of effect was found between alcohol problems and internalizing symptoms but differed between genders. A unidirectional relationship varying with age was identified for males where alcohol problems initially predicted internalizing symptoms followed by internalizing symptoms predicting alcohol problems. For females, a unidirectional relationship existed wherein alcohol problems predicted internalizing symptoms. Conclusions/Importance: We conclude that the relationship between alcohol problems and internalizing symptoms is complex and differ between genders. In males, both phenotypes are predictive of each other, while in females the relationship is driven by alcohol problems. Importantly, our study examines a population-based sample, revealing that the observed relationships between alcohol problems and internalizing symptoms are not limited to individuals with clinically diagnosed mental health or substance use problems.

Initial body fat gain is related to brain volume changes in adolescents: A repeated-measures voxel-based morphometry study

OBJECTIVE

Individuals with obesity versus those within a healthy weight range show brain volume differences, but it is unclear whether these differences reflect initial vulnerability factors or are secondary to weight gain.

METHODS

One hundred sixty-two adolescents (M age = 15.3 ± 1.1; 81 females) with healthy weight were scanned at baseline. Sixty subjects (M baseline age: 15.2 ± 1.1; M follow-up age: 17.7 ± 1.2; 34 females) completed a second scan at 2- or 3-year follow-up. Voxel-based morphometry assessed global and regional gray matter (GM) and white matter (WM) volumes. Body fat percentage was assessed yearly over follow-up.

RESULTS

Baseline global/regional GM/WM volume did not predict body fat gain over follow-up. Adolescents who gained body fat showed greater decreases in GM volume in the putamen compared with those who showed loss of body fat. Adolescents who gained body fat showed greater increases in WM volume in the anterior cingulate cortex compared with those who showed stability of or loss of body fat.

CONCLUSIONS

Body fat gain versus stability and loss produce GM and WM volume changes, rather than baseline volumetric differences predicting body fat gain.

The Effect of Residence, School Status, Work Status, and Social Influence on the Prevalence of Alcohol Use Among Emerging Adults

OBJECTIVE

The first year after high school is a transitional year, with increased independence from parental supervision, contact with other independent youth, and exposure to new environments, all of which may influence substance use. This article reports longitudinal predictors of change in the prevalence of alcohol use and heavy episodic drinking among adolescents and environmental correlates (i.e., residence, college attendance, and work status) with drinking the year after high school.

METHOD

A national sample of study participants (N = 2,659; 55% female) in the NEXT Generation Health Study were followed annually from 10th grade (Wave 1) to the year after high school (Wave 4). Longitudinal binary outcomes, including recent (30-day) drinking and two measures of heavy episodic drinking, were examined. Transition models with generalized estimating equations estimated the effect of previous drinking behaviors, social influences, and current residential status and activity (school and/or work) on drinking prevalence.

RESULTS

Drinking increased from 40.5% among high school seniors (Wave 3) to 53.5% in Wave 4 for 30-day use, and from 29.0% to 41.2% for heavy episodic drinking. Significant predictors of 30-day drinking included previous drinking status (odds ratio [OR] = 5.48), peer drinking often (OR = 3.25), parental expectations (OR = 0.91), and current year living on campus (OR = 2.10). The same significant predictors with similar magnitudes were found for both measures of heavy episodic drinking. Peer use did not interact with college attendance or residence.

CONCLUSIONS

Predictors of drinking and heavy episodic drinking during the first year after high school included being White, living on campus, previous drinking, lower parental expectations, and having peers who drink.

Interactions Between Internalizing Symptoms and Urgency in the Prediction of Alcohol Use and Expectancies Among Low-Income, Minority Early Adolescents

This study examined whether urgency, a disposition to rash action under conditions of strong emotion, moderates associations between internalizing symptoms and alcohol use and related expectancies. Data from the Camden Youth Development Study, a longitudinal, community-based study of early adolescents (N = 144, mean age at intake = 11.9 years; 65% Hispanic, 30% African-American; 50% male), were used. Self-report questionnaire measures of depressive symptoms, social and generalized anxiety symptoms, urgency, alcohol use, and alcohol expectancies were used. Mixed models were used to examine the effects of internalizing symptoms, urgency, and their interaction on alcohol use and expectancy trajectories over time. Depressive symptoms interacted with urgency such that youth with high levels of both tended to have elevated levels of global positive alcohol expectancies. Social anxiety symptoms interacted with urgency to be associated with increasing levels of social behavior alcohol expectancies such that youth with high levels of both tended to experience particular increases in these expectancies over time. Generalized anxiety was not found to be associated with alcohol-related constructs. Therefore, high levels of urgency combine with depressive and social anxiety symptoms to be associated with particularly increased risk for alcohol expectancies that are associated with later alcohol use and problems, indicating particular risk for youth with these combinations of personality traits and psychopathology symptoms.

Dynamic Patterns of Adolescent Substance Use: Results From a Nationally Representative Sample of High School Students

OBJECTIVE

Use of tobacco, alcohol, marijuana, and other drugs increases during the high school years, yet little is known about individual patterns over time, particularly patterns of contemporaneous multiple-substance use. This study examined trajectories of contemporaneous substance use and how individual and social factors differentially predict patterns of substance use.

METHOD

Longitudinal trajectories of substance use were examined in a nationally representative sample of students (N = 2,512) over a 3-year period (10th through 12th grades) using latent class analysis. Individual, parental, and peer risk factors in 10th grade were examined in relation to membership in trajectory classes.

RESULT

A five-class model was identified: nonusers (45.5%); tobacco, alcohol, and other drug users (9.2%); alcohol and other drug users (9.2%); increasing multiple-substance users (16.7%); and decreasing multiple-substance users (19.4%). Depressive symptoms at baseline were associated with a higher likelihood of membership in all classes except the increasing multiple-substance-user class, but the association becomes insignificant when social influence factors were adjusted. Parental-monitoring knowledge was associated with a lower likelihood of membership in all classes except increasing multiple-substance-user class, whereas perceived parental disapproval was associated with a lower likelihood of membership in the tobacco, alcohol, and other drug user class. Peer substance use was associated with a higher likelihood of membership in each of the substance use classes.

CONCLUSIONS

The identified longitudinal profiles highlight the pervasiveness and dynamic patterns of contemporaneous multiple-substance use during 10th through 12th grades. Negative peer influence increased risk, whereas positive parenting behaviors decreased risk. The findings are consistent with the need to foster social influences and protective factors against adolescent substance use.

Predictors of alcohol-related negative consequences in adolescents: A systematic review of the literature and implications for future research

OBJECTIVE

To conduct a systematic review of the literature examining risk and protective factors of alcohol related negative consequences (ARNCs) among adolescents.

METHODS

We conducted a systematic search of original empirical articles published between January 1, 1990 and June 1, 2015. The qualitative synthesis was performed using the Theory of Triadic Influence as a framework.

RESULTS

Fifty-two studies were reviewed. Intrapersonal (e.g., personality traits, drinking motives and expectancies, depression), interpersonal (e.g., parental and peer alcohol use, violence exposure) and attitudinal factors (e.g., media exposure to alcohol, religiosity) influence ARNCs. Emerging evidence of new trends contributing to ARNCs include ready mixed alcohol drinks and childhood trauma and abuse.

CONCLUSIONS

Risk factors from all domains of influence were observed. More research is needed on protective factors and how alcohol use interacts with preventive factors in predicting ARNCs. The conceptualization of negative consequences varies significantly between studies and may impact the external validity of previous research.

Reciprocal Effects of Internalizing and Oppositional Defiance Symptoms on Heavy Drinking and Alcohol-Related Harms in Young Adulthood

There is a need for longitudinal research to understand how psychopathology relates to the onset and maintenance of substance use from adolescence into young adulthood. Hence, we investigate the longitudinal, reciprocal influences of internalizing (anxiety and depression) and externalizing (oppositional defiance) symptoms on heavy episodic drinking (HED; ≥5 drinks per occasion) and alcohol-related harms in a community-based sample of youth aged 12–27 years. Participants were chosen from the Victoria Healthy Youth Survey, followed six times, biennially between 2003 and 2013 (N = 662). Analyses used cross-lagged panel models to examine reciprocal relations over time. Differences across age and sex were also tested. Defiance symptoms predicted increases in HED, which reciprocally predicted increases in defiance symptoms for females. Internalizing symptoms were related to HED within time for females. Alcohol-related harms had reciprocal positive associations with internalizing and defiance symptoms for both males and females. Associations were largely invariant across age groups, suggesting that the presence and strength of associations persisted across development. While psychopathology preceded the onset of HED and harms, the overall findings suggest that these risk processes are mutually reinforcing across development and that youth may become entrenched in an interdependent cycle that significantly increases their risk of comorbid disorders in adulthood.

Early adolescent symptoms of social phobia prospectively predict alcohol use

OBJECTIVE

The current study examined whether social phobia (SP) symptoms in early adolescence prospectively predicted alcohol use through middle adolescence in a community sample of youth.

METHOD

Data from an ongoing longitudinal study (N = 277) of mechanisms of HIV-related risk behaviors in youth were used to assess the extent to which SP symptoms in early adolescence (mean [SD] age = 11.00 years [0.81]) would predict alcohol use across five annual assessment waves. Adolescents completed measures of SP symptoms, depressive symptoms, and alcohol use at each wave.

RESULTS

Higher SP symptoms at baseline predicted higher average odds of alcohol consumption during subsequent waves but did not significantly predict an increase in the odds of alcohol use as a function of time. Within a lagged model, SP symptoms measured at a prior assessment point (1 year earlier) predicted greater odds of drinking alcohol at the following assessment point. Importantly, alcohol use did not significantly predict SP symptoms over time. These results suggest that early SP symptoms are an important risk factor for increased odds of subsequent alcohol use.

CONCLUSIONS

The present findings highlight that elevated SP symptoms place adolescents at risk for early alcohol use. Early interventions targeting SP symptoms may be crucial for the prevention of problematic alcohol use in early to mid-adolescence. Implications for prevention and treatment approaches are discussed.

Delineating selection and mediation effects among childhood personality and environmental risk factors in the development of adolescent substance abuse

Utilizing the large, longitudinal Minnesota Twin Family Study (N = 2510; 96 % European American ancestry), we examined the influence of several person-environment transactions on adolescent substance abuse. We focused on the two childhood personality traits found to be most predictive of substance abuse in this sample-socialization (willingness to follow rules and endorse conventional values) and boldness (social engagement and assurance, stress resilience, thrill seeking)-and the environmental variables of antisocial and prosocial peers, academic engagement, parent-child relationship quality, and stressful life events. Path analysis revealed that low socialization had a selection effect for each environmental risk factor, that is, socialization at age 11 predicted environmental risk at age 14, after controlling for the stability of the environmental variables from ages 11 to 14. Antisocial peers and academic engagement at age 14 then mediated some of the risk of low socialization on substance abuse at age 17, but the majority of risk for substance abuse was accounted for by the stability of socialization from age 11 to 14. Boldness at age 11 also increased risk for substance abuse, but did so primarily via a direct effect. The findings help to parse the nature of person-environment transactions across multiple personality traits and contextual risk factors that contribute to adolescent substance abuse.

Brain reward region responsivity of adolescents with and without parental substance use disorders

The present study tested the competing hypotheses that adolescents at risk for future substance abuse and dependence by virtue of parental substance use disorders show either weaker or stronger responsivity of brain regions implicated in reward relative to youth without parental history of substance use disorders. Adolescents (n = 52) matched on demographics with and without parental substance use disorders, as determined by diagnostic interviews, who denied substance use in the past year were compared on functional MRI (fMRI) paradigms assessing neural response to receipt and anticipated receipt of monetary and food reward. Parental-history-positive versus -negative adolescents showed greater activation in the left dorsolateral prefrontal cortex and bilateral putamen, and less activation in the fusiform gyrus and inferior temporal gyrus in response to anticipating winning money, as well as greater activation in the left midbrain and right paracentral lobule, and less activation in the right middle frontal gyrus in response to milkshake receipt. Results indicate that adolescents at risk for future onset of substance use disorders show elevated responsivity of brain regions implicated in reward, extending results from 2 smaller prior studies that found that individuals with versus without parental alcohol use disorders showed greater reward region response to anticipated monetary reward and pictures of alcohol. Collectively, results provide support for the reward surfeit model of substance use disorders, rather than the reward deficit model.

Characterizing high school students who play drinking games using latent class analysis

Heavy alcohol use and its associated negative consequences continue to be an important health issue among adolescents. Of particular concern are risky drinking practices such as playing drinking games. Although retrospective accounts indicate that drinking game participation is common among high school students, it has yet to be assessed in current high school students. Utilizing data from high school students who reported current drinking game participation (n=178), we used latent class analysis to investigate the negative consequences resulting from gaming and examined underlying demographic and alcohol-related behavioral characteristics of students as a function of the resultant classes. Three classes of "gamers" emerged: (1) a "lower-risk" group who had a lower probability of endorsing negative consequences compared to the other groups, (2) a "higher-risk" group who reported that they experienced hangovers and difficulties limiting their drinking, got physically sick, and became rude, obnoxious, or insulting, and (3) a "sexual regret" group who reported that they experienced poor recall and unplanned sexual activity that they later regretted. Although the frequency of participating in drinking games did not differ between these three groups, results indicated that the "lower-risk" group consumed fewer drinks in a typical gaming session compared to the other two groups. The present findings suggest that drinking games are common among high school students, but that mere participation and frequency of play are not necessarily the best indicators of risk. Instead, examination of other constructs such as game-related alcohol consumption, consequences, or psychosocial variables such as impulsivity may be more useful.

Onset of alcohol or substance use disorders following treatment for adolescent depression

OBJECTIVE

This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD).

METHOD

For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in the Treatment for Adolescents with Depression Study (TADS; TADS Team, 2004) and who had no prior diagnoses of AUD or SUD. TADS initial treatments were cognitive behavior therapy (CBT), fluoxetine alone (FLX), the combination of CBT and FLX (COMB), or clinical management with pill placebo (PBO). We used both the original TADS treatment response rating and a more restrictive symptom count rating. During follow-up, diagnostic interviews were completed at 6- or 12-month intervals to assess onset of AUD or SUD as well as MDD recovery and recurrence.

RESULTS

Achieving a positive response to MDD treatment was unrelated to subsequent AUD but predicted a lower rate of subsequent SUD, regardless of the measure of positive response (11.65% vs. 24.72%, or 10.0% vs. 24.5%, respectively). Type of initial MDD treatment was not related to either outcome. Prior to depression treatment, greater involvement with alcohol or drugs predicted later AUD or SUD, as did older age (for AUD) and more comorbid disorders (for SUD). Among those with recurrent MDD and AUD, AUD preceded MDD recurrence in 24 of 25 cases.

CONCLUSION

Effective short-term adolescent depression treatment significantly reduces the rate of subsequent SUD but not AUD. Alcohol or drug use should be assessed prior to adolescent MDD treatment and monitored even after MDD recovery.

Changes in self-control problems and attention problems during middle school predict alcohol, tobacco, and marijuana use during high school

Although deficits in impulse control have been linked to adolescent use of alcohol and illicit drugs, less attention has been given to variability in change in impulse control across adolescence and whether this variability may be a signal of risk for early substance use. The goals of the current study were to examine growth in two aspects of impulse control, self-control problems and attention problems, across middle adolescence, and to test the prospective effects of level and change in these variables on levels and change over time in substance use. Data are from a community sample of 955 adolescents interviewed (along with their parents and teachers) annually from 6th to 11th grade. Results indicated that greater self-control problems and attentional problems in the 6th grade and increases in these problems over time were associated with higher levels of substance use at 11th grade. Our results suggest that modeling change over time enhances the understanding of how impulse control influences the development of substance use.

Longitudinal associations of alcohol involvement with subjective well-being in adolescence and prediction to alcohol problems in early adulthood

Adolescent alcohol involvement is associated with numerous negative outcomes, but also appears to have positive correlates, including subjective well-being. Additional research is needed to understand these paradoxical findings. The current study examines alcohol use, adverse alcohol-related (and other substance-related) consequences, and subjective well being in adolescence, and prediction to problem alcohol use in early adulthood. Participants in this longitudinal study, which extended from age 11 to age 21, were 208 rural teens (109 girls) and their families. Covariates included early substance use, early conduct problems, early depressed mood, gender, and parent educational attainment. Structural equation modeling showed that subjective well-being at age 16 positively predicted increased alcohol use at age 18. Alcohol use was not a significant predictor of subjective well-being; however, alcohol use at age 18 positively predicted alcohol problems at age 21, even while controlling for earlier adverse consequences and other predictors. Results help to further elucidate both the negative and positive correlates of underage drinking, and support the value of delaying alcohol initiation.

Developmental cascade effects of the New Beginnings Program on adolescent adaptation outcomes

Using data from a 6-year longitudinal follow-up sample of 240 youth who participated in a randomized experimental trial of a preventive intervention for divorced families with children ages 9-12, the current study tested alternative cascading pathways by which the intervention decreased symptoms of internalizing disorders, symptoms of externalizing disorders, substance use, and risky sexual behavior and increased self-esteem and academic performance in mid- to late adolescence (15-19 years old). It was hypothesized that the impact of the program on adolescent adaptation outcomes would be explained by progressive associations between program-induced changes in parenting and youth adaptation outcomes. The results supported a cascading model of program effects in which the program was related to increased mother-child relationship quality that was related to subsequent decreases in child internalizing problems, which then was related to subsequent increases in self-esteem and decreases in symptoms of internalizing disorders in adolescence. The results were also consistent with a model in which the program increased maternal effective discipline that was related to decreased child externalizing problems, which was related to subsequent decreases in symptoms of externalizing disorders, less substance use, and better academic performance in adolescence. There were no significant differences in the model based on level of baseline risk or adolescent gender. These results provide support for a cascading pathways model of child and adolescent development.

Other-sex friendships in late adolescence: risky associations for substance use and sexual debut?

Adolescents' friendships with other-sex peers serve important developmental functions, but they may also facilitate engagement in problem behavior. This study examines the unique contributions of other-sex friendships and friends' behavior to alcohol use, smoking, and initiation of sexual intercourse among late adolescent girls and boys. A total of 320 adolescents (53% girls; 33% racial/ethnic minorities) provided sociometric nominations of friendships annually in grades 10-12. Friendship networks were derived using social network analysis in each grade. Adolescents and their friends also reported on their alcohol use, smoking, and sexual debut at each assessment. After controlling for demographics, previous problem behavior, and friends' behavior, other-sex friendships in 10th grade were associated with initiation of smoking among girls over the following year, and other-sex friendships in 11th grade were linked with lower levels of subsequent alcohol use among boys. Additionally, friends' smoking and sexual experience in 10th grade predicted the same behaviors for all adolescents over the following year. Other-sex friendships thus appear to serve as a risk context for adolescent girls' smoking and a protective context for adolescent boys' drinking. Promoting mixed-gender activities and friendships among older high school students may be helpful in reducing males' alcohol use, but may need to incorporate additional components to prevent increases in females' smoking.

Neural circuitry associated with risk for alcohol use disorders

The core features of risk for alcohol use disorders (AUD), including behavioral disinhibition, affective dysregulation, and executive dysfunction, map onto distinct neural circuits that have been found to be abnormal in the offspring of alcohol dependent individuals. Components of the cerebellothalamocortical system and the extended limbic network may provide the underpinnings for the behavioral and emotional dysfunction observed in individuals at heightened risk for AUD. In addition, abnormalities in these structures appear to be altered in individuals with the predisposition for other psychiatric conditions that may share a similar genetic diathesis. This review proposes several neurobehavioral mechanisms of genetic vulnerability that may account for phenotypic characteristics in individuals at risk for AUD.

Alcohol abuse and dependence symptoms: a multidimensional model of common and specific etiology

This study tested a theoretical model hypothesizing differential pathways from 5 predictors to alcohol abuse and dependence symptoms. The participants were college students (N = 2,270) surveyed on 2 occasions in a 6-month prospective design. Social norms, perceived utility of alcohol use, and family history of alcohol problems were indirectly associated with Time 2 abuse and dependence symptoms through influencing level of alcohol consumption. Poor behavioral control had a direct effect on alcohol abuse but not on dependence symptoms at Time 2, whereas affective lability exhibited a direct prospective effect on alcohol dependence but not on abuse symptoms. A multigroup analysis showed that high levels of poor control increased the strength of paths from both consumption level and affective lability to abuse symptoms. Implications for prevention of alcohol problems among college students are discussed.

Substance use and abuse trajectories across adolescence: a latent trajectory analysis of a community-recruited sample of girls

We used data from a school-based study of 496 adolescent girls to identify qualitatively distinct substance use and substance abuse developmental trajectory groups and tested whether the problematic groups differed from the non-problematic groups on baseline and outcome validation variables. Results identified four substance use groups (late users, normative users, late-heavy users, early-heavy users) and four substance abuse groups (non-abusers, moderate-escalating abusers, moderate decreasing abusers, adolescent-limited heavy abusers). Problematic substance use and abuse trajectory groups, relative to non-problematic groups, showed elevations in baseline validation variables (age 14 delinquency, depressive symptoms, negative affectivity, parental support deficits, body dissatisfaction) and outcome validation variables (age 20 delinquency, depressive symptoms, social impairment, legal problems, school dropout, and substance abuse diagnosis), providing partial validation of this trajectory model.

Positive urgency predicts illegal drug use and risky sexual behavior

There are several different personality traits that dispose individuals to engage in rash action. One such trait is positive urgency: the tendency to act rashly when experiencing extremely positive affect. This trait may be relevant for college student risky behavior, because it appears that a great deal of college student risky behavior is undertaken during periods of intensely positive mood states. To test this possibility, the authors conducted a longitudinal study designed to predict increases in risky sexual behavior and illegal drug use over the course of the first year of college (n=407). In a well-fitting structural model, positive urgency predicted increases in illegal drug use and risky sexual behavior, even after controlling for time 1 (T1) involvement in both risky behaviors, biological sex, and T1 scores on four other personality dispositions to rash action. The authors discuss the theoretical and practical implications of this finding.

Testing a gender additive model: the role of body image in adolescent depression

Despite consistent evidence that adolescent girls are at greater risk of developing depression than adolescent boys, risk factor models that account for this difference have been elusive. The objective of this research was to examine risk factors proposed by the gender additive model of depression that attempts to partially explain the increased prevalence of depression in adolescent girls. The theory suggests that body image and eating related variables predict depression for girls, but not for boys, above and beyond the variance accounted for by other well-known risk factors, some of which were examined in the current study. The sample was 247 adolescent girls and 181 adolescent boys studied over a 24-month duration. Results suggest that body dissatisfaction is a potent predictor of depression for girls, but not for boys, above and beyond the predictive effects of other established risk factors. Results provide insight into the etiology of adolescent depression and the disparate rate of depression among adolescent girls and provide direction for identifying high-risk individuals and developing effective prevention programs.

A Rasch model analysis of alcohol consumption and problems across adolescence and young adulthood

BACKGROUND

Recent investigations using item response modeling have begun to conceptualize alcohol consumption, problems, and dependence as representing points along a single continuum of alcohol involvement. Such a conceptualization may be of particular benefit to measurement of alcohol involvement in adolescents, but investigations to date have been limited to adult samples and may not generalize to adolescents due to age-related developmental differences.

METHODS

This study used Rasch model analyses to examine the properties of indices of alcohol consumption and problems among 6,353 adolescents, aged 12 to 18 years, in Wave 1 of the Add Health survey. A particular focus was on whether the functioning of items changed when these adolescents were re-interviewed in Wave 3 when they were 18 to 24 years of age.

RESULTS

Rasch model analyses supported the unidimensionality and additive properties of the items in the Wave 1 data. Comparisons of Wave 1 and Wave 3 data indicated differential item functioning in most of the items such that items related to alcohol consumption were more severe during adolescence, whereas items related to alcohol problems were more severe in young adulthood.

CONCLUSIONS

A valid index of alcohol involvement in adolescents can be constructed combining indices of alcohol consumption and alcohol problems. Such an index covers a range of severity and functions similarly across sex and race/ethnicity. A similar index can be constructed in young adulthood. However, the interpretation of scores must be attentive to developmental differences. In particular, for adolescents, indices of alcohol consumption are relatively closer in severity to indices of alcohol problems than they are among young adults. Thus, alcohol problems are more likely among adolescents than young adults given a similar level of drinking.

Dimensions of adolescent alcohol involvement as predictors of young-adult major depression

OBJECTIVE

Adolescent alcohol involvement may increase risk for young-adult depression; however, findings are mixed and important questions remain unanswered. Because alcohol involvement among teens is multidimensional, this study examined the extent to which four different adolescent alcohol dimensions (i.e., frequency of alcohol use, quantity of consumption, frequency of heavy episodic drinking, and frequency of problem use) were predictive of young-adult major depressive disorder (MDD).

METHOD

Participants in this prospective longitudinal study, which extended from age 11 to age 22, were 429 rural teens (including 222 girls) and their families. Self-reports of each dimension of adolescent alcohol involvement were obtained at ages 16 and 18. Depression diagnoses were obtained at age 22, using a structured interview. Analyses included adolescent depressed mood, measured via self-report at ages 16 and 18. Data were analyzed using confirmatory factor analysis and structural equation modeling.

RESULTS

The multidimensional nature of adolescent alcohol involvement was best represented by a first-order problem-use factor and a second-order alcohol-intake factor comprised of quantity, frequency, and heavy drinking. After controlling for gender and depressed mood, adolescent problem use, but not alcohol intake, was a significant positive predictor of young-adult MDD.

CONCLUSIONS

Findings help clarify the link between alcohol involvement and depression and suggest that harm-reduction strategies may help prevent later mood disorders.

Decision making and binge drinking: a longitudinal study

BACKGROUND

Behavioral decision making, as measured by the Iowa Gambling Task (IGT) is found to be diminished in individuals with substance dependence and other types of disinhibitory psychopathology. However, little is known regarding the relation between heavy alcohol use and decision-making skills in young adults. This study therefore investigated whether binge drinking is related to disadvantageous decision making, as measured by the IGT. We also examined the relation between decision making and impulsivity.

METHODS

Latent class growth analysis was used to classify college students into 4 groups (each group n=50, 50% male), based on their binge drinking trajectories over a 2-year time period (precollege through second year of college). Participants were 200 college students, divided in 4 subgroups: (1) low binge drinkers, (2) stable moderate binge drinkers, (3) increasing binge drinkers, and (4) stable high binge drinkers. A measure of decision making, the IGT, impulsivity questionnaires, and multiple indicators of heavy alcohol use were included.

RESULTS

The stable high binge-drinking group made less advantageous choices on the IGT than the low binge-drinking group. Impulsivity was not related to decision-making performance. Decision-making performance did not differ by gender, but deck preferences and decision time patterns did differ; women preferred low frequency, high amount punishments to a greater extent than men.

CONCLUSIONS

Although disadvantageous decision making is related to binge-drinking patterns in emerging adulthood, this relation is independent of impulsivity. Additionally, the association appears attributable to those who engage in heavy (binge) drinking at an early age, but not to age of onset of drinking in general.

A prospective test of the negative affect model of substance abuse: moderating effects of social support

The authors tested whether dimensions of negative affect--specifically, trait levels of negative emotionality and state levels of depressive symptoms--increased risk for substance abuse onset and whether perceived social support moderated this relation using data from a 5-year prospective study of 496 school-recruited adolescent girls. Initial negative emotionality, but not depressive symptoms, and deficits in parental, but not peer, support predicted future substance abuse onset in a multivariate hazard model. Tests of the interaction between negative affect dimensions and social support suggested that support did not moderate the relation of negative affect to risk for substance abuse onset. Results provide prospective support for the etiological role in the onset of substance abuse of trait-linked negative affect and of parental support.

Does Problem Behavior Elicit Poor Parenting?: A Prospective Study of Adolescent Girls

This study tested the hypothesis that perceived parenting would show reciprocal relations with adolescents' problem behavior using longitudinal data from 496 adolescent girls. Results provided support for the assertion that female problem behavior has an adverse effect on parenting; elevated externalizing symptoms and substance abuse symptoms predicted future decreases in perceived parental support and control. There was less support for the assertion that parenting deficits foster adolescent problem behaviors; initially low parental control predicted future increases in substance abuse, but not externalizing symptoms, and low parental support did not predict future increases in externalizing or substance abuse symptoms. Results suggest that problem behavior is a more consistent predictor of parenting than parenting is of problem behavior, at least for girls during middle adolescence.

Similarities and differences of longitudinal phenotypes across alternate indices of alcohol involvement: a methodologic comparison of trajectory approaches

Extant developmental research distinguishing young adults who moderate versus persist in alcohol consumption has not consistently evaluated the domain of alcohol involvement being modeled, making it difficult to compare findings across studies. In the present study, the authors characterized the developmental course of 5 indices of alcohol involvement using a prospective (6-wave) sample of 377 young adults (Year 1 age = 18.52 years; 55% female; 51% with family history of alcoholism) over 11 years. Growth mixture models were applied to each measure. Despite similarity in trajectory shape, predicted prevalences varied, and the consistency of trajectory classifications across alternate indices revealed low agreement. Correlates of drinking course, however, were somewhat robust across alcohol index. The finding that trajectories are conditional on the specific indices used suggests that it may be hazardous to generalize across alternate indices of alcohol involvement.

Prospective relations between bulimic pathology, depression, and substance abuse: unpacking comorbidity in adolescent girls

To elucidate the processes that contribute to the comorbidity between bulimic pathology, depression, and substance abuse, the authors tested the temporal relations between these disturbances with prospective data from adolescent girls (N = 496). Multivariate analyses indicated that depressive symptoms predicted onset of bulimic pathology but not of substance abuse, bulimic symptoms predicted onset of depression but not of substance abuse, and substance abuse symptoms predicted onset of depression but not of bulimic pathology. Results suggest that the comorbidity arises because certain disorders are risk factors for the other disorders. Findings also provide support for select etiologic theories and further establish the clinical significance of these conditions by showing that they increase risk for onset of other psychiatric disturbances.