The adolescent drug involvement scale

Adolescent Sleep Quality and Alcohol Use: An Initial Examination of the Serial Indirect Effects of Anxiety Symptoms and Coping Motives for Alcohol Use

Background: Insufficient sleep and insomnia are associated with alcohol use as well as anxiety during adolescence and young adulthood. A negative reinforcement path to explain the association between sleep difficulties and alcohol misuse has been proposed. Within this pathway, it is speculated that while sober, insomnia and insufficient sleep lead to increased anxiety as well as anxiolytic responses to alcohol, thereby increasing the risk for both alcohol use and alcohol use problems. No work to date has examined the negative reinforcement path to alcohol use among adolescents who have consumed alcohol. Objectives: The current study aims to address this gap in the literature by examining if sleep quality is related to adolescent alcohol use problems and frequency through serial indirect effects of adolescent anxiety symptoms and coping motives for alcohol use. A total of 147 adolescents between the ages of 13 and 18 years (Mage = 16.31; SD = 0.96) from all geographic regions in the US were recruited using social media platforms (i.e., Facebook and Instagram). Participants who reported having tried alcohol at least once completed self-report measures to examine sleep quality, anxiety symptoms, alcohol use problems, alcohol use frequency, and coping motives for alcohol use. Results: Adolescent sleep quality was found to be associated with higher levels of both alcohol use problems and alcohol use frequency through the serial indirect effect of anxiety symptoms and coping motives for alcohol use. Conclusions: Overall, these findings represent a step towards understanding the complex relationship between sleep quality, alcohol, anxiety, and coping motives among adolescents.

The Associations of Adverse Childhood Experiences (ACEs) With Substance Use in Young Adults: A Systematic Review

Introduction

Young adulthood is a transitional period between adolescence and adulthood. Due to the unique pressures of taking on a new social role and associated uncertainties, young adults are at heightened risk for drug and alcohol use. Furthermore, adverse childhood experiences (ACEs) increases the likelihood of using maladaptive coping strategies such as using substances to avoid or soothe negative emotions. The current review aimed to summarize the associations between exposure to ACEs before the age of 18 years and subsequent drug or alcohol use between the ages of 18 and 25 years.

Methods

The review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search of the Web of Science, PubMed, and PsycINFO databases was conducted in February 2022.

Results

The initial search yielded 7178 articles, with 777 duplicates. Consequently, 6401 titles were inspected for relevance. After reading the full text, 88 articles were included in the review.

Conclusion

This review provides clear evidence that exposure to multiple ACEs is a robust risk factor for the use of alcohol, cannabis and other drugs by young adults. Poor self-regulation and maladaptive coping strategies were identified as mechanisms explaining this link; however, further detailed research is needed.

Circadian, Reward, and Emotion Systems in Teens prospective longitudinal study: protocol overview of an integrative reward-circadian rhythm model of first onset of bipolar spectrum disorder in adolescence

BACKGROUND

Bipolar spectrum disorders (BSDs) are associated with a heightened sensitivity to rewards and elevated reward-related brain function in cortico-striatal circuitry. A separate literature documents social and circadian rhythm disruption in BSDs. Recently, integrated reward-circadian models of BSDs have been proposed. These models draw on work indicating that the two systems influence each other and interact to affect mood functioning. When dysregulated, reward and circadian system signaling may combine to form a positive feedback loop, whereby dysregulation in one system exacerbates dysregulation in the other. Project CREST (Circadian, Reward, and Emotion Systems in Teens) provides a first systematic test of reward-circadian dysregulation as a synergistic and dynamic vulnerability for first onset of BSD and increases in bipolar symptoms during adolescence.

METHODS

This NIMH-funded R01 study is a 3-year prospective, longitudinal investigation of approximately 320 community adolescents from the broader Philadelphia area, United States of America. Eligible participants must be 13-16 years old, fluent in English, and without a prior BSD or hypomanic episode. They are being selected along the entire dimension of self-reported reward responsiveness, with oversampling at the high tail of the dimension in order to increase the likelihood of BSD onsets. At Times 1-6, every 6 months, participants will complete assessments of reward-relevant and social rhythm disruption life events and self-report and diagnostic assessments of bipolar symptoms and episodes. Yearly, at Times 1, 3, and 5, participants also will complete self-report measures of circadian chronotype (morningness-eveningness) and social rhythm regularity, a salivary dim light melatonin onset (DLMO) procedure to assess circadian phase, self-report, behavioral, and neural (fMRI) assessments of monetary and social reward responsiveness, and a 7-day ecological momentary assessment (EMA) period. During each EMA period, participants will complete continuous measures of sleep/wake and activity (actigraphy), a daily sleep diary, and three within-day (morning, afternoon, evening) measures of life events coded for reward-relevance and social rhythm disruption, monetary and social reward responsiveness, positive and negative affect, and hypo/manic and depressive symptoms. The fMRI scan will occur on the day before and the DLMO procedure will occur on the first evening of the 7-day EMA period.

DISCUSSION

This study is an innovative integration of research on multi-organ systems involved in reward and circadian signaling in understanding first onset of BSD in adolescence. It has the potential to facilitate novel pharmacological, neural, and behavioral interventions to treat, and ideally prevent, bipolar conditions.

Patient Characteristics and Positive Outcomes Associated With a Novel Youth Inpatient Program for Concurrent Disorders

ABSTRACT

Concurrent substance use and mental health disorders in youth are a major public health concern and require specialized and comprehensive services. In this paper, a novel inpatient tertiary care facility serving youth aged 13 to 18 with significant concurrent substance use and mental health issues is introduced. The development of this unit was prompted by the opioid overdose crisis in British Columbia and serves as the third concurrent disorders unit in Canada catered specifically to an adolescent population. From its opening in 2017, preadmission and postadmission data from each patient was gathered with the aim of providing a robust image of the serviced patient population as well as the efficacy of this service model. Patients admitted to this program had significantly higher quality of life ( d = 0.65) and significantly lower suicidality ( d = 0.86) at discharge, compared with at admission. Patients identifying as female had significantly lower quality of life, higher suicidality, and higher prevalence of adverse childhood events compared with patients identifying as male. Results from this program evaluation outline the efficacy of a novel concurrent disorders program for youth while further providing an overview of clinical and relevant demographic characteristics from an underanalyzed patient population.

Self-Regulation and Shame as Mediators Between Childhood Experiences and Young Adult Health

The purpose of this study was to determine whether self-regulation and shame mediated the relationship between adverse and positive childhood experiences (ACEs and PCEs) and young adult health. Data came from the Flourishing Families Project (FFP), a 10-year longitudinal study. Adolescent participants (N = 489; 51% female) completed an annual survey. Data were analyzed using structural equation modeling. Results indicated that PCEs negatively predicted shame and positively predicted self-regulation while ACEs negatively predicted self-regulation. Shame mediated the relationship between PCEs and depression. Self-regulation mediated the relationship between both ACEs and PCEs with anxiety; self-regulation also mediated the relationship between ACEs and substance abuse. Childhood experiences appear to affect the development and maintenance of self-regulation in adolescence. Self-regulation appears to be especially important in protecting against depression, anxiety, and substance abuse in young adulthood.

The Role of Social Reward and Corticostriatal Connectivity in Substance Use

This report describes an ongoing R03 grant that explores the links between trait reward sensitivity, substance use, and neural responses to social and nonsocial reward. Although previous research has shown that trait reward sensitivity and neural responses to reward are linked to substance use, whether this relationship is impacted by how people process social stimuli remains unclear. We are investigating these questions via a neuroimaging study with college-aged participants, using individual difference measures that examine the relation between substance use, social context, and trait reward sensitivity with tasks that measure reward anticipation, strategic behavior, social reward consumption, and the influence of social context on reward processing. We predict that substance use will be tied to distinct patterns of striatal dysfunction. Specifically, reward hyposensitive individuals will exhibit blunted striatal responses to social and non-social reward and enhanced connectivity with the orbitofrontal cortex; in contrast, reward hypersensitive individuals will exhibit enhanced striatal responses to social and non-social reward and blunted connectivity with the orbitofrontal cortex. We also will examine the relation between self-reported reward sensitivity, substance use, and striatal responses to social reward and social context. We predict that individuals reporting the highest levels of substance use will show exaggerated striatal responses to social reward and social context, independent of self-reported reward sensitivity. Examining corticostriatal responses to reward processing will help characterize the relation between reward sensitivity, social context and substance use while providing a foundation for understanding risk factors and isolating neurocognitive mechanisms that may be targeted to increase the efficacy of interventions.

Pubertal Timing and Substance use in Adolescence: an Investigation of Two Cognitive Moderators

Off-time pubertal development is a predictor of substance use among adolescents. Early-maturing girls and early- and late-maturing boys appear to be at greater risk for substance use, although findings are more consistent for girls. Although cognitive factors are also important in the etiology of adolescent substance use, few studies have investigated potential cognitive risk and protective factors in these associations. The current study tested whether future orientation or cognitive style (e.g., attributions youth make about the causes and consequences of negative life events) moderated the association between pubertal timing and substance use two years later and whether this effect was stronger for females. Multiple linear regressions revealed cognitive style and future orientation significantly moderated the association between pubertal timing and substance use, and these effects did not differ by sex. Importantly, the pattern of these interactions differed, such that early pubertal timing predicted more substance use in the context of more negative and moderate cognitive styles and greater and moderate future orientation. Follow-up analyses revealed that an adolescent's attributions about the consequences, globality, and self-worth implications of negative life events significantly moderated the pubertal timing - future substance use association. Furthermore, the pattern of these interactions predicted each of the four types of substances assessed in the context of cognitive style, but only predicted nicotine and marijuana use in the context of future orientation. These results highlight which cognitive factors may influence risk for substance use for early-maturing youth.

The influence of adverse and advantageous childhood experiences during adolescence on young adult health

BACKGROUND

Research indicates that adverse childhood experiences (ACEs) can lead to poorer adult health, but less is known how advantageous childhood experiences (counter-ACEs) may neutralize the negative effects of ACEs, particularly in young adulthood.

PURPOSE

We examined the independent contributions of Adverse Childhood Experiences (ACEs) and Advantageous Childhood Experiences (counter-ACEs) that occur during adolescence on five young adult health indicators: depression, anxiety, risky sexual behaviors, substance abuse, and positive body image.

PARTICIPANTS AND SETTING

The sample included 489 adolescents from a large northwestern city in the United States who were 10-13 years at baseline (51 % female).

METHODS

Flourishing Families Project survey data were used for this secondary analysis using structural equation modeling. Adolescents and their parents completed an annual survey. ACEs and counter-ACEs were measured over the first five years of the study. The five health indicators were measured in wave 10 when participants were 20-23 years old.

RESULTS

Participants had on average 2.7 ACEs and 8.2 counter-ACEs. When both ACEs and counter-ACEs were included in the model, ACEs were not predictive of any of the health indicators and counter-ACEs were predictive of less risky sex (-.12, p < .05), substance abuse (-.12, p < .05), depression (-.11, p < .05), and a more positive body image (.15, p < .01). Higher ratios of counter-ACEs to ACEs had a particularly strong effect on improved young adult health.

CONCLUSIONS

Counter-ACEs that occur in adolescence may diminish the negative effects of ACEs on young adult health and independently contribute to better health.

Adolescent Depression and Substance Use: the Protective Role of Prosocial Peer Behavior

Adolescents with depression disorders have higher rates of substance use. In order to advance contextually relevant mental health interventions, basic research is needed to test social ecological mechanisms hypothesized to influence adolescent depression and substance use. Accordingly, we conducted growth curve modeling with a sample of 248 urban adolescents to determine if depression's effect on substance use was dependent upon peer network health (sum of peer risk and protective behaviors) and activity space risk (likelihood of high-risk behaviors at routine locations). Results showed that peer network health moderated the effects of depression on substance use, but this effect was not altered by activity space risk. These findings suggest the importance of peer network health relative to depression and substance use, particularly for young adolescents.

Longitudinal changes of inflammatory biomarkers moderate the relationship between recent stressful life events and prospective symptoms of depression in a diverse sample of urban adolescents

This study investigated whether longitudinal changes in inflammatory physiology moderated the relationship between recent stressful life events and subsequent depressive symptoms in adolescence. A diverse sample of adolescents representative of an urban community (N = 129; Age at baseline = 12.5 years; 48.8% female; 55.0% African American) completed measures of stressful life events, depressive symptoms, and two annual blood draws (BD1 and BD2). Controlling for inflammatory activity at BD1, depression at BD1, demographics and the time between assessments, increases in interleukin-6 (IL-6; b = 0.878, p = .007) and C-reactive protein (CRP; b = 0.252, p = .024) from BD1 to BD2 interacted with recent stressful life events before BD1 to predict severity of depressive symptoms at BD2. Similar associations were evident for IL-6 (b = 2.074, p = .040) and CRP (b = 0.919, p = .050) when considering acute stressful life events that had occurred within the two weeks before the first blood collection. More frequent stressful life events before BD1 predicted significantly more severe depressive symptoms at BD2, but only for adolescents with moderate (50th percentile) and high (84th percentile) levels of IL-6 and CRP at BD2. In conclusion, adolescents who experienced both recent stressful life events and larger increases in inflammatory activity following these stressors were at increased risk for more severe depressive symptoms after approximately one year. The findings indicate that the interaction of stress and larger changes in inflammatory activity following these stressors are prognostic risk factors for depression severity in adolescents.

Relations Between Parental Distress Intolerance, Adolescent Motives for Cigarette Use, and Adolescent Cigarette Smoking Levels

Background: A relatively large body of evidence indicates that coping motives for cigarette smoking are associated with a number of problematic outcomes (e.g., greater smoking frequency) among adolescents. Evidence also indicates that lower distress tolerance (or higher distress intolerance) is related to higher levels of coping motives for cigarette smoking among adults and adolescents. Therefore, it is critical to improve our understanding of factors that may increase the likelihood of smoking to cope among adolescents. In addition, evidence suggests that a number of parenting behaviors may affect adolescent smoking behavior. No work to date, however, has examined the relation between parental distress intolerance and adolescent smoking motives, or adolescent smoking behavior. Objective/methods: The current study involving adolescents (n = 46) and one of their parents aimed to address this gap in the literature by examining the association between parent-reported parental distress intolerance, self-reported adolescent motives for cigarette use, and self-reported adolescent cigarette smoking levels. Results: Results indicated that parental distress intolerance was related to greater adolescent coping motives for cigarette smoking, but not to other motives for adolescent cigarette use. Furthermore, results indicated that parental distress intolerance was indirectly associated with higher adolescent cigarette smoking levels through adolescent coping motives for cigarette smoking. Conclusions: Parental distress intolerance is associated with coping motives for adolescent cigarette smoking. This suggests parental emotional factors may be associated with adolescent cigarette use.

Geographic Imputation of Missing Activity Space Data from Ecological Momentary Assessment (EMA) GPS Positions

This research presents a pilot study to develop and compare methods of geographic imputation for estimating the location of missing activity space data collected using geographic ecological momentary assessment (GEMA). As a demonstration, we use data from a previously published analysis of the effect of neighborhood disadvantage, captured at the U.S. Census Bureau tract level, on momentary psychological stress among a sample of 137 urban adolescents. We investigate the impact of listwise deletion on model results and test two geographic imputation techniques adapted for activity space data from hot deck and centroid imputation approaches. Our results indicate that listwise deletion can bias estimates of place effects on health, and that these impacts are mitigated by the use of geographic imputation, particularly regarding inflation of the standard errors. These geographic imputation techniques may be extended in future research by incorporating approaches from the non-spatial imputation literature as well as from conventional geographic imputation and spatial interpolation research that focus on non-activity space data.

Young Urban Adolescents' Activity Spaces, Close Peers, and the Risk of Cannabis Use: A Social-Spatial Longitudinal Analysis

BACKGROUND

An understudied, yet important area of youth development research is the examination of how place affects critical psychosocial processes such as identity formation, problem solving, emotional regulation, and in particular with adolescents, belongingness, autonomy, social competency, and behavioral health. A growing spatially informed literature indicates that youth interact with meaningful places as environmental strategies, shaping developmental trajectories related to behavioral health.

OBJECTIVES

The objective is to investigate the relationship between place preference and health behavior among adolescents, with a focus on substance use behavior, specifically, cannabis use. We theorize that cannabis use is associated with place preference for urban, city types of places, and that this particular place preference interacts with close peer network behaviors.

METHODS

To understand the role of preferred locations, close peer relations, and mental health on cannabis use, 248 adolescents (ages 13 to 14) were studied longitudinally. Logistic regression models tested the moderating effects of peer network health (sum of close friends risk and protective behaviors) on selecting city locations (urban stress/neighborhoods) as preferred places, and subsequent cannabis use.

RESULTS

Results indicated that peer network health moderated the effects of choosing city locations as favorite, increasing the odds of cannabis use more than eight-fold at 24 months.

CONCLUSIONS

Favorite places located in city environments appear to interact with peer risk behaviors influencing the cannabis use of young urban adolescents, even after controlling for the influence of baseline cannabis use, neighborhood disorder the home neighborhood, age, gender, and mental health effects.

Addictive Disorders in Adolescents

Addictive disorders in youth represent a dynamic field characterized by shifting patterns of substance use and high rates of experimentation, while retaining the risky behaviors and negative outcomes associated with established drug classes. Youth/adolescents are also at the forefront of use of new technologies, and non-substance-related disorders are pertinent. These disorders present with similar pictures of impairment, and can be diagnosed following the same principles. An underlying mental disorder and the possibility of a dual diagnosis need to be assessed carefully, and optimal treatment includes psychosocial treatments with applicable pharmacologic management, the latter representing an expanding field.

Neighborhood disorder, peer network health, and substance use among young urban adolescents

BACKGROUND

The current study investigated the moderating effect of peer networks on neighborhood disorder's association with substance use in a sample of primarily African American urban adolescents.

METHODS

A convenience sample of 248 adolescents was recruited from urban health care settings and followed for two years, assessing psychological, social, and geographic risk and protective characteristics. A subset of 106 substance using participants were used for the analyses. A moderation model was tested to determine if the influence of neighborhood disorder (percent vacant housing, assault index, percent single parent headed households, percent home owner occupied, percent below poverty line) on substance use was moderated by peer network health (sum of peer risk and protective behaviors).

RESULTS

Evidence for hypothesized peer network moderation was supported. A latent growth model found that peer network health is most strongly associated with lower baseline substance use for young adolescents residing in more disordered neighborhoods. Over the course of two years (ages approximately 14-16) this protective effect declines, and the decline is stronger for more disordered neighborhoods.

CONCLUSIONS

Understanding the longitudinal moderating effects of peer networks within high-risk urban settings is important to the development and testing of contextually sensitive peer-based interventions.

RESULTS

suggest that targeting the potential protective qualities of peer networks may be a promising approach for interventions seeking to reduce substance use, particularly among younger urban adolescents living in high-risk neighborhoods.

Does substance use moderate the association of neighborhood disadvantage with perceived stress and safety in the activity spaces of urban youth?

BACKGROUND

This study investigates the association of activity space-based exposure to neighborhood disadvantage with momentary perceived stress and safety, and the moderation of substance use on those associations, among a sample of 139 urban, primarily African American, adolescents.

METHOD

Geospatial technologies are integrated with Ecological Momentary Assessment (EMA) to capture exposure to neighborhood disadvantage and perceived stress and safety in the activity space. A relative neighborhood disadvantage measure for each subject is calculated by conditioning the neighborhood disadvantage observed at the EMA location on that of the home neighborhood. Generalized estimating equations (GEE) are used to model the effect of relative neighborhood disadvantage on momentary perceived stress and safety, and the extent to which substance use moderates those associations.

RESULTS

Relative neighborhood disadvantage is significantly associated with higher perceived stress, lower perceived safety, and greater substance use involvement. The association of relative neighborhood disadvantage with stress is significantly stronger among those with greater substance use involvement.

CONCLUSION

This research highlights the value of integrating geospatial technologies with EMA and developing personalized measures of environmental exposure for investigating neighborhood effects on substance use, and suggests substance use intervention strategies aimed at neighborhood conditions. Future research should seek to disentangle the causal pathways of influence and selection that relate neighborhood environment, stress, and substance use, while also accounting for the role of gender and family and peer social contexts.

Parents, Peers, and Places: Young Urban Adolescents' Microsystems and Substance Use Involvement

Limited research is available that explains complex contextual and interactive effects of microsystems such as family relationships, peer networks, and place-based influences have on urban adolescent substance use. We contend that research into these complex processes is improved by integrating psychological, social, and geographic data to better understand urban adolescent substance use involvement. Accordingly, we tested a longitudinal, 3-way moderation model to determine if the direct effect of teen-parent relationships on substance use involvement is moderated by peer network characteristics, which in turn is moderated by the risk and protective attributes within urban adolescents' activity spaces, among a sample of 248 adolescents. Results revealed that peer networks moderate the effects of relations with parents on substance use involvement for those adolescents with higher levels of risk attributes within their activity space, but not for those who spend time in locations with less risk. Thus, the teen-parent relationship interacts with peer net-work characteristics, for those urban adolescents whose activity space is constituted within high-risk environments. We conclude that peer networks have important interactive effects with family relationships that influence substance use, and that this is particularly salient for young adolescents who are exposed to risky environments. This finding underscores the importance of continued study into the interrelations among microsystems of urban adolescents, and provides further support that substance use is a social practice that is constituted within the unique geography of young adolescents' lives.

The role of schools in substance use prevention and intervention

Schools provide an ideal setting for screening, brief interventions, and outpatient treatment for substance use disorders (SUD). Individual treatment for SUD is effective at decreasing substance use as well as substance-related harm. In some contexts, rather than being helpful, group interventions can result in harm to participants; therefore, individual treatment may be preferred. Early interventions for adolescents who are using alcohol and other drugs (AOD) are generally effective in decreasing frequency and quantity of AOD use as well as decreasing risky behaviors.

La Grille de dépistage de la consommation problématique d’alcool et de drogues chez les adolescents et les adolescentes (DEP-ADO) : développement et qualités psychométriques

La Grille de dépistage de la consommation problématique d’alcool et de drogues chez les adolescents (DEP-ADO) a été créée pour répondre aux besoins des milieux de pratique québécois. Cet article rapporte les résultats de deux études portant sur les qualités psychométriques de la DEP-ADO. Une première étude a révélé que l’outil était pertinent et possédait une très bonne validité d’apparence, tant auprès des intervenants que des jeunes. Une seconde étude a été menée auprès de 673 élèves de 14 à 17 ans provenant de trois écoles secondaires du Québec et de 64 jeunes inscrits dans des centres de réadaptation en toxicomanie pour évaluer la structure factorielle, la fidélité et la validité de l’outil. Les résultats indiquent que les qualités psychométriques de la DEP-ADO sont nettement satisfaisantes et se comparent avantageusement à celles constatées auprès des autres outils de repérage de la consommation abusive de substances psychoactives chez les adolescents (validité de construit, cohérence interne, fidélité test-retest et inter modes de passation, validité critériée concomitante). Fait intéressant, les analyses factorielles ont permis d’identifier, en plus d’un facteur global, trois facteurs dont le sens clinique est bien identifiable (consommation d’alcool et de cannabis, consommation d’autres drogues, conséquences de la consommation de substances psychoactives). Tout en confirmant de façon globale la validité et la fidélité de la version originale, l’étude a également permis d’y apporter des améliorations et d’ouvrir des perspectives nouvelles sur l’utilisation qui peut en être faite.