Prescription Stimulant Misuse and Risk Correlates among Racially-Diverse Urban Adolescents

Psychometric validation of the Positive Drinking Consequences Questionnaire in adolescents

BACKGROUND

The Positive Drinking Consequences Questionnaire (PDCQ) was developed to measure positive consequences of alcohol use endorsed by college drinkers. Efforts to assess positive drinking consequences experienced by adolescents have been much more limited. The aim of the present study was to advance the psychometric testing and evaluation of the factor structure of the PDCQ in adolescents.

METHODS

The current sample consisted of 173 adolescents at T1 (mean age = 15 years, range = 13-17; 61% female) who reported alcohol use in the past 12 months. Data were collected at two time points over a 12-month interval in the United States. Confirmatory factor analyses, internal consistency, test-retest reliability, and discriminant, concurrent, predictive, and incremental validity were tested.

RESULTS

Our analyses supported four factors of positive alcohol-related consequences: sociability, liquid courage, sexual enhancement, and tension reduction. Internal consistency was moderate to high (α = 0.78-0.94, ω = 0.86-0.91 at T1; α = 0.59-0.93, ω = 0.85-0.93 at T2). Test-retest reliability was fair to good (ICC = 0.46-0.55). The PDCQ total and subscale factor scores demonstrated discriminant validity from negative alcohol expectancy. PDCQ total and subscale factor scores were positively associated with current alcohol consumption (ρs = 0.19-0.50 at T1; ρs = 0.17-0.46 at T2), indicating concurrent validity. Predictive validity analyses showed that the overall PDCQ scale score and the sociability subscale positively predicted maximum drinks 1 year later (ρs = 0.18-0.22). However, the sexual enhancement subscale was negatively predictive of typical drinking frequency 1 year later. Finally, the PDCQ showed incremental validity for concurrent alcohol consumption beyond that for alcohol expectancies and drinking motives.

CONCLUSION

The present findings support for the reliability and validity of PDCQ for use in adolescents where it may have utility as an assessment tool for characterizing various aspects of positive drinking.

Cannabis use for sleep aid among high school students: Concurrent and prospective associations with substance use and sleep problems

INTRODUCTION

Adolescents are at risk for both sleep problems and cannabis use. Despite emerging evidence for college students' self-medication with cannabis to help sleep, generalizability to earlier developmental stages remains unknown. This study remedied this literature gap by characterizing high school students' cannabis sleep aid use in terms of psychosocial correlates and prospective associations with substance use and sleep.

METHODS

Data were drawn froma longitudinal urban adolescent health behavior study, Project Teen, including 4079th-11thgraders(Year 1 Mage = 16.00 [SD = 1.08, range = 13-19]; 58% female; 41% Black, 22% White, 18% Asian, 17% multiracial,2% Native Hawaiian or other Pacific Islander, 1% American Indian or Alaska Native; 12% Hispanic/Latinx). Students completed two web-based surveys (Minterval = 388.89 days [SD = 27.34]) assessingsubstance use and sleep at Year 1 (Y1) and Year 2 (Y2).

RESULTS

Students reporting lifetime cannabis sleep aid use (8%) endorsed greater depression and anxiety symptoms at Y1, as well as greater cannabis, alcohol, and cigarette use (but not insomnia symptoms or sleep durations) at Y1 and Y2, compared to non-using peers. Over one year, cannabis sleep aid use was associated with increased cannabis dependence symptoms among students using cannabis, past-2-week binge drinking among students using alcohol, and lifetime cigarette use. However, cannabis sleep aid use was not prospectively associated with changes in insomnia symptoms or sleep durations.

CONCLUSIONS

Although replication is needed, cannabis sleep aid use among high school students may be associated with exacerbated cannabis dependence symptoms and increased binge drinking and cigarette use over time, without the intended sleep benefit.

Understanding the Impact of Deviant Peer Association on Risk for Stimulant/Amphetamine Use: The Moderating Role of Exposure to Violence

Prior research has indicated that deviant peer association is associated with increased risk for stimulant/amphetamine use. However, there remain gaps in our understanding of the context under which this relationship occurs. This study examined two forms of exposure to violence (direct victimization, witnessed violence) as moderators of the relationship between deviant peer association and stimulant/amphetamine use risk. All 11 waves of the Pathways to Desistance longitudinal data were used in analyses. Mixed effects logistic regression models were used to estimate relationships of interest while accounting for repeated measures nested within individual participants across time. Findings indicated that greater deviant peer association was associated with greater odds of stimulant/amphetamine use. Experiencing direct victimization significantly moderated this relationship, but in the opposite of the hypothesized direction, with individuals reporting direct victimization also reporting less reactivity to deviant peer association as it pertained to stimulant/amphetamine use. Witnessed violence did not moderate this relationship.

Outcomes and Predictors of Stimulant Misuse in College Students with and Without ADHD

In recent years, rates of prescription stimulant misuse have increased among young adults ages 18 to 25 along with increases in dispensing rates of these medications. Preliminary studies suggest that college students with Attention-Deficit Hyperactivity Disorder (ADHD) may be more likely to misuse their stimulant medication than their non-ADHD peers. Research is needed to further explore possible rates, correlates, and outcomes of prescription stimulant misuse among college students with and without ADHD. Data regarding study strategies, psychological functioning, stimulant misuse, and GPA were collected from students from universities within the US (N = 144), showing significantly higher rates of misuse among college students with ADHD. With depression and anxiety entered into the predictive model, inattentive symptoms were the only significant predictor of misuse in the full sample. The present findings have implications for academic interventions aimed at supporting the success of college students with and without ADHD and inform academic outcomes of prescription stimulant misuse.

Prospective Associations of Discrimination, Race, and Sexual Orientation with Substance Use in Adolescents

Objective: Adolescents are at high risk for alcohol and cannabis use. Emerging evidence suggests that discrimination exposure is prospectively associated with risk for alcohol use among adolescents of marginalized race, sexual orientation, or gender identity. However, it is unknown whether prospective discrimination-substance use associations among marginalized adolescents are also present for cannabis use. This study examined prospective associations of race, sexual orientation, and discrimination exposure with alcohol and cannabis use over one year. Methods: Data were drawn from a two-wave longitudinal health survey study of 9-11^th graders (n = 350 for the current analyses; Year 1 M_age=15.95 [SD = 1.07, range = 13-19]; 44% male; 44% Black, 22% White, 18% Asian, 16% Multiracial; 16% LGB; 10% Hispanic/Latinx ethnicity) at an urban high school. Two multinomial logistic regressions examined associations of Year 1 race, sexual orientation, and discrimination experiences with Year 2 alcohol and cannabis consumption separately. Results: Year 1 Discrimination exposure was associated with increased risk for Year 2 past-year alcohol use among Asian (OR = 1.34) and past-month alcohol use among Multiracial (OR = 1.30) adolescents, but not Black or LGB adolescents. Discrimination exposure was not associated with any cannabis use pattern in any group. Independent of discrimination, LGB adolescents were at greater risk for monthly alcohol (OR = 3.48) and cannabis use (OR = 4.07) at Year 2. Conclusions: Discrimination exposure is prospectively associated with risk for alcohol use among adolescents of understudied (Asian, Multiracial) racial backgrounds, and should be considered in alcohol prevention and intervention strategies. Risk factors for alcohol and cannabis use among LGB adolescents should continue to be explored.

Alcohol and Cannabis Use Milestones in Diverse Urban Adolescents: Associations with Demographics, Parental Rule Setting, Sibling and Peer Deviancy, and Outcome Expectancies

Objective: Alcohol and cannabis use progression milestones in adolescence (such as ages at first use, first intoxication and at onset of regular use) may inform the development of alcohol and cannabis use disorders. Although parent, sibling, and peer behavior and alcohol-related cognitions have been shown to be associated with alcohol milestone attainment, findings have been mixed; further, those factors' associations with cannabis use milestones are unknown. This study examined whether progression through such milestones differed as a function of perceived peer/sibling deviancy, parental rule-setting, and substance use outcome expectancies in a racially diverse adolescent sample.Methods: Data were drawn from a two-wave longitudinal health survey study of 9-11^th graders (n = 355 for the current analyses; M_age=15.94 [SD = 1.07]; 44% male; 43% Black; 22% White; 18% Asian; 17% Multiracial; 10% Hispanic/Latinx ethnicity) at an urban high school. A series of logistic and proportional hazards regressions examined associations of peer/sibling deviancy, parental rule-setting, and outcome expectancies with age and attainment of alcohol/cannabis use milestones.Results: For both alcohol and cannabis, greater peer deviancy and positive expectancies were associated with higher odds of milestone attainment, while negative expectancies were associated with slower progression through milestones. For cannabis, but not alcohol, greater perceived sibling deviancy was positively associated with milestone attainment, while negative expectancies were associated with lower odds of milestone attainment.Conclusions: Perceived deviant behavior by peers and siblings, in addition to adolescents' expectancies for either alcohol or cannabis use, is associated with attainment and progression through key adolescent substance use milestones.