Willingness to drink as a function of peer offers and peer norms in early adolescence

The Association of Substance Use Before Sex and Condomless Sex: The Moderating Effects of Sexual Risk Behaviors, Perceived Sex Approval, and HIV/STI Risk Perception Among Youth

Youth are disproportionately affected by substance use and associated sexual risk behaviors, increasing STI and HIV susceptibility. This study analyzed the interplay between alcohol/drug use before sex (ABS/DBS), perceived sex approval (e.g., perceived familial or peer approval in engaging in sex), and HIV/STI risk perception among youth aged 13-21 (n = 150). We assessed how these factors influenced condomless vaginal/anal sex (VAS) and oral sex practices. Results showed significant interactions between perceived sex approval and lifetime ABS for lifetime condomless VAS, and between HIV/STI risk perception and lifetime ABS for current condomless oral sex. These findings underline the influence of perceived sex approval and HIV/STI risk perception on youth's sexual behaviors. Implications for targeted interventions are discussed.

Commercial Cannabidiol for Community-Based Young Adolescents: Predicting Medicinal Use

Objectives: Cannabidiol (CBD) is rising in popularity, including as a potential medicinal product. Yet data on use of commercial CBD for medicinal or health reasons in adolescents are lacking. In this study we aim to detail characteristics of adolescents given commercial CBD for health reasons (health CBD [hCBD]) and to investigate predictors of use. Materials and Methods: The Adolescent Brain Cognitive Development (ABCD) Study is a population-based cohort study following U.S. healthy, community-based adolescents annually, with data from 2018 to 2022 (11- to 15-year-olds; N=11,189). Participants and caregivers completed questionnaires, including whether adolescents were given CBD with parent or doctor's permission. Participants reported past-month pain, attention problems, externalizing symptoms, internalizing symptoms, and total mental health problems. Caregivers reported youth sociodemographics, sleep problems, whether the youth had mental health treatment or sought medical treatment, and rules about recreational cannabis use. We describe youth given hCBD, and run generalized estimating equations predicting odd ratios (ORs) and 95% confidence intervals of adolescents given hCBD by mental health, physical health, or sociodemographics of factors. Results: Of the 11,189 participants across up to three waves of data, 48% were female. Mean age across waves was 12.8 years old (SD=1). In total, 307 (2.8%) were given hCBD. Common administration methods were oil (42%), topical (31%), and edibles (29%). Increased hCBD odds were associated with being older (OR=1.32 [1.17-1.49]), White (relative to Black, OR=05.97 [2.81-12.65] or Hispanic, OR=1.82 [1.17-2.82]), parents with some college (relative to no high school diploma, OR=3.55 [1.09-11.6]), internalizing symptoms (OR=1.81 [1.13-2.91]), mental health treatment (OR=1.76 [1.3-2.38]), pain (OR=1.38 [1.09-1.76]), medical treatment (OR=1.39 [1.08-1.79]), and sleep problems (OR=1.69 [1.27-2.25]). Rules against recreational cannabis decreased odds of hCBD (OR=1.75 [1.30-2.36]). Conclusions: Findings indicate some healthy adolescents are given hCBD, and predictors of use include mental and physical health concerns, being White, older, and parents with some college education. Providers should ask if their youth patients are being given CBD medicinally, and transparently discuss potential benefits, consequences, and unknowns of CBD.

Cross-substance Effects of Adolescent Exposure to Alcohol Content in Popular Movies on Cannabis Initiation

Objective

Alcohol is the most frequently depicted substance in the media, and adolescent exposure to alcohol in the media predicts alcohol use. There is relatively little research on exposure to cannabis in the media, but exposure to alcohol content may exert cross-substance effects on cannabis use. Given the social and health risks associated with early cannabis use, the present study aims to assess the cross-substance effects of exposure to alcohol media content on age of cannabis initiation.

Method

A sample of 830 middle school students (53% female) reported on movie alcohol exposure and cannabis initiation longitudinally until high school completion. Discrete-time survival models examined whether movie alcohol exposure predicted subsequent initiation among students who were cannabis-naïve at baseline, controlling for demographic, social, and behavioral covariates. The interaction between sex and movie alcohol exposure was also explored.

Results

One third (33%) of participants reported cannabis initiation with a mean of 5.57 estimated hours (SD = 4.29) of movie alcohol exposure. A 1-hour increase in movie exposure predicted a significant 16% increased probability of cannabis initiation in models adjusted for demographic variables and a significant 14% increase in models adjusted for demographic, behavioral, and social variables. No differences were observed across sex.

Conclusions

Greater adolescent exposure to alcohol content in the media was associated with earlier cannabis initiation above and beyond other etiologically relevant demographic, behavioral, and social variables. The influence of cross-substance media exposures warrants further exploration and should be taken into consideration in the development of preventive interventions for youth substance use.

Self-management with alcohol over lifespan: psychological mechanisms, neurobiological underpinnings, and risk assessment

Self-management includes all behavioural measures and cognitive activities aimed at coping with challenges arising throughout the lifespan. While virtually all of these challenges can be met without pharmacological means, alcohol consumption has long been instrumentalized as a supporting tool to help coping with problems arising selectively at adolescence, adulthood, and ageing. Here, we present, to our knowledge, the first systematic review of alcohol instrumentalization throughout lifespan. We searched MEDLINE, Google Scholar, PsycINFO and CINAHL (from Jan, 1990, to Dec, 2022) and analysed consumption patterns, goals and potential neurobiological mechanisms. Evidence shows a regular non-addictive use of alcohol to self-manage developmental issues during adolescence, adulthood, and ageing. Alcohol is selectively used to overcome problems arising from dysfunctional personality traits, which manifest in adolescence. A large range of psychiatric disorders gives rise to alcohol use for the self-management of distinct symptoms starting mainly in adulthood. We identify those neuropharmacological effects of alcohol that selectively serve self-management under specific conditions. Finally, we discuss the adverse effects and associated risks that arise from the use of alcohol for self-management. Even well-controlled alcohol use adversely impacts health. Based on these findings, we suggest the implementation of an entirely new view. Health policy action may actively embrace both sides of the phenomenon through a personalized informed use that allows for harm-controlled self-management with alcohol.

Associations Among Enacted Stigma, Perceived Chances for Success, Life Satisfaction, and Substance Use Among Sexual Minority and Heterosexual Youth

Background: Sexual minority youth report high rates of substance use compared to heterosexual youth. Stigma can diminish perceptions of future success and life satisfaction and contribute to elevated substance use. This study examined whether experiences of enacted stigma (i.e., discrimination) and substance use among sexual minority and heterosexual youth were indirectly associated through perceived chances for success and life satisfaction. Method: In a sample of 487 adolescents who indicated their sexual identity (58% female, M age = 16.0, 20% sexual minority), we assessed substance use status and factors that might explain sexual minority disparities in substance use. Using structural equation modeling, we examined indirect associations between sexual minority status and substance use status through these factors. Results: Compared to heterosexual youth, sexual minority youth reported greater stigma, which was associated with both lower perceived chances for success and life satisfaction, which were in turn associated with greater likelihood of substance use. Conclusions: Findings highlight the importance of attending to stigma, perceived chances for success, and general life satisfaction to understand and intervene to prevent substance use among sexual minority youth.

Who are Australia's young heavy drinkers? a cross-sectional population study

OBJECTIVE

In light of the recent declines in youth drinking, the socio-demographic correlates of (1) annual total alcohol consumption (volume) and (2) monthly single occasion risky drinking among underage young people (14-17-year-olds) and young adults (18-24-year-olds) were examined.

METHODS

Cross-sectional data were drawn from the 2019 National Drug Strategy Household Survey (n=1,547). Multivariable negative binomial regression analyses identified the socio-demographic correlates of total annual volume and monthly risky drinking.

RESULTS

Those who spoke English as first language reported higher total volume and rates of monthly risky drinking. Not being in school predicted total volume for 14-17-year-olds, as did having a certificate/diploma for 18-24-year-olds. Living in affluent areas predicted a greater total volume for both age groups, and risky drinking for 18-24-year-olds. Young men in regional areas and working in labour and logistics reported higher total volume than young women in the same groups.

CONCLUSIONS

There are important differences among young heavy drinkers related to gender, cultural background, socio-economic status, education, regionality and work industry.

IMPLICATIONS FOR PUBLIC HEALTH

Prevention strategies that are sensitively tailored towards high risk groups (e.g. young men in regional areas and working in trade and logistics) may be of public health benefit.

Alcohol norms and alcohol intake among high school students

AIMS

To analyse whether parental alcohol norms were associated with the alcohol intake of high school students and whether this association persisted across different levels of alcohol intake in school and trustful communication with parents.

METHODS

This was a cross-sectional study among 70,544 high school students (mean age 18 years) participating in the Danish National Youth Study 2014. We examined the associations between parental alcohol norms and individual alcohol intake as the number of drinks at the most recent school party and the frequency of binge drinking in the last 30 days using negative binomial regression. We then performed joint analyses of parental alcohol norms and alcohol intake at school level, and parental alcohol norms and trustful communication with parents.

RESULTS

The mean intake of alcohol at the most recent school party was 9.9 units of alcohol for boys and 7.6 units of alcohol for girls. A total of 36.2% of boys and 24.7% of girls were binge drinking frequently (more than four occasions in the last month). Lenient parental alcohol norms and a low level of trustful communication with parents were associated with a higher intake at the most recent school party and with the frequency of binge drinking. Joint analyses showed that these associations persisted across different levels of school level alcohol intake and levels of trustful communication with parents.

CONCLUSIONS

Among high school students, parental alcohol norms were strongly associated with alcohol intake and consistently so across different levels of school level alcohol intake and level of trustful communication with parents. This indicates that the role of parents in preventing excessive drinking is important, even in older adolescents.

Measurement Invariance of the Resistance to Peer Influence Scale Across Culture and Gender

Abstract. The current study aimed to test for measurement invariance of the Resistance to Peer Influence scale across samples of Chinese, Canadian, and Tanzanian. Participants included N = 3,771 students from four public schools in China ( N = 2,073, Mage = 16.36 years, SD = 1.14 years; 925 boys), from sixteen public schools in Canada ( N = 642, Mage = 12.13 years, SD = 0.78 years; 321 boys), and from four public schools in Tanzanian ( N = 1,056, Mage = 15.87 years, SD = 2.02 years; 558 boys). Students provided self-reports of resistance to peer influence. The results from multigroup confirmatory factor analysis and the alignment optimization method demonstrated that configural, metric, and partial scalar invariances of resistance to peer influence held across gender and all three countries. Chinese boys had the highest factor mean levels and Canadian boys had the lowest. The findings help us understand peer influence resistance across cultures and genders.

Party, Academic, or Prepped for College? School Norm Profiles and Adolescent Well-being using National Data

The current study examined how schoolwide norms came together into distinct profiles and how norm profile membership was linked to adolescent well-being. Using school-level (N = 786) and student-level data (N = 174,587 12th grade students; 52% female; 64% White, 13% Latino, 12% Black, 12% other) from Monitoring the Future (MTF), we identified four distinct school profiles-average, academic, prepped-for-college, party-that had unique patterns of shared norms. Compared with average schools, academic schools (high academics and low substance use and social integration norms) were most advantageous for students, prepped-for-college schools (high academics, substance use, and social integration norms) had both benefits and drawbacks, and party schools (low academics and high substance use and social integration norms) were most detrimental.

Examining the Moderating Role of Behavioral Willingness on Indirect Relations Between Alcohol Expectancies and Negative Consequences

AIMS

Alcohol expectancies are directly linked to alcohol misuse and indirectly linked to negative consequences via use. Likewise, willingness to experience negative consequences imparts direct risk for negative consequences and may represent an important individual difference when predicting risky alcohol use. To date, no studies have examined how willingness to experience consequences may moderate relations between expectancies and alcohol use in the prediction of negative consequences. It is possible that those who expect appetitive effects and are high in willingness may discount the severity of negative consequences and drink more to realize positive expectations. Alternatively, those who expect aversive alcohol-related effects and are high in willingness may drink more to overcome negative experiences.

METHODS

The current study tested these hypotheses in a sample of undergraduate students (N = 657) from a larger study focused on alcohol and cannabis co-use.

RESULTS

Findings suggested that high-arousal positive expectancies (e.g. sociable, lively, talkative) function as a risk factor for negative consequences indirectly through heavier drinking, whereas low-arousal positive (e.g. mellow, relaxed) expectancies served as an indirect protective factor against negative consequences through lighter drinking. Willingness to experience negative consequences had direct and indirect effects on negative consequences through drinking but did not interact with alcohol expectancies.

CONCLUSIONS

The present study demonstrates the utility of assessing the full range of alcohol expectancies and behavioral willingness in continued research into the dynamic nature of antecedents to alcohol misuse and negative consequences.

Individual-, peer-, and parent-level substance use-related factors among 9- and 10-year-olds from the ABCD Study: Prevalence rates and sociodemographic differences

Background

Although a relatively large body of research has identified multiple factors associated with adolescent substance use, less is known about earlier substance-related factors during preadolescence, including curiosity to use substances. The present study examined individual-, peer-, and parent-level domains pertaining to substance use and how these domains vary by sociodemographic subgroups and substance type.

Methods

Participants were 11,864 9- and 10-year-olds from the baseline sample of the Adolescent Brain Cognitive Development (ABCD) Study. Youth-reported measures were curiosity to use substances and perceived peer substance use. Parent-reported measures were availability of and rules about substances. Generalized logistic mixed models (GLMM) were used to compare these measures across alcohol, nicotine, and marijuana and across sociodemographic subgroupings (sex, race/ethnicity, household income, and family history of alcohol problems). GLMM was then used to examine predictors of curiosity to use by substance type.

Results

The most striking descriptive differences were found between race/ethnicity and income categories (e.g., positive associations between greater income and greater availability of alcohol). In multivariable analyses, greater curiosity to use alcohol was associated with being male, higher household income, perceived peer alcohol use, and easy alcohol availability; greater curiosity to use nicotine was associated with being male, perceived peer cigarette use, easy availability of cigarettes, and no parental rules about cigarette use.

Conclusions

This study identified substance use-related individual-, peer-, and parent-level factors among a diverse, national sample. Findings highlight the importance of considering sociodemographic and substance-specific variability and may help identify risk and protective factors preceding adolescent substance use.

What Does it Mean to be Susceptible to Influence? A Brief Primer on Peer Conformity and Developmental Changes that Affect it

Peer influence is a twofold process that entails a behavior by an agent of influence that elicits conformity from the target of influence. Susceptibility describes the likelihood that conformity will occur. This review focuses on factors that shape susceptibility to peer influence. We argue that conformity has two distinct sources. In some instances, conformity is a product of characteristics of the target of influence, operationalized as stable individual difference variables. Trait-like attributes associated with susceptibility to peer influence include conformity dispositions, social goals, resource acquisition strategies, vulnerabilities, and maturational status. In other instances, conformity is a product of the context in which the target is situated, operationalized as impermanent individual difference variables. State-like circumstances associated with susceptibility to peer influence include conditions of uncertainty, personal attributes that differ from the partner or group, perceived benefits of impression management, unmet social needs, and social referents and beliefs about their behavior. Empirical illustrations are provided. We close with a discussion of developmental changes hypothesized to impact variations in susceptibility to peer influence.

Randomized controlled trial to test the efficacy of a brief, communication-based, substance use preventive intervention for parents of adolescents: Protocol for the SUPPER Project (Substance Use Prevention Promoted by Eating family meals Regularly)

Background

Substance use among adolescents in the U.S. is associated with adverse physical and mental health outcomes in the long-term. Universal youth-focused substance use prevention programs have demonstrated effectiveness but are often not sustainable due to the significant amount of time, effort, and resources required. We describe a trial protocol for a brief, low-participant-burden intervention to improve substance use-specific parent-child communication through the promotion of family meals and increased parental engagement.

Methods

This study is a parallel-group randomized controlled trial designed to assess the efficacy of a 13-week intervention. A total of 500 dyads of parents and their 5^th-7^th grade children are recruited from across Massachusetts. Dyads are randomized to the intervention or attention-control condition using block urn randomization, based on child grade, gender, and school. Parents/guardians in the substance use preventive intervention arm receive a short handbook, attend two meetings with an interventionist, and receive two SMS messages per week. Parents/guardians in the control arm receive the same dose but with content focused on nutrition, physical activity, and weight stigma. Participant dyads submit videos of family meals, audio recordings of prompted conversations, and quantitative surveys over an 18-month period (baseline, 3, 6, 12, 18 months post-intervention). The primary outcomes measure the quantity and quality of parent-child substance use conversations and proximal child indicators (i.e., substance use attitudes and expectancies, affiliation with substance-using peers, and intentions and willingness to use substances). The secondary outcome is child substance use initiation.

Discussion

This is a novel, brief, communication-focused intervention for parents/guardians that was designed to reduce participant burden. The intervention has the potential to improve parent-child engagement and communication and conversations about substance use specifically and decrease child substance use risk factors and substance use initiation.

Trial registration

ClinicalTrials.gov NCT03925220. Registered on 24 April 2019.

Comprehensive measurement invariance of alcohol outcome expectancies among adolescents using regularized moderated nonlinear factor analysis

Alcohol outcomes expectancies (AOEs) are robust predictors of alcohol initiation and escalation of drinking behavior among adolescents. Although measurement invariance is a prerequisite for inferring valid comparisons of AOEs across groups (e.g., age), empirical evidence is lacking. In a secondary data analysis study, we employed regularized moderated nonlinear factor analysis (MNLFA) to simultaneously test differential item functioning (DIF) across age, sex, race, ethnicity, socioeconomic status (SES), and alcohol initiation for a 22-item, two-factor measure of positive and negative AOEs among adolescents (analytic n = 936 drawn from a parent study of 1023 adolescents). Evidence of DIF was minimal, with no DIF for the negative AOE factor and DIF for only two items of the positive AOE factor. The item "feel grown up" exhibited DIF by age, and the item "feel romantic" exhibited DIF by SES. After accounting for DIF, the positive AOE latent factor mean differed by SES, age, and alcohol initiation, and exhibited lower variability by alcohol initiation. The negative AOE latent factor mean differed by sex and SES, with greater variability by SES and age and lower variability by alcohol initiation. Group-differences findings for age and alcohol initiation are consistent with prior work, and differences by sex and SES are a new contribution to the literature that should prompt additional research to ensure replicability. The present study demonstrates the utility of the MNLFA technique for examining comprehensive measurement invariance, particularly for applied researchers who seek to examine substantive research questions while accounting for any DIF present in the scales used.

HISTORICAL AND CONTEMPORARY CONTEXTS OF ALCOHOL CONSUMPTION IN MODERN UKRAINE

OBJECTIVE

The aim: To identify and to describe the historical and current factors that determine the patterns of alcohol consumption in modern Ukraine.

PATIENTS AND METHODS

Materials and methods: A review and analysis of existing literature focused on historical and contemporary contexts of alcohol use in modern Ukraine. Epidemiological data from general population adolescents survey (N=2038; 2020) and adults survey (N=1200; 2019) conducted in the Lviv region are analyzed from the sociological perspective.

CONCLUSION

Conclusions: Studies results demonstrate the existence of special mechanism that conserves and strengthens the predisposition of positive attitude towards alcohol since early childhood. This information will help to shift the focus of anti-alcohol policy towards a more diverse set of strategies (including administrative intervention and harm reduction strategy).

Perceived norms, personal agency, and postpartum family planning intentions among first-time mothers age 15-24 years in Kinshasa: A cross-sectional analysis

Unintended pregnancy is an important global health problem and frequently occurs during the immediate postpartum period. However, few studies have examined postpartum family planning (PPFP) intentions among adolescent girls and young women. This study assessed whether perceived norms and personal agency predicted PPFP intentions among first-time mothers age 15–24 in Kinshasa, the Democratic Republic of Congo. Data were derived from the 2018 Momentum Project baseline survey. Analysis was based on 2,418 nulliparous pregnant women age 15–24 who were approximately six months pregnant with their first child in six health zones of Kinshasa. Overall PPFP intentions were low and ten to thirteen percent of women stated they were very likely to discuss PPFP next month with (a) their husband/male partner and (b) a health worker, and to (c) obtain and (d) use a contraceptive method during the first six weeks following childbirth. The results of multivariable linear regression models indicated that the PPFP intention index was predicted by description norms, perceptions of the larger community’s approval of PPFP, normative expectations, perceived behavioral control, self-efficacy, and autonomy. Rejection of family planning myths and misconceptions was also a significant predictor. Interaction terms suggested that the association of normative expectations with PPFP intentions varied across ethnic groups and that the positive association of injunctive norms with PPFP intentions was significantly increased when the larger community was perceived to disapprove of PPFP use. Normative expectations and PPFP-related self-efficacy accounted for two-thirds of the variance in PPFP intentions. The results suggested that understanding different normative influences may be important to motivate women to use contraception in the immediate postpartum period. In addition to addressing institutional, individual, and social determinants of PPFP, programs should consider integrating norm-based and empowerment strategies.

Peers' Choices Influence Adolescent Risk-taking Especially When Explicit Risk Information is Lacking

This study examines the impact of peers' previous cautious versus risky choices on adolescents' risk-taking depending on the level of information about the risk. Adolescents completed an adaptation of the BART that manipulated social influence (cautious and risky) and risk information (i.e., informed, noninformed). Results showed that social influence impacts adolescents' decisions on the noninformed BART but not on the informed BART. In the noninformed BART, the peers' cautious choices strongly decreased risk-taking and led to greater performance. The peers' risky choices increase adolescents' risk-taking, but this effect is limited to situations involving minimal risk. Thus social experience may be a specific social context that represents a valuable source of information during adolescence, especially in situations with high uncertainty.

E-cigarette use among Asian Americans: a systematic review

The use of electronic cigarettes (e-cigarettes) has been rising among adolescents and adults in the United States, including among Asian Americans. However, despite being one of the largest racial/ethnic minority groups, the specific trends and patterns of e-cigarette use among Asian Americans are understudied and unclear. This review aimed to summarize relevant information in the last two decades. This systematic review followed the a priori guide outlined by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were gathered from PsycINFO, PubMed, Sage Journals Online, ScienceDirect, and SpringerLink. Forty articles were reviewed and analyzed. Most articles reviewed only reported on the prevalence rate of e-cigarettes among Asian Americans and indicated regional differences. Results noted between- and within-group differences among racial/ethnic groups that warrant further examination. There is a dearth of information regarding health outcomes and correlates or predictors of e-cigarette use among Asian Americans. Despite its popularity and prevalence among Asian Americans, the use of e-cigarettes and related factors or outcomes deserves more nuanced studies and analyses. It is important to delineate subgroup differences by adjusting study designs and data analytic methods to glean meaningful information regarding Asian American's e-cigarette use in the future.

The Altered Course of Learning: How Alcohol Outcome Expectancies Are Shaped by First Drinking Experiences

According to expectancy theory, outcome expectancies are first formed vicariously (through observing other people) and then through direct experience. This cohort-sequential longitudinal study explored these expectancy origins in 1,023 youths (52% female, ages 10.5-15.5 years at recruitment, M = 12.47 years, SD = 0.95). Discontinuous multilevel growth models described patterns of change in expectancies before and after the first experience of distinct drinking milestones (i.e., first sip, first full drink, first heavy-drinking situation). Youths' expectations for positive and negative drinking outcomes generally increased and decreased over adolescence, respectively, reflecting general developmental trends. Drinking experiences altered learning trajectories, however, reifying positive expectancies and invalidating negative expectancies at each milestone and altering the course of expectancy change thereafter. For positive outcome expectancies, the influence of direct experience on learning was stronger when drinking milestones were met at an earlier age. Conversely, invalidation of negative expectancies was stronger when the first-drink milestone was met at a later age.

Socio-economic differences in factors associated with alcohol use among adolescents in Slovenia: a cross-sectional study

OBJECTIVES

This paper aims to investigate the association of parental, friends, and personal factors with the risk of alcohol use in a sample of Slovenian adolescents, and whether these associations differ by socio-economic status of the school area (SES).

METHODS

The survey involved 2946 students of 44 Slovenian primary schools in the school year 2010/2011. The association between sociodemographic characteristics, parental alcohol use and permissiveness to drink, parental monitoring, perception of friends' alcohol use, beliefs towards alcohol, self-esteem and refusal skills, and the probability of recent alcohol use was evaluated through multiple multilevel logistic regression analysis.

RESULTS

Parental alcohol use, parental permissiveness to drink alcohol, low parental monitoring, perception of friends' alcohol use, positive beliefs towards alcohol use, and low refusal skills were significantly associated with the risk of alcohol use. Parental drinking and permissive attitudes were stronger correlates of alcohol use among adolescents of middle and low SES schools, while friends' alcohol use and personal factors among adolescents of high SES schools.

CONCLUSIONS

Alcohol prevention programs should be tailored to school socio-economic environment taking into account friends and personal determinants among high SES, and parental factors among low SES school students.

Parent-child conversations associated with alcohol-related risk behaviours in young people (13-17 years) in the UK: a cross-sectional study

OBJECTIVE

To investigate different types of parent-child conversations associated with young people's (13-17 years) alcohol-related risk behaviours.

DESIGN

Secondary analysis of the 2016 Drinkaware Monitor Survey. This survey employed a cross-sectional design and collected data using self-completion questionnaires.

SETTING

UK-wide.

PARTICIPANTS

561 parent-child pairs were included in the analysis. The nationally representative quota sample was weighted by reference to the UK population.

METHODOLOGY

Data were analysed using purposeful selection modelling (adjusted OR (AOR), 95% CIs). RISK BEHAVIOURS: 'Whether have ever drank' and 'whether vomited as a result of alcohol'.

RESULTS

50% (277/553) of young people reported drinking a whole alcoholic drink, and 22% (60/277) of these experienced vomiting as a result. After adjusting for age and gender, the likelihood of ever having drank alcohol was significantly increased among the following young people: those whose parents believed they knew a little about how much they drink (AOR 1.80, 95% CI 1.04 to 3.13) or that some/most/all friends drink (AOR 3.82, 95% CI 2.40 to 6.08); those given gentle reminders about taking care when drinking alcohol (AOR 1.82, 95% CI 1.15 to 2.88), practical advice (AOR 2.09, 95% CI 1.20 to 3.64) or designated time, led by the parent, to instil care around alcohol through a formal sit-down (AOR 1.79, 95% CI 1.07 to 2.99). The likelihood was reduced for parents aged 40-49 years (AOR 0.52, 95% CI 0.31 to 0.89) and conversations providing information (AOR 0.53, 95% CI 0.29 to 0.98). Vomiting was significantly associated with some/most/all friends drinking alcohol (AOR 3.65, 95% CI 1.08 to 12.30), parent's beliefs about child's frequency of drinking alcohol (AOR 1.26, 95% CI 1.02 to 1.54), parental harmful/dependency drinking (AOR 3.75, 95% CI 1.13 to 12.50) and having a formal sit-down conversation (AOR 2.15, 95% CI 0.99 to 4.66).

CONCLUSIONS

We found evidence of mostly negative associations between young people's risk behaviours and different types of parent-child conversations. Conversations providing information were linked to a reduced tendency to have ever drunk alcohol. All other types of conversations were negatively associated with risk behaviours. Psychological reactance and conversation quality possibly explain these findings.

Fluctuations in progesterone moderate the relationship between daily mood and alcohol use in young adult women

BACKGROUND

Research has demonstrated associations between hormonal fluctuations during the menstrual cycle and women's alcohol use. This association has been explained by mood changes that, for some women, accompany decreasing levels of progesterone during the menstrual cycle, particularly during the late luteal/premenstrual phase. The current study examined whether participants' daily ratings of mood interact with changing levels of progesterone to predict alcohol use.

METHOD

Young adult women attended two sessions scheduled two weeks apart, during which they completed questionnaires and provided salivary samples for the assay of progesterone levels. In the intervening two weeks, participants completed daily logs of their mood, alcohol use, and menses. Ordered Generalized Linear Mixed Models assessed the effects of daily mood (examined as both a within- and between-subject variable) on the likelihood of drinking, as a function of menstrual cycle phase and changes in progesterone across the two weeks.

RESULTS

One standard deviation increase in progesterone corresponded to a 1.61 decrease in the odds of drinking. This main effect was moderated by daily mood. Women were more likely to drink during a decrease in progesterone on days they rated their mood as negative, whereas during an increase in progesterone they were more likely to drink on days they reported a positive mood. Between-subject analyses showed that women who reported lower overall mood during the two-week period were more likely to drink with an increase in progesterone and less likely with a decrease.

CONCLUSIONS

Women's likelihood to drink increased when they experienced negative mood in the context of decreasing levels of progesterone, whereas the negative-mood/drinking association was mitigated among those with increasing levels of progesterone. However, compared to women who on average had an overall more positive mood, women with an overall lower mood (and corresponding higher levels of depression and anxiety at baseline) did not experience the protective effects of rising progesterone levels on drinking.

Lability in Parent- and Child-Based Sources of Parental Monitoring Is Differentially Associated with Adolescent Substance Use

Parental knowledge about adolescents' whereabouts and activities remains one of the strongest predictors of reduced adolescent substance use. A recent study found that across middle childhood and adolescence, parental knowledge is characterized by fluctuations on a year-to-year basis, termed lability, even more-so than by linear trends, and that lability too is a predictor of adolescent substance use (Lippold et al., Dev. Psychol. 17, 274-283, 2016). The present study replicates Lippold et al. (Dev. Psychol. 17, 274-283, 2016) by quantifying developmental change and lability in parental knowledge across adolescence and examining associations with drinking, smoking, and other drug use later in adolescence, and extends the study by examining the sources of knowledge: child disclosure, parental solicitation, and parental control, separately. Using a community-based sample of 1023 youth in the Northeastern region of the USA, all three sources of knowledge were characterized by developmental change and lability. In general, higher levels and steeper developmental declines in knowledge were associated with substance use outcomes. Findings for child disclosure replicated the prior findings: increased lability of child disclosure predicted substance use. Unexpectedly, decreased lability of parental solicitation and control was associated with worse substance use outcomes. Findings suggest different mechanisms by which lability in child- and parent-driven cultivation of knowledge is associated with substance use. If replicated in studies that address causality, these mechanisms could be leveraged for prevention/intervention efforts. For example, increasing the consistency of child disclosure may help prevent substance use, but teaching parents to be more responsive to time-specific challenges with adolescents may be more effective than increasing the consistency of parents' knowledge-building parenting behaviors.

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.

Brain responses and approach bias to social alcohol cues and their association with drinking in a social setting in young adult males

Alcohol is mainly consumed in social settings, in which people often adapt their drinking behaviour to that of others, also called imitation of drinking. Yet, it remains unclear what drives this drinking in a social setting. In this study, we expected to see stronger brain and behavioural responses to social compared to non-social alcohol cues, and these responses to be associated with drinking in a social setting. The sample consisted of 153 beer-drinking males, aged 18-25 years. Brain responses to social alcohol cues were measured during an alcohol cue-exposure task performed in an fMRI scanner. Behavioural responses to social alcohol cues were measured using a stimulus-response compatibility task, providing an index of approach bias towards these cues. Drinking in a social setting was measured in a laboratory mimicking a bar environment. Specific brain responses to social alcohol cues were observed in the bilateral superior temporal sulcus and the left inferior parietal lobe. There was no approach bias towards social alcohol cues specifically; however, we did find an approach bias towards alcohol (versus soda) cues in general. Brain responses and approach bias towards social alcohol cues were unrelated and not associated with actual drinking. Thus, we found no support for a relation between drinking in a social setting on the one hand, and brain cue-reactivity or behavioural approach biases to social alcohol cues on the other hand. This suggests that, in contrast to our hypothesis, drinking in a social setting may not be driven by brain or behavioural responses to social alcohol cues.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

Randomized effectiveness trial of a parent and youth combined intervention on the substance use norms of Latino middle school students

This article advances knowledge about the effectiveness of applying a community-based efficacious parenting intervention in parallel with an efficacious preadolescent intervention in changing substance abuse norms among preadolescent Latino youth. The study employed a longitudinal, randomized control group design comparing three groups: (1) Parent intervention combined with a Youth intervention: Parent/Youth; (2) Parent intervention without a Youth intervention: Parent Only; and (3) Treatment as usual: Comparison. In the comparison group, parents participated in a standard parenting program delivered by the community partner, and the youth received the usual drug use prevention programming offered in their schools. Data from both parents and youth at the19 participating schools were collected at pre-test, immediate post-test (4 months after pre-test), and two follow-up (8 & 20 months after the pre-test). The total sample includes 532 families (parent-child dyads). The parent-child dyads consisted of one parent and one youth ages 12-14. The retention rates for both parents and preadolescent were high across the different waves of data collection (79%-96%). Regression results of youth substance use norms were calculated based on three permutations of data: (a) original data, with no imputation and no propensity score matching; (b) imputed data but no propensity score matching; and (c) imputed data plus propensity score matching. Compared to the Comparison group, the Parent/Youth condition was the most effective in changing youth's norms, closely followed by the Parent Only condition. These findings make a significant contribution in advancing knowledge on family/youth substance use prevention for Latinos in a community environment. Although the study took place in a specific urban center in the Southwest US, its findings can be generalized to other urban communities of similar characteristics across the country.

Changes in peer norms as a mediator of reduction in adolescent alcohol use

Background: Evidence from college samples suggests that changes in peer norms (perception about peer use) mediate changes in alcohol use. There is relatively little intervention-based research in adolescents. Objectives: To investigate whether changes in peer norms mediate the relationship between a brief intervention to reduce alcohol use, and level of use; additionally, to determine whether any mediation effects differ by adolescent age. Methods: Eighty-four adolescents aged 14-18 (Mean = 16.49, SD = 1.00), presenting to school-based health centers with moderate to high risk alcohol use were randomized to receive an electronic screening and feedback tool (Check Yourself) in addition to their visit, or their visit alone. Check Yourself includes provision of normative feedback regarding adolescent alcohol use. Measures of self-reported alcohol use, and peer norms were collected at baseline and 2-month follow-up. Results: Changes in perceptions of the proportion of peers using alcohol significantly mediated the relationship between the intervention and all three alcohol outcomes (frequency, typical quantity, and maximum quantity) such that reductions in perceived peer use were associated with reduced use. Moderated mediation suggested that these effects were stronger for younger adolescents compared with older adolescents. Perceptions of the frequency and quantity of peer use were not significant mediators of alcohol use. Conclusions/Importance: Results suggest that integrating normative feedback regarding peer alcohol use is a promising approach in adolescent focused school interventions. They extend previous findings by suggesting that perceptions of the proportion of peers using may be particularly meaningful, and that effects may be more pronounced in younger adolescents.

Parental drinking as context for parental socialization of adolescent alcohol use

INTRODUCTION

While alcohol-specific parenting practices have demonstrated unique effects on adolescent substance use, their efficacy in the context of parental drinking levels has not been studied. This study assessed the influence of three alcohol-specific parenting practices (rules, punishment, communication) on adolescent alcohol use, and the degree to which those associations varied by parents' own drinking.

METHODS

We conducted logistic regression analyses among US adolescents (N = 1023; 52% female; 12% Hispanic; 76% Caucasian, 5% Black, 8% mixed race, 11% other race/ethnicity; mean age at enrollment = 12.2 years) to examine the relationship between alcohol-specific parenting practices and the odds of ever having experienced two drinking milestones, having a full drink of alcohol and a heavy drinking episode, and whether parental drinking levels moderated those associations.

RESULTS

Strict rules for drinking, higher levels of cautionary communication messages, and punishment for drinking were associated with lower odds of alcohol use. Witnessing parent drinking increased the risk for both alcohol outcomes. Furthermore, parental drinking modified the influence of parental cautionary messages on alcohol use such that the effect was particularly salient for those youth who witnessed and whose parents reported higher levels of alcohol use.

CONCLUSIONS

Family-based preventive interventions should include skills training in alcohol-specific parenting practices with emphasis on reducing parental alcohol use particularly when children are present.

Adolescent recanting of alcohol use: A longitudinal investigation of time-varying intra-individual predictors

BACKGROUND

Recanting - denying previous reports of lifetime substance use - occurs frequently in longitudinal investigations of adolescent substance use. While research has focused on how individual differences contribute to recanting, intra-individual factors associated with recanting over time remain understudied.

METHODS

Adolescents (n = 1023) were assessed six times between 2009 - 2015. The sample included participants who reported ever-sipping alcohol in at least one assessment who maintained or recanted ever-sipping at the subsequent assessment (n = 543, 53.1% of full sample; 54.5% female; 84.9% white; 89.5% non-Hispanic). The majority (58.6%) of the sample recanted ever-sipping. We fit linear mixed models to investigate whether prospective changes in perceived peer drinking, peer approval, alcohol expectancies, and fear of reprisal predicted recanting. To explore whether mechanisms of recanting differed for delayed (i.e., two assessments or later) recanting, we refit the models in a subset of data excluding immediate (i.e., subsequent assessment) recanters.

RESULTS

Prospective increases in perceived peer drinking (OR = 0.65), peer approval of drinking (OR = 0.82), and positive and negative alcohol expectancies (OR = 0.96; 0.98, respectively) predicted lower odds of recanting. Similar effects were observed among only delayed recanters.

CONCLUSION

Time-varying, intra-individual factors uniquely predicted recanting over time. Although most recanting occurs immediately following the initial report of ever-sipping, the observed effects were consistent between delayed recanters and the sample as a whole. Considering the systematic patterns evident in recanting, researchers should consider using computer-assisted or other research methods that minimize or verify recanting when it occurs while also informing missing data models.

Identifying adolescents with alcohol use disorder: Optimal screening using the National Institute on Alcohol Abuse and Alcoholism screening guide

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) screening guide (SG) uses a 2-question screening process to identify adolescents at risk for alcohol use. The aim of this study was to identify the optimal screening rule in terms of identifying adolescents with alcohol use disorder (AUD) using the NIAAA questions by examining whether the cutpoint should vary by gender, race/ethnicity, grade, and/or age. Youth aged 12 through 18 years (N = 1,573; 27% Black, 51% Hispanic) were screened using the NIAAA SG, and then completed a survey. We used receiver operating characteristic curve analyses to identify the optimal cutpoint for the NIAAA screener question on self-use with AUD as the outcome. We compared the resulting screening rule with the NIAAA SG rule. We found that the optimal cutpoint depended on age and grade of adolescents. The resulting screening rule was the same as the NIAAA SG, and thus independently validated the NIAAA SG, with the exception of screening for adolescents 18 years of age, for which a lower cutpoint was indicated. The performance of both screening rules was highly similar when applied to the study sample, with a sensitivity of 0.89 for the optimal screening rule and a sensitivity of 0.87 for the NIAAA SG. In settings in which the cost of a false positive is relatively low (depending on available resources and cost of the intervention), lower cutpoints for older adolescents should be considered, as this may increase sensitivity of identifying these individuals at risk for AUD. (PsycINFO Database Record

The Role of Sensation Seeking and R-rated Movie Watching in Early Substance Use Initiation

Adolescence is a time of heightened impulsivity as well as substantial exposure to the effects of popular media. Specifically, R-rated movie content and sensation seeking have been shown to be individually and multiplicatively associated with early alcohol initiation, as well as to mutually influence one another over time. The present study attempts to replicate and extend these findings to cigarette and marijuana use, considering several peer, parental, and individual correlates, as well as substance-specific movie exposure, among 1023 youth (mean age 12.4 years, 52% female), using a combination of cross-lagged path models, latent growth models, and discrete-time survival models. Changes over time were associated between R-rated movie watching and sensation seeking, and both individually, not multiplicatively, predicted earlier alcohol initiation. R-rated movie watching (but not sensation seeking) also predicted earlier smoking and marijuana initiation. Parental R-rated movie restriction may thus potentially delay smoking and marijuana initiation as well as adolescent drinking.

Resistance to peer influence moderates the relationship between perceived (but not actual) peer norms and binge drinking in a college student social network

INTRODUCTION

Adolescent and young adult binge drinking is strongly associated with perceived social norms and the drinking behavior that occurs within peer networks. The extent to which an individual is influenced by the behavior of others may depend upon that individual's resistance to peer influence (RPI).

METHODS

Students in their first semester of college (N=1323; 54.7% female, 57% White, 15.1% Hispanic) reported on their own binge drinking, and the perceived binge drinking of up to 10 important peers in the first-year class. Using network autocorrelation models, we investigated cross-sectional relationships between participant's binge drinking frequency and the perceived and actual binge drinking frequency of important peers. We then tested the moderating role of RPI, expecting that greater RPI would weaken the relationship between perceived and actual peer binge drinking on participant binge drinking.

RESULTS

Perceived and actual peer binge drinking were statistically significant predictors of participant binge drinking frequency in the past month, after controlling for covariates. RPI significantly moderated the association between perceptions of peer binge drinking and participant's own binge drinking; this association was weaker among participants with higher RPI compared to those with lower RPI. RPI did not interact with the actual binge drinking behavior of network peers.

CONCLUSIONS

RPI may function to protect individuals from the effect of their perceptions about the binge drinking of peers, but not from the effect of the actual binge drinking of peers.

Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods

One of the objectives of the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org/) is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States.

Exposure to Alcohol Content in Movies and Initiation of Early Drinking Milestones

BACKGROUND

Exposure to alcohol content in movies has been shown to be associated with adolescent use of alcohol, including earlier onset. This study examined the influence of movie alcohol exposure on subsequent alcohol onset, considering the social context (whether the movie was viewed with a friend or parent). We examined whether media's influence holds across a spectrum of early drinking milestones: sipping (but not consuming a full drink of) alcohol, consuming a full drink of alcohol, and engaging in heavy episodic drinking (HED).

METHODS

Data were taken from a sample of 882 middle school youth (52% female; 24% non-White) enrolled in an ongoing study on alcohol initiation and progression. Exposure to alcohol content in films was measured using a method that combines content analysis and random assignment of movie titles to youth surveys. The hazard of initiating alcohol use (sip, full drink, HED) as a function of exposure was estimated using survival analysis. Associations were adjusted for demographic, personality, and social influence factors known to be associated with both movie exposure and alcohol use.

RESULTS

Exposure to alcohol content was common. Hours of exposure prospectively predicted earlier onset of alcohol involvement across all outcomes. Viewing movies with friends appeared to augment the media exposure effect, in contrast to viewing movies with parents, which was not a significant predictor of initiation.

CONCLUSIONS

Exposure to alcohol in films is involved in the entry into early stages of alcohol involvement. Findings support further investigation into the role of the media in underage drinking, especially in the context of consuming media with friends and peers. Limiting media exposure and/or stronger Federal Trade Commission oversight of movie ratings should be a priority for preventing underage drinking.

Peer norms and susceptibility mediate the effect of movie alcohol exposure on alcohol initiation in adolescents

Movie alcohol exposure is a known and consistent predictor of adolescent alcohol use initiation and escalation. Nearly 90% of the top U.S. movies contain alcohol content. Social-cognitive theory posits reciprocal links among environmental influences (e.g., movie alcohol exposure), social-cognitive processes (e.g., perceived norms, susceptibility, alcohol outcome expectancies), and behavior (alcohol use), but these links have been tested in only 1 direction. In the current study, we assessed movie alcohol exposure, alcohol cognitions, and alcohol initiation among adolescents (N = 1,023; 52% female, mean age = 13.7 years) in 4 annual survey waves. Cross-lagged panel models tested bidirectional relations between cognitions and movie alcohol exposure. Finally, we tested bidirectional mediation effects in the prospective prediction of alcohol initiation. Movie alcohol exposure prospectively predicted increases in descriptive norms, injunctive norms, and susceptibility but not positive or negative alcohol outcome expectancies. All factors predicted subsequent alcohol initiation. Close friend injunctive and descriptive norms, peer descriptive norms, and susceptibility mediated the effect of earlier movie alcohol exposure on subsequent alcohol initiation. Movie alcohol exposure mediated the effect of earlier close friend descriptive norms on subsequent alcohol initiation. Movie alcohol exposure and social-cognitive processes are interrelated facets that impact alcohol initiation. Permissive cognitions infrequently predicted higher subsequent exposure to movie alcohol. Clinical and preventative implications of this work are discussed. (PsycINFO Database Record

Developmental relations between alcohol expectancies and social norms in predicting alcohol onset

Expectations about alcohol's effects and perceptions of peers' behaviors and beliefs related to alcohol use are each shown to strongly influence the timing of drinking onset during adolescence. The present study builds on prior work by examining the conjoint effects of within-person changes in these social-cognitive factors on age of adolescent drinking onset. We related youths' alcohol status (i.e., alcohol-naive, initiation during study, prior initiation) to increases in positive and negative alcohol outcome expectancies (AOEs), as well as increases in perceived peer/close friend alcohol use and acceptance, during adolescence. We also investigated whether changes in AOEs and perceived social norms prospectively predicted alcohol onset in alcohol-naïve adolescents. Participants were 1,023 adolescents aged 12.2 years on average at enrollment (SD = 0.98), 52% female, participating in an ongoing longitudinal survey on substance use and health behaviors. Positive AOEs, close friends' norms, and same-age peer norms increased linearly, whereas negative AOEs decreased linearly. Changes were attenuated for participants who remained alcohol-naïve and increased for participants who experienced initiation during the study. Furthermore, we found associations between individual changes in AOEs and perceived social norms. Finally, survival models revealed that onset of alcohol use was prospectively predicted by stronger initial positive AOEs, as well as increases in close friends' norms and decreases in negative AOEs over time. These findings emphasize codevelopment of AOEs and perceived social norms, coinciding with, and predictive of, onset of alcohol use, and point toward a unique role for within-individual changes in identifying youth at risk for early onset of alcohol use. (PsycINFO Database Record

The influence of peer behavior as a function of social and cultural closeness: A meta-analysis of normative influence on adolescent smoking initiation and continuation

Although the influence of peers on adolescent smoking should vary depending on social dynamics, there is a lack of understanding of which elements are most crucial and how this dynamic unfolds for smoking initiation and continuation across areas of the world. The present meta-analysis included 75 studies yielding 237 effect sizes that examined associations between peers' smoking and adolescents' smoking initiation and continuation with longitudinal designs across 16 countries. Mixed-effects models with robust variance estimates were used to calculate weighted-mean Odds ratios. This work showed that having peers who smoke is associated with about twice the odds of adolescents beginning (OR ¯ = 1.96, 95% confidence interval [CI] [1.76, 2.19]) and continuing to smoke (OR ¯ = 1.78, 95% CI [1.55, 2.05]). Moderator analyses revealed that (a) smoking initiation was more positively correlated with peers' smoking when the interpersonal closeness between adolescents and their peers was higher (vs. lower); and (b) both smoking initiation and continuation were more positively correlated with peers' smoking when samples were from collectivistic (vs. individualistic) cultures. Thus, both individual as well as population level dynamics play a critical role in the strength of peer influence. Accounting for cultural variables may be especially important given effects on both initiation and continuation. Implications for theory, research, and antismoking intervention strategies are discussed. (PsycINFO Database Record

Friends' Alcohol-Related Social Networking Site Activity Predicts Escalations in Adolescent Drinking: Mediation by Peer Norms

PURPOSE

Adolescents' increased use of social networking sites (SNS) coincides with a developmental period of heightened risk for alcohol use initiation. However, little is known regarding associations between adolescents' SNS use and drinking initiation nor the mechanisms of this association. This study examined longitudinal associations among adolescents' exposure to friends' alcohol-related SNS postings, alcohol-favorable peer injunctive norms, and initiation of drinking behaviors.

METHODS

Participants were 658 high-school students who reported on posting of alcohol-related SNS content by self and friends, alcohol-related injunctive norms, and other developmental risk factors for alcohol use at two time points, 1 year apart. Participants also reported on initiation of three drinking behaviors: consuming a full drink, becoming drunk, and heavy episodic drinking (three or more drinks per occasion). Probit regression analyses were used to predict initiation of drinking behaviors from exposure to alcohol-related SNS content. Path analyses examined mediation of this association by peer injunctive norms.

RESULTS

Exposure to friends' alcohol-related SNS content predicted adolescents' initiation of drinking and heavy episodic drinking 1 year later, controlling for demographic and known developmental risk factors for alcohol use (i.e., parental monitoring and peer orientation). In addition, alcohol-favorable peer injunctive norms statistically mediated the relationship between alcohol-related SNS exposure and each drinking milestone.

CONCLUSIONS

Results suggest that social media plays a unique role in contributing to peer influence processes surrounding alcohol use and highlight the need for future investigative and preventive efforts to account for adolescents' changing social environments.

The role of perceived injunctive alcohol norms in adolescent drinking behavior

Peers have a major influence on youth during adolescence, and perceptions about peer alcohol use (perceived norms) are often associated with personal drinking behavior among youth. Most of the research on perceived norms among adolescents focuses on perceived descriptive norms only, or perceptions about peers' behavior, and correcting these perceptions are a major focus of many prevention programs with adolescents. In contrast, perceived injunctive norms, which are personal perceptions about peers' attitudes regarding the acceptability of behaviors, have been minimally examined in the adolescent drinking literature. Yet correcting perceptions about these perceived peer attitudes may be an important component to include in prevention programs with youth. Using a sample of 2493 high school-aged youth (mean age=17.3), we assessed drinking behavior (past year use; past month frequency, quantity, and peak drinks), drinking consequences, and perceived descriptive and injunctive norms to examine the relationships of perceived injunctive and descriptive norms on adolescent drinking behavior. Findings indicated that although perceived descriptive norms were associated with some drinking outcomes (past year use; past month frequency; past month quantity; peak drinks), perceived injunctive norms were associated with all drinking outcomes, including outcomes of consequences, even after controlling for perceived descriptive norms. Findings suggest that consideration of perceived injunctive norms may be important in models of adolescent drinking. Prevention programs that do not include injunctive norms feedback may miss an important opportunity to enhance effectiveness of such prevention programs targeting adolescent alcohol use.

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

Drinking Motives and Willingness to Drink Alcohol in Peer Drinking Contexts

Drinking motives are important proximal predictors of alcohol consumption in adolescents and emerging adults (EAs). Despite the importance of peer context on alcohol use decision-making, research on drinking motives is commonly divorced from the contexts where such decisions are made. Behavioral willingness (BW), or openness to engaging in a given behavior, is a contextually dependent aspect of nondeliberative decision-making for youth. As BW and drinking motives are proximal predictors of alcohol use, it was hypothesized that they would interact in the prediction of later drinking. Eighty-seven EAs reported their BW in simulated drinking contexts, drinking motives, and alcohol consumption upon entering college as well as drinking patterns 8 months later. Context-specific BW potentiated coping motives' impact on increased alcohol consumption and potentially hazardous drinking at the end of participants' first year. These findings support the importance of BW and context in understanding motivation's role in drinking behavior for EAs.

The Prospective Association Between Sleep and Initiation of Substance Use in Young Adolescents

PURPOSE

This study aimed to determine the unique utility of poor sleep health in predicting the onset of substance use in adolescents.

METHODS

Middle school students (N = 829, mean (M)age = 12.6 years, 52% female, 73% white) who participated in an ongoing prospective study of alcohol onset and progression completed a set of Web-based health behavior surveys over a 4-year period, with recruitment beginning in 2009. Surveys included assessments of alcohol, cigarette, and marijuana use as well as sleep duration, bedtime delay (from weekdays to weekends), and daytime sleepiness. Data were analyzed using discrete-time Cox Proportional hazard's regression.

RESULTS

Controlling for participant age at sleep assessment, gender, and internalizing and externalizing behaviors, shorter sleep duration and greater daytime sleepiness in year 1 were associated with increased odds of having had a full drink of alcohol, having engaged in heavy episodic drinking, and having experienced alcohol-related consequences by year 4. Shorter sleep duration was also associated with increased odds of marijuana use by year 4. No sleep parameter was uniquely associated with increased odds of cigarette use (first puff or first full cigarette). Effects were evident for both males and females. Age at sleep assessment did not moderate effects.

CONCLUSIONS

Sleep health is a prospective predictor of the onset of alcohol and marijuana use among adolescents. Increased efforts to prevent and intervene in sleep problems among adolescents are warranted.

Combining Social Norms and Social Marketing to Address Underage Drinking: Development and Process Evaluation of a Whole-of-Community Intervention

Youth alcohol consumption has been steadily declining in Australia, as in other countries; fewer young people are drinking and the age of initiation is increasing. However, young people, their parents and others in their communities continue to believe that adolescent (excessive) drinking is the norm. This perception, and the concurrent misperception that the majority of parents are happy to provide their underage children with alcohol, creates a perceived culture of acceptance of youth alcohol consumption. Young people believe that it is accepted, and even expected, that they will drink; and parents perceive that not providing their adolescent children with alcohol will lead to social exclusion. There is evidence that shifting social norms can have an immediate and lasting effect adolescents’ (and adults’) alcohol related attitudes and behaviors. This paper reports on a novel, community based social marketing intervention designed to correct misperceptions of alcohol related social norms in an Australian community. The project utilized a social marketing approach, informed by the full complement of Andreasen’s social marketing benchmarking criteria, and concurrently targeted adolescents, parents of adolescents and the broader community. Using extensive formative research and multiple evaluation techniques, the study demonstrates that shifts in community social norms are possible and suggests that this approach could be used more widely to support the positive trends in youth alcohol consumption and parental supply.

Alcohol Consumption Milestones: Comparing First- Versus Last-Reported Age of Onset

Multiple assessments of age of onset of alcohol use milestones may produce inconsistent reports, yielding potentially different results, depending on the report utilized. Using data from a prospective study of 1,023 middle-school students, we modeled risk of onset of four drinking milestones as a function of multiple correlates of alcohol use and compared models using first versus last reported age for each milestone. . While forward telescoping was evident, no significant differences were obtained for any models examined. Substantive conclusions about associations of correlates of early drinking are not greatly impacted by misreporting age of first use.

Internalizing Symptoms, Peer Substance Use, and Substance Use Initiation

This study used longitudinal survey and social network data covering sixth through ninth grades to test whether internalizing symptoms make early adolescents more prone to (1) exposure to and (2) influence by substance-using peers. Random effects regressions revealed that increases in symptoms were significantly associated with increases in the proportion of friends who used cigarettes, alcohol, and marijuana; some associations weakened across grades. Event history models revealed that the effect of friends' smoking on smoking initiation decreased as internalizing symptoms increased; symptoms did not moderate the effects of friends' alcohol and marijuana use on alcohol and marijuana use initiation. These findings counter the influence hypothesis of the co-occurrence of internalizing symptoms with substance use and partly support the exposure hypothesis.

Developmental cascade model for adolescent substance use from infancy to late adolescence

A developmental cascade model for adolescent substance use beginning in infancy was examined in a sample of children with alcoholic and nonalcoholic parents. The model examined the role of parents' alcohol diagnoses, depression and antisocial behavior in a cascading process of risk via 3 major hypothesized pathways: first, via parental warmth/sensitivity from toddler to kindergarten age predicting higher parental monitoring in middle childhood through early adolescence, serving as a protective pathway for adolescent substance use; second, via child low self-regulation in the preschool years to a continuing externalizing behavior problem pathway leading to underage drinking and higher engagement with substance using peers; and third, via higher social competence from kindergarten age through middle childhood being protective against engagement with delinquent and substance using peers, and leading to lower adolescent substance use. The sample consisted of 227 intact families recruited from the community at 12 months of child age. Results were supportive for the first 2 pathways to substance use in late adolescence. Among proximal, early adolescent risks, engagement with delinquent peers and parent's acceptance of underage drinking were significant predictors of late adolescent alcohol and marijuana use. The results highlight the important protective roles of maternal warmth/sensitivity in early childhood to kindergarten age, parental monitoring in middle childhood, and of child self-regulation in the preschool period as reducing risk for externalizing behavior problems, underage drinking, and engagement with delinquent peers in early adolescence. Specific implications for the creation of developmentally fine-tuned preventive intervention are discussed. (PsycINFO Database Record

A novel application in the study of client language: Alcohol and marijuana-related statements in substance-using adolescents during a simulation task

The current study explored whether laboratory-based techniques can provide a strategy for studying client language as a mechanism of behavior change. Specifically, this study examined the potential of a simulation task to elicit healthy talk, or self-motivational statements in favor of healthy behavior, related to marijuana and alcohol use. Participants (N = 84) were adolescents reporting at least 10 lifetime substance use episodes recruited from various community settings in an urban Pacific Northwest setting. Participants completed the Adolescent Simulated Intoxication Digital Elicitation (A-SIDE), a validated paradigm for assessing substance use decision making in peer contexts. Participants responded to 4 types of offers in the A-SIDE: (a) marijuana, (b) food (marijuana control), (c) alcohol, and (d) soda (alcohol control). Using a validated coding scheme adapted for the current study, client language during a structured interview assessing participants' response to the simulated offers was evaluated. Associations between percent healthy talk (PHT, calculated by dividing the number of healthy statements by the sum of all substance-related statements) and cross-sectional outcomes of interest (previous substance use, substance use expectancies, and behavioral willingness) were explored. The frequency of substance-related statements differed in response to offer type; rate of PHT did not. PHT was associated with behavioral willingness to accept the offer. However, PHT was not associated with decontextualized measures of substance use. Associations between PHT and global expectancies were limited. Simulation methods may be useful in investigating the impact of context on self-talk and to systematically explore client language as a mechanism of change. (PsycINFO Database Record

Hypothetical evaluations of positive and negative alcohol consequences in adolescents across various levels of drinking experience

Research supports the importance of the subjective evaluation of alcohol-related consequences, and theory suggests that these evaluations may depend on one's prior experience. The goal of the present study was to understand how adolescents subjectively evaluate the potential negative and positive consequences of drinking and to test the hypothesis that evaluations differ as a function of personal experience with alcohol use and consequences. Participants were 697 adolescents (55% female) who completed online surveys assessing lifetime drinking experience and hypothetical evaluations of 13 negative and 9 positive consequences. Never having consumed a full drink of alcohol (vs. having consumed a full drink, but not having negative consequences) was significantly associated with higher mean negative evaluations and lower mean positive evaluations. Those who had a full drink (vs. those who had not) rated close to half of the negative consequence items as significantly less bothersome, and all of the positive consequences as significantly more enjoyable. However, there was little evidence in this sample that evaluations differ between drinkers with and without experience with negative consequences. Overall, findings suggest that youth who have experience with simply consuming alcohol may place more value on the positive and less value on some of the negative consequences of drinking, which has the potential to impact decisions to continue to drink. Longitudinal research uncovering the direction of evaluation-experience effects and mechanisms other than consequence experience, are essential next steps. (PsycINFO Database Record