Tobacco, nicotine and counter-marketing promotions using Instagram's branded content tool

BACKGROUND

The social media conglomerate, Meta, has a policy prohibiting promotion of tobacco products, vaporisers, electronic cigarettes or other products that simulate smoking via their branded content tools. This study examines if branded Instagram posts comply with these self-regulatory efforts.

METHODS

We analysed the presence and content of tobacco/nicotine promotion, as well as counter-marketing, in a sample of 400 branded/paid partnership-labelled Instagram posts with tobacco/nicotine-related terms made between 31 July 2022 and 31 March 2023, gathered from Meta's CrowdTangle tool and classified by CrowdTangle as being in English.

RESULTS

Of the 217 active branded posts that mentioned or depicted tobacco/nicotine products, most promoted rather than countered the sale of such products (84.3% vs 15.7%, respectively). Posts originating from US Instagram users accounted for 42.6% of promotional content. After the USA, posts from Indonesia (19.1%), Pakistan (9.8%) and India (8.2%) were most frequent. Most posts were fully in English (74.9%). Posts featured hookah (39.4%), electronic nicotine delivery systems (ENDS) accessories (17.5%), ENDS devices and e-liquids (16.9%) and various types of cigars (15.3%). The majority of US posts promoted venues or events where tobacco/nicotine products were featured (71.8%). Almost half of all promotional posts (47.0%) were sponsored by tobacco industry accounts. Posts that encouraged cessation were primarily (47.1%) sponsored by non-government organisations.

CONCLUSION

Despite attempts at self-regulation, paid partnership posts promoting tobacco and nicotine products are present on Instagram, especially posts promoting venues and events that feature tobacco and nicotine use. Self-regulation of this content shows limited success, suggesting a need for federal oversight and additional counter-marketing in social media settings.

Driving Skills at Licensure and Time to First Crash

BACKGROUND AND OBJECTIVES

Young drivers are overrepresented in crashes, and newly licensed drivers are at high risk, particularly in the months immediately post-licensure. Using a virtual driving assessment (VDA) implemented in the licensing workflow in Ohio, this study examined how driving skills measured at the time of licensure contribute to crash risk post-licensure in newly licensed young drivers.

METHODS

This study examined 16 914 young drivers (<25 years of age) in Ohio who completed the VDA at the time of licensure and their subsequent police-reported crash records. By using the outcome of time to first crash, a Cox proportional hazard model was used to estimate the risk of a crash during the follow-up period as a function of VDA Driving Class (and Skill Cluster) membership.

RESULTS

The best performing No Issues Driving Class had a crash risk 10% lower than average (95% confidence interval [CI] 13% to 6%), whereas the Major Issues with Dangerous Behavior Class had a crash risk 11% higher than average (95% CI 1% to 22%). These results withstood adjusting for covariates (age, sex, and tract-level socioeconomic status indicators). At the same time, drivers licensed at age 18 had a crash risk 16% higher than average (95% CI 6% to 27%).

CONCLUSIONS

This population-level study reveals that driving skills measured at the time of licensure are a predictor of crashes early in licensure, paving the way for better prediction models and targeted, personalized interventions. The authors of future studies should explore time- and exposure-varying risks.

Individual differences in delay discounting are associated with dorsal prefrontal cortex connectivity in children, adolescents, and adults

Delay discounting is a measure of impulsive choice relevant in adolescence as it predicts many real-life outcomes, including obesity and academic achievement. However, resting-state functional networks underlying individual differences in delay discounting during youth remain incompletely described. Here we investigate the association between multivariate patterns of functional connectivity and individual differences in impulsive choice in a large sample of children, adolescents, and adults. A total of 293 participants (9-23 years) completed a delay discounting task and underwent 3T resting-state fMRI. A connectome-wide analysis using multivariate distance-based matrix regression was used to examine whole-brain relationships between delay discounting and functional connectivity. These analyses revealed that individual differences in delay discounting were associated with patterns of connectivity emanating from the left dorsal prefrontal cortex, a default mode network hub. Greater delay discounting was associated with greater functional connectivity between the dorsal prefrontal cortex and other default mode network regions, but reduced connectivity with regions in the dorsal and ventral attention networks. These results suggest delay discounting in children, adolescents, and adults is associated with individual differences in relationships both within the default mode network and between the default mode and networks involved in attentional and cognitive control.

The role of conspiracy mindset in reducing support for child vaccination for COVID-19 in the United States

Introduction

We have previously proposed and tested a model that predicts reluctance to vaccinate against COVID-19 in the US from embrace of a conspiracy mindset that distrusts the federal health agencies of the US government and regards their intentions as malevolent. In this study, we tested the model's ability to predict adult support for COVID vaccination of children ages 5-11 after the vaccine was approved for this age group.

Methods

Relying on a national panel that was established in April 2021 (N = 1941) and followed until March of 2022, we examined the relation between conspiratorial thinking measured at baseline and belief in misinformation and conspiracies about COVID vaccines, trust in various health authorities, perceived risk of COVID to children, and belief in conspiracy theories about the pandemic's origin and impact. In addition, we tested a structural equation model (SEM) in which conspiracy mindset predicted adult support for childhood vaccination for COVID in January and March of 2022 as well as the adults own vaccination status and their willingness to recommend vaccinating children against measles, mumps and rubella (MMR).

Results

The model accounted for 76% of the variance in support for childhood vaccination for COVID-19; the relation between the mindset and support for vaccination was entirely mediated by baseline assessments of misinformation, trust, risk, and acceptance of pandemic conspiracy theories.

Discussion

The SEM replicated the prior test of the model, indicating that a conspiracy mindset present among at least 17% of the panel underlies their resistance to vaccinate both themselves and children. Efforts to counteract the mindset will likely require the intervention of trusted spokespersons who can overcome the skepticism inherent in conspiratorial thinking about the government and its health-related agencies' recommendations for a particular vaccine.

Individual Differences in Delay Discounting are Associated with Dorsal Prefrontal Cortex Connectivity in Youth

Delay discounting is a measure of impulsive choice relevant in adolescence as it predicts many real-life outcomes, including substance use disorders, obesity, and academic achievement. However, the functional networks underlying individual differences in delay discounting during youth remain incompletely described. Here we investigate the association between multivariate patterns of functional connectivity and individual differences in impulsive choice in a large sample of youth. A total of 293 youth (9-23 years) completed a delay discounting task and underwent resting-state fMRI at 3T. A connectome-wide analysis using multivariate distance-based matrix regression was used to examine whole-brain relationships between delay discounting and functional connectivity was then performed. These analyses revealed that individual differences in delay discounting were associated with patterns of connectivity emanating from the left dorsal prefrontal cortex, a hub of the default mode network. Delay discounting was associated with greater functional connectivity between the dorsal prefrontal cortex and other parts of the default mode network, and reduced connectivity with regions in the dorsal and ventral attention networks. These results suggest that delay discounting in youth is associated with individual differences in relationships both within the default mode network and between the default mode and networks involved in attentional and cognitive control.

Seasonal suicide trends in adolescents in the US: Did they explain the apparent effect of the Netflix show 13 Reasons Why?

INTRODUCTION

Controversy surrounds the effects of the first season of the Netflix show 13 Reasons Why on adolescent suicide in the United States. This research reexamined the question using more sensitive weekly suicide counts and more sensitive tests for seasonal changes in suicide.

METHODS

Weekly suicide counts for adolescents ages 10-19 and young people ages 20-29 obtained from CDC were analyzed from 2013 to 2018 NVSS Mortality Data using time series methods.

RESULTS

Adolescents ages 10-19 exhibited seasonal changes in suicides that increased from March to April and that also paralleled the school year. The same seasonal pattern was evident in males ages 20-24. There was no evidence of an effect of 13 Reasons in male adolescent suicides in 2017 once seasonality, auto-correlation, and longer term trends were removed.

CONCLUSION

Seasonal changes and secular increases can explain why previous studies observed suicide increases in March and April of 2017 in male adolescents. The association between school year and suicide suggests that stressors associated with schooling increase the risk of suicide in some youth. How to reduce these risks is an important focus for future research as is the need to understand the conditions under which fictional depictions of suicide lead to contagion.

Adolescents' own views on their risk behaviors, and the potential effects of being labeled as risk-takers: A commentary and review

Adolescents are stereotypically viewed as risk-takers ("stereotypical risk-takers") in science, mainstream media, fictional literature and in everyday life. However, increasing research suggests that adolescents do not always engage in "heightened" risk-taking, and adolescents' own perspectives (motives) on risk-taking are largely neglected in research. Hence, this paper is a commentary and review with two aims. First, taking a cross-national perspective, we discuss the definition of adolescence and risk behavior. We argue that much of the research on what drives adolescent risk behavior (e.g., substance use) focuses on the harms that this behavior promotes rather than on the need to explore and grow into adulthood. Thereafter we summarize the dominant approach to studying motives behind substance use, which has mostly considered young adults, and which has typically not focused on adolescents' own self-generated motives. The few empirical studies (including one of our qualitative studies) on adolescents' own motivations for engaging in risk behavior (i.e., cannabis use, alcohol use, and tobacco smoking) show that the most frequently mentioned motives by adolescents were being cool/tough, enjoyment, belonging, having fun and experimenting and coping. Interestingly, the "cool/tough identity" motive is virtually overlooked in research on adolescent risk-taking. The above-mentioned motives, however, generally support newer theories, such as the Developmental Neuro-Ecological Risk-taking Model (DNERM) and the Life-span Wisdom Model that suggest that adolescents' motivations to engage in risk-taking include experimentation, identity development, explorative behavior, and sensation seeking, all of which run counter to the stereotype of adolescents engaging in risk-taking due to "storm and stress." Hence, we also briefly consider additional recent attempts to study positive forms of risk taking. Second, extrapolating from sociological/criminological theories on labeling, we suggest that caution is warranted when (inaccurately) labeling adolescents as the "stereotypical risk-takers," because this can instigate a risk-taking identity in adolescents and/or motivate them to associate with risk-taking peers, which could in turn lead to maladaptive forms of risk-taking. Empirical research testing these hypotheses is needed. To conclude we argue that research on adolescent risk-taking could further benefit from considering adolescent's own motivations, which is also in line with the participatory approach advocated by international children's rights standards.

Conspiratorial thinking as a precursor to opposition to COVID-19 vaccination in the US: a multi-year study from 2018 to 2021

Despite widespread availability of safe and effective COVID-19 vaccines in the US, only about 66% of the eligible US population had taken the recommended initial doses of the COVID-19 vaccines as of April 2022. Explanations for this hesitancy have focused on misinformation about the vaccines, lack of trust in health authorities, and acceptance of conspiracy theories about the pandemic. Here we test whether those with a conspiratorial mindset, which distrusts a wide range of institutions, were poised to reject COVID vaccines before the pandemic even began. To answer that question, we reinterviewed members of a national US panel that we had previously surveyed beginning in 2018. As hypothesized, having a conspiratorial mindset in 2019 predicted COVID-vaccination hesitancy in 2021 better than prior trust in health authorities or acceptance of vaccine misinformation. Those with the mindset were also more likely to consume media that bolstered belief in pandemic conspiracies. Research is needed on the determinants of conspiratorial mindset and ways to minimize the likelihood that consequential health decisions will be influenced by it.

Cascades From Early Adolescent Impulsivity to Late Adolescent Antisocial Personality Disorder and Alcohol Use Disorder

PURPOSE

The behavioral disinhibition model (BDM) posits that a liability toward impulsivity evident by early adolescence underlies the coemergence of antisocial behavior and alcohol use (i.e., problem behaviors) in early-adolescence to mid-adolescence, but that the subsequent development of these problem behaviors (rather than impulsivity itself) predicts the emergence of antisocial personality disorder (APD) and alcohol use disorder (AUD) in late adolescence. The present study was designed to test these predictions of the BDM from early to late adolescence.

METHODS

We used five-year longitudinal self-report data from the Philadelphia Trajectory Study that was collected from 2006-2012. Mediational analyses were performed using the Random Intercept Cross-lagged Panel Model, which enables the detection of within-person predictions of changes in problem behaviors during adolescence. The sample was ethnically and socioeconomically diverse, including 364 urban US community youth (at baseline: M_age = 13.51(.95); 49.1% female).

RESULTS

Consistent with the BDM, mediational analyses revealed that changes in early adolescent impulsivity predicted late adolescent APD and AUD criteria, mediated by changes in mid-adolescent alcohol use and conduct problems.

DISCUSSION

Interventions targeting impulsivity in early adolescence could potentially halt the cascading chain of events leading to both late adolescent APD and AUD by decelerating growth in antisocial behavior and alcohol use during early-adolescence to mid-adolescence. From mid-adolescence to late-adolescence, the consequences of early impulsivity, especially involvement in antisocial behaviors, become a more relevant predictor of both APD and AUD rather than impulsivity itself.

Misinformation about vaccine safety and uptake of COVID-19 vaccines among adults and 5-11-year-olds in the United States

Despite increasing rates of vaccination for COVID-19 in the US, hesitancy continues to be a barrier to the full immunization of the eligible population. Hesitancy appears to be particularly pronounced among adults deciding whether to recommend that children be vaccinated against COVID-19. In this research, we tested whether embrace of misinformation about the safety of vaccination is associated with hesitancy to vaccinate oneself and to recommend vaccination of a 5-11-year-old child for COVID-19. In a national probability panel created in April 2021, we assessed belief in both general vaccination misinformation and misinformation about COVID-19 vaccines, in particular. As hypothesized, belief in general vaccination misinformation predicted the uptake in reported vaccination among adults through September 2021, and likelihood to recommend COVID-19 vaccination of children aged 5-11 in January 2022, three months after the approval of that vaccine. In addition, misinformation about COVID-19 vaccines that arose over time correlated highly with more general vaccination misinformation. For both outcomes, general vaccine misinformation predicted vaccination hesitancy beyond concerns about the health risks of contracting COVID-19 for one's family and children ages 5-11. The findings indicate that continued efforts are needed to bolster beliefs about the safety of authorized and approved vaccines of many types and not just those for COVID-19. Some strategies to achieve this objective are suggested.

Novel use of a virtual driving assessment to classify driver skill at the time of licensure

Motor vehicle crash rates are highest immediately after licensure, and driver error is one of the leading causes. Yet, few studies have quantified driving skills at the time of licensure, making it difficult to identify at-risk drivers before independent driving. Using data from a virtual driving assessment implemented into the licensing workflow in Ohio, this study presents the first population-level study classifying degree of skill at the time of licensure and validating these against a measure of on-road performance: license exam outcomes. Principal component and cluster analysis of 33,249 virtual driving assessments identified 20 Skill Clusters that were then grouped into 4 major summary "Driving Classes"; i) No Issues (i.e. careful and skilled drivers); ii) Minor Issues (i.e. an average new driver with minor vehicle control skill deficits); iii) Major Issues (i.e. drivers with more control issues and who take more risks); and iv) Major Issues with Aggression (i.e. drivers with even more control issues and more reckless and risk-taking behavior). Category labels were determined based on patterns of VDA skill deficits alone (i.e. agnostic of the license examination outcome). These Skill Clusters and Driving Classes had different distributions by sex and age, reflecting age-related licensing policies (i.e. those under 18 and subject to GDL and driver education and training), and were differentially associated with subsequent performance on the on-road licensing examination (showing criterion validity). The No Issues and Minor Issues classes had lower than average odds of failing, and the other two more problematic Driving Classes had higher odds of failing. Thus, this study showed that license applicants can be classified based on their driving skills at the time of licensure. Future studies will validate these Skill Cluster classes in relation to their prediction of post-licensure crash outcomes.

Licensing Examination and Crash Outcomes Postlicensure in Young Drivers

IMPORTANCE

Despite US graduated driver licensing laws, young novice driver crash rates remain high. Study findings suggest comprehensive license policy that mandates driver education including behind-the-wheel (BTW) training may reduce crashes postlicensure. However, only 15 states mandate BTW training.

OBJECTIVE

To identify differences in licensing and crash outcomes for drivers younger than 18 years who are subject to comprehensive licensing requirements (graduated driver licensing, driver education, and BTW training) vs those aged 18 to 24 years who are exempt from these requirements.

DESIGN, SETTING, AND PARTICIPANTS

This prospective, population-based cohort study used Ohio licensing data to define a cohort of 2018 license applicants (age 16-24 years, n = 136 643) and tracked licensed driver (n = 129 897) crash outcomes up to 12 months postlicensure. The study was conducted from January 1, 2018, to December 31, 2019, and data analysis was performed from October 7, 2019, to February 11, 2022.

MAIN OUTCOMES AND MEASURES

Licensing examination performance and population-based, police-reported crash rates in the first 2 months and 12 months postlicensure across age groups, sex, and census tract-level sociodemographic variables were measured. Poisson regression models compared newly licensed driver crash rates, with reference to individuals licensed at 18 years, while controlling for census tract-level sociodemographic factors, time spent in the learner permit period, and licensing examination performance measures.

RESULTS

Of 136 643 novice drivers, 69 488 (50.9%) were male and 67 152 (49.1%) were female. Mean (SD) age at enrollment (age at first on-road examination) was 17.7 (2.1) years. License applicants aged 16 and 17 years performed best on license examinations (15 466 [21.6%] and 5112 [30.9%] failing vs 7981 [37.5%] of applicants aged 18 years). Drivers licensed at 18 years had the highest crash rates of all those younger than 25 years. Compared with drivers licensed at 18 years, crash rates were 27% lower in individuals aged 16 years and 14% lower in those aged 17 years during the first 2 months postlicensure when controlling for socioeconomic status, time spent in learner permit status, and license examination performance measures (adjusted relative risk [aRR] at age 16 years: 0.73; 95% CI, 0.67-0.80; age 17 years: aRR, 0.86; 95% CI, 0.77-0.96). At 12 months postlicensure, crash rates were 19% lower for individuals licensed at age 16 years (aRR, 0.81; 95%, CI, 0.77-0.85) and 6% lower at age 17 years (aRR, 0.94; 95% CI, 0.89-0.99) compared with individuals aged 18 years.

CONCLUSIONS AND RELEVANCE

In Ohio, drivers younger than 18 years who are subject to graduated driver licensing and driver education, including BTW training requirements, had lower crash rates in the first year postlicensure compared with those aged 18 years, with controls applied. These findings suggest that it may be fruitful for future work to reconsider the value of mandated driver license policies, including BTW training, and to examine reasons for delayed licensure and barriers to accessing training.

Selection versus socialization effects of peer norms on adolescent cigarette use

Adolescent smokers tend to have friends who also smoke. This association has been attributed to peer socialization and peer selection effects. However, evidence regarding timing and relative magnitude of these effects is mixed. Using a random-intercept cross-lagged panel model, we examined the reciprocal relations between adolescent cigarette use and perceptions of friends’ cigarette use in a sample of 387 adolescents, assessed annually for 4 years. Adolescent cigarette use predicted increases in perceived friend use before the reverse effect emerged. Further, some of the effect of early adolescent cigarette use on subsequent use was mediated by changes in perceived friend use. The results support a greater role for friend selection than socialization in predicting early adolescent cigarette use.

Conspiratorial thinking, selective exposure to conservative media, and response to COVID-19 in the US

Rationale

Previous research has shown that during the early months of the COVID-19 pandemic in the US, users of conservative media were more likely to accept conspiracy theories about the pandemic and less likely to accept pandemic mitigation measures such as mask-wearing and vaccination.

Objective

To test the hypothesis that during the first year of the pandemic, viewers who were prone to conspiratorial thinking engaged in selective exposure to conservative media which served to enhance pandemic-related conspiracy beliefs.

Methods

A national 3-wave longitudinal survey of 883 US respondents running from March to November 2020 assessed media-use habits, belief in COVID-related conspiracies, conspiratorial thinking, mask-wearing, intention to accept a COVID vaccine, and trust in the Centers for Disease Control and Prevention (CDC). Growth curve models were used to analyze changes in conspiracy beliefs and associated public health outcomes.

Results

Users of conservative media were disproportionately likely to engage in conspiratorial thinking, to vote for President Trump, and to be ideologically conservative. They were also less likely to use mainstream news sources and displayed increasing belief in pandemic conspiracies. Increases in conspiracy beliefs were associated with reduced support for pandemic prevention. Although users of conservative media supported vaccination and trusted the CDC at the outset of the study, continued exposure to conservative media reduced support for both. Increasing use of mainstream print was associated with less endorsement of pandemic conspiracy beliefs. Viewers of mainstream television news did not exhibit change in pandemic conspiracy beliefs over time.

Conclusion

Conservative media in the US have attracted users prone to conspiratorial thinking and conservative political views who are also less exposed to mainstream news. The selective use of these media enhances belief in conspiracies that pose challenges to the country's ability to control a public health crisis such as the COVID pandemic.

Patterns of Media Use, Strength of Belief in COVID-19 Conspiracy Theories, and the Prevention of COVID-19 From March to July 2020 in the United States: Survey Study

BACKGROUND

Holding conspiracy beliefs regarding the COVID-19 pandemic in the United States has been associated with reductions in both actions to prevent the spread of the infection (eg, mask wearing) and intentions to accept a vaccine when one becomes available. Patterns of media use have also been associated with acceptance of COVID-19 conspiracy beliefs. Here we ask whether the type of media on which a person relies increased, decreased, or had no additional effect on that person's COVID-19 conspiracy beliefs over a 4-month period.

OBJECTIVE

We used panel data to explore whether use of conservative and social media in the United States, which were previously found to be positively related to holding conspiracy beliefs about the origins and prevention of COVID-19, were associated with a net increase in the strength of those beliefs from March to July of 2020. We also asked whether mainstream news sources, which were previously found to be negatively related to belief in pandemic-related conspiracies, were associated with a net decrease in the strength of such beliefs over the study period. Additionally, we asked whether subsequent changes in pandemic conspiracy beliefs related to the use of media were also related to subsequent mask wearing and vaccination intentions.

METHODS

A survey that we conducted with a national US probability sample in March of 2020 and again in July with the same 840 respondents assessed belief in pandemic-related conspiracies, use of various types of media information sources, actions taken to prevent the spread of the disease and intentions to vaccinate, and various demographic characteristics. Change across the two waves was analyzed using path analytic techniques.

RESULTS

We found that conservative media use predicted an increase in conspiracy beliefs (β=.17, 99% CI .10-.25) and that reliance on mainstream print predicted a decrease in their belief (β=-.08, 99% CI -.14 to -.02). Although many social media platforms reported downgrading or removing false or misleading content, ongoing use of such platforms by respondents predicted growth in conspiracy beliefs as well (β=.072, 99% CI .018-.123). Importantly, conspiracy belief changes related to media use between the two waves of the study were associated with the uptake of mask wearing and changes in vaccination intentions in July. Unlike other media, use of mainstream broadcast television predicted greater mask wearing (β=.17, 99% CI .09-.26) and vaccination intention (β=.08, 95% CI .02-.14), independent of conspiracy beliefs.

CONCLUSIONS

The findings point to the need for greater efforts on the part of commentators, reporters, and guests on conservative media to report verifiable information about the pandemic. The results also suggest that social media platforms need to be more aggressive in downgrading, blocking, and counteracting claims about COVID-19 vaccines, claims about mask wearing, and conspiracy beliefs that have been judged problematic by public health authorities.

The association between the rise of gun violence in popular US primetime television dramas and homicides attributable to firearms, 2000-2018

Injuries and fatalities due to firearms are a major burden on public health in the US. The rise in gun violence in popular movies has been suggested as a potential cultural influence on this behavior. Nevertheless, homicide rates have not increased over recent decades in the US, suggesting that media portrayals have had little influence on gun violence. Here we challenge this interpretation by examining trends in the proportion of violence that are attributable to firearms, a measure that should be more sensitive to media violence. In addition, we examine trends in the portrayal of guns in popular television (TV) dramas, which are viewed more frequently than movies. We ask (a) whether gun violence has increased in these TV shows not only on an absolute basis but also as a proportion of violent scenes and (b) whether trends in gun portrayal on these shows are associated with corresponding trends in the proportion of real-world violence attributable to firearms in the US from 2000 to 2018. To answer these questions, we coded annual instances of violence, gun violence, and proportion of violence involving guns for each 5-minute segment of 33 popular TV dramas in the police, medical, and legal genres from 2000 to 2018. Trends in annual rates of violence, gun violence and proportion of violence involving guns were determined over the study period and were compared to annual rates of homicide attributable to firearms in three age groups: 15–24, 25–34 and 35 and older. Although violence on TV dramas peaked in 2011, gun use steadily increased over the study period both in absolute terms and in relation to other violent methods. The latter metric paralleled trends in homicides attributable to firearms for all three age groups, with the strongest relationship for youth ages 15–24 (R² = .40, P = .003). The positive relation between relative amount of TV violence involving guns and actual homicides due to firearms, especially among youth, is consistent with the hypothesis that entertainment media are contributing to the normative acceptance of guns for violent purposes. Future research is needed to study the influence of media violence on gun acquisition at the individual level.

James G. Kelly (1929-2020)

Memorializes James G. Kelly (1929-2020), one of the founders of the field of Community Psychology in the United States. Jim was one of the last surviving attendees of the 1965 Swampscott Conference, an event sponsored by the National Institute of Mental Health that is considered the origin of community psychology in the United States. He was a founding member of the Division of Community Psychology of the American Psychological Association in 1967 (now The Society for Community Research and Action, SRCA). Jim mentored doctoral students and postdoctoral scholars with an extraordinary level of commitment to their development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Problems posed by the Werther effect as a 'net effect': a comment on recent scholarly work on the effects of 13 Reasons Why

Recent research estimated that an additional 195 suicides among 10- to 17-year-old youths occurred following the release of the television series 13 Reasons Why. There is an underrecognised aspect in this line of research that this effect represents a net effect based on different possible underlying patterns (e.g. +195/-0 or +395/-200).

A Novel Health-Transportation Partnership Paves The Road For Young Driver Safety Through Virtual Assessment

Motor vehicle crashes remain the leading cause of adolescent mortality and injury in the United States. For young drivers, crash risk peaks immediately after licensure and declines during the next two years, making the point of licensure an important safety intervention opportunity. Legislation in Ohio established a unique health-transportation partnership among the State of Ohio, Children's Hospital of Philadelphia, and Diagnostic Driving, Inc., to identify underprepared driver license applicants through a virtual driving assessment system. The system, a computer-based virtual driving test, exposes drivers to common serious crash scenarios to identify critical skill deficits and is delivered in testing centers immediately before the on-road examination. A pilot study of license applicants who completed it showed that the virtual driving assessment system accurately predicted which drivers would fail the on-road examination and provided automated feedback that informed drivers on their skill deficits. At this time, the partnership's work is informing policy changes around integrating the virtual driving assessment system into licensing and driver training with the aim of reducing crashes in the first months of independent driving. The system can be developed to identify deficits in safety-critical skills that lead to crashes in new drivers and to address challenges that the coronavirus disease 2019 pandemic has introduced to driver testing and training.

Conspiracy theories as barriers to controlling the spread of COVID-19 in the U.S

RATIONALE

The COVID-19 pandemic poses extraordinary challenges to public health.

OBJECTIVE

Because the novel coronavirus is highly contagious, the widespread use of preventive measures such as masking, physical distancing, and eventually vaccination is needed to bring it under control. We hypothesized that accepting conspiracy theories that were circulating in mainstream and social media early in the COVID-19 pandemic in the US would be negatively related to the uptake of preventive behaviors and also of vaccination when a vaccine becomes available.

METHOD

A national probability survey of US adults (N = 1050) was conducted in the latter half of March 2020 and a follow-up with 840 of the same individuals in July 2020. The surveys assessed adoption of preventive measures recommended by public health authorities, vaccination intentions, conspiracy beliefs, perceptions of threat, belief about the safety of vaccines, political ideology, and media exposure patterns.

RESULTS

Belief in three COVID-19-related conspiracy theories was highly stable across the two periods and inversely related to the (a) perceived threat of the pandemic, (b) taking of preventive actions, including wearing a face mask, (c) perceived safety of vaccination, and (d) intention to be vaccinated against COVID-19. Conspiracy beliefs in March predicted subsequent mask-wearing and vaccination intentions in July even after controlling for action taken and intentions in March. Although adopting preventive behaviors was predicted by political ideology and conservative media reliance, vaccination intentions were less related to political ideology. Mainstream television news use predicted adopting both preventive actions and vaccination.

CONCLUSIONS

Because belief in COVID-related conspiracy theories predicts resistance to both preventive behaviors and future vaccination for the virus, it will be critical to confront both conspiracy theories and vaccination misinformation to prevent further spread of the virus in the US. Reducing those barriers will require continued messaging by public health authorities on mainstream media and in particular on politically conservative outlets that have supported COVID-related conspiracy theories.

Does Initiating Vaginal Sexual Intercourse During a Safer Sex Media Campaign Influence Life Satisfaction Among African American Adolescents?

PURPOSE

Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, intervention impacts on life satisfaction are relatively unexplored. This study is a secondary analysis of data (N = 1,658) from a randomized, multisite, multilevel safer sex media campaign (Project iMPPACS) analyzing life satisfaction across baseline and follow-up data collected from 2006 to 2008 among participants (mean age 15.08 years) who reported never having had vaginal sex at baseline (n = 787).

METHODS

Participants were separated into groups based on whether they reported having vaginal sex (yes/no) at baseline. Then taking into account the nested study design and controlling for confounders, a mixed model repeated measures analysis of variance assessed whether differences in mean total life satisfaction (LS) were associated across time in the media and nonmedia study conditions separately by gender.

RESULTS

A significant interaction between time and media condition was detected (p = .039) where mean total LS increased +.065 units from baseline (M = 5.364) to last contact in media cities and decreased -.084 units from baseline (M = 5.557) to last contact in nonmedia cities when controlling for the effect of initiating vaginal sex. No significant differences in LS at baseline were observed between media and nonmedia intervention cities. Results by gender suggest most positive change in LS was observed for females with mixed findings for males.

CONCLUSIONS

Although Project iMPPACS was not designed with the intent on improving participants' life satisfaction, results advance the LS literature by demonstrating a temporal sequence for sexual risk taking and LS over time.

Numeracy and memory for risk probabilities and risk outcomes depicted on cigarette warning labels

OBJECTIVE

Greater numeracy is associated with higher likelihood to quit smoking. We examined whether numeracy supports learning of numeric health-risk information and, in turn, greater risk perceptions and quit intentions.

METHOD

Adult smokers (N = 696) viewed text warnings with numeric risk information four times each in one of three warning-label types (text-only, low-emotion pictorial [i.e., with image], high-emotion pictorial). They completed posttest measures immediately or 6 weeks later. Emotional reactions to warnings were reported the second time participants viewed the warnings. Numeracy, memory for risk probabilities and risk outcomes, risk perceptions, and quit intentions were assessed postexposures.

RESULTS

Memory for risk probabilities and risk outcomes depended on warning-label type and posttest timing. Consistent with memory-consolidation theory, memory for high- versus low-emotion labels was lower immediately, but declined less for high-than low-emotion labels. Label memory was similar between conditions at 6 weeks. Numeracy predicted overall superior memory (especially for risk probabilities) controlling for health literacy and education. It also indirectly predicted greater risk perceptions and quit intentions via memory. In exploratory analyses, however, the superior recall of risk probabilities of smoking among those higher in numeracy was associated with lower risk perceptions.

CONCLUSIONS

Numeracy is associated with superior risk memory, which relates to greater risk perceptions and quit intentions. More numerate and educated smokers may be better able to quit due to their superior learning of smoking's risks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Pictorial Warning Labels and Memory for Cigarette Health-risk Information Over Time

BACKGROUND

Pictorial cigarette warning labels are thought to increase risk knowledge, but experimental research has not examined longer-term effects on memory for health risks named in text.

PURPOSE

To investigate memory-consolidation predictions that high- versus low-emotion warnings would support better long-term memory for named cigarette health risks and to test a mediational model of warning-label effects through memory on risk perceptions and quit intentions.

METHODS

A combined sample of U.S.-representative adult smokers, U.S.-representative teen smokers/vulnerable smokers, and Appalachian-representative adult smokers were randomly assigned to a warning-label condition (High-emotion pictorial, Low-emotion pictorial, Text-only) in which they were exposed four times to nine warning labels and reported emotional reactions and elaboration. Memory of warning-label risk information, smoking risk perceptions, and quit intentions were assessed immediately after exposures or 6 weeks later.

RESULTS

Recall of warning-label text was low across the samples and supported memory-consolidation predictions. Specifically, immediate recall was highest for Low-emotion warnings that elicited the least emotion, but recall also declined the most over time in this condition, leaving its 6-week recall lowest; 6-week recall was similar for High-emotion and Text-only warnings. Greater recall was associated with higher risk perceptions and greater quit intentions and mediated part of warning-label effects on these important smoking outcomes. High-emotion warnings had additional non-memory-related effects on risk perceptions and quit intentions that were superior to text-only warnings.

CONCLUSIONS

High- but not Low-emotion pictorial warning labels may support the Food and Drug Administration's primary goal to "effectively convey the negative health consequences of smoking."

CLINICALTRIALS.GOV IDENTIFIER

NCT03375840.

Neighborhood Stress and Life Satisfaction: Is there a Relationship for African American Adolescents?

This study identified associations between perceived neighborhood stress and adolescents' perceptions of life satisfaction. African American adolescents aged 13-18 (n=1,658) from four matched, mid-sized cities in the northeastern and southeastern USA, completed a self-report questionnaire using an audio computer-assisted self-interview (ACASI). Analyses examined relationships between perceived neighborhood stress and perceived life satisfaction, while controlling for socioeconomic status (SES). Life satisfaction was found to be related to neighborhood stress for both males and females, with variability in neighborhood stress characteristics and in the magnitude of associations by gender. Further research should identify the particular characteristics of youth and specific aspects of adolescent life satisfaction associated with perceived neighborhood stress to develop community-based and culturally-sensitive quality of life improvement/health promotion programs.

Can a Multilevel STI/HIV Prevention Strategy for High Risk African American Adolescents Improve Life Satisfaction?

Addressing adolescent sexual risk behaviors in the STI/HIV prevention literature is well documented; however, impacts from interventions on life satisfaction are relatively unexplored. This study examined data (n = 1658) from a randomized, multi-site, multi-level STI/HIV prevention intervention trial (Project iMPAACS) to determine whether increased protective and reduced sexual risk-taking behaviors associated with STI/HIV would also improve self-reported life satisfaction. Taking into account the nested study design and controlling for confounders, a mixed model ANOVA was performed where Total mean life satisfaction scores were analyzed at baseline and 3, 6, 12, and 18 months post-recruitment. Significance levels of 0.05 were used to determine significance and η 2 was used to assess effect size. We hypothesized that as intervention participants engaged in the intentional activity associated with increasing protective behaviors and reducing sexual risk-taking behaviors associated with STI/HIV, life satisfaction reports would also improve over the course of the intervention. A significant main effect for sex was detected (F = 5.19, p = .02, η 2 = .03), along with three interactions: between experimental condition and media intervention (F = 7.96, p = .005, η 2= .04); experimental condition, sex, and media intervention (F = 6.51, p = .01, η 2 = .04); and experimental condition, sex, assessment point, and media intervention (F = 3.23, p = .01, η 2 = .02). With the exception of the control condition, female life satisfaction reports improved from baseline assessments to 18-months post-recruitment, whereas male reports decreased. Project iMPPACS was not designed with the intent on improving participants' life satisfaction. However, study results suggest incorporating strategies to address subjective well-being into future adolescent STI/HIV risk-reduction interventions is beneficial for females and additional research is necessary for males.

Reanalysis of the Bridge et al. study of suicide following release of 13 Reasons Why

Bridge et al. recently presented a time series analysis of suicide rates in the US following the release of the 2017 Netflix series "13 Reasons Why." Their analysis found a powerful effect of the show on boys ages 10-17 for nine months after the show was released in April 2017. I questioned this finding on two grounds. First, contagion would be expected to be stronger for girls than boys for this story, and second their analysis did not take into account strong secular trends in suicide, especially in boys from 2016 to 2017. I reanalyzed their data using a simple auto-regression model that tested for changes in rates after removing auto-correlation and national trends in suicide. I found that the increase for boys observed by Bridge et al. in April was no greater than the increase observed during the prior month before the show was released. There were also no effects in later months of that year. For girls, I found a small but nonsignificant increase in suicide in April that was unique to that month, potentially consistent with a combined protective and harmful effect of the show. In total, I conclude that it is difficult to attribute harmful effects of the show using aggregate rates of monthly suicide rates. More fine-grained analyses at the weekly level may be more valid but only after controlling for secular changes in suicide that have been particularly strong since 2008 in the US.

Intersubject Synchronization of Late Adolescent Brain Responses to Violent Movies: A Virtue-Ethics Approach

Movies that involve violence increasingly attract large audiences, leading to concern that such entertainment will encourage imitation by youth, especially when the violence is seen as justified. To assess differences between brain responses to justified and unjustified film violence, we computed intersubject correlation (ISC) of fMRI BOLD time courses in a sample of late adolescents while they watched pairs of movie segments featuring violent characters prior to and during violent action. Based on a virtue-ethics approach that emphasizes motives in moral evaluation, we hypothesized significant ISC in lateral orbital frontal cortex (lOFC) and ventromedial prefrontal cortex (vmPFC) in response to unjustified and justified scenes of movie violence, respectively. Our predictions were confirmed. In addition, unjustified violence elicited greater intersubject synchrony in insular cortex, consistent with an empathic response to the pain experienced by victims of this kind of violence. The results provide evidence supporting the notion that lOFC and vmPFC play unique roles in moral evaluation of violence, with lOFC becoming more synchronous in response to unacceptable violence and vmPFC becoming more synchronous in response to virtuous forms of self-defense, thereby expanding the purview of current models that only focus on vmPFC. The results suggest that justified violence in popular movies is acceptable to youth who are accustomed to viewing such entertainment.

Depressive symptoms as a longitudinal predictor of sexual risk behaviors among African-American adolescents

OBJECTIVE

Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship.

METHODS

The sample consisted of 782 sexually active African-American adolescents (Mage = 15.3 years, SD = 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening.

RESULTS

Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents.

CONCLUSIONS

These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Is the Brief Multidimensional Student's Life Satisfaction Scale Valid and Reliable for African American Adolescents?

BACKGROUND

Health promotion/education strive to promote healthful conditions that improve quality of life1 based on the perceptions of those whose lives are affected.2-4 Though health promotion/education might have instrumental value in reducing risks for premature morbidity and mortality, their ultimate value lies in contributions to quality of life.1 Life satisfaction (LS) has been defined as an individual's assessment of their quality of life based upon personal criteria5,6 and linked to adolescent health risk behaviors7,8 and developmental assets.9.

PURPOSE

We investigated the psychometrics of the Brief Multidimensional Students' Life Satisfaction Scale [BMSLSS] with an adolescent sample of African Americans (N=1,658) from four mid-sized cities in the United States (US). Reliability and validity of the BMSLSS has not been determined for samples of exclusively African American adolescents.

METHODS

Data analysis included calculating mean ratings, standard deviations and effect sizes (Cohen's d) and inspecting the scale's internal structure, reliability, and relationships to other variables.

RESULTS

Evidence of internal structure, internal consistency reliability, and hypothesized relationships to other variables for participants were determined.

TRANSLATION TO HEALTH EDUCATION PRACTICE

The BMSLSS is a useful indicator of LS for research and health education assessment purposes among African American adolescents where brevity of psychometric measures is imperative.

Working Memory Development and Motor Vehicle Crashes in Young Drivers

IMPORTANCE

Adolescent drivers have the highest rate of motor vehicle crashes, and among equally novice drivers, crash risk is inversely age graded. Working memory (WM), crucial to driving hazard awareness, is also age graded, with ongoing development into late adolescence. Variability in WM capacity and growth trajectory positions WM as a candidate crash risk factor for study, clinical screening, and possible preventative intervention.

OBJECTIVE

To test the association between crashes and differential WM development.

DESIGN, SETTING, AND PARTICIPANTS

This prospective cohort study used data from a longitudinal cohort of 118 community youth in Philadelphia, Pennsylvania. Working memory and other risk factors were measured annually from age 11 to 13 years (prelicensure, in 2005) to 14 to 16 years (in 2009), and again at 18 to 20 years (in 2013). In 2015, a follow-up survey of driving experience identified 84 participants who had started driving. Latent growth curve modeling was used to examine the association between variability in the baseline (intercept) and developmental trajectory (slope) of WM and the crash outcome.

MAIN OUTCOMES AND MEASURES

Self-reported crashes were the primary outcome. Variability in the relative growth of WM development along with traits and behaviors associated with risky driving were assessed.

RESULTS

Of 84 participants (39 [46%] male; mean [SD] age, 20.46 [1.09] years), 25 (29.8%) reported they had been involved in at least 1 crash. Controlling for other crash risk factors, the model indicated that variation in the linear slope of WM growth was inversely associated with reporting a crash (b = -6.41; SE = 2.64; P = .02). Crashes were also associated with reckless driving behavior (b = 0.40; SE = 0.18; P = .03). Variation in the intercept of WM was not associated with crashes (b = -0.245; SE = 0.67; P = .72).

CONCLUSIONS AND RELEVANCE

The results suggest that a relatively slower WM growth trajectory is associated with young driver crashes. Routine assessment of WM across adolescence may help to identify at-risk teen drivers and opportunities for providing adaptive interventions (eg, driving aids or training) that can address limitations in WM-related skills that are critical for safe driving.

Connectivity between visual and auditory cortices mediates the influence of argument strength on the effectiveness of smoking-cessation videos among smokers low in sensation seeking

Purpose

Argument strength (AS) is a validated measure of persuasiveness that has been identified as one of the key variables determining the effectiveness of video ads. Smoking-cessation videos with high AS are more effective at reducing smoking behavior than videos with low AS. The neural processes that mediate the effects of AS on subsequent smoking have not been identified. In the present study, we tested whether the efficacy of high-AS smoking-cessation videos is determined by the level of integration of visual and auditory (ie, multisensory) processes. In addition, we tested differences in sensation seeking, which is repeatedly associated with smokers’ sensitivity to cessation interventions.

Patients and methods

Using functional magnetic resonance imaging (fMRI), we recorded the brain response of 66 smokers randomly assigned to view either 16 high-AS or 16 low-AS smoking-cessation videos. Multisensory processing was assessed by the functional connectivity between brain regions that encoded visual and auditory information in the videos. Smoking behavior was indexed by the urine level of cotinine, a nicotine metabolite, immediately before and approximately 30 days after the fMRI session.

Results

We found a significant moderated mediation effect, such that the connectivity between visual and auditory cortices mediated the effect of AS on subsequent smoking, but only for smokers lower in sensation seeking. The prediction performance of the model was confirmed by leave-one-out cross-validation.

Conclusion

Our study suggests that audiovisual integration underlies the greater efficacy of high- vs low-AS smoking-cessation videos for individuals lower in sensation seeking. High-sensation-seeking smokers may be responsive to other characteristics of smoking-cessation videos.

Problem Solving Reduces Sexual Risk Associated with Sensation Seeking, Substance Use, and Depressive Symptoms Among African-American Adolescents

OBJECTIVE

African-American adolescents experience higher rates of sexually transmitted infections (STIs) compared to same-age Caucasian peers. Substance use, sensation seeking, and depression have all been linked to risky sexual practices. Theory suggests that problem-solving skills may help to buffer against these risk factors.

METHOD

To test this hypothesis, we used data from African-American adolescents (N = 1018; M age = 16.7, SD = 1.1; 58% female) who participated in a prevention trial.

RESULTS

Nearly half of the sample (47%) reported lifetime marijuana use, while 13% reported drug use prior to most recent sexual encounter. Sexual sensation seeking was directly associated with drug use prior to sex (β = 1.13, b = 0.13,
SE = 0.02, p < .001) and lower problem-solving skills (β = -0.08, b = -0.06,
SE = 0.02, p = .01). Problem-solving skills were associated with drug use prior to sex (β = 0.92, b = -0.08, SE = 0.03, p = .004), such that those with greater problem-solving skills were less likely to report drug use prior to most recent sex. Lastly, problem solving skills mediated the association between sexual sensation seeking and drug use prior to sex, though the effect was small (β = 0.01, 95% CI: .001, .01).

CONCLUSIONS

Problem-solving skills can have a protective influence on risky behavior for adolescents. Future research might examine the utility of strengthening problem-solving skills in order to reduce STI/HIV risk among African American adolescents.

Disentangling longitudinal relations between youth cannabis use, peer cannabis use, and conduct problems: developmental cascading links to cannabis use disorder

AIMS

To determine whether cannabis use during adolescence can increase risk not only for cannabis use disorder (CUD) but also for conduct problems, potentially mediated by exposure to peers who use cannabis.

DESIGN, SETTING, PARTICIPANTS

Longitudinal study analyzing four waves of longitudinal data from 364 racially and socio-economically diverse, urban, US community youth (at baseline: Mage  = 13.51 (0.95); 49.1% female).

MEASUREMENTS

Self-reports of cannabis use, conduct problems, proportion of peers using cannabis and CUD criteria at the final wave were analyzed using a method sensitive to changes over development, the random-intercept cross-lagged panel model.

FINDINGS

Change in cannabis use did not predict changes in conduct problems or peer cannabis use over time, controlling for gender, race-ethnicity and socio-economic status. Instead, increases in conduct problems predicted increases in cannabis use and ultimately CUD, with some of the effect mediated by increases in the prevalence of peer cannabis use [β = 0.12, 95% confidence interval (CI) = 0.07, 0.20]. Additionally, affiliation with peers who used cannabis predicted subsequent CUD via increased personal cannabis use (β = 0.08, 95% CI = 0.04, 0.14). Significant within-person betas for the cross-lagged effects ranged between 0.20 and 0.27.

CONCLUSIONS

Cannabis use in adolescence does not appear to lead to greater conduct problems or association with cannabis-using peers apart from pre-existing conduct problems. Instead, adolescents who (1) increasingly affiliate with cannabis-using peers or (2) have increasing levels of conduct problems are more likely to use cannabis, and this cascading chain of events appears to predict cannabis use disorder in emerging adulthood.

African-American sexual minority adolescents and sexual health disparities: An exploratory cross-sectional study

PURPOSE

To better understand sexual health disparities among African-American sexual minority adolescents.

METHODS

African-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history.

RESULTS

Compared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV.

CONCLUSIONS

African-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents.

Differences Between Florida and the Rest of the United States in Response to Local Transmission of the Zika Virus: Implications for Future Communication Campaigns

For those at risk for Zika virus infection, prevention requires an approach that includes individual, interpersonal, and community-level support for behavior change. In August 2016, the announcement of local Zika transmission in Florida provided an opportunity to determine whether Zika-related knowledge, attitudes, and behaviors might be affected differentially in Florida compared to the rest of the nation. From August 8-October 3, 2016, we conducted nationally representative weekly surveys (N = 12,236), oversampling Florida residents, measuring Zika virus news exposure, knowledge about transmission and prevention of the infection, and attitudes and behaviors toward prevention. We tested two classes of models: those focused on individual Zika risk perceptions (e.g., protection motivation theory) and one focused on community action beyond those directly at risk (social consensus model). Analyses assessed differences between Florida and the rest of the nation by survey week. Consistent with both models, Floridians demonstrated significantly higher levels of perceived susceptibility and knowledge, more positive attitudes toward Zika virus prevention, and higher likelihood of engaging in protective behavior than non-Floridians. Consistent with theories of individual risk perception, response was greater among respondents who saw themselves at risk of infection. However, consistent with the SCM, irrespective of personal risk, response was greater among Floridians. Nevertheless, more than half of the public took no direct action to prevent the spread of Zika. Communities at increased risk for a novel infection such as Zika may quickly acquire Zika-related knowledge, attitudes, and behavior, but large-scale community-wide response might be difficult without further community-level public education.

Modeling Trajectories of Sensation Seeking and Impulsivity Dimensions from Early to Late Adolescence: Universal Trends or Distinct Sub-groups?

Developmental imbalance models attribute the rise in risk-taking during adolescence to a universal imbalance between rising reward sensitivity and lagging cognitive control. This study tested predictions of an alternate Lifespan Wisdom Model that distinguishes between exploratory/adaptive (e.g., sensation seeking) and maladaptive (e.g., acting-without-thinking, delay discounting) risk-taking propensities and attributes the latter to a sub-set of youth with weak cognitive control. Latent trajectory modeling of six waves of data from 387 adolescents (52% females; spanning average ages of 11-18 years) revealed distinct sub-groups with heterogeneous trajectory patterns for acting-without-thinking and delay-discounting. Only those trajectory groups with weak cognitive control, characterized as "high-increasing" acting-without thinking and "high-stable" delay discounting were predictive of a maladaptive risk-taking outcome, namely substance use disorder. Sensation seeking demonstrated a universal peak, but high levels of sensation seeking were not associated with weakness in cognitive control and were unrelated to substance use disorder, controlling for impulsivity. The findings suggest that maladaptive risk-taking characterized by weak cognitive control over reward-driven impulses is a phenomenon limited to only a sub-set of youth.

Misleading Claims About Tobacco Products in YouTube Videos: Experimental Effects of Misinformation on Unhealthy Attitudes

BACKGROUND

Recent content analyses of YouTube postings reveal a proliferation of user generated videos with misleading statements about the health consequences of various types of nontraditional tobacco use (eg, electronic cigarettes; e-cigarettes).

OBJECTIVE

This research was aimed at obtaining evidence about the potential effects of YouTube postings about tobacco products on viewers' attitudes toward these products.

METHODS

A sample of young adults recruited online (N=350) viewed one of four highly viewed YouTube videos containing misleading health statements about chewing tobacco, e-cigarettes, hookahs, and pipe smoking, as well as a control YouTube video unrelated to tobacco products.

RESULTS

The videos about e-cigarettes and hookahs led to more positive attitudes toward the featured products than did control videos. However, these effects did not fully translate into attitudes toward combustive cigarette smoking, although the pipe video led to more positive attitudes toward combustive smoking than did the chewing and the hookah videos, and the e-cigarette video led to more positive attitudes toward combustive cigarette smoking than did the chewing video.

CONCLUSIONS

This research revealed young people's reactions to misleading claims about tobacco products featured in popular YouTube videos. Policy implications are discussed.

Parental Desensitization to Gun Violence in PG-13 Movies

: media-1vid110.1542/5745216462001PEDS-VA_2017-3491Video Abstract OBJECTIVE: To assess effects of justified versus unjustified screen violence on parents' willingness to allow children to view films that contain extensive gun violence.

METHODS

A national US sample of 610 parents with at least 1 child between ages 6 and 17 was randomly assigned to view a series of four 90-second video clips from popular films depicting violent gun use under either justified or unjustified conditions. Graphic consequences were removed to mimic the violence common in PG-13 movies. Parents reported their perceived justification for the violence, their emotional reaction while viewing it, the minimum age they would consider appropriate for viewing the film, and whether they would allow their own child to view it. Predictors included experimental condition, viewing order, child age, and recent moviegoing. Growth curve modeling determined the effects of the predictors on both intercepts and slopes of viewing order.

RESULTS

Parents were less emotionally upset and more accepting of child viewing for justified than unjustified gun violence, with perceptions of justification better predictors of parental restriction than emotion. Nevertheless, with the exception of parents with extensive moviegoing habits, parents viewed justified violence as appropriate for adolescents starting at age 15, older than the PG-13 rating suggests.

CONCLUSIONS

Parents are less restrictive of child viewing of gun violence in PG-13 movies when it features characters whose weapon use is seen as justified. The apparent acceptance of rising gun violence in PG-13 movies may be partly attributable to the perception that the violence in those films is justified.

Effects of Pictorial Warning Labels for Cigarettes and Quit-Efficacy on Emotional Responses, Smoking Satisfaction, and Cigarette Consumption

Background

Experimental research on pictorial warning labels for cigarettes has primarily examined immediate intentions to quit.

Purpose

Here, we present the results of a clinical trial testing the impact on smoking during and after a 28-day period of naturalistic exposure to pictorial versus text-only warnings.

Methods

Daily cigarette smokers (N = 244) at two sites in the USA were randomly assigned to receive their regular brand of cigarettes for 4 weeks with one of three warnings: (a) text-only, (b) pictures and text as proposed by FDA, or (c) the warnings proposed by FDA with additional text that elaborated on the risks of smoking. Analyses examined the effects of pictorial versus text-only warnings and self-efficacy for quitting on cigarette consumption during and 1 month after the trial as mediated by emotional and cognitive responses as well as satisfaction with smoking.

Results

Stronger emotional responses to pictorial than text-only warnings predicted reduced satisfaction with smoking during the trial and lower cigarette consumption at follow-up among the majority of smokers who continued to smoke. Consistent with the efficacy-desire model, those with moderate efficacy reported the greatest reduction in consumption at follow-up. However, a small proportion of smokers (7%) who reported 7-day abstinence at follow-up did not exhibit a significant relation with self-efficacy.

Conclusions

Pictorial warning labels proposed by FDA create unfavorable emotional reactions to smoking that predict reduced cigarette use compared to text alone, with even smokers low in self-efficacy exhibiting some reduction. Predictions that low self-efficacy smokers will respond unfavorably to warnings were not supported.

Cigarette Graphic Warning Labels Are Not Created Equal: They Can Increase or Decrease Smokers' Quit Intentions Relative to Text-Only Warnings

Introduction

Cigarette graphic-warning labels elicit negative emotion. Research suggests negative emotion drives greater risk perceptions and quit intentions through multiple processes. The present research compares text-only warning effectiveness to that of graphic warnings eliciting more or less negative emotion.

Methods

Nationally representative online panels of 736 adult smokers and 469 teen smokers/vulnerable smokers were randomly assigned to view one of three warning types (text-only, text with low-emotion images, or text with high-emotion images) four times over 2 weeks. Participants recorded their emotional reaction to the warnings (measured as arousal), smoking risk perceptions, and quit intentions. Primary analyses used structural equation modeling.

Results

Participants in the high-emotion condition reported greater emotional reaction than text-only participants (bAdult = 0.21; bTeen = 0.27, p's < .004); those in the low-emotion condition reported lower emotional reaction than text-only participants (bAdult = -0.18; bTeen = -0.22, p's < .018). Stronger emotional reaction was associated with increased risk perceptions in both samples (bAdult = 0.66; bTeen = 0.85, p's < .001) and greater quit intentions among adults (bAdult = 1.00, p < .001). Compared to text-only warnings, low-emotion warnings were associated with reduced risk perceptions and quit intentions whereas high-emotion warnings were associated with increased risk perceptions and quit intentions.

Conclusion

Warning labels with images that elicit more negative emotional reaction are associated with increased risk perceptions and quit intentions in adults and teens relative to text-only warnings. However, graphic warnings containing images which evoke little emotional reaction can backfire and reduce risk perceptions and quit intentions versus text-only warnings.

Implications

This research is the first to directly manipulate two emotion levels in sets of nine cigarette graphic warning images and compare them with text-only warnings. Among adult and teen smokers, high-emotion graphic warnings were associated with increased risk perceptions and quit intentions versus text-only warnings. Low-emotion graphic warnings backfired and tended to reduce risk perceptions and quit intentions versus text-only warnings. Policy makers should be aware that merely placing images on cigarette packaging is insufficient to increase smokers' risk perceptions and quit intentions. Low-emotion graphic warnings will not necessarily produce desired population-level benefits relative to text-only or high-emotion warnings.

The Importance of Relevant Emotional Arousal in the Efficacy of Pictorial Health Warnings for Cigarettes

Introduction

Warning labels for cigarettes proposed by Food and Drug Administration (FDA) were rejected by the courts partly because they were thought to be emotionally evocative but have no educational value. To address this issue, we compared three types of smoking warnings: (1) FDA-proposed warnings with pictures illustrating the smoking hazards; (2) warnings with the same text information paired with equally aversive but smoking-irrelevant images; and (3) text-only warnings.

Methods

Smokers recruited through Amazon's Mechanical Turk were randomly assigned to one of the three conditions. They reported how many cigarettes they smoked per day (CPD) during the past week and then viewed eight different warnings. After viewing each warning, they rated its believability and perceived ability to motivate quitting. One week later, 62.3% of participants again reported CPD during the past week, rated how the warnings they viewed the week before changed their feeling about smoking, rated their intention to quit in the next 30 days, and recalled as much as they could about each of the warnings they viewed.

Results

Compared to the irrelevant image and text-only warnings, FDA warnings were seen as more believable and able to motivate quitting and at the follow-up, produced lower CPD, worse feeling about smoking, and more memory for warning information, controlling for age and baseline CPD.

Conclusions

Emotionally evocative warning images are not effective in communicating the risks of smoking, unless they pertain to smoking-related hazards. In future versions of warning labels, pictorial contents should be pretested for the ability to enhance the health-hazard message.

Implications

Our study shows that contrary to court opinions, FDA-proposed pictorial warnings for cigarettes are more effective in communicating smoking-related hazards than warnings that merely contain emotionally aversive but smoking-irrelevant images. The suggestion that FDA's proposed warnings employed emotionally arousing pictures with no information value was not supported. Pictures that illustrate the risk carry information that enhances the persuasiveness of the warning. The congruence between pictures and text should be a criterion for selecting warning images in the future.

Executive Function Capacities, Negative Driving Behavior and Crashes in Young Drivers

Motor vehicle crashes remain a leading cause of injury and death in adolescents, with teen drivers three times more likely to be in a fatal crash when compared to adults. One potential contributing risk factor is the ongoing development of executive functioning with maturation of the frontal lobe through adolescence and into early adulthood. Atypical development resulting in poor or impaired executive functioning (as in Attention-Deficit/Hyperactivity Disorder) has been associated with risky driving and crash outcomes. However, executive function broadly encompasses a number of capacities and domains (e.g., working memory, inhibition, set-shifting). In this review, we examine the role of various executive function sub-processes in adolescent driver behavior and crash rates. We summarize the state of methods for measuring executive control and driving outcomes and highlight the great heterogeneity in tools with seemingly contradictory findings. Lastly, we offer some suggestions for improved methods and practical ways to compensate for the effects of poor executive function (such as in-vehicle assisted driving devices). Given the key role that executive function plays in safe driving, this review points to an urgent need for systematic research to inform development of more effective training and interventions for safe driving among adolescents.

Individual differences in the processing of smoking-cessation video messages: An imaging genetics study

Studies testing the benefits of enriching smoking-cessation video ads with attention-grabbing sensory features have yielded variable results. Dopamine transporter gene (DAT1) has been implicated in attention deficits. We hypothesized that DAT1 polymorphism is partially responsible for this variability. Using functional magnetic resonance imaging, we examined brain responses to videos high or low in attention-grabbing features, indexed by "message sensation value" (MSV), in 53 smokers genotyped for DAT1. Compared to other smokers, 10/10 homozygotes showed greater neural response to High- vs. Low-MSV smoking-cessation videos in two a priori regions of interest: the right temporoparietal junction and the right ventrolateral prefrontal cortex. These regions are known to underlie stimulus-driven attentional processing. Exploratory analysis showed that the right temporoparietal response positively predicted follow-up smoking behavior indexed by urine cotinine. Our findings suggest that responses to attention-grabbing features in smoking-cessation messages is affected by the DAT1 genotype.