Disentangling the interplay between genes, cognitive skills, and educational level in adolescent and young adult smoking - The TRAILS study

Recent studies suggest that smoking and lower educational attainment may have genetic influences in common. However, little is known about the mechanisms through which genetics contributes to educational inequalities in adolescent and young adult smoking. Common genetic liabilities may underlie cognitive skills associated with both smoking and education, such as IQ and effortful control, in line with indirect health-related selection explanations. Additionally, by affecting cognitive skills, genes may predict educational trajectories and hereby adolescents' social context, which may be associated with smoking, consistent with social causation explanations. Using data from the Dutch TRAILS Study (N = 1581), we estimated the extent to which polygenic scores (PGSs) for ever smoking regularly (PGSSMOK) and years of education (PGSEDU) predict IQ and effortful control, measured around age 11, and whether these cognitive skills then act as shared predictors of smoking and educational level around age 16, 19, 22, and 26. Second, we assessed if educational level mediated associations between PGSs and smoking. Both PGSs were associated with lower effortful control, and PGSEDU also with lower IQ. Lower IQ and effortful control, in turn, predicted having a lower educational level. However, neither of these cognitive skills were directly associated with smoking behaviour after controlling for covariates and PGSs. This suggests that IQ and effortful control are not shared predictors of smoking and education (i.e., no indirect health-related selection related to cognitive skills). Instead, PGSSMOK and PGSEDU, partly through their associations with lower cognitive skills, predicted selection into a lower educational track, which in turn was associated with more smoking, in line with social causation explanations. Our findings suggest that educational differences in the social context contribute to associations between genetic liabilities and educational inequalities in smoking.

Decline in positive future orientations among adolescents during covid-19: The role of socioeconomic status, parental support, and sense of control

INTRODUCTION

Before coronavirus disease (covid-19), adolescents from a lower socioeconomic status (SES) background tend to have less positive future orientations, receive less parental support, and have a weaker sense of control than adolescents from a higher SES background. The covid-19 pandemic has potentially increased the socioeconomic gaps in positive future orientations, parental support, and sense of control among adolescents who are currently in vocational education. As societies are aiming to return back to precovid norms, certain groups of adolescents might require more attention for ensuring a stable future than others.

METHODS

Two-wave questionnaire data of 689 Dutch adolescents (Mage  = 17.8; 56% female) from the Youth Got Talent project was analyzed. Latent Change Score models are a relatively novel approach that allows two-wave data to estimate associations between precovid predictor variables and changes in outcome variables from before to during covid-19 (e.g., SES, positive future orientations, parental support, and sense of control). Analyses were preregistered.

RESULTS

The precovid socioeconomic differences in adolescent's positive future orientations and sense of control remained stable during covid-19, whereas the socioeconomic difference in parental support decreased during covid-19. A decline in parental support, an increase in sense of control, and more covid-19 hardships were associated with an increase in future orientations.

CONCLUSION

The covid-19 situation has not substantially increased socioeconomic differences in positive future orientations and sense of control, but did decrease socioeconomic differences in parental support among adolescents. Short-term policies should aim to facilitate parental support and positive future orientations to all adolescents who experienced a decline, while also long-term focusing on the more consistent socioeconomic difference in sense of control among adolescents.

ADHD Symptoms and Educational Level in Adolescents: The Role of the Family, Teachers, and Peers

Few studies have explored the contribution of family and school factors to the association between ADHD symptoms and lower education. Possibly, having more ADHD symptoms contributes to poorer family functioning and less social support, and consequently a lower educational level (i.e., mediation). Moreover, the negative effects of ADHD symptoms on education may be stronger for adolescents with poorer family functioning or less social support (i.e., interaction). Using data of the Dutch TRAILS Study (N = 2,229), we evaluated associations between ADHD symptoms around age 11 and educational level around age 14, as well as between ADHD symptoms around age 14 and 16 years and subsequent changes in educational level around age 16 and 19, respectively. We assessed the potential mediating role of family functioning, and social support by teachers and classmates, all measured around ages 11, 14, and 16, while additionally evaluating interactions between ADHD symptoms and these hypothesized mediators. ADHD symptoms were associated with poorer family functioning, less social support by teachers and classmates, and lower education throughout adolescence. No conclusive evidence of mediation was found, because unique associations between family functioning and social support by teachers and classmates and education were largely absent. Furthermore, we found no interactions between ADHD symptoms and family functioning and social support by teachers and classmates. Although social support by teachers and classmates and good family functioning may benefit the wellbeing and mental health of adolescents with high levels of ADHD symptoms, they will not necessarily improve their educational attainment.

Country-level social mobility and inequalities in adolescent health behaviours in 32 countries

Background

Higher family affluence is associated with healthier behaviours in adolescents, but the strength of this association varies across countries. Differences in social mobility at the country-level, i.e. the extent to which adolescents develop a different socioeconomic status (SES) than their parents, may partially explain why the association between family affluence and adolescent health behaviours is stronger in some countries than in others.

Methods

Using data from adolescents aged 11-15 years from 32 different countries, participating in the 2017/2018 wave of the Health Behaviour in School-aged Children (HBSC) study (N = 185,086), we employed multilevel regression models with cross-level interactions to examine whether country-level social mobility moderates the association between family affluence and adolescent health behaviours (i.e. moderate-to-vigorous physical activity, vigorous physical activity, healthy foods consumed, unhealthy foods consumed, having breakfast regularly, weekly smoking).

Results

Higher family affluence was more strongly associated with higher levels of physical activity in countries characterized by high levels of social mobility (cross-level interaction linear regression coefficient 0.34; 95% CI 0.08 to 0.60; p = 0.009 for moderate-to-vigorous physical activity, and 0.31; 0.11 to 0.50; p = 0.002 for vigorous physical activity). No cross-level interactions were found for any of the other health behaviours.

Conclusions

Our findings suggest that differences in social mobility at the country-level may contribute to cross-national variations in socioeconomic inequalities in adolescent physical activity. Further research can shed light on the mechanisms linking country-level social mobility to inequalities in adolescent physical activity to identify targets for policy and interventions.

Key messages

• This is one of the first studies to investigate country-level social mobility in relation to health equity. Inequalities in adolescent physical activity were steeper in socially mobile countries.

• Stronger efforts to engage adolescents from low-affluent families in physical activity may be necessary in countries characterized by high levels of social mobility.

Socioeconomic inequalities in adolescent health behaviours across 32 different countries - The role of country-level social mobility

Higher family affluence is associated with healthier behaviours in adolescents, but the strength of this association varies across countries. Differences in social mobility at the country-level, i.e. the extent to which adolescents develop a different socioeconomic status (SES) than their parents, may partially explain why the association between family affluence and adolescent health behaviours is stronger in some countries than in others. Using data from adolescents aged 11-15 years from 32 countries, participating in the 2017/2018 wave of the Health Behaviour in School-aged Children (HBSC) study (N = 185,086), we employed multilevel regression models with cross-level interactions to examine whether country-level social mobility moderates the association between family affluence and adolescent health behaviours (i.e. moderate-to-vigorous physical activity, vigorous physical activity, healthy and unhealthy foods consumption, having breakfast regularly, and weekly smoking). Higher family affluence was more strongly associated with higher levels of adolescent physical activity in countries characterized by high levels of social mobility. No cross-level interactions were found for any of the other health behaviours. Differences in social mobility at the country-level may contribute to cross-national variations in socioeconomic inequalities in adolescent physical activity. Further research can shed light on the mechanisms linking country-level social mobility to inequalities in adolescent physical activity to identify targets for policy and interventions.

Educational level and alcohol use in adolescence and early adulthood-The role of social causation and health-related selection-The TRAILS Study

Both social causation and health-related selection may influence educational gradients in alcohol use in adolescence and young adulthood. The social causation theory implies that the social environment (e.g. at school) influences adolescents’ drinking behaviour. Conversely, the health-related selection hypothesis posits that alcohol use (along other health-related characteristics) predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as drinking may be both a cause and consequence of low educational attainment. Furthermore, educational gradients in alcohol use may reflect the impact of ‘third variables’ already present in childhood, such as parental socioeconomic status (SES), effortful control, and IQ. We investigated social causation and health-related selection in the development of educational gradients in alcohol use from adolescence to young adulthood in a selective educational system. We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level and drinking at ages around 14, 16, 19, 22, and 26 years (waves 2 to 6). First, we evaluated the directionality in longitudinal associations between education and drinking with cross-lagged panel models, with and without adjusting for pre-existing individual differences using fixed effects. Second, we assessed the role of childhood characteristics around age 11 (wave 1), i.e. IQ, effortful control, and parental SES, both as confounders in these associations, and as predictors of educational level and drinking around age 14 (wave 2). In fixed effects models, lower education around age 14 predicted increases in drinking around 16. From age 19 onward, we found a tendency towards opposite associations, with higher education predicting increases in alcohol use. Alcohol use was not associated with subsequent changes in education. Childhood characteristics strongly predicted education around age 14 and, to a lesser extent, early drinking. We mainly found evidence for the social causation theory in early adolescence, when lower education predicted increases in subsequent alcohol use. We found no evidence in support of the health-related selection hypothesis with respect to alcohol use. By determining initial educational level, childhood characteristics also predict subsequent trajectories in alcohol use.

Multiple health risk behaviors and mental health from a life course perspective: The Dutch TRAILS study

We examined trajectories of multiple health risk behavior (MHRB) patterns throughout adolescence, and changes in mental health from childhood to young adulthood. Further, we assessed how continuity or onset of MHRBs overall were associated with subsequent changes in mental health, and whether this varied by type of MHRBs. We used six waves of the prospective Dutch TRAILS study (2001-2016; n = 2229), covering ages 11 until 23. We measured MHRBs (substance use: alcohol misuse, cannabis use, smoking; and obesity-related: overweight, physical inactivity, irregular breakfast intake) at three time points during adolescence. We assessed mental health as Youth/Adult Self-report total problems at ages 11 and 23. Latent class growth analyses and ANOVA were used to examine longitudinal trajectories and associations. We identified six developmental trajectories for the total of MHRBs and mental health. Trajectories varied regarding likelihood of MHRBs throughout adolescence, mental health at baseline, and changes in mental health problems in young adulthood. We found no associations for the continuity of overall MHRBs throughout adolescence, and neither for early, mid- or late onset, with changes in mental health problems in young adulthood. However, continuity of MHRBs in the obesity-related subgroup was significantly associated with an increase in mental health problems. Adolescents with the same MHRB patterns may, when reaching adulthood, have different levels of mental health problems, with mental health at age 11 being an important predictor. Further, involvement with obesity-related MHRBs continuously throughout adolescence is associated with increased mental health problems in young adulthood.

Educational level, attention problems, and externalizing behaviour in adolescence and early adulthood: the role of social causation and health-related selection-the TRAILS study

Social causation and health-related selection may contribute to educational differences in adolescents' attention problems and externalizing behaviour. The social causation hypothesis posits that the social environment influences adolescents' mental health. Conversely, the health-related selection hypothesis proposes that poor mental health predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as attention problems and externalizing behaviour have the potential to interfere with educational attainment, but may also be affected by differences in the educational context. Furthermore, educational gradients in mental health may reflect the impact of 'third variables' already present in childhood, such as parental socioeconomic status (SES), and IQ. We investigated both hypotheses in relation to educational differences in externalizing behaviour and attention problems throughout adolescence and young adulthood. We used data from a Dutch cohort (TRAILS Study; n = 2229), including five measurements of educational level, externalizing behaviour, and attention problems from around age 14-26 years. First, we evaluated the directionality in longitudinal associations between education, externalizing behaviour, and attention problems with and without adjusting for individual differences using fixed effects. Second, we assessed the role of IQ and parental SES in relation to attention problems, externalizing behaviour, and educational level. Attention problems predicted decreases in education throughout all of adolescence and young adulthood. Differences in parental SES contributed to increases in externalizing behaviour amongst the lower educational tracks in mid-adolescence. Childhood IQ and parental SES strongly predicted education around age 14. Parental SES, but not IQ, also predicted early adolescent attention problems and externalizing behaviour. Our results provide support for the health-related selection hypothesis in relation to attention problems and educational attainment. Further, our results highlight the role of social causation from parental SES in determining adolescent educational level, attention problems, and externalizing behaviour.

Educational level, attention problems, and externalizing behaviour in adolescence and early adulthood

Background

Social causation as well as health-related selection may contribute to educational gradients in adolescents' attention problems (AP) and externalizing behaviour (EB). From past studies it is unclear which of these mechanisms predominates, as AP and EB have the potential to disrupt adolescents' educational careers, but may also be affected by differences in their social environment. Furthermore, gradients in AP and EB may reflect ‘third variables' already present in childhood, such as parental socioeconomic status (SES) and IQ. We investigated social causation and health-related selection in the development of educational differences in EB and AP.

Methods

We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level, EB, and AP at ages around 14, 16, 19, 22, and 26 years. First, we evaluated the directionality in longitudinal associations between education, EB, and AP with cross-lagged panel models, with and without adjusting for pre-existing individual differences using fixed effects. Second, we assessed the role of parental SES and IQ in childhood both as confounders in longitudinal associations, and as predictors of AP, EB, and educational level around age 14.

Results

In fixed effects models, AP, but not EB, consistently predicted decreases in educational level throughout all of adolescence and young adulthood. Regarding social causation, differences in parental SES contributed to increases in EB amongst the lower educational tracks in mid-adolescence. Childhood IQ and parental SES strongly predicted education around age 14. Parental SES, but not IQ, also predicted early adolescent AP and EB.

Conclusions

We found health-related selection attributable to AP throughout all phases of adolescence and young adulthood. Further, our results highlight the role of social causation from parental SES in determining adolescent educational level, AP, and EB.

Key messages

AP have the potential to negatively impact adolescents’ educational careers and may trigger downward mobility in the educational system in all phases of adolescence and young adulthood. The results of this study call for actions to reduce the impact of AP on education. Further, it is essential to address the effects of insufficient economic resources on education and mental health.

Alcohol and Brain Development in Adolescents and Young Adults: A Systematic Review of the Literature and Advisory Report of the Health Council of the Netherlands

Young people, whose brains are still developing, might entail a greater vulnerability to the effects of alcohol consumption on brain function and development. A committee of experts of the Health Council of the Netherlands evaluated the state of scientific knowledge regarding the question whether alcohol negatively influences brain development in young people. A systematic literature search for prospective studies was performed in PubMed and PsychINFO, for longitudinal studies of adolescents or young adults ranging between 12 and 24 y of age at baseline, investigating the relation between alcohol use and outcome measures of brain structure and activity, cognitive functioning, educational achievement, or alcohol use disorder (AUD), with measures at baseline and follow-up of the outcome of interest. Data were extracted from original articles and study quality was assessed using the Newcastle-Ottawa Scale. A total of 77 studies were included, 31 of which were of sufficient quality in relation to the study objectives. There were indications that the gray matter of the brain develops abnormally in young people who drink alcohol. In addition, the more often young people drink or the younger they start, the higher the risk of developing AUD later in life. The evidence on white matter volume or quality, brain activity, cognitive function, and educational achievement is still limited or unclear. The committee found indications that alcohol consumption can have a negative effect on brain development in adolescents and young adults and entails a risk of later AUD. The committee therefore considers it a wise choice for adolescents and young adults not to drink alcohol.

Time trends in schoolwork pressure among Dutch adolescents, 2001-2017: Gender and educational differences

AIMS

This study investigated gender and educational differences in trends in schoolwork pressure between 2001 and 2017 in nationally representative samples of Dutch adolescents in secondary education.

METHODS

Data from five surveys of the Dutch Health Behaviour in School-aged Children study were used.

RESULTS

Across the surveys, an increase in perceived schoolwork pressure was observed. Girls and adolescents enrolled in the higher educational levels reported higher levels of perceived schoolwork pressure and the strongest increase in schoolwork pressure over time. Especially for girls, there was a stronger increase in schoolwork pressure for those enrolled in higher educational tracks.

CONCLUSIONS

Increases in schoolwork pressure over time were stronger among Dutch girls and students in the higher educational levels. Over time, schoolwork pressure increased most among girls in the highest educational levels. Explanations and implications for these results are discussed.

Daily Identity Dynamics in Adolescence Shaping Identity in Emerging Adulthood: An 11-Year Longitudinal Study on Continuity in Development

According to identity theory, short-term day-to-day identity exploration and commitment processes are the building blocks for long-term development of stable commitments in emerging adulthood. This key assumption was tested in a longitudinal study including 494 individuals (43% girls, M_age T1 = 13.31 years, range 11.01–14.86 years) who were followed from adolescence into emerging adulthood, covering ages 13 to 24 years. In the first five years, adolescents reported on their daily identity processes (i.e., commitment, reconsideration and in-depth exploration) across 75 assessment days. Subsequently, they reported on their identity across four (bi-) annual waves in emerging adulthood. Findings confirmed the existence of a dual-cycle process model of identity formation and identity maintenance that operated at the within-person level across days during adolescence. Moreover, individual differences in these short-term identity processes in adolescence predicted individual differences in identity development in emerging adulthood. Specifically, those adolescents with low daily commitment levels, and high levels of identity reconsideration were more likely to maintain weak identity commitments and high identity uncertainty in emerging adulthood. Also, those adolescents characterized by stronger daily changes in identity commitments and continuing day-to-day identity uncertainty maintained the highest identity uncertainty in emerging adulthood. These results support the view of continuity in identity development from short-term daily identity dynamics in adolescence to long-term identity development in emerging adulthood.

Testing sampling bias in estimates of adolescent social competence and behavioral control

In 5 of the 6 large Dutch developmental cohorts investigated here, lower SES adolescents are underrepresented and higher SES adolescents overrepresented. With former studies clearly revealing differences between SES strata in adolescent social competence and behavioral control, this misrepresentation may contribute to an overestimation of normative adolescent competence. Using a raking procedure, we used national census statistics to weigh the cohorts to be more representative of the Dutch population. Contrary to our expectations, in all cohorts, little to no differences between SES strata were found in the two outcomes. Accordingly, no differences between weighted and unweighted mean scores were observed across all cohorts. Furthermore, no clear change in correlations between social competence and behavioral control was found. These findings are most probably explained by the fact that measures of SES in the samples were quite limited, and the low SES participants in the cohorts could not be considered as representative of the low SES groups in the general population. Developmental outcomes associated with SES may be affected by a raking procedure in other cohorts that have a sufficient number and sufficient variation of low SES adolescents.

Education and alcohol use in adolescence – The role of social causation and health-related selection

Background

Both social causation and health-related selection may influence educational gradients in alcohol use in adolescence. From past studies it is unclear which of these mechanisms predominates, as drinking may be both a cause and consequence of low educational attainment. Furthermore, gradients in alcohol use may reflect 'third variables' already present in childhood, such as parental socioeconomic status (SES), effortful control, and IQ. We investigated social causation and health-related selection in the development of educational gradients in alcohol use.

Methods

We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level and drinking at ages around 14, 16, 19, 22, and 26 years. First, we evaluated the directionality in longitudinal associations between education and alcohol use with cross-lagged panel models, with and without adjusting for pre-existing individual differences using fixed effects. Second, we assessed the role of childhood characteristics around age 11, i.e. IQ, effortful control, and parental SES, both as confounders in these longitudinal associations, and as predictors of educational level and drinking around age 14.

Results

In fixed effects models, lower education at age 14 strongly predicted increases in drinking at 16. From age 19 onward, we found a non-significant tendency towards opposite associations, with higher education predicting increases in alcohol use. Alcohol use was not associated with subsequent changes in education. All childhood characteristics strongly predicted education around age 14 and, to a lesser extent, early drinking.

Conclusions

We found conclusive evidence for social causation from education to alcohol use in early adolescence only, and no evidence for selection attributable to alcohol use. By determining initial educational level, childhood characteristics also predict subsequent trajectories in alcohol use.

Key messages

Our findings illustrate the importance of social causation in relation to alcohol use in early adolescence, while no support was found for health-related selection from alcohol use to education. Parental SES, effortful control, and IQ in childhood strongly predicted educational level in early adolescence, which subsequently predicted trajectories in alcohol use during adolescence.

Immigration background and adolescent mental health problems: the role of family affluence, adolescent educational level and gender

PURPOSE

European studies demonstrated that immigrant adolescents are at a higher risk for mental health problems than native adolescents, but little is known about the role of socioeconomic status (SES) and gender in this association. This study examined to what extent differences in the mental health problems of non-western immigrant and native Dutch adolescents were explained by adolescents' family affluence and educational level and differed with the adolescents' family affluence, educational level, and gender.

METHODS

Adolescents in a Dutch nationally representative sample of 11-16-year old native Dutch (n = 5283) and non-western immigrants (n = 1054) reported on their family affluence, own educational level, conduct problems, emotional symptoms, peer relationship problems, and hyperactivity-inattention problems.

RESULTS

Non-western immigrant adolescents were at a higher risk for conduct problems and peer relationship problems than native Dutch adolescents, but family affluence and educational level explained only a very small proportion of these differences. With two exceptions, differences in the mental health problems of non-western immigrants and natives were highly comparable for different family affluence levels, educational levels, and for boys and girls. Only for natives, a higher family SES was related to less conduct problems. Furthermore, only for non-western immigrants a high family SES related to more hyperactivity-inattention problems.

CONCLUSIONS

Our findings illustrate that the association between immigration background and adolescent mental health problems is largely independent of SES and gender. Future studies should include other factors to facilitate our understanding of the association between immigration background and adolescent mental health problems.

The wide-ranging life outcome correlates of a general psychopathology factor in adolescent psychopathology

BACKGROUND

The structure of psychopathology has been much debated within the research literature. This study extends previous work by providing comparisons of the links between psychopathology and several life outcomes (temperamental, economic, social, psychological and health) using a three-correlated-factors model, a bifactor model, a revised-bifactor model and a higher-order model.

METHODS

Data from a sample of Dutch adolescents were used (n = 2 230), and psychopathology factors were modelled using self-reported and parent-reported longitudinal data from youth across four assessments during adolescence, from ages 11 to 19. Outcome variables were assessed at age 22 using adolescent-reports and parent-reports and more objective measures (e.g. body mass index).

RESULTS

While no measurement model was clearly superior, we found modest associations between the psychopathology factors and life outcomes. Importantly, after taking into account a general factor, the associations with life outcomes decreased for the residual parts of thought problems (across all domains) and internalizing problems (for temperamental and psychological outcomes), but not for externalizing problems, compared with the traditional three-correlated-factors model. Patterns were similar for adolescent-reported and parent-reported data.

CONCLUSIONS

Findings suggest that a general factor is related to psychopathology and life outcomes in a meaningful way. Results are discussed in terms of individual differences in propensity to psychopathology and more broadly in light of recent developments concerning the structure of psychopathology. © 2019 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.

Classroom Popularity Hierarchy Predicts Prosocial and Aggressive Popularity Norms Across the School Year

This study examined the coevolution of prosocial and aggressive popularity norms with popularity hierarchy (asymmetries in students' popularity). Cross-lagged-panel analyses were conducted on 2,843 secondary school students (Nclassrooms  = 120; Mage  = 13.18; 51.3% girls). Popularity hierarchy predicted relative change in popularity norms over time, but not vice versa. Specifically, classrooms with few highly popular and many unpopular students increased in aggressive popularity norms at the beginning of the school year and decreased in prosocial popularity norms at the end of the year. Also, strong within-classroom asymmetries in popularity predicted relatively higher aggressive popularity norms. These findings may indicate that hierarchical contexts elicit competition for popularity, with high aggression and low prosocial behavior being seen as valuable tools to achieve popularity.

The role of academic status norms in friendship selection and influence processes related to academic achievement

This study examined the role of academic status norms in friendship selection and influence processes related to academic achievement across the 2nd year of secondary school (SNARE project; N = 1,549 students from 70 classes; M_age = 13.69 years). Academic status norms were operationalized as the class-level correlation between academic achievement and 4 types of peer status: popularity, acceptance, unpopularity, and rejection. Longitudinal social network analyses indicated that the unpopularity and popularity norm play a role in friendship selection processes (but not influence processes) related to academic achievement. In line with our hypotheses, the unpopularity norm in the classroom strengthened similarity-based friendship selection among low-achieving adolescents and predicted greater avoidance of academically similar friends among high-achieving adolescents. Also, the popularity norm strengthened friendship selection among similar peers, both among low and high achievers. Acceptance and rejection norms did not play a role in friendship processes. In sum, the average achievement of popular and unpopular peers shapes friendship preferences in the classroom, which may have important implications for adolescent academic development. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Long-term incidence and recurrence of common mental disorders after abortion. A Dutch prospective cohort study

In a previous study (Van Ditzhuijzen et al., 2017) we investigated the incidence and recurrence of mental disorders 2.5 to 3 years post-abortion. The aim of the current study was to extend these findings with longer term follow up data, up until 5-6 years post-abortion. We compared data of women who had had an abortion of the Dutch Abortion and Mental Health Study (DAMHS) to women who did not have an abortion from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2) (N_total = 2227). We used 1-to-1 matching on background confounding variables and measured post-abortion incidence and recurrence of common DSM-IV mental disorders (mood, anxiety, and substance use disorders) using the Composite International Diagnostic Interview (CIDI) version 3.0. After matching on confounding variables, abortion did not increase the likelihood that women had incident or recurrent mental disorders in the 5-6 years post-abortion (any incident mental disorder: OR = 3.66, p = .16; any recurrent mental disorder: OR = 0.22, p = .47). We found no evidence that experiencing an abortion increases the risk on new or recurrent mental disorders on the longer term.

Identity uncertainty and commitment making across adolescence: Five-year within-person associations using daily identity reports

A central assumption of identity theory is that adolescents reconsider current identity commitments and explore identity alternatives before they make new commitments in various identity domains (Erikson, 1968; Marcia, 1966). Yet, little empirical evidence is available on how commitment and exploration dynamics of identity formation affect each other across adolescence at the within-person level. Therefore, the current study (N = 494, Mage Time 1 = 13.3 years) examined reciprocal within-person longitudinal linkages between adolescents' identity exploration and identity commitment making in the interpersonal and educational identity domains. For this purpose, we constructed a multilevel type cross-lagged panel model from early to late adolescence (i.e., across 5 successive years). Results supported Erikson's (1968) hypothesis that adolescents reconsider current identity commitments and explore alternatives before they make strong commitments within the interpersonal identity domain across early to late adolescence. Within the educational identity domain, increasing identity commitment level and commitment fluctuations predicted less identity reconsideration over time. Our findings support identity theory, but indicate that the processes of identity formation might differ depending on the identity domain. (PsycINFO Database Record

[Abortion and the risk of mental disorders]

Research into the potential mental health consequences of abortion yields inconsistent results and is characterized by methodological limitations.<br /> AIM: To offer a more conclusive insight into women's mental health after an abortion by stringently taking both pre-abortion mental health and confounding covariates into account.<br /> METHOD: A prospective longitudinal cohort study, the Dutch Abortion and Mental Health Study (DAMHS), through which women with and without abortion experiences could be compared. The study was designed in a similar way to the large scale Dutch population study into mental health of the Trimbos Institute, the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2).<br /> RESULTS: Women who had an abortion were significantly more likely to have had previous DSM-IV mental disorders. Psychiatric history appeared to be associated with how women experienced and handled the unwanted pregnancy and abortion. A prior history of mental disorders, averse recent life events or an unstable partner relationship increased the risk of developing post abortion mental disorders, while experiencing an abortion did not.<br /> CONCLUSION: Women who have had an abortion more often have a history of mental disorders, yet there is no evidence that an abortion in itself would increase the risk of developing a mental disorder.

The Happiest Kids on Earth. Gender Equality and Adolescent Life Satisfaction in Europe and North America

Cross-national differences in adolescent life satisfaction in Europe and North America are consistent, but remain poorly understood. While previous studies have predominantly focused on the explanatory role of economic factors, such as national wealth and income equality, they revealed weak associations, at most. This study examines whether societal gender equality can explain the observed cross-national variability in adolescent life satisfaction. Based on the assumption that gender equality fosters a supportive social context, for example within families through a more equal involvement of fathers and mothers in child care tasks, adolescent life satisfaction was expected to be higher in more gender-equal countries. To test this hypothesis, national-level data of gender equality (i.e., women’s share in political participation, decision making power, economic participation and command over resources) were linked to data from 175,470 adolescents aged 11–16 years old (M_age = 13.6, SD = 1.64, 52% girls) from 34 European and North American countries involved in the 2009/10 Health Behaviour in School-aged Children (HBSC) study. Results of linear multilevel regression analyses indicate that adolescents in countries with relatively high levels of gender equality report higher life satisfaction than their peers in countries with lower levels of gender equality. The association between gender equality and adolescent life satisfaction remained significant after controlling for national wealth and income equality. It was equally strong for boys and girls. Moreover, the association between gender equality and life satisfaction was explained by social support in the family, peer and school context. This analysis suggests that gender equality fosters social support among members of a society, which in turn contributes to adolescent life satisfaction. Thus, promoting gender equality is likely to benefit all members of a society; not just by giving equal rights to women and girls, but also by fostering a supportive social climate for all.

The quest for identity in adolescence: Heterogeneity in daily identity formation and psychosocial adjustment across 5 years

Identity formation is one of the key developmental tasks in adolescence. According to Erikson (1968) experiencing identity uncertainty is normative in adolescence. However, empirical studies investigating identity uncertainty on a daily basis are lacking. Hence, studying individual differences in daily certainty (i.e., identity commitment levels) and uncertainty (i.e., identity commitment fluctuations and identity reconsideration) in the identity formation process may advance our knowledge about the extent to which adolescents' identity uncertainty is part of normative identity development. Therefore, this longitudinal study examined heterogeneity in certainty and uncertainty dynamics of adolescents' daily identity formation using a longitudinal microlevel approach. Dutch adolescents (N = 494; Mage = 13.03 years at T1; 56.7% boys) reported on 2 key dimensions of identity formation (i.e., commitment and reconsideration) in both the educational and interpersonal domain on a daily basis for 3 weeks within 1 year, across 5 successive years. Multivariate latent class growth analyses suggested both in the educational and interpersonal identity domain a class of adolescents displaying a "crisis-like" identity formation process, and an "identity synthesis" class. Classes revealed differential development of (global and school) anxiety, aggression, and best friend support. Taken together, the present study confirmed Erikson's notion that experiencing daily identity uncertainty is common during adolescence. However, a substantial amount of adolescents also showed a process toward identity maturation already during adolescence. (PsycINFO Database Record

Correlates of Common Mental Disorders Among Dutch Women Who Have Had an Abortion: A Longitudinal Cohort Study

CONTEXT

Credible research has not found any evidence that abortion causes mental disorders. It is not known, however, whether abortion-specific risk indicators and other variables are associated with the incidence or recurrence of mental disorders after abortion.

METHODS

As part of a prospective cohort study conducted in the Netherlands, 325 women were interviewed between April 2010 and January 2011, between 20 and 40 days after having an abortion; 264 were followed up an average of 2.7 years later. Associations between selected baseline variables and postabortion incident or recurrent mental disorders among the 199 women at risk were investigated using bivariate and multivariate logistic regression analyses.

RESULTS

Thirty-two percent of women at risk of an incident or recurrent mental disorder experienced one after the abortion. In multivariate analyses, no abortion-related variables (e.g., history of multiple abortions, second-trimester abortion, preabortion decision difficulty or uncertainty, and postabortion negative emotions) were associated with experience of any postabortion incident or recurrent mental disorders. The outcome was positively associated with having conceived within an unstable relationship (odds ratio, 3.0), number of negative life events in the past year (1.4) and having a history of mental disorders (2.4).

CONCLUSIONS

Correlates of postabortion mental disorders were variables that have been identified as general risk factors for mental disorders, which supports the idea that abortion does not pose specific risks to future mental health. Future research should investigate in what way unstable relationships, adverse life events and psychiatric history affect postabortion mental health.

Early Adolescent Friendship Selection Based on Externalizing Behavior: the Moderating Role of Pubertal Development. The SNARE Study

This study examined friendship (de-)selection processes in early adolescence. Pubertal development was examined as a potential moderator. It was expected that pubertal development would be associated with an increased tendency for adolescents to select their friends based on their similarities in externalizing behavior engagement (i.e., delinquency, alcohol use, and tobacco use). Data were used from the first three waves of the SNARE (Social Network Analysis of Risk behavior in Early adolescence) study (N = 1144; 50 % boys; M_age = 12.7; SD = 0.47), including students who entered the first year of secondary school. The hypothesis was tested using Stochastic Actor-Based Modeling in SIENA. While taking the network structure into account, and controlling for peer influence effects, the results supported this hypothesis. Early adolescents with higher pubertal development were as likely as their peers to select friends based on similarity in externalizing behavior and especially likely to remain friends with peers who had a similar level of externalizing behavior, and thus break friendship ties with dissimilar friends in this respect. As early adolescents are actively engaged in reorganizing their social context, adolescents with a higher pubertal development are especially likely to lose friendships with peers who do not engage in externalizing behavior, thus losing an important source of adaptive social control (i.e., friends who do not engage in externalizing behavior).

Incidence and recurrence of common mental disorders after abortion: Results from a prospective cohort study

Research in the field of mental health consequences of abortion is characterized by methodological limitations. We used exact matching on carefully selected confounders in a prospective cohort study of 325 women who had an abortion of an unwanted pregnancy and compared them 1-to-1 to controls who did not have this experience. Outcome measures were incidence and recurrence of common DSM-IV mental disorders (mood, anxiety, substance use disorders, and the aggregate measure 'any mental disorder') as measured with the Composite International Diagnostic Interview (CIDI) version 3.0, in the 2.5-3 years after the abortion. Although non-matched data suggested otherwise, women in the abortion group did not show significantly higher odds for incidence of 'any mental disorder', or mood, anxiety and substance use disorders, compared to matched controls who were similar in background variables but did not have an this experience. Having an abortion did not increase the odds for recurrence of the three disorder categories, but for any mental disorder the higher odds in the abortion group remained significant after matching. It is unlikely that termination of an unwanted pregnancy increases the risk on incidence of common mental disorders in women without a psychiatric history. However, it might increase the risk of recurrence among women with a history of mental disorders.

Context Effects of Alcohol Availability at Home: Implicit Alcohol Associations and the Prediction of Adolescents' Drinking Behavior

OBJECTIVE

Recent studies suggest that the predictive effect of implicit alcohol associations is context dependent. Findings indicate that implicit associations are more easily retrieved in an alcohol-associated setting or context (e.g., bar) compared with a neutral setting. In line with this reasoning, we hypothesized that alcohol availability at home might moderate the relationship between implicit alcohol associations and future drinking behavior of adolescents.

METHOD

Participants were 262 at-risk adolescents (235 boys, 27 girls, adolescents with externalizing behavioral problems) with a mean age of 14.11 years (SD = 0.86, age range: 12-16 years) at baseline. Adolescents completed a questionnaire and a modified version of the Implicit Association Test (i.e., Single Category Implicit Association Test; SC-IAT).

RESULTS

Stronger implicit alcohol associations predicted increase in frequency of alcohol use, only in adolescents who indicated that alcohol was available at home. No moderating effects were found for increase in quantity of alcohol use and problematic alcohol use, suggesting that implicit alcohol associations particularly influence the decision of whether to drink in adolescence.

CONCLUSIONS

The findings illustrate that the availability of alcohol in the home setting influences adolescents' implicit alcohol associations and consequently affects the frequency of alcohol use. In this way, alcohol availability at home may be an important contextual factor to consider when examining the effect of implicit alcohol associations on the future drinking behavior of adolescents.

Patterns of Psychological Acculturation in Adult and Adolescent Moroccan Immigrants Living in the Netherlands

Psychological acculturation patterns within a Moroccan adult and adolescent population in the Netherlands were determined through latent class analysis. The Psychological Acculturation Scale (PAS) was adapted, and strong psychometric properties were demonstrated. We found Dutch and Moroccan Psychological Acculturation Subscales (D-PAS; M-PAS). Three classes with similar patterns of acculturation were revealed for both populations. One class showed medium scores on the D-PAS and M-PAS items and one class revealed a pattern with high scores on the M-PAS and medium to high scores on the D-PAS items. The third class was characterized by low scores on the D-PAS and high scores on the M-PAS items. These acculturation classes were shown to be meaningful constructs and yield detailed information about acculturation.

Executive functioning before and after onset of alcohol use disorder in adolescence. A TRAILS study

INTRODUCTION

The aim of the present study was to investigate whether executive functioning (EF) in early adolescence predicted alcohol use disorder (AUD) in late adolescence and whether adolescents with AUD differed in maturation of EF from controls without a diagnosis.

METHODS

We used the data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a cohort of 2230 Dutch adolescents. Working memory, inhibition, and attention were measured at ages 11 and 19. At age 19, lifetime DSM-IV diagnoses were determined, resulting in a control group (n = 1111) and two AUD groups, i.e., alcohol abusers (n = 381) and alcohol dependents (n = 51). Regression analyses assessed whether EF at age 11 predicted the transition to AUD in late adolescence and whether AUD affected maturation of EF from age 11 to 19.

RESULTS

EF in early adolescence did not predict AUD in late adolescence. A significant interaction effect emerged between gender and alcohol dependence for shift attention (β = 0.12, SE=0.36), with girls showing smaller maturational rates. This effect remained significant after controlling for alcohol intake (ages 16 and 19) and comorbid psychiatric disorders.

DISCUSSION

Our results do not replicate the finding that EF in early adolescence is a significant predictor of AUD in late adolescence. Furthermore, for the majority of tasks, adolescents with AUD do not differ in EF maturation over the course of adolescence. Alcohol dependent girls however, show less maturation of shift attention. This is independent of the quantity of alcohol intake, which could suggest that non-normative maturation of EF is associated with the behavioural components of AUD.

Secondary Effects of an Alcohol Prevention Program Targeting Students and/or Parents

The secondary effects of an alcohol prevention program (PAS) on onset of weekly smoking and monthly cannabis use are examined among >3000 Dutch early adolescents (M age=12.64) randomized over four conditions: 1) parent intervention (PI), 2) student intervention (SI), 3) combined intervention (CI) and 4) control condition (CC). Rules about alcohol, alcohol use, and adolescents' self-control were investigated as possible mediators. PI had a marginal aversive effect, slightly increasing the risk of beginning to smoke at T1, and increased the likelihood of beginning to use cannabis use at T1 and T2. SI delayed the onset of monthly cannabis use at T3. CI increased the risk to use cannabis at T3. No mediational processes were found. In conclusion, though this study show mixed results, negative side effects of the PI were found, particularly at earlier ages. Moreover, these results indicate the need for multi-target interventions.

Longitudinal patterns and predictors of multiple health risk behaviors among adolescents: The TRAILS study

BACKGROUND

Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants.

PURPOSE

To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents.

METHODS

Eight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001-2008; n=2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013-2014).

RESULTS

Rates of >5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking.

CONCLUSIONS

Multiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes.

Adolescent Heavy Drinking Does Not Affect Maturation of Basic Executive Functioning: Longitudinal Findings from the TRAILS Study

Background and Aims

Excessive alcohol use is assumed to affect maturation of cognitive functioning in adolescence. However, most existing studies that have tested this hypothesis are seriously flawed due to the use of selective groups and/or cross-sectional designs, which limits the ability to draw firm conclusions. This longitudinal study investigated whether patterns of alcohol use predicted differences in maturation of executive functioning in adolescence. Additionally, gender was tested as a possible moderator.

Methods

We used data from the Tracking Adolescents’ Individual Lives Survey (TRAILS), which comprises a cohort of 2,230 Dutch adolescents. Maturation of executive functioning was measured by assessing the standardized improvement on each of four basic executive functions (i.e., inhibition, working memory, and shift- and sustained attention) between ages 11 and 19. Participants were assigned to one of six (heavy) drinking groups (i.e., non-drinkers, light drinkers, infrequent heavy drinkers, increased heavy drinkers, decreased heavy drinkers, and chronic heavy drinkers). We conducted linear regression analyses, and adjusted for relevant confounders.

Results

The six drinking groups did not reveal significant differences in maturation between drinking groups. E.g., maturation executive functioning of chronic heavy drinkers in comparison to non-drinkers; inhibition: B = -0.14, 95% CI [-0.41 to 0.14], working memory: B = -0.03, 95% CI [-0.26 to 0.21], shift attention: B = 0.13, 95% CI [-0.17 to 0.41], sustained attention: B = 0.12, 95% CI [-0.60 to 0.36]. Furthermore, gender was not found to be a significant moderator.

Conclusions

Four years of weekly heavy drinking (i.e., chronic heavy drinkers) did not result in measurable impairments in four basic executive functions. Thus, regular heavy drinking in adolescence does not seem to affect these basic behavioural measures of executive functioning.

Assessment of identity during adolescence using daily diary methods: Measurement invariance across time and sex

The aim of this study was to assess measurement invariance of adolescents' daily reports on identity across time and sex. Adolescents (N = 497; mean age = 13.32 years at Time 1, 56.7% boys) from the general population reported on their identity commitments, exploration in depth and reconsideration on a daily basis for 3 weeks within 1 year across 5 years. We used the single-item version of the Utrecht Management of Identity Commitments Scale (UMICS; Klimstra et al., 2010), a broad measure of identity-formation processes covering both interpersonal and educational identity domains. This study tested configural, metric, scalar, and strict measurement invariance across days within weeks, across sex, across weeks within years, and across years. Results indicated that daily diary reports show strict measurement invariance across days, across weeks within years, across years, and across boys and girls. These results support the use of daily diary methods to assess identity at various time intervals ranging from days to years and across sex. Results are discussed with regard to future implications to study identity processes, both on smaller and larger time intervals. (PsycINFO Database Record

Personality and the prediction of high-risk trajectories of alcohol use during adolescence

OBJECTIVE

Early onset of alcohol use and persistent use of alcohol during adolescence have been associated with later problem behavior, such as heavy drinking and the use of other substances. Several personality characteristics have been related to the onset and persistent use of alcohol during adolescence. In the present study, we examined the relationship between personality and different high-risk trajectories of alcohol use in adolescents.

METHOD

Participants were 374 8th graders (330 boys; Mage = 13.6 years) from 17 different secondary special education schools (i.e., for adolescents with externalizing behavioral problems) in the Netherlands. Adolescents were followed for 2 years (i.e., four waves), and alcohol use and personality characteristics (Substance Use Risk Profile Scale) were assessed.

RESULTS

Using latent transition analysis, three trajectories of alcohol use were identified-a nondrinking group (reference group), an onset group (after Time 1), and an early-onset (before Time 1) persistent-drinking group. Baseline high sensation seeking predicted group membership in the onset group (odds ratio [OR] = 2.55) and the early-onset persistent-drinking group (OR = 3.57). Baseline low anxiety sensitivity predicted group membership in the early-onset persistent-drinking group (OR = 0.42). Particularly in this latter group, high prevalence rates of illegal substance use (i.e., cannabis, Ecstasy [3,4-methylenedioxymethamphetamine; MDMA], and cocaine) were found 2 years later.

CONCLUSIONS

High sensation seeking and low anxiety sensitivity appear to be important predictors of the early onset of adolescents' alcohol use. Moreover, a combination of early onset and persistent alcohol use demonstrates a heightened risk for the use of other illegal substances in adolescence. Implications for interventions are discussed.

Effects of a combined parent-student alcohol prevention program on intermediate factors and adolescents' drinking behavior: A sequential mediation model

OBJECTIVE

Previous work revealed that the combined parent-student alcohol prevention program (PAS) effectively postponed alcohol initiation through its hypothesized intermediate factors: increase in strict parental rule setting and adolescents' self-control (Koning, van den Eijnden, Verdurmen, Engels, & Vollebergh, 2011). This study examines whether the parental strictness precedes an increase in adolescents' self-control by testing a sequential mediation model.

METHODS

A cluster randomized trial including 3,245 Dutch early adolescents (M age = 12.68, SD = 0.50) and their parents randomized over 4 conditions: (1) parent intervention, (2) student intervention, (3) combined intervention, and (4) control group. Outcome measure was amount of weekly drinking measured at age 12 to 15; baseline assessment (T0) and 3 follow-up assessments (T1-T3).

RESULTS

Main effects of the combined and parent intervention on weekly drinking at T3 were found. The effect of the combined intervention on weekly drinking (T3) was mediated via an increase in strict rule setting (T1) and adolescents' subsequent self-control (T2). In addition, the indirect effect of the combined intervention via rule setting (T1) was significant. No reciprocal sequential mediation (self-control at T1 prior to rules at T2) was found.

CONCLUSIONS

The current study is 1 of the few studies reporting sequential mediation effects of youth intervention outcomes. It underscores the need of involving parents in youth alcohol prevention programs, and the need to target both parents and adolescents, so that change in parents' behavior enables change in their offspring.

Longitudinal relations between cognitive bias and adolescent alcohol use

INTRODUCTION

To prospectively predict the development of adolescent alcohol use with alcohol-related cognitive biases, and to predict the development of alcohol-related cognitive biases with aspects of impulsivity.

METHODS

Data were used from a two-year, four-wave online sample of 378 Dutch young adolescents (mean age 14.9 years, 64.8% female). With zero-inflated Poisson regression analysis we prospectively predicted weekly alcohol use using baseline cognitive biases. Additionally, multiple regression analyses were used to prospectively predict the emergence of alcohol-specific cognitive biases by baseline impulsivity and alcohol use.

RESULTS

Zero-inflated Poisson analyses demonstrated that the Visual Probe Task reliably predicted weekly alcohol use at different time points. Baseline alcohol use and baseline impulsivity measures did generally not predict alcohol-specific cognitive biases.

CONCLUSIONS

The findings of this study indicated that while certain measures of alcohol-related attentional bias predicted later alcohol use in young adolescents, approach biases did not. Baseline measures of impulsivity and alcohol use did not predict later alcohol-related cognitive biases. We discuss implications for cognitive models on the development of cognitive biases and their role in early addictive behaviors.

Substance use outcomes in the Healthy School and Drugs program: results from a latent growth curve approach

AIM

To assess the effectiveness of the Healthy School and Drugs (HSD) program for secondary schools on the development of substance use among Dutch early adolescents and to explore whether boys, adolescents of lower educational backgrounds, or adolescents high on personality risk traits, would benefit more from the HSD program than others.

DESIGN

Randomized clustered trial with two intervention conditions (i.e., lessons and integral) among a general population of adolescents in the Netherlands.

PARTICIPANTS

A total of 3784 students of 23 Dutch secondary schools.

MEASUREMENTS

Structured digital questionnaires were administered pre-intervention and at 8, 20, and 32months follow-ups. The outcome measure was the rate of change in substance use across follow-ups. Differential effectiveness of the HSD program was examined for sex, educational level, and personality traits.

FINDINGS

Our results show no HSD intervention effects on the development of substance use. Sex, education level, and personality characteristics of the participants did not moderate the intervention effects.

CONCLUSION

The absence of effects of the Healthy School and Drugs program on the development of substance use indicates that the program should be renewed and redeveloped.

Do online assessed self-report and behavioral measures of impulsivity-related constructs predict onset of substance use in adolescents?

Introduction

To prospectively predict the onset of use of alcohol, cigarettes and marijuana among Dutch adolescents, using behavioral and self-report measures of impulsivity-related facets. Specifically, we investigated whether behavioral measures of impulsivity predicted the onset of substance use above and beyond self-report measures of impulsivity and sensation seeking in an online sample.

Methods

Self-report and behavioral data from 284 adolescents (195 girls, mean age = 14.8 years, SD = 1.26) were collected at four time points over a period of two years, using an online survey system. Impulsivity-related facets were assessed at time point 1 with the Delay Discounting Task, the Balloon Analogue Risk Task and the Passive Avoidance Learning Task. We conducted logistic regression analysis to examine whether behavioral and self-report measures uniquely predicted onset of alcohol use, heavy episodic drinking, smoking and marijuana use.

Results

Onset of cigarette smoking was associated with behavioral assessment of impulsive decision making, but not after controlling for self-reported impulsivity and sensation seeking. Behavioral measures were sometimes associated with, but appeared not to prospectively predict, the onset of substance use in this online sample after controlling for self-report measures.

Conclusions

Based on the present results, the added value of online behavioral assessment of impulsivity-related factors in the prediction of onset of substance use was not confirmed. We suggest that factors specific to each behavioral task underlie their lack of prediction and suggest that future research addresses limitations of current behavioral tasks to increase their validity in online testing.

•

We predicted substance use onset with self-report and behavioral impulsivity.

•

Self-report impulsivity, not behavioral impulsivity, predicted onset overall.

•

Delay discounting predicted smoking, but not after other predictors were included.

The role of general parenting and cannabis-specific parenting practices in adolescent cannabis and other illicit drug use

AIMS

To investigate general and cannabis-specific parenting practices in relation to adolescent cannabis and other illicit drug use.

METHODS

Data were derived from the Dutch National School Survey on Substance Use among students (N=3209; aged 12-16 years) and one of their parents in 2011.

RESULTS

Logistic regression analyses revealed that 1) parental cannabis use was significantly related to more adolescent lifetime and recent cannabis use, and 2) restrictive cannabis-specific parental rules were associated with less adolescent recent cannabis and lifetime use of other illicit drugs, even when controlled for sociodemographic factors, general parenting, adolescent tobacco use, and tobacco-specific parenting. In addition, no significant interaction was observed between parental cannabis use and cannabis-specific rules in their relation to adolescent cannabis and other illicit drug use, indicating that cannabis rules are evenly associated with adolescent drug use for families with and without parental cannabis experience.

CONCLUSIONS

In addition to general parenting practices, restrictive cannabis-specific rules are related to lower adolescent cannabis and other illicit drug rates. Parents who ever used cannabis have children with a higher prevalence of cannabis use. However, their restrictive cannabis-specific rules are equally related to a lower chance of adolescent cannabis use.

Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders

BACKGROUND

With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders.

METHOD

We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths.

RESULTS

Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5-10% of the sample, experiencing 34-55% of all severe lifetime disorders.

CONCLUSIONS

At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5-10% of the adolescent population.

The relation between bullying and subclinical psychotic experiences and the influence of the bully climate of school classes

This study aims to examine the association between the bully climate of school classes and the prevalence of subclinical psychotic experiences among students who are involved in bullying (either as bully or as victim). Data were derived from the Dutch health behavior in school-aged children survey of 2005, a nationally representative cross-sectional study with a total of 5,509 adolescents between the age of 12 and 16. The data were analyzed using a multilevel regression analysis. The study revealed that both bullying and being bullied in school classes was associated with an increased level of subclinical psychotic experiences. The bully climate of a school class moderates this effect, i.e., the higher risk for bully-victims on subclinical psychotic experiences was less strong in classes with a higher percentage of classmates involved in bullying. Thus, bully climate has to be taken into account when studying the psychological experiences associated with being bullied.

Long-term efficacy of nicotine replacement therapy for smoking cessation in adolescents: a randomized controlled trial

BACKGROUND

A double-blind RCT on the short-term efficacy of nicotine patches compared to placebo patches among Dutch adolescents was conducted. The findings demonstrated that nicotine patches are efficacious for smoking cessation at end-of-treatment; however, only in highly compliant participants. We tested whether the effects of NRT also held in 6- (T7) and 12-month (T8) follow-up assessments.

METHODS

Adolescents aged 12-18 years, who smoked at least seven cigarettes a day and who were motivated to quit smoking were recruited at school yards and randomly assigned to either a nicotine patch (n=182) or a placebo patch (n=180) condition according to a computer generated list. Participants (N=257, age: 16.7 ± 1.13 years) attended an information meeting followed by a 6- or 9-week treatment. Smoking cessation, compliance, and potential covariates were measured by means of online questionnaires. Smoking cessation at T8 was biochemically validated by saliva cotinine.

RESULTS

At T7, 8.1% and 5.7% of participants were abstinent in the nicotine and placebo patch groups, respectively. At T8, abstinence was 4.4% and 6.6%, respectively. Intention-to-treat analyses showed no significant effects of NRT on abstinence rates at T7 (OR=1.54, 95% CI=0.57, 4.16) and validated abstinence rates at T8 (OR=0.64, 95% CI=0.21, 1.93) neither after considering compliance nor after adjusting for covariates.

CONCLUSIONS

NRT fails in helping adolescents quit smoking at 6- and 12-month follow-ups. This finding suggests that a more intensive approach is needed to assist youngsters in their quit attempts.

Do child's psychosocial functioning, and parent and family characteristics predict early alcohol use? The TRAILS Study

BACKGROUND

Given the negative consequences of early alcohol use for health and social functioning, it is essential to detect children at risk of early drinking. The aim of this study is to determine predictors of early alcohol use that can easily be detected in Preventive Child Healthcare (PCH).

METHODS

We obtained data from the first two waves on 1261 Dutch adolescents who participated in TRAILS (TRacking Adolescents' Individual Lives Survey) at ages 10-14 years and from the PCH records regarding ages 4-10 years. Early adolescence alcohol use (age 10-14 years) was defined as alcohol use at least once at ages 10-12 years (wave 1) and at least once in the previous 4 weeks at ages 12-14 years (wave 2). Predictors of early alcohol use concerned parent and teacher reports at wave 1 and PCH registrations, regarding the child's psychosocial functioning, and parental and socio-demographic characteristics.

RESULTS

A total of 17.2% of the adolescents reported early alcohol use. Predictors of early alcohol use were teacher-reported aggressive behaviour [odds ratios (OR); 95% confidence interval (CI): 1.86; 1.11-3.11], being a boy (OR 1.80, 95%-CI 1.31-2.56), being a non-immigrant (OR 2.31, 95%CI 1.05-5.09), and low and middle educational level of the father (OR 1.71, 95%CI 1.12-2.62 and OR 1.77, 95%CI 1.16-2.70, respectively), mutually adjusted.

CONCLUSION

A limited set of factors was predictive for early alcohol use. Use of this set may improve the detection of early adolescence alcohol use in PCH.

Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use: a randomized clustered trial

AIM

To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents.

DESIGN

Randomized clustered trial with two intervention conditions (i.e. e-learning and integral).

SETTING

General population of 11-15-year-old adolescents in the Netherlands.

PARTICIPANTS

A total of 3784 students of 23 Dutch secondary schools.

MEASUREMENTS

Structured digital questionnaires were administered pre-intervention and at 32 months follow-up. The primary outcome measures were new incidences of alcohol (life-time and 1-month prevalence), tobacco (life-time and 1-month prevalence) and marijuana use (life-time prevalence).

FINDINGS

Main effect analyses showed no programme effects on incidences of alcohol consumption (life-time prevalence: e-learning condition: B = 0.102, P = 0.549; integral condition: B = -0.157, P = 0.351; 1-month prevalence: e-learning condition: B = 0.191, P = 0.288; integral condition: B = -0.140, P = 0.445), tobacco consumption (life-time prevalence: e-learning condition: B = 0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1-month prevalence: e-learning condition: B = 0.088, P = 0.746; integral condition: B = 0.261, P = 0.093), or marijuana consumption (life-time prevalence: e-learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P = 0.214).

CONCLUSION

The non-significant impact of the Healthy School and Drugs programme (a Dutch school-based prevention programme for early adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately.

Adolescents' use of care for behavioral and emotional problems: types, trends, and determinants

OBJECTIVE

While adolescents use various types of care for behavioral and emotional problems, evidence on age trends and determinants per type is scarce. We aimed to assess use of care by adolescents because of behavioral and emotional problems, overall and by type, and its determinants, for ages 10-19 years.

METHODS

We obtained longitudinal data on 2,230 adolescents during ages 10-19 from four measurements regarding use of general care and specialized care (youth social care and mental healthcare) in the preceding 6 months, the Child Behavior Checklist (CBCL) and Youth Self-Report, and child and family characteristics. We analyzed data by multilevel logistic regression.

RESULTS

Overall rates of use increased from 20.1% at age 10/11 to 32.2% at age 19: general care was used most. At age 10/11 use was higher among boys, at age 19 among girls. Use of general care increased for both genders, whereas use of specialized care increased among girls but decreased among boys. This differential change was associated with CBCL externalizing and internalizing problems, school problems, family socioeconomic status, and parental divorce. Preceding CBCL problems predicted more use: most for mental health care and least for general care. Moreover, general care was used more frequently by low and medium socioeconomic status families, with odds ratios (95%-confidence intervals): 1.52 (1.23;1.88) and 1.40 (1.17;1.67); youth social care in case of parental divorce, 2.07 (1.36;3.17); and of special education, 2.66 (1.78;3.95); and mental healthcare in case of special education, 2.66 (1.60;4.51).

DISCUSSION

Adolescents with behavioral and emotional problems use general care most frequently. Overall use increases with age. Determinants of use vary per type.