From Impulse to Action? Cognitive Mechanisms of Impulsivity-Related Risk for Externalizing Behavior.

Trait impulsivity is an established risk factor for externalizing behavior problems in adolescence, but little is understood about the cognitive mechanisms involved. Negative automatic thoughts are associated with externalizing behaviors and impulsivity is associated with less cognitive reappraisal. This study sought to adapt the bioSocial Cognitive Theory (bSCT) of impulsivity and substance use (an externalizing behavior) for externalizing behavior in general. It was predicted that only the component of impulsivity characterized by lack of forethought (rash impulsiveness; RI) would be associated with (non-substance use-related) externalizing behaviors, not reward sensitivity/drive. Further, this association would be mediated by negative automatic thoughts. Participants were 404 (226 female, 63%) adolescents from 6 high schools across South-East Queensland (age = 13-17 years, mean age = 14.97 years, SD = 0.65 years) of mostly Australian/New Zealand (76%) or European (11%) descent. Participants completed self-report measures of impulsivity, negative automatic thoughts, and externalizing behaviors. Path analysis revealed that, as predicted, only RI was uniquely associated with negative automatic thoughts and externalizing behaviors. However, only negative automatic thoughts centered around hostility mediated the positive association between RI and externalizing behaviors, with the indirect mediation effect being smaller than the direct association. In contrast to substance use, only one component of impulsivity, RI, was associated with general adolescent externalizing behavior. Hostile automatic thoughts may be an important mechanism of risk, supporting a role for cognitive-behavioral interventions. Other biopsychosocial mechanisms are clearly involved and the bSCT may provide a useful framework to guide future research.

Additive effectiveness of mindfulness meditation to a school-based brief cognitive-behavioral alcohol intervention for adolescents.

OBJECTIVE: This randomized controlled trial is the 1st study to evaluate the additive efficacy of mindfulness meditation to brief school-based universal cognitive behavior therapy (CBT + MM) for adolescent alcohol consumption. Previous studies have lacked strong controls for nonspecific effects, and treatment mechanisms remain unclear. The present study compared a CBT + MM condition to an active control CBT intervention with progressive muscle relaxation (CBT + PMR) for nonspecific effects and an assessment-only control (AoC). METHOD: Cluster sampling was used to recruit Australian adolescents (N = 404; 62% female) ages 13-17 years (M = 14.99, SD = .66) of mostly Australian-New Zealand or European descent. School classes were randomized to 3 intervention conditions (CBT + PMR = 8 classes, CBT + MM = 7 classes, AoC = 7 classes), and adolescents completed preintervention, postintervention, and 3- and 6-month follow-up assessments, including measures of alcohol consumption, mindfulness, impulsivity, and the alcohol-related cognitions of alcohol expectancies and drinking refusal self-efficacy. RESULTS: Multilevel modeling analyses revealed that both intervention conditions reduced the growth of alcohol consumption compared to the AoC (b = -.18, p = .014), although CBT + MM was no more effective than was CBT + PMR (b = -.06, p = .484). Negative alcohol expectancies increased for adolescents in the intervention conditions compared to the AoC (b = 1.09, p = .012), as did positive alcohol expectancies (b = 1.30, p = .008). There was no effect of interventions on mindfulness, drinking refusal self-efficacy, or impulsivity. CONCLUSIONS: There was no evidence of mindfulness-specific effects beyond existing effects of CBT within a brief universal school-based CBT intervention. Hypothesized mechanisms of change were largely unsupported. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Parent-Related Stress of Male and Female Carers of Adolescents with Intellectual Disabilities and Carers of Children within the General Population: A Cross-Sectional Comparison.

BACKGROUND: Carers of children with intellectual disability show high rates of parent-related stress and are at an increased risk for deleterious physical and mental health. MATERIALS AND METHODS: This study investigated the relationship between demographic and social characteristics and parenting stress, within two different cross-sectional samples of carers: those who care for an adolescent with an intellectual disability and carers from a population based sample. Participants were 1152 carers from the Household Income and Labour Dynamic in Australia study and 284 carers of adolescents with intellectual disabilities from the Ask study. RESULTS AND CONCLUSIONS: The results supported previous research suggesting carers of children with intellectual disabilities experience high parent-related stress. The results also support the buffer model of social support, as high social support was related to lower parent-related stress. Self-rated prosperity, financial pressure and relationship status were also related to lower levels of parent-related stress.

Validation of the Adolescent Drinking Expectancy Questionnaire and development of a short form.

AIMS: This study aimed to validate the Drinking Expectancy Questionnaire-Adolescent version (DEQ-A) in a large adolescent sample and to develop and validate a brief measure, the Drinking Expectancy Questionnaire-Shortened Adolescent version (DEQ-SA). DESIGN AND METHODS: Cross-sectional survey of secondary school students (n = 2357, aged 13-16, M = 14.66 years, SD = 0.60). Students completed the DEQ-A in school, and measures of alcohol consumption including the Alcohol Use Disorders Identification Test-Consumption. The data were randomly split, and Exploratory Factor Analysis was performed using subsample 1, and Confirmatory Factor Analysis and reliability and validity testing were performed using subsample 2. RESULTS: The 24-item DEQ-A was successfully reduced to 12 items (DEQ-SA) without compromising psychometric properties. The DEQ-A and the DEQ-SA both demonstrated adequate-to-good fit to the data and very good internal reliability. The DEQ-A and DEQ-SA explained 20 and 18% of the variance in alcohol consumption. Adolescents who drank endorsed more positive alcohol expectancies, whereas alcohol-naïve adolescents scored higher on negative alcohol expectancies. As the DEQ-SA comprises two subscales of the DEQ-A, the endorsement rates are applicable to both scales. DISCUSSION AND CONCLUSIONS: The DEQ-A and the short form of this scale developed in this study (DEQ-SA) show good reliability, internal structure and account for a large proportion of variance in alcohol consumption. Both scales can assist in targeting cognitive change processes within tailored alcohol prevention and treatment approaches, and investigating hypothesised mechanisms of change. The DEQ-SA is recommended for more time-limited environments. [Patton KA, Connor JP, Rundle-Thiele S, Dietrich T, Young RM, Gullo MJ. Validation of the Adolescent Drinking Expectancy Questionnaire and development of a short form.