Adolescent Substance Use and Individual Beliefs That Drug Use Is Wrong: A Statewide Epidemiological Study.

OBJECTIVE: Informed by cognitive dissonance theory, the current study investigated the ability of youths' belief that drug use is wrong to predict likelihood of past year substance use abstinence as well as frequency of use at grades 8, 10, and 12. METHOD: Study analyses were executed from a statewide epidemiological survey of more than 125,000 youth using multi-group Zero-Inflated Poisson regression modeling. RESULTS: Personal belief that drug use is wrong demonstrated the largest magnitude of effect at each grade among the individual, family, and school-based factors under examination; this finding emerged with respect to predicting past year substance use abstinence as well as rates of substance use among individuals reporting past year use. Although differences across grades were evident for the magnitude of effect within various risk and protective factors, the rank ordering in magnitude of effect between factors was consistent across grades 8, 10, and 12. CONCLUSION: Current results underscore the salience of youths' belief that drug use is wrong in explaining likelihood of past year substance use at multiple time points during adolescence.Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2034877 .

Rationale and design of an ancillary study evaluating the effects of the cocoa flavanol and/or multivitamin interventions on falls and physical performance outcomes in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS).

BACKGROUND: Falls and decreased physical function increase markedly with age and result in injury, hospitalization, and premature death. Emerging studies show potential benefits of supplemental cocoa extract on physical performance, including grip strength and walking speed in older adults. However, there are no large, long-term randomized controlled trials of effects of supplemental cocoa extract on falls, muscle performance, and/or fall-related injuries. METHODS: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a double-blind, placebo-controlled, 2 × 2 factorial trial investigating effects of supplementation with cocoa extract (500 mg/d, including 80 mg (-)-epicatechin) and/or a multivitamin on prevention of cardiovascular disease and cancer in 21,442 women (≥65 years) and men (≥60 years). COSMOS: Effects on Falls and Physical Performance is an ancillary study to COSMOS that will clarify effects of cocoa extract and/or multivitamin supplementation on falls, physical performance, and incident fracture outcomes in older adults. Injurious fall(s) resulting in healthcare utilization and recurrent falls were regularly assessed by follow-up questionnaires in the overall cohort. Incident fractures were also assessed by annual questionnaires. Circumstances surrounding falls and any fall-related injuries will be confirmed by medical record review. Effects of the interventions on 2-year changes in physical performance measures (grip strength, walking speed, and the Short Physical Performance Battery) will be tested in a clinic sub-cohort (n = 603). CONCLUSION: Results from this ancillary study will determine whether supplemental cocoa extract slows age-related declines in physical performance and decrease injurious and recurrent falls and fall-related injuries and fractures that are major public health problems in older adults.

Suicidal Ideation Among Transgender and Gender Expansive Youth: Mechanisms of Risk.

Purpose: Suicide is a leading public health concern among transgender and gender expansive adolescents, although little research has examined mechanisms through which gender identity is associated with suicidal ideation. This study examined the indirect effects of peer victimization, dating violence, substance use (SU), SU problems, and depressive symptoms in the relationship between gender identity and suicidal ideation. Methods: Secondary data analysis was conducted from a 2018 statewide survey, including 4464 adolescents who identified as male, female, transgender, or gender expansive (n=1116 per gender). The sample was frequency matched on grade, race, geographic region, and free/reduced lunch status. Mediation analyses were performed. Results: Reports of suicidal ideation were highest among transgender (49.29%) and gender expansive (41.31%) adolescents compared with male (10.82%) and female adolescents (19.08%). Using the Karlson, Holm, and Breen approach, 50.45% of the effect of being transgender on suicidal ideation was mediated through peer victimization, dating violence, and depressive symptoms, and 39.29% through SU, SU problems, and depressive symptoms. The mediation through the same pathways for being gender expansive was 46.37% and 39.89%, respectively. Across both models, depressive symptoms predominately accounted for the mediating effect. Conclusion: Transgender and gender expansive youth are at alarming risk for suicidal ideation, which illustrates the critical need for suicide prevention within this population. Programs that promote mental health and work to prevent bullying, dating violence, SU, and SU problems are crucial; although longitudinal research is needed, targeting these mechanisms may play a critical role in reducing suicidal ideation and risk.

Opioid use at the transition to emerging adulthood: A latent class analysis of non-medical use of prescription opioids and heroin use.

BACKGROUND: Although rates of nonmedical opioid use are highest in late adolescence and emerging adulthood, efforts to understand the extent of the heterogeneity in opioid misuse during this time have been limited. The current study aimed to derive and define typologies of opioid use in high school students at the onset of emerging adulthood. METHODS: Survey responses from a statewide sample of high school students aged 18 and 19 (N = 26,223) were analyzed. Group-based comparisons between participants reporting opioid use and those not reporting opioid use were conducted. Among those reporting opioid use (n = 1,636), we conducted a latent class analysis (LCA) to identify heterogeneous subgroups of opioid users on the basis of non-medical use of prescription opioids (NMUPO) and heroin use. The resulting classes were then compared across various risk and protective factors using multinominal logistic regression. RESULTS: Consistent differences were observed between participants using opioids and participants not using opioids, with moderate to large effect sizes. Results from LCA revealed three subclasses: NMUPO-Any Use, NMUPO To Get High, and Heroin Use. Subclass differences were observed for non-opioid substance use, mental health, and demographics. CONCLUSIONS: Findings from this study underscore the variability of youth who engage in opioid use in late adolescence. Results also indicate that opioid use during adolescence is likely indicative of a broader set of substance use and mental health issues.