Prospective relationships between sleep problems and substance use, internalizing and externalizing problems.

While research has shown that sleep problems and substance use are reciprocally associated in adults, much less is known about this association in early adolescence. The main aim of the current longitudinal study was to explore bidirectional relationships between sleep problems, substance use, internalizing and externalizing problems in young adolescents. A prospective design was used incorporating two waves (approximately 1 year interval). A total of 555 young adolescents (290 females, M age = 13.96) participated in this study. All participants completed self-report measures in classrooms during regular school hours (questionnaires about sleep quality and sleep hygiene were used to measure sleep problems). The results indicated that sleep problems predicted changes in substance use, internalizing and externalizing problems over time, but problem behaviours did not predict changes in sleep problems, adjusted for gender, age and puberty. One exception was that alcohol use negatively predicted changes in sleep problems. This study suggests that sleep problems are important precursors of substance use, internalizing and externalizing problems in adolescence.

Mediation and moderation effects of an in-home family intervention: the "in control: no alcohol!" pilot study.

The aim of this study was to examine the effect of a theory-based in-home family intervention (In control: No alcohol!) on adolescent alcohol cognitions via its putative mediators using a randomized controlled design. In the South Holland region of the Netherlands, a total of 213 children (11-12 years) and their mothers were randomly assigned to the prevention program (108 dyads) and the control condition (105 dyads). Mediation effects were analyzed using pretest and two follow-up measurements (5 and 12 months after baseline). A path model was estimated (using Mplus) to examine the effect of the intervention on the putative mediators (frequency- and quality of mother-child communication, rules about alcohol, establishing a nondrinking agreement, and parental monitoring of the child's whereabouts). Outcomes were adolescents' perceived harmfulness of drinking and intention to drink. Multigroup analyses were performed to examine potential differences across gender. The program led to an increase in frequency of alcohol-specific communication, nondrinking agreements, and parental monitoring. Moreover, adolescents in the experimental condition perceived drinking to be more harmful and had less intention to drink compared to adolescents in the control condition. The effect of the program on adolescent alcohol cognitions was significantly mediated through having more frequent conversations about alcohol, yet only among boys. Although results on actual drinking need to be added, findings indicate that this relatively inexpensive, easy-to-administer home intervention is promising.

Parental alcohol-specific rules and alcohol use from early adolescence to young adulthood.

BACKGROUND: Several studies stress the importance of alcohol-specific rules during adolescence to prevent them from drinking early and heavily. However, most studies have short follow-up periods and do not cover the relevant developmental period in which direct parental control diminishes and adolescent alcohol use increases. The current study aimed to provide a developmental perspective on the link between alcohol-specific rules and alcohol use from early adolescence until early adulthood in the Netherlands. METHODS: The sample consisted of 428 Dutch families including fathers, mothers and adolescents from 2 age groups (13 and 15 years old) at Time 1 (T1), who have been surveyed annually for 6 years. To address the effect of alcohol-specific rules on adolescent alcohol use over time, a latent growth curve analytic approach with time-varying covariates was employed. RESULTS: Over time, adolescent alcohol use increased, whereas alcohol-specific rules decreased. Most importantly, however, the lagged paths of alcohol-specific rules consistently predicted subsequent alcohol use across the 6 assessments for both younger and older siblings. Thus, strict alcohol-specific rules at a certain point in time were related to a lower intensity of adolescent alcohol use a year later. CONCLUSIONS: Although parents turn somewhat less strict in alcohol-specific rules over time, and adolescent alcohol use increases over time, the specific rules parents set remain important in restraining the alcohol use of their adolescent offspring. Thus, parents should and can feel confident about their parenting capabilities, and they should maintain being strict to prevent their offspring from drinking.

The moderating role of working memory capacity and alcohol-specific rule-setting on the relation between approach tendencies and alcohol use in young adolescents.

BACKGROUND: Dual process models of alcohol addiction propose that the transition from normative alcohol consumption to heavy drinking is the result of an imbalance in interplay between relatively impulsive or automatic and reflective or controlled processes. The current study examines whether impulsive and reflective processes are also detectable in a sample of adolescents with limited alcohol use. METHODS: Specifically, we tested the interaction between alcohol approach tendencies and 2 types of reflective processes, working memory capacity (WMC) and alcohol-specific rule-setting, on changes in alcohol use of 238 young adolescents (mean age: 13.82 years). Gender differences in these associations were also explored. RESULTS: Results showed that WMC did not moderate the relation between approach tendencies and subsequent alcohol use, whereas rule-setting did, with stronger associations between approach tendencies and alcohol use for male adolescents reporting more permissive parents than male adolescents with parents enforcing stricter rules involving alcohol use. Associations between approach tendencies and subsequent alcohol use did not emerge for female adolescents. CONCLUSIONS: Results indicate that even in a sample of adolescents with limited drinking experience, automatic processes are positively associated with alcohol use for male adolescents that are not motivated by parents to control their drinking.

The moderating effect of alcohol-specific parental rule-setting on the relation between the dopamine D2 receptor gene (DRD2), the µ-opioid receptor gene (OPRM1) and alcohol use in young adolescents.

AIMS: The main aim of the study was to test the moderating effect of two genetic polymorphisms, one in the dopamine D2 receptor gene (DRD2) and one in the mu-opioid receptor gene (OPRM1), on the link between parental rule-setting and adolescent alcohol use. METHODS: A total of 214 adolescents (M(age )=13.7, 44.9% male) provided saliva samples and completed survey items describing alcohol use and parental rule-setting. RESULTS: Findings indicated that alcohol-specific parental rule-setting was more robustly associated with alcohol use for adolescents with the DRD2 A1 risk allele and for those with the OPRM1 G-allele. CONCLUSION: This study replicates the interaction between parental rule-setting and the DRD2 risk allele on adolescent alcohol use and extends the literature by demonstrating the moderating effects of the OPRM1 risk allele on the link between parental rule-setting and adolescent alcohol use.

Results of the 'in control: no alcohol!' pilot study.

More than 50% of Dutch 12-year olds already started drinking. Since it is known that delaying the onset of alcohol use results in a lower risk of alcohol-related problems, the recently developed 'In control: No alcohol!' prevention program is targeted at elementary school children and their mothers. In this pilot study, the success of program implementation and impact of the program on quality of alcohol-specific communication, rules and monitoring were evaluated, using a randomized controlled design. A total of 108 children (11-12 years) and their mothers participated in the prevention program, while the control group consisted of 105 dyads. Families participating in the experimental condition showed an increase in frequency of alcohol-specific communication and 75% of the dyads reported that they took part in at least 3 of 5 magazines, suggesting implementation was successful. The program led to an increase in quality of communication but only for those dyads in which mothers' alcohol use was above average. The program led parents to set up a non-drinking contract with their children and to monitor their children more closely. Results are promising but need to be replicated in a larger longitudinal study.

Effectiveness of the home-based alcohol prevention program "In control: no alcohol!": study protocol of a randomized controlled trial.

BACKGROUND: In the Netherlands, children start to drink at an early age; of the Dutch 12-year olds, 40% reports lifetime alcohol use, while 9.7% reports last-month drinking. Starting to drink at an early age puts youth at risk of developing several alcohol-related problems later in life. Recently, a home-based prevention program called "In control: No alcohol!" was developed to delay the age of alcohol onset in children. The main aim of this project is to conduct a Randomized Controlled Trial (RCT) to evaluate the effectiveness of the program. METHODS/DESIGN: The prevention program will be tested with an RCT among mothers and their 6 grade primary school children (11-12 years old), randomly assigned to the prevention or control condition. The program consists of five printed magazines and an activity book designed to improve parental alcohol-specific socialization. Parent-child dyads in the control group receive a factsheet information brochure, which is the standard alcohol brochure of the Trimbos Institute (the Netherlands Institute for Mental Health and Addiction).Outcome measures are initiation of alcohol use (have been drinking at least one glass of alcohol), alcohol-specific parenting, susceptibility to drinking alcohol, alcohol expectancies, self-efficacy, and frequency and intensity of child alcohol use. Questionnaires will be administered online on secured Internet webpages, with personal login codes for both mothers and children. Mothers and children in both the experimental and control condition will be surveyed at baseline and after 6, 12, and 18 months (follow-ups). DISCUSSION: The present study protocol presents the design of an RCT evaluating the effectiveness of the home-based "In control: No alcohol!" program for 6 grade primary school children (11-12 years old). It is hypothesized that children in the prevention condition will be less likely to have their first glass of alcohol, compared to the control condition. When the prevention appears to be effective, it can easily and relatively quickly be implemented as a standard alcohol prevention program on a large scale. TRIAL REGISTRATION: Nederlands Trial Register NTR2564.

Bidirectional associations between sibling relationships and parental support during adolescence.

Sibling relationships and parental support are important for adolescents' development and well-being, yet both are likely to change during adolescence. Since adolescents participate in both the sibling relationship and the parent-child relationship, we can expect sibling relationships and parental support to be associated with each other. Theoretically, it can be expected that there is either a spillover from one relationship to another (congruence hypothesis) or that one relationship can compensate for the other (compensation hypothesis). However, research examining these associations in adolescence is limited. The present study longitudinally investigated the bidirectional associations between sibling relationships and parental support during adolescence. For five consecutive years, data were collected using self-reports of 428 families, consisting of a father, a mother, and two adolescent siblings. The mean ages of the first-born (52.8% males) and second-born (47.7% males) were 15 and 13 years at T1, respectively. For the second-born siblings, prospective associations were found between sibling relationships and adolescent-reported parental support in early adolescence, with no differences between same-sex and mixed-sex dyads. These associations were not found for first-born siblings or for parents' reports of support. The findings suggest a spillover from the sibling relationship to adolescent-reported parental support only in early adolescence. Findings and implications are discussed in terms of the congruence/spillover and the compensation hypothesis.

Puberty-dependent sleep regulation and alcohol use in early adolescents.

BACKGROUND: Research has shown a bi-directional relation between alcohol use and sleep regulation in adults. Much less is known about this association in early adolescents, while profound puberty-dependent transitions regarding sleep patterns take place in early adolescence. Moreover, puberty has been associated with an increase in alcohol use of adolescents. METHODS: In this study, we investigated the associations between pubertal development, sleep preference, sleep problems, and alcohol use in 431 early adolescents (mean age: 13.66). Second, it was studied whether the associations changed when controlling for adolescent internalizing and externalizing problems. Furthermore, we included gender as a moderator on all the associations. RESULTS: Results showed that pubertal development was positively associated with sleep problems and more evening-type tendencies (e.g., favoring later bedtimes), which in turn were positively related to alcohol use. Underlying psychopathology, gender and educational level did not change these relationships. CONCLUSIONS: From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.

Identification and prediction of drinking trajectories in early and mid-adolescence.

The aim of this study was to identify subgroups of early and mid-adolescents with different drinking trajectories. In addition, we examined whether gender, parental, and peer factors predicted adolescents' membership of these drinking trajectories. We used longitudinal data of 428 families (fathers, mothers, mid-adolescents, and their younger siblings). Latent Class Growth Analyses were performed to identify drinking trajectories. Four drinking trajectories emerged for early adolescents: abstainers, light drinkers, increasers, and heavy drinkers. For mid-adolescents, we identified a fifth group (stable drinkers) in addition to the four trajectories identified for early adolescents. Our results showed that being a boy, having a best friend or father who drinks heavily, and having parents who are permissive toward adolescents' alcohol creates increased risk for both siblings to attend the more heavy drinking trajectories.

Partner effects and bidirectional parent-child effects in family alcohol use.

INTRODUCTION: The current study investigated partner effects and bidirectional parent-child effects in family alcohol use. METHODS: A full family, longitudinal design was used to test the hypotheses. Participants were 428 families, including mothers, fathers, and 2 children. Associations were measured over two waves with a 2-year interval, by means of structural equation modeling. RESULTS: Whereas alcohol use of the younger children was affected by alcohol use of both parents, alcohol use of the older children was only affected by alcohol use of mother. Moreover, although the effects were small, alcohol use of older children affected later alcohol use of both parents. CONCLUSIONS: Associations between alcohol use of parents and children seem to be bidirectional. Future studies are needed to find out whether these findings are incidental or structural. If the effects are structural, potential underlying reciprocal processes within the family play a role in the development of adolescent alcohol use.

Alcohol-specific rules, personality and adolescents' alcohol use: a longitudinal person-environment study.

AIMS: To examine the bi-directional associations between providing alcohol-specific rules and adolescents' alcohol use. Further, to explore person-environment interactions, we tested whether Big Five personality traits moderate the assumed association between providing alcohol-specific rules and adolescents' alcohol use. DESIGN: Longitudinal data (three waves in 2 years) from 428 families, consisting of both parents and two adolescents (aged 13-16 years) were used for the analyses. Analyses were conducted on four samples: a group of older adolescents and a group of younger adolescents who already consumed alcohol, and a group of older and younger adolescents who were not drinking at baseline measurement. FINDINGS: In general, results of structural equation modelling showed that providing clear alcohol-specific rules lowers the likelihood of drinking initiation, regardless of the age of the youngsters. Once adolescents have established a drinking pattern, the impact of parental alcohol-specific rules declined or even disappeared. Finally, the Big Five personality traits did not moderate the association between providing alcohol-specific rules and adolescents' alcohol involvement. CONCLUSIONS: In sum, in particular during the initiation phase of drinking, parents could prevent the drinking of their offspring, regardless of the age or personality of their youngsters, by providing clear alcohol-specific rules.

Best friends and alcohol consumption in adolescence: a within-family analysis.

Although friends and siblings are considered to be important role models in adolescents' peer contexts, these peer influences on adolescent alcohol consumption over time are seldom examined simultaneously in a within-family design. The present study examined the relative impact of alcohol use of the best friend, adolescent sibling and sibling's best friend on the development of alcohol consumption during adolescence. Data reported in this study are part of an ongoing longitudinal questionnaire study among families with two adolescent siblings (N=416). Results from structural equation modeling showed a strong similarity in drinking between best friends and adolescents cross-sectionally. Over time, however, only marginal effects of friends alcohol use on drinking of the youngest sibling, and no effects for the oldest sibling were found. Robust evidence was found for peer-selection processes. In addition, we found a moderate to high relative similarity in drinking within sibling pairs, but no longitudinal effect of sibling's drinking. We also found no support for a possible additional influence of sibling's best friend's drinking on adolescent drinking. Therefore, we tested several potential moderating variables on peer influences, but found no effects of a set of relationship characteristics or individual characteristics on the links between peer and adolescent drinking over time.

Correspondence in collateral and self-reports on alcohol consumption: a within family analysis.

The present study tests the degree to which parents and children correspond in their reports on each others quantity and frequency of alcohol consumption. Furthermore, the degree of inaccurate estimation by parents might be related to inappropriate parenting. Particularly, parents who have little control over and knowledge of their offspring's activities and whereabouts might underestimate adolescent alcohol consumption. A full family design was employed in which both parents and two adolescents were included. A total of 428 Dutch families participated and filled in questionnaires at home in the presence of a trained interviewer on frequency and quantity of drinking. Findings showed that parents as well as children underestimate alcohol consumption of each other, in particular concerning the quantity of drinking. It appears that parents are better able to accurately estimate when their child is not drinking than when their child is drinking. Children on the other hand are better able to predict frequency and quantity of parental drinking, but not parental heavy drinking. Finally, parental underestimations of adolescent drinking are indeed related to lack of parental knowledge and control. However, this was primarily found among mothers. In conclusion, survey studies using collateral reports on parental and adolescent drinking should acknowledge the fact that in most cases family members underestimate alcohol consumption.

Similarities and bi-directional influences regarding alcohol consumption in adolescent sibling pairs.

Ample studies have established that parents as well as peers function as role models in the development of adolescents' alcohol use. The role of siblings, however, has been largely neglected despite the long-term nature of a sibling relationship. The present study examined the impact of siblings on drinking behavior of adolescents using longitudinal data from 416 sibling dyads. Moreover, we explored which factors (gender constellation of the sibling dyad, quality of the sibling relationship, and similarity in norms about alcohol) affect reciprocal influences in alcohol use of siblings. Descriptive analyses showed that although older siblings drink more frequently and intensively than the younger siblings, moderate associations were found between frequency and intensity of drinking in siblings. Findings of structural equation modeling demonstrated that alcohol use of the older sibling marginally affected drinking of the younger sibling one year later. Drinking of the younger sibling did not affect drinking of the older sibling. Further, we found no moderating effects of having the same or opposite gender as a sibling, a low or high quality relationship, and the same or different norms about alcohol, on the association between siblings' alcohol use and adolescents' drinking over time.

Parental attachment, parental control, and early development of alcohol use: a longitudinal study.

The authors explored the predictive influence of both parental attachment and parental control on early onset of alcohol consumption in adolescence by use of a longitudinal sample of 1,012 young adolescents. Whether the relationship between parental control and adolescents' drinking is moderated by parental attachment was also examined. Consistent with other studies, attachment and strict control were cross-sectionally related to adolescents' alcohol use at all 3 measurements. However, the longitudinal results of structural equation modeling analyses suggest that a good attachment relationship between parent and child does not prevent adolescents from drinking. In addition, strict control was related to lower engagement in alcohol use. Furthermore, with regard to the moderating effect, parental attachment did not moderate longitudinally the association between parental control and an early development of alcohol use. Implications for further research are discussed.

Pathways to alcohol use among Dutch students in regular education and education for adolescents with behavioral problems: the role of parental alcohol use, general parenting practices, and alcohol-specific parenting practices.

The present study explored the role of parents' alcohol use, general parenting practices (support and behavioral control), and alcohol-specific parenting practices (alcohol-specific rule enforcement and alcohol availability at home) on adolescent alcohol use. Structural equation analyses were performed on cross-sectional data from adolescents who received special education because of behavioral problems (n=411) and from adolescents who received regular education (n=428). The main findings show that alcohol-specific parenting practices appear to be highly important in regulating adolescent alcohol use. Parental alcohol use was related to alcohol-specific rule enforcement and alcohol availability at home. Behavioral control was also related to alcohol-specific rule enforcement. Furthermore, the relationships between parental alcohol use, parenting practices, and adolescent alcohol use did not appear to differ substantially for students in special and regular education.

The role of alcohol-specific socialization in adolescents' drinking behaviour.

AIMS: To determine which alcohol-specific socialization practices are related to adolescents' alcohol use, and to investigate whether parents differ in their alcohol-specific socialization towards their children. DESIGN: In a sample of 428 families, both parents and two adolescents (aged 13-16 years) completed a questionnaire at home about alcohol-specific parenting and their own alcohol use. Based on the reports of each family member, three different models of alcohol-specific socialization were formulated: from the perspective of the siblings, the mother and the father. FINDINGS: Results of structural equation modelling generally showed the same associations between alcohol-specific socialization and drinking of younger and older adolescents. The strongest association was found for providing alcohol-specific rules. Applying strict rules about alcohol use was negatively related to adolescents' alcohol use; this was also the case for having confidence in the effectiveness of alcohol-specific socialization. Unexpectedly, frequency of communication about alcohol issues was positively associated with alcohol consumption of adolescents. CONCLUSIONS: This study is one of the first to examine associations between alcohol-specific socialization and adolescents' drinking using a between- and a within-family design. Results showed strong associations between alcohol-specific socialization (particularly of enforcing rules) and adolescent alcohol use. Although parents strongly differentiated their socialization practices between children, no differences in associations between alcohol-specific socialization and drinking were found between older and younger adolescents.

Impulsive and reflective processes related to alcohol use in young adolescents.

BACKGROUND: Dual process models suggest that the development of addictive behaviors is the result of interplay between impulsive and reflective processes, modulated by boundary conditions such as individual or situational factors. Empirical support for this model has been repeatedly demonstrated in adult samples [for a meta-analysis, see Ref. (1)]. The purpose of this study was to test these processes as they relate to emerging alcohol use in adolescents. Specifically, the interactive effects of several measures of impulsive and reflective processes and working memory capacity (WMC) are examined as predictors of changes in alcohol use among adolescents. It was expected that measures of reflective processes would better predict changes in alcohol use than measures of impulsive processes. Moreover, it was anticipated that WMC would moderate the relation between alcohol-specific impulsive and reflective processes and changes in adolescent alcohol use. METHODS: The sample consisted of 427 adolescents (47.7% male) between 12 and 16 years of age (M = 13.96, SD = 0.78) who reported drinking alcohol at least once. Four measures of impulsive processes were included. Attentional bias for alcohol was assessed with a Visual Probe Test; approach bias toward alcohol was assessed with a Stimulus Response Compatibility (SRC) Test; and memory associations with alcohol were assessed with an Implicit Association Test (IAT) and a Word Association Test. Two measures of reflective measures were included: positive and negative expectancies. WMC was measured using a Self-Ordered Pointing Task. RESULTS: RESULTS showed that positive expectancies predicted changes in alcohol use, but this effect was qualified by an interaction with IAT scores. Moreover, SRC scores predicted changes in alcohol use only when negative expectancies were low. Attentional bias and word association scores did not predict changes in alcohol use. The relations between alcohol-specific processes or reflective processes and alcohol use were not moderated by WMC. CONCLUSION: Although there is empirical evidence for the validity of the model in predicting heavier alcohol use in adolescents, or alcohol abuse and dependence in adults, these observations do not generalize to a sample of normative, early adolescents. More specifically, results indicated that reflective processes are more important predictors of changes in alcohol use than impulsive process during adolescence.

The mediating role of alcohol-related memory associations on the relation between perceived parental drinking and the onset of adolescents' alcohol use.

AIMS: The aim of the current study was to examine the mediating role of alcohol-related memory associations in the relation between perceived parental drinking and the onset of adolescents' alcohol use. Gender and grade were also included in the analyses. DESIGN: We tested a mediation model within a structural path modelling framework using longitudinal data (two waves). SETTING AND PARTICIPANTS: The sample consisted of 608 Canadian adolescents (42.9% boys), who did not have any alcohol experiences at the first measurement. The adolescents were recruited from all grades 7-9 classes in a large school district in western Canada. MEASUREMENTS: Alcohol-related memory associations were tested with the Word Association Test. We used adolescent self-reports of alcohol use and parental drinking. FINDINGS: Results clearly showed a mediation effect of alcohol-related memory associations [estimate = 0.023, 95% confidence interval (CI): 0.002-0.044). That is, parental drinking as perceived by the adolescent was related positively to alcohol-related memory associations, which in turn predicted adolescents' alcohol use a year later. Gender and grade were related to alcohol-related memory associations. That is, boys and adolescents of higher grades had more memory associations. CONCLUSIONS: Children appear to form memory associations related to alcohol before they ever drink alcohol themselves, and these associations appear to mediate the link between their perceptions of their parents' drinking and their own initial alcohol use.