Childhood social environmental and behavioural predictors of early adolescent onset cannabis use.

INTRODUCTION AND AIMS: This study prospectively investigates behavioural and social antecedents of different patterns of adolescent cannabis use, specifically, early adolescent onset cannabis use and late onset occasional use. DESIGN AND METHODS: The sample comprised 852 adolescents (53% female) drawn from the Australian arm of the International Youth Development Study. Data were collected via self-report surveys. Risk and protective factors from a modified version of the Communities That Care youth survey were measured in fifth grade (mean [M] = 10.9 years, SD = 0.4). Frequency of cannabis use was measured at six time-points throughout adolescence (ages 12-19 years). RESULTS: Early adolescent onset cannabis use (10.7% of the sample [n = 91]) was predicted by childhood family-related factors including poor family management, family history of antisocial behaviour and attachment to parents. Cigarette use and drinking until drunk were the strongest predictors of early adolescent onset cannabis use. Cumulative risks associated with community, family, peer/individual environments and early substance use (cigarettes, alcohol) in childhood were predictive of early adolescent onset cannabis use (e.g. relative risk ratio = 2.64; 95% confidence interval 1.40-4.97 for early substance use). Family and early substance use-related cumulative risks were predictive of late adolescent onset occasional cannabis use (n = 231; 27%). Cumulative early substance use risk was the strongest independent predictor of both early adolescent onset and late adolescent onset occasional cannabis use. DISCUSSION AND CONCLUSIONS: Primary prevention efforts should focus on reducing exposure and access to licit substances during late childhood and delaying the onset of use. Prevention and intervention targeted toward the family environment also appears likely to be important in the prevention of early adolescent onset cannabis use.

Delinquency, School Context, and Risk Factors in India, Australia, and the United States: Implications for Prevention.

There is a dearth of research on delinquency, school context, and risk factors across developed and developing nations. Using representative samples and matched surveys, we examined delinquency among cohorts in Mumbai, India (N = 3,717); Victoria, Australia (N = 1,842); and Washington State (WA), United States (N = 1,828). We used multivariate Poisson hierarchical linear modeling. Risk factor and delinquency levels varied across sites. Delinquency clustered within certain schools, particularly in Mumbai. Community disorganization exhibited an association with delinquency as a school-level context effect in Mumbai and Victoria. Peer delinquency, sensation seeking, and poor family management exhibited cross-nationally consistent associations with delinquency. Programs that target schools, the clustering of problem behaviors, and cross-nationally consistent risk factors should be considered internationally.

Reciprocal associations between early adolescent antisocial behavior and depressive symptoms: A longitudinal study in Victoria, Australia and Washington State, United States.

PURPOSE: Reciprocal prospective associations between adolescent antisocial behavior and depressive symptoms were examined. METHODS: Seventh grade students (average age 13 years; N=2,314/2,348) were surveyed (T1), and then followed-up 12 (T2) and 24 months (T3) later, using the same methods in Washington State and Victoria, Australia. RESULTS: Negative binomial regressions showed antisocial behavior (T1, T2) did not prospectively predict depressive symptoms (T2, T3). T1 multivariate predictors for T2 depressive symptoms included female gender (incident rate ratio [IRR] = 1.70), prior depressive symptoms (IRR = 1.06), alcohol use (IRR = 1.13), family conflict (IRR = 1.13), antisocial peers (IRR = 1.08) and bullying victimization (IRR = 1.06). Depressive symptoms (T1, T2) did not predict antisocial behavior (T2, T3). T1 multivariate predictors for T2 antisocial behavior included female gender (IRR = .96), age (IRR = .97), prior antisocial behavior (IRR = 1.32), alcohol use (IRR = 1.04), antisocial peers (IRR = 1.11) and academic failure (IRR = 1.03). CONCLUSIONS: Depressive symptoms and antisocial behaviors showed considerable predictive stability in early adolescence but were not reciprocally related. Prevention and intervention strategies in adolescence may benefit by targeting common predictors such as alcohol, peer interactions and early symptoms for depression and antisocial behavior.

Are Bullying Perpetration and Victimization Associated with Adolescent Deliberate Self-Harm? A Meta-Analysis.

This study sought to appraise internationally published literature investigating bullying in its association with deliberate self-harm (DSH). A systematic review and series of meta-analyses using random effects models were conducted. A total of 68 effect sizes, analyzing data from 156,284 adolescents aged 11-19 years were examined. Results showed significant associations between both traditional bullying perpetration (OR 1.81, 95% CI [1.33, 2.47], p < .0001) and victimization (OR 2.34, 95% CI [1.89, 2.89], p < .0001) and DSH. Cyber-bullying victimization (OR 3.55, 95% CI [2.71, 4.65], p < .0001) and the co-occurrence of traditional and cyber-bullying victimization (OR 3.39, 95% CI [1.56, 7.37], p = .002) were also associated with DSH. Moderator analyses showed variation in results based on methodological- and sample-level variables. Findings suggested that exposure to bullying, either as perpetrators or victims, poses risks for DSH.

Predicting Alcohol Misuse Among Australian 19-Year-Olds from Adolescent Drinking Trajectories.

BACKGROUND: Alcohol use in adolescence predicts future alcohol misuse. However, the extent to which different patterns of adolescent use present risk remains unclear. OBJECTIVES: This study investigated how adolescent trajectories of alcohol consumption during the school years predict alcohol misuse at age 19 years. METHODS: Data were drawn from 707 students from Victoria, Australia, longitudinally followed for 7 years. Five alcohol use trajectories were identified based on the frequency of alcohol use from Grade 6 (age 12 years) to Grade 11 (age 17 years). At age 19 years, participants completed measures indicating Heavy Episodic Drinking (HED), dependency - Alcohol Use Disorders Identification Test (AUDIT) and social harms. RESULTS: At 19 years of age, 64% of participants reported HED, 42% high AUDIT scores (8+), and 23% social harms. Participants belonging to a steep escalator trajectory during adolescence had twice the odds at 19 years of age of high AUDIT scores and social harms, and three times greater odds of HED than participants whose alcohol use slowly increased. Stable moderate consumption was also associated with an increased risk of HED compared to slowly increasing use. Abstinence predicted a reduced likelihood of all forms of misuse at 19 years of age compared to slowly increased alcohol use. CONCLUSIONS: Trajectories of drinking frequency during adolescence predict alcohol misuse at age 19 years. Although rapid increasing use presents the greatest risk, even slowly increasing drinking predicts increased risk compared to abstinence. The findings indicate that alcohol policies should recommend nonuse and reduced frequency of use during adolescence.

Longitudinal, reciprocal relationships between family management and antisocial peer associations.

INTRODUCTION: Poor family management and antisocial peer associations are related risk factors for negative outcomes such as adolescent substance misuse and conduct disorders. The relationship between family management and antisocial peer associations is complex. The purpose of this study was to test the reciprocal relationships between youth-reports of poor family management and antisocial peer associations over multiple time-points. METHODS: We used four data points (5th-11th grade) from the Australian arm of the longitudinal International Youth Development Study (IYDS) to test a random-intercepts cross-lagged path model (N = 922). RESULTS: The model fit the data well with path estimates showing that poor family management predicted greater antisocial peer associations at the next wave but not the reverse. A second model included a third autoregressive path to control for youth's own antisocial behavior; the direction of the relationships between poor family management and antisocial peer associations did not change. CONCLUSIONS: These results indicate that across adolescence poor family management predicts greater antisocial peer association, which provides evidence that family-focused interventions are an important prevention strategy even in adolescence.

The impact of transitional programmes on post-transition outcomes for youth leaving out-of-home care: a meta-analysis.

Youth residing in out-of-home care settings have often been exposed to childhood trauma, and commonly report experiencing adverse outcomes after transitioning from care. This meta-analysis appraised internationally published literature investigating the impact of transitional programme participation (among youth with a baseline age of 15-24 years) on post-transition outcomes of housing, education, employment, mental health and substance use. A comprehensive search of sociology (e.g. ProQuest Sociology), psychology (e.g. PsycInfo) and health (e.g. ProQuest Family Health) electronic abstraction databases was conducted for the period 1990-2014. Search terms included 'out-of-home care', 'transition', 'housing', 'education', 'employment', 'mental health' and 'substance use'. Nineteen studies, all from the United States, met the inclusion criteria and were included in the meta-analysis. Living independently and homelessness were the most commonly described housing outcomes. Rates of post-transition employment varied, while rates of post-secondary education were low. Depression and alcohol use were commonly reported among transitioning youth. Findings of the meta-analysis showed that attention should be given to the potential benefit of transitional programme participation on outcomes such as housing, employment and education. Moderator analyses showed that these benefits may differ based on study design, sample size and sampling unit, but not for mean age or gender. Detailed and rigorous research is needed internationally to examine the characteristics of transitional programmes resulting in more successful outcomes for youth, and whether these outcomes are sustained longitudinally.

myTREEHOUSE Self-Concept Assessment: preliminary psychometric analysis of a new self-concept assessment for children with cerebral palsy.

AIM: To evaluate the preliminary validity and reliability of the myTREEHOUSE Self-Concept Assessment for children with cerebral palsy (CP) aged 8 to 12 years. METHOD: The myTREEHOUSE Self-Concept Assessment includes 26 items divided into eight domains, assessed across three Performance Perspectives (Personal, Social, and Perceived) and an additional Importance Rating. Face and content validity was assessed by semi-structured interviews with seven expert professionals regarding the assessment construct, content, and clinical utility. Reliability was assessed with 50 children aged 8 to 12 years with CP (29 males, 21 females; mean age 10y 2mo; Gross Motor Function Classification System [GMFCS] level I=35, II=8, III=5, IV=1; mean Wechsler Intelligence Scale for Children - Fourth Edition [WISC-IV]=104), whose data was used to calculate internal consistency of the scale, and a subset of 35 children (20 males, 15 females; mean age 10y 5mo; GMFCS level I=26, II=4, III=4, IV=1; mean WISC-IV=103) who participated in test-retest reliability within 14 to 28 days. RESULTS: Face and content validity was supported by positive expert feedback, with only minor adjustments suggested to clarify the wording of some items. After these amendments, strong internal consistency (Cronbach's α 0.84-0.91) and moderate to good test-retest reliability (intraclass correlation coefficient 0.64-0.75) was found for each component. INTERPRETATION: The myTREEHOUSE Self-Concept Assessment is a valid and reliable assessment of self-concept for children with CP aged 8 to 12 years.

Gendered Pathways From Child Abuse to Adult Crime Through Internalizing and Externalizing Behaviors in Childhood and Adolescence.

Gender differences in externalizing and internalizing pathways from child abuse to adult crime were examined across four waves of an extended longitudinal study ( N = 186 males and 170 females) using multiple-group structural equation modeling. Results show that child abuse was associated with both internalizing and externalizing behaviors in the elementary school years for both males and females. However, gender differences were found such that internalizing behaviors increased the risk of adult crime for females only, and externalizing behaviors increased the risk of adult crime for males only. Internalizing behaviors among males actually lessened the risk of adult crime, and externalizing behaviors were unrelated to adult crime among females. Findings confirm distinct pathways leading from child abuse to later crime for males and females, which is important for prevention and intervention strategies.

Influence of Early Onset of Alcohol Use on the Development of Adolescent Alcohol Problems: a Longitudinal Binational Study.

This study examined cross-national similarities in a developmental model linking early age of alcohol use onset to frequent drinking and heavy drinking and alcohol problems 1 and 2 years later in a binational sample of 13-year-old students from two states: Washington State, USA and Victoria, Australia (N = 1833). A range of individual, family, school, and peer influences was included in analyses to investigate their unique and shared contribution to development of early and more serious forms of alcohol use and harms from misuse. Data were collected annually over a 3-year period from ages 13 to 15. Analyses were conducted using multiple-group structural equation modeling. For both states, early use of alcohol predicted frequent drinking, which predicted alcohol problems. Family protective influences had neither direct effects on heavy drinking nor effects on alcohol harm in either state, whereas school protection directly reduced the risk of heavy drinking in both states. Exposure to antisocial peers and siblings predicted a higher likelihood of heavy drinking and alcohol harm for students in both Washington and Victoria. Implications for the prevention of adolescent alcohol problems are discussed.

Depression and Anxiety Outcomes Associated with Failed Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis.

OBJECTIVE: Our study examined the psychological outcomes associated with failed ART treatment outcomes in men and women. SEARCH STRATEGY: A systematic search for studies published between January 1980 and August 2015 was performed across seven electronic databases. INCLUSION CRITERIA: Studies were included if they contained data on psychosocial outcomes taken pre and post ART treatment. DATA EXTRACTION AND SYNTHESIS: A standardised form was used to extract data and was verified by two independent reviewers. Studies were meta-analysed to determine the association of depression and anxiety with ART treatment outcomes. Narrative synthesis identified factors to explain variations in the size and directions of effects and relationships explored within and between the studies. MAIN RESULTS: Both depression and anxiety increased after a ART treatment failure with an overall pooled standardised mean difference (SMD) of 0.41 (95% CI: 0.27, 0.55) for depression and 0.21 (95% CI: 0.13, 0.29) for anxiety. In contrast, depression decreased after a successful treatment, SMD of -0.24 (95% CI: -0.37,-0.11). Both depression and anxiety decreased as time passed from ART procedure. Nonetheless, these remained higher than baseline measures in the group with the failed outcome even six months after the procedure. Studies included in the narrative synthesis also confirmed an association with negative psychological outcomes in relation to marital satisfaction and general well-being following treatment failure. CONCLUSION: Linking ART failure and psychosocial outcomes may elucidate the experience of treatment subgroups, influence deliberations around recommendations for resource allocation and health policy and guide patient and clinician decision making.

Risk Factors and Risk-Based Protective Factors for Violent Offending: A Study of Young Victorians.

PURPOSE: The present study aims to examine risk factors and risk-based and interactive protective factors for violent offending in a group of 437 young Australians. METHODS: Participants were recruited into the study when they were in Grade 5 (10-11 years) and followed up almost annually until young adulthood (18-19 years). Measures of violent offending, risk and protective factors, and demographics were obtained through a modification of the Communities That Care youth survey. The data collected enabled identification of groups of students at-risk of violent offending according to drug use, low family socioeconomic status, and antisocial behavior. RESULTS: Results showed that there were very few associations between the risk factors and risk-based protective factors measured in this study (e.g., belief in the moral order, religiosity, peer recognition for prosocial involvement, attachment to parents, low commitment to school, and poor academic performance) and later self-reported violent offending. There were no statistically significant interactive protective factors. CONCLUSIONS: Further longitudinal analyses with large sample sizes are needed to examine risk factors and risk-based protective factors and interactive protective factors in at-risk groups. The findings support the need for multi-faceted prevention and early intervention approaches that target multiple aspects of youth's lives.

Depressed Mood During Early to Middle Adolescence: A Bi-national Longitudinal Study of the Unique Impact of Family Conflict.

Adolescent depressed mood is related to the development of subsequent mental health problems, and family problems have been linked to adolescent depression. Longitudinal research on adolescent depressed mood is needed to establish the unique impact of family problems independent of other potential drivers. This study tested the extent to which family conflict exacerbates depressed mood during adolescence, independent of changes in depressed mood over time, academic performance, bullying victimization, negative cognitive style, and gender. Students (13 years old) participated in a three-wave bi-national study (n = 961 from the State of Washington, United States, n = 981 from Victoria, Australia; 98 % retention, 51 % female in each sample). The model was cross-lagged and controlled for the autocorrelation of depressed mood, negative cognitive style, academic failure, and bullying victimization. Family conflict partially predicted changes in depressed mood independent of changes in depressed mood over time and the other controls. There was also evidence that family conflict and adolescent depressed mood are reciprocally related over time. The findings were closely replicated across the two samples. The study identifies potential points of intervention to interrupt the progression of depressed mood in early to middle adolescence.

Problem gambling patterns among Australian young adults: Associations with prospective risk and protective factors and adult adjustment.

There is instability in the developmental course of problem gambling [PG] over time; however, studies that examine PG at an aggregate level obscure these variations. The current study employed data from a longitudinal study of Australian young adults to investigate: 1) PG patterns (i.e., resistance, persistence, desistence, and new incidence); 2) prospective risk and protective factors for these patterns; and 3) behavioural outcomes associated with these patterns. A sample of 2261 young adults (55.73% female) from Victoria, Australia, who were part of the International Youth Development Study completed a survey in 2010 (T1, age 21) and 2012 (T2, age 23) measuring PG (two items based on established measures), risk and protective factors, and behavioural outcomes. The majority of the sample (91.69%) were resistors (no PG at T1 and T2), 3.62% were new incidence PG cases, 2.63% were desistors (PG at T1 but not T2), and 2.07% reported persistent PG at T1 and T2. Individual civic activism was protective of new incidence PG, while affiliation with antisocial peers and frequent alcohol use increased the risk of persistence. Persistent problem gamblers also experienced the greatest number of poor behavioural outcomes at T2. New incidence was associated with internalising symptoms at T2, while desistance was not associated with any behavioural outcomes. In conclusion, each PG pattern was associated with different predictors and outcomes, highlighting the need to consider variation in the course of young adult PG in order to provide efficacious prevention and intervention approaches, and to protect against relapse.

Relationships Between Sport Participation, Problem Alcohol Use, and Violence: A Longitudinal Study of Young Adults in Australia.

There is a growing body of evidence suggesting a link between sport participation and violent behavior outside of the sporting context. However, there have been few studies that have investigated the basis of this relationship. The current study examined longitudinal relationships between sport participation, problem alcohol use, and various violent behaviors, and whether sport participation moderates relationships between problem alcohol use and violence. The sample comprised 2,262 young adults (55% female, age range at Time 1 = 17-24 years) from Victoria, Australia, surveyed in 2010 and 2012. When controlling for common risk factors, substance use, and past violence, sport participation was not associated with any violent behaviors 2 years later. However, sport participation moderated the relationship between problem alcohol use and fighting, whereby problem alcohol use was associated with engaging in fights 2 years later for sport participants, but not for nonparticipants. These findings suggest that it is not sport participation per se that influences later violence but the drinking norms or culture embedded within certain sporting contexts. Prevention approaches that address the drinking culture and social approval of excessive alcohol consumption within sporting contexts may reduce the incidence of violent behavior in the community.

Peer Group Patterns of Alcohol-Using Behaviors Among Early Adolescents in Victoria, Australia, and Washington State, United States.

The goal of this study was to examine and cross-nationally compare the peer group patterns of alcohol-drinking behaviors among cohorts of early adolescents (ages 11-14 years) in Victoria, Australia, and Washington State, United States. Latent transition analysis revealed that after 1 year, transitions congruent with peer influence (whereby non-drinking adolescents initiated alcohol use in the presence of drinking peers) and reverse peer influence were observed in both states; however, transitions congruent with peer selection (whereby drinking adolescents self-selected into drinking peer groups) were only observed among Victorian early adolescents. Findings were interpreted to suggest that Australian family and cultural norms that more commonly allow early adolescent alcohol use lead to a higher rate of peer selection.

The Social, Behavioral, and Emotional Correlates of Bullying and Victimization in a School-Based Sample.

Bullying is a prevalent problem in schools that is associated with a number of negative outcomes for both the child who bullies and his or her victims. In a community sample of 284 ethnically diverse school-children (54.2 % girls) between the ages of 9 and 14 years (M = 11.28, SD = 1.82), the current study examined whether the level of victimization moderated the association between bullying and several behavioral, social, and emotional characteristics. These characteristics were specifically chosen to integrate research on distinct developmental pathways to conduct problems with research on the characteristics shown by children who bully others. Results indicated that both bullying and victimization were independently associated with conduct problems. However, there was an interaction between bullying and victimization in the prediction of callous-unemotional (CU) traits, such that the association between bullying and CU traits was stronger for those lower on victimization. Further, bullying was positively associated with positive attitudes towards bullying and anger expression and neither of these associations were moderated by the level of victimization. In contrast, bullying was not associated with the child's perceived problems regulating anger, suggesting that children with higher levels of bullying admit to expressing anger but consider this emotional expression as being under their control.

Developmental trajectories of adolescent cannabis use and their relationship to young adult social and behavioural adjustment: A longitudinal study of Australian youth.

This study aimed to identify distinct developmental trajectories (sub-groups of individuals who showed similar longitudinal patterns) of cannabis use among Australian adolescents, and to examine associations between trajectory group membership and measures of social and behavioural adjustment in young adulthood. Participants (n=852, 53% female) were part of the International Youth Development Study. Latent class growth analysis was used to identify distinct trajectories of cannabis use frequency from average ages 12 to 19, across 6 waves of data. Logistic regression analyses and analyses of covariance were used to examine relationships between trajectory group membership and young adult (average age: 21) adjustment, controlling for a range of covariates. Three trajectories were identified: abstainers (62%), early onset users (11%), and late onset occasional users (27%). The early onset users showed a higher frequency of antisocial behaviour, violence, cannabis use, cannabis-related harms, cigarette use, and alcohol harms, compared to the abstinent group in young adulthood. The late onset occasional users reported a higher frequency of cannabis use, cannabis-related harms, illicit drug use, and alcohol harms, compared to the abstinent group in young adulthood. There were no differences between the trajectory groups on measures of employment, school completion, post-secondary education, income, depression/anxiety, or alcohol use problems. In conclusion, early onset of cannabis use, even at relatively low frequency during adolescence, is associated with poorer adjustment in young adulthood. Prevention and intervention efforts to delay or prevent uptake of cannabis use should be particularly focussed on early adolescence prior to age 12.

Sexual Risk Behaviors, Sexual Offenses, and Sexual Victimization Among Homeless Youth: A Systematic Review of Associations With Substance Use.

The use of substances among youth experiencing homelessness is an important issue in the context of addressing the developing burden of morbidities arising due to illness, injury, physical and mental health concerns, and low rates of health care utilization among this population group. Youth experiencing homelessness report engaging in and being victimized by various forms of sexual behavior. Of interest in this systematic review were published studies investigating substance use in its association with perpetration of sexual offenses, engagement in sexual risk behavior, or experience of sexual victimization among homeless youth. A systematic search of 12 psychology, health, and social science electronic databases was conducted. Search terms included "homeless*," "youth," "sex crimes," "sexual victimization," "survival sex," "rape," "drugs," and "substance abuse." Twenty-three studies were identified that met the inclusion criteria. No studies statistically examining substance use in its association with perpetrating sexual offenses were located. Findings showed substance use was generally associated with sexual risk behavior or sexual victimization; however, it remains unclear whether substance use precedes or follows these behaviors and experiences. It is possible substances are used by homeless youth as a means of coping with sexual risk behavior and victimization. Implications of the review findings in relation to prevention and intervention approaches aimed to decrease the incidence and severity of health concerns among homeless youth are discussed.

Incidence and Course of Adolescent Deliberate Self-Harm in Victoria, Australia, and Washington State.

PURPOSE: There have been few longitudinal studies of deliberate self-harm (DSH) in adolescents. This cross-national longitudinal study outlines risk and protective factors for DSH incidence and persistence. METHODS: Seventh and ninth grade students (average ages 13 and 15 years) were recruited as state-representative cohorts, surveyed, and then followed up 12 months later (N = 3,876), using the same methods in Washington State and Victoria, Australia. The retention rate was 99% in both states at follow-up. A range of risk and protective factors for DSH were examined using multivariate analyses. RESULTS: The prevalence of DSH in the past year was 1.53% in Grade 7 and .91% in Grade 9 for males and 4.12% and 1.34% for Grade 7 and Grade 9 females, respectively, with similar rates across states. In multivariate analyses, incident DSH was lower in Washington State (odds ratio [OR] = .67; 95% confidence interval [CI] = .45-1.00) relative to Victoria 12 months later. Risk factors for incident DSH included being female (OR = 1.93; CI = 1.35-2.76), high depressive symptoms (OR = 3.52; CI = 2.37-5.21), antisocial behavior (OR = 2.42; CI = 1.46-4.00), and lifetime (OR = 1.85; CI = 1.11-3.08) and past month (OR = 2.70; CI = 1.57-4.64) alcohol use relative to never using alcohol. CONCLUSIONS: Much self-harm in adolescents resolves over the course of 12 months. Young people who self-harm have high rates of other health risk behaviors associated with family and peer risks that may all be targets for preventive intervention.