Alcohol First, Cannabis Last: Identification of an Especially Risky Use Pattern among Individuals Who Co-Use Alcohol and Cannabis.

Background: Alcohol and cannabis co-use is common and confers increased risk for potential harms, such as negative consequences and substance dependence. The existing evidence suggests that factors such as dose of delta-9-tetrahydrocannabinol (THC) consumed and order of use of each substance (i.e., using alcohol or cannabis first or last when co-using) may impact co-use outcomes. Existing co-use research has focused primarily on college-samples or young adults, and few studies have explored these nuanced relations among community samples. Methods: We examined survey data from 87 community members (mean age 32.9 years, 49.4% female) recruited from legal market cannabis dispensaries. Using a combination of regression techniques (i.e., OLS, negative binomial, censor-inflated) we modeled relations among co-use ordering patterns, THC dose and cannabis outcomes as well as interactions with sex assigned at birth and age. Results: Individuals who endorsed co-use reported significantly higher CUDIT scores than those who had never co-used (p < 0.01). Using alcohol first and cannabis last (a pattern we refer to as "AFCL") was more common among females than males (p < 0.01). In the context of typical substance use weeks, more frequently engaging in the AFCL pattern was associated with significantly higher CUDIT scores (p < 0.001) and negatively predicted positive consequences (p < 0.001). Other patterns predicted higher CUDIT scores during heavy use weeks. Conclusions: Results indicate that co-use ordering patterns are related to substance use outcomes. Further research leveraging within-subjects, longitudinal designs is needed to test causal relations between these variables.

Using Latent Profile Analysis to Examine Cannabis Use Contexts: Associations with Use, Consequences, and Protective Behaviors.

OBJECTIVE: College students represent a large portion of the population, and report high rates of cannabis use and related negative outcomes, including interpersonal problems, risky behaviors, or physical dependency. The contexts in which students use cannabis (e.g., at a party, when feeling down or depressed, after a fight with a loved one) likely affect their risk of experiencing consequences. We aimed to discern profiles of cannabis use contexts and compare profiles on use frequency, consequences, and the use of cannabis protective behavioral strategies (PBS). METHOD: College students were surveyed regarding their cannabis use contexts, frequency, consequences, and PBS use (n = 265; female = 72.8%). We used Latent Profile Analysis to identify patterns of cannabis use contexts and auxiliary testing to compare profiles on use frequency, consequences, and PBS use. RESULTS: Our examination revealed three latent profiles of cannabis use. The Social Use Profile was associated with use in predominantly social/uplifting contexts. The Physical & Emotional Pain Profile was also associated with use in these contexts but was defined by additional use in response to pain. The All Contexts Profile was associated with frequent use in all contexts, including those that were least endorsed by the other profiles. Profiles differed in cannabis use frequency, PBS use, and the number of consequences experienced, such that profiles were more likely to be associated with more frequent cannabis use, higher risk of experiencing use-consequences, and using fewer PBS as the number of use contexts increased across the profiles. CONCLUSIONS: The contexts in which people use cannabis are associated with cannabis risk and protection. Prevention and intervention efforts may benefit from considering contexts of cannabis use.

Patterns of Simultaneous and non-Simultaneous Use of Cannabis and Alcohol Among American Indian Adolescents.

Background: American Indian (AI) adolescents report earlier initiation and higher rates of cannabis and alcohol use compared to their non-AI peers. Simultaneous cannabis and alcohol (SCA) use is increasingly common. A primary goal of our research was to identify profiles of cannabis and alcohol use, including SCA use, among AI adolescents using latent class analysis (LCA). Method: Data from 1,673 7th - 12th grade students attending 45 reservation-area schools throughout the U.S. who reported using alcohol and/or cannabis in the past year were used to identify the latent classes. Multinomial logistic regression analysis determined associations of sex, grade, and multiethnicity to class membership. Results: A four-class solution was found: 1) SCA-Heavier Use (16.1%); 2) SCA-Lighter Use (25.2%); 3) Primarily Cannabis Use (33.3%); and 4) Primarily Alcohol Use (25.4%). Multinomial regression showed higher grade, identifying as multiethnic, and being female were associated with higher likelihood of membership in the SCA class. Conclusion: AI adolescents were more likely to be classified in the Primarily Cannabis Use class as compared to all other classes. Characterizing profiles of use may help identify those engaging in risky or co-use and help researchers and clinicians better understand how AI adolescents engage with alcohol and marijuana.

Understanding social network support, composition, and structure among cancer caregivers.

OBJECTIVE: We examined the social network support, composition, and structure of pediatric cancer caregivers. METHODS: We used a self-report survey to collect egocentric social network data from 107 caregivers of pediatric cancer patients and calculated descriptive statistics to examine cancer-related support network composition, function, and structure. We then ran logistic regressions to examine the relationships between network characteristics and overall satisfaction with social support. RESULTS: Family members were the most common source of emotional support and logistical support, and health care providers were the most common source of informational support. Participants perceived the "most helpful" forms of support as being: (1) emotional support from family and health care providers; (2) informational support from health care providers and other cancer caregivers; and (3) logistical support from family. Overall, caregivers wished that 9.8% of their network ties had provided more support, with family members being the most common alter type to disappoint caregivers and offer less support than needed/expected. Caregivers who reported higher network disappointment (having network members who offered less support than needed/expected) were significantly less satisfied with emotional support than those with lower network disappointment (Odds Ratio = 0.18, p = 0.02), and caregivers with higher network disappointment were significantly less satisfied with logistical support compared to those with lower network disappointment (Odds Ratio = 0.14, p = 0.01). CONCLUSION: Our results show differences in the nature of social support provided by different types of network members. These findings have implications for tailoring social network interventions to improve caregiver and family outcomes.

Associations between alcohol and cannabis use order, frequency, quantity, and consequences in a college sample of individuals who co-use alcohol and cannabis.

BACKGROUND AND OBJECTIVES: Using both alcohol and cannabis (either at the same time or at different times) is common among college students, and is called "co-use." Using these substances simultaneously, such that their effects overlap, is thought to be an especially risky co-use pattern. Gaining a better understanding of how co-use patterns relate to substance use and consequences could aid prevention and intervention efforts. METHODS: We examined college students (N = 401) who reported using both alcohol and cannabis at least once in the past 30 days. Path analysis was used to explore relations among co-use patterns (number of days in a typical week that participants used both alcohol and cannabis; the number of days using alcohol first, cannabis first, alcohol last, and cannabis last; the number of days of simultaneous use), past-30-day alcohol and cannabis consequences, use frequency, and typical quantities used. RESULTS: Each additional day of using alcohol first was associated with fewer past-30-day cannabis consequences. Each additional day of using cannabis first was associated with fewer alcohol-related consequences. Each additional day of using alcohol and cannabis on the same day and each additional day of simultaneous use were both associated with less cannabis used and alcohol consumed in a typical week. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This study is among the first to identify associations between alcohol and cannabis order and outcomes (i.e., consequences and consumption). Results suggest that modifying which substance is used first on a given day could be a practical intervention strategy for individuals who co-use alcohol and cannabis.

The relationship between depressed affect, parental monitoring, and sex on cannabis use among American Indian youth.

BACKGROUND AND OBJECTIVES: American Indian (AI) adolescents report higher rates of cannabis use than national US adolescents. Previous study examined interactive relationships between depressed affect and family factors on AI adolescent alcohol use. These factors have not been investigated for cannabis use. We examined whether parental monitoring dampened risk for cannabis use due to depressed affect, and potential moderation by sex. METHODS: We measured cannabis use, depressed affect, parental monitoring, and sex among reservation area AI youth among students in grades 7-12 attending 45 schools. We used censor-inflated regression models to identify parental monitoring as a moderator of the relationship between depressed affect and cannabis use. RESULTS: In the logistic portion of censor-inflated models, level of depressed affect and parental monitoring significantly related to last 30-day cannabis use. Higher levels of parental monitoring at lower levels of depressed affect related to lower likelihood of cannabis use. Female students had greater likelihood of endorsing cannabis use at higher levels of depressed affect. In the linear portion of the censor-inflated regression models, sex and level of parental monitoring significantly related to cannabis use frequency. Male students endorsed more frequent cannabis use while higher levels of parental monitoring related to lower frequency of use. DISCUSSION AND CONCLUSIONS: Parental monitoring may dampen the effect of depressed affect on cannabis use among AI youth on reservations. SCIENTIFIC SIGNIFICANCE: Future interventions should foster skill-building prevention efforts directed at coping with depression, along with parental training for effective monitoring. Special attention to AI female adolescents may be indicated.

Expectancies that Predict Cannabis Initiation in Response to Legalization.

Background: Recent and prospective changes to nonmedical/recreational cannabis laws in the United States and abroad raise questions about how legalization may influence cannabis use behaviors. Objectives: In the current study, we examined links between legalization, context-specific likelihood of using cannabis, and cannabis expectancies using cross-sectional survey data from 121 college students who had never used or were abstaining from cannabis in a U.S. state where laws prohibit nonmedical cannabis. Results: We found that across scenarios, 61% of students reported they would be more likely to use cannabis if it were legal. Social/sexual facilitation expectancies predicted a higher likelihood of using cannabis after legalization in a social context. Relaxation/tension reduction expectancies predicted a higher likelihood of using in an anxiety relief context. Perceptual/cognitive enhancement expectancies predicted a higher likelihood of using in a pain relief context. Cognitive/behavioral impairment expectancies predicted a lower likelihood of using in social, pain relief, relaxation, and concert contexts. Global negative effects expectancies predicted a lower likelihood of using in relaxation and concert contexts. Conclusions: Our findings suggest that among college students who do not use cannabis, expectancies are linked to cannabis use likelihood in certain contexts if cannabis were legal. This work highlights cannabis expectancies and contexts as possible targets for evidence-based public health education and clinical prevention initiatives related to the potential increase in cannabis use associated with cannabis policy implementation. College students may benefit from initiatives that address cannabis expectancies and enhance harm reduction skills to help them effectively navigate contexts in which cannabis is available to them.

Utility of the Brief Young Adult Alcohol Consequences Questionnaire to Identify College Students At-Risk for Alcohol Related Problems: Relative Operating Characteristics across Seven Countries.

Background: It is important to identify students who would benefit from early interventions to reduce harmful drinking patterns and associated consequences. the Brief Young Adult Alcohol Consequences Questionnaire (B-YAACQ) could be particularly useful as a screening tool in university settings. Objectives. The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Objectives: The present study examined the utility of the B-YAACQ to distinguish among students at-risk for problematic alcohol use as measured by the AUDIT. Methods: A sample of 6382 students (mean age=20.28, SD=3.75, 72.2% females) from seven countries (i.e., U.S., Canada, South-Africa, Spain, Argentina, Uruguay, England) completed the B-YAACQ, the AUDIT and different measures of alcohol use. Results: ROC analyses suggested that a cutoff score of 5 maximized the YAACQ's discrimination utility to differentiate between students at low versus moderate/high risk in the total sample and across countries (except in Canada, where the cutoff was 4). In addition, a cutoff of 7 differentiated between students at low/moderate versus high risk in the total sample, while cutoffs of 10, 9, 8 and 7 differentiate between students at low/moderate versus high risk in Uruguay, U.S and Spain (10), Argentina (9), England (8), and Canada and South-Africa (7), respectively. Students classified at the three risk levels (i.e., low, moderate and high) differed in age (i.e., a younger age was associated with higher risk) and drinking patters (i.e., higher drinking frequency, quantity, binge drinking and AUDIT and B-YAACQ scores in the higher risk groups). Conclusions: This study suggest that the B-YAACQ is a useful tool to identify college students at-risk for experiencing problematic patterns of alcohol use.

Preliminary psychometric properties of an inhibition task in young children with Down syndrome.

Background: Executive function (EF) skills are important treatment targets for people with Down syndrome (DS); however, few EF measures have been evaluated for use with young children in this population. Methods: The present study evaluated preliminary psychometric properties of a measure of the EF component of inhibition. Participants were 73 children with DS between 2.5 and 8.67 years old who completed an adapted ability to delay task using a desirable toy. Results: Across two separate trials, latencies to touch the toys were significantly correlated. Latencies increased overall with chronological and mental age, with caveats for the youngest and oldest participants. Conclusion: Findings suggest that an adapted prohibition task is an appropriate method of measuring inhibition for children with DS between 4 and 7 years old, though many children in this chronological age range are at early stages of acquiring this skill set.

An initial investigation of using smartphone-enabled micro-temporal data collection to increase acceptability, feasibility, and validity of research on cancer caregiving.

PURPOSE: Smartphone-enabled micro-temporal data collection has potential to increase reliability, validity, and feasibility of participant-reported data and is a promising strategy for pediatric oncology supportive care and quality-of-life research. Given the demands of pediatric cancer caregiving, we sought to understand the feasibility and acceptability of smartphone data collection that included short surveys administered daily for 14 days via text message link. METHODS: We recruited pediatric cancer caregivers, whose children (ages 0-18 years) were on active treatment, to complete a 14-day daily survey study via smartphone. We implemented our study procedures and examined feasibility through study enrollment rates, reasons for refusal, retention rates, number of reminders and number of completed surveys. We examined acceptability using caregiver ratings of survey length, burden, and ease of completion on a smartphone. RESULTS: We recruited (N = 75) caregivers to the study and had an 84% enrollment rate. Reasons for declining participation included passive refusal (n = 13) and too busy (n = 1). The participant retention rate was 100% and compliance with daily survey completion was 99%. Most surveys were completed following two prompts and took participants 5 minutes or less to complete. Caregivers rated the surveys as easy to complete, low burden, and just right in length. CONCLUSION: A daily self-report, using a brief (≤5 minutes) survey administered on a smartphone via text message prompt, is a feasible and acceptable method. Future research should extend these findings to understand the generalizability across pediatric cancer caregiving contexts.

A cross-national examination of cannabis protective behavioral strategies' role in the relationship between Big Five personality traits and cannabis outcomes.

Background: Problematic cannabis use is common among young adults across the world. However, limited research has examined whether etiological models predicting negative consequences are universal.Objective: The present study examined whether the Five-Factor Model of personality (openness, conscientiousness, extraversion, agreeableness, and neuroticism) relates to cannabis outcomes via use of cannabis protective behavioral strategies (PBS) in a cross-national sample of college student cannabis users (i.e., used cannabis in the last 30 days).Method: Participants were 1175 university students (63.27% female) across five countries (United States, Argentina, Spain, Uruguay, and the Netherlands) recruited to complete an online survey.Results: PBS use mediated the associations between personality traits and cannabis consequences, such that higher conscientiousness (ß = .20), agreeableness (ß = .11), and lower emotional stability [i.e., higher neuroticism] (ß = -.14) were associated with more PBS use. Higher PBS use was, in turn, associated with lower frequency of cannabis use (ß = -.32); lower frequency of use was then associated with fewer cannabis consequences (ß = .34). This sequential pathway was invariant across sex, but not countries. Notably, there were a number of differences in links between PBS and cannabis outcomes when comparing countries (e.g., negative associations in the US sample, but positive associations in the Argentina sample).Conclusions: Cannabis PBS mediates the relationship between personality traits and cannabis outcomes, but there are nuanced differences across countries (i.e., relationship between PBS and cannabis outcomes). Overall, students that are low in conscientiousness, agreeableness, and neuroticism and/or report low rates of PBS use may benefit from cannabis PBS-focused interventions that promote utilization of PBS.

You're Stressing Me Out: The Secondhand Effects of Alcohol.

Introduction: Secondhand effects of alcohol use (SEA) are adverse consequences experienced by an individual due to another's drinking (i.e., study/sleep interrupted, being insulted or humiliation, sexual assault or rape). SEA is a serious public health concern among college students due to its serious consequences and high prevalence (60-84%). The present study examined the associations among SEA, personal alcohol use, depression, anxiety, and stress. Methods: 836 students completed an online survey that assessed for study variables. Results: SEA significantly predicted all outcomes with those endorsing SEA reporting higher levels of depression, anxiety, and stress. Moreover, participants who endorsed SEA also reported 30% more frequent binge drinking and 18% more drinks on their heaviest reported drinking day. Conclusions: Findings indicate that the experience of SEA is a risk factor for poor mental and behavioral health outcomes among college students.

Compounding Privilege, Resilience, and Nonmedical Prescription Stimulant Use among College Students.

Background: In this study, we examined why non-Hispanic White cisgender men are more likely than other subgroups to misuse prescription stimulants in college. The objective of the current study was to use a strength-based framework to examine intersectional demographic predictors. Methods: We examined gender and race/ethnicity as predictors of nonmedical prescription stimulant use (NPS) among college students. We also investigated resilience as a moderator. This report uses data from an online multisite study conducted at seven universities with 4,764 undergraduate students (70.1% women and 52.0% People of Color). Results: We found that college students who were cisgender men and non-Hispanic White used NPS significantly more than students who identified as another gender and as People of Color. There was also a buffering effect of resilience between race/ethnicity and NPS, such that resilience predicted lower NPS for People of Color, but not non-Hispanic White people 28% of the time. Conclusions: It may be that Students of Color are more resilient than non-Hispanic White students, and this resilience is protective of NPS use in college. Importantly, a compounding-privilege and/or intersectional approach to identity is crucial to fully understanding behavior (in this case NPS) in a diversity of college students; future studies should continue to use and develop such approaches.

Assessing invariance of cannabis use motives by veteran status and binary gender identity among college students.

Student service members/veterans (SSM/V) are distinct from non-veteran students in a variety of ways, including in their cannabis use patterns and potentially their motives for cannabis use. Additionally, previous research has shown that men and women endorse different motives for their cannabis use. The present study was designed to assess whether a popular measure of cannabis use motives is invariant across veteran status and gender identity. Based on previous research, we hypothesized that cannabis motives would show invariance across SSM/V men, SSM/V women, non-veteran men, and non-veteran women (n = 1,011, SSM/V = 553) among those who indicated using cannabis at least once in their lifetime. Results from the four-group invariance testing procedure revealed metric invariance. This suggests that while the factor structure and factor loadings are invariant, there are differences at the intercept level for cannabis motives across groups. The same items load onto the same latent constructs and the strength of the items loading onto the latent factors was also the same across groups. The demonstrated invariance has implications for use in SSM/V and non-veteran clients. As this scale is brief, it could easily be used as a screening tool or used to guide intervention content.

The role of mindfulness in associations among depression symptoms, sleep duration, and insulin resistance in adolescents.

Sleep difficulties may be one explanatory factor in the association between depression and insulin resistance; yet, explicit tests of this hypothesis are lacking. We determined if there was an indirect effect of depression symptoms on insulin resistance through sleep duration in adolescents at risk for excess weight gain. We also investigated whether dispositional mindfulness moderated the interconnections among depression, sleep, and insulin resistance. Ninety adolescents (14.2 ± 1.6y; 50% female) at risk for excess weight gain (body mass index [BMI, kg/m2] z score 1.6 ± 0.6) participated in the cross-sectional, baseline phase of a health behaviors study. Depression was assessed with the Center for Epidemiologic Studies-Depression Scale, sleep duration with the Sleep Habits Survey, and mindfulness with the Mindful Attention and Awareness Scale. Homeostatic model assessment of insulin resistance was determined from fasting insulin and glucose. The product-of-coefficients method was used to test the indirect effect of depression on insulin resistance through sleep duration, accounting for age, sex, BMIz, puberty, and socioeconomic status (SES). Dispositional mindfulness was tested as a moderator of the associations among depression, sleep, and insulin resistance. There was a significant indirect effect of depression on insulin resistance through sleep duration, controlling for age, sex, BMIz, puberty, and SES, 95%CI [0.001, 0.05]. Dispositional mindfulness moderated the association between sleep duration and insulin resistance, such that lower sleep duration related to greater insulin resistance only among adolescents with lower mindfulness (p < .001). Short sleep may be one explanatory factor in the depression-insulin resistance connection in adolescents at risk for excess weight gain. Adolescents with poorer mindfulness and short sleep are at highest risk for insulin resistance, whereas higher mindfulness may be protective.

Moderated Mediation of the eCHECKUP TO GO College Student Cannabis Use Intervention.

Background: Cannabis use rates are rising among college students, creating a need for effective and accessible intervention options. One such intervention, the Marijuana eCHECKUP TO GO (eCTG) program, has relatively few studies investigating mechanisms of change and related outcomes. This intervention provides users with personalized normative feedback to adjust user's normative perceptions and use patterns. The current study tested moderated mediation of program effects between the eCTG intervention condition and a healthy stress management (HSM) control condition in a college student sample of near-daily cannabis users. Protective behavioral strategies (PBS) were measured among the eCTG conditionMethods: Data were analyzed from a sample of 227 students who were randomly assigned to the eCTG intervention condition or HSM control condition. Change in cannabis use frequency was measured by re-administering the baseline survey at a six-week follow-up. Multi-group moderated mediation path analysis tested the effects of the eCTG intervention on change in cannabis use frequency through PBS, descriptive norms, and injunctive norms, with multi-group categories defined by sex.Results: Direct effects indicated the intervention predicted reduced descriptive norm perceptions and cannabis use frequency. An indirect effect was found for the intervention condition on reducing cannabis use frequency through change in descriptive norms in males. Similarly, an indirect effect was seen for intervention condition on reducing cannabis use frequency through change in injunctive norms for females.Conclusions: Findings suggest changes in descriptive norms played a sex-specific mediating role in the mechanisms of change for the eCTG intervention on reductions in cannabis use frequency.

A longitudinal investigation of the meaning-making model in midlife adults who have experienced trauma.

INTRODUCTION: Park and Folkman's (1997) meaning-making model posits that distress from traumatic events stems from discrepancies between one's global meaning framework and appraised situational meaning of the traumatic event, with meaning making diminishing these discrepancies and thus bolstering well-being. The current study investigates this supposition over a 19-year span in mid-life adults. METHODS: We selected participants from the Midlife in the United States (MIDUS) study who had indicated the experience of a negatively impactful traumatic event (N = 1687). We hypothesized that increased positive reappraisal (a type of meaning making) would have an indirect effect on positive and negative affect through the three dimensions of meaning in life (significance, coherence, and purpose). RESULTS: All direct and indirect effects were significant and supported hypotheses. CONCLUSION: Results suggest that the assertions of the meaning-making model hold true over a period of nearly two decades among mid-life adults who have experienced traumatic events.

Moral Injury, Substance Use, and Posttraumatic Stress Disorder Symptoms Among Military Personnel: An Examination of Trait Mindfulness as a Moderator.

Mindfulness-based approaches have been suggested as possible methods to treat moral injury in military personnel. However, empirical research has yet to evaluate if mindfulness acts as a protective factor for the possible negative effects of moral injury, such as alcohol use, drug use, or posttraumatic stress disorder (PTSD) symptoms. In this study, we investigated if five facets of mindfulness (i.e., observing, nonjudging, nonreactivity, awareness, and describing) moderated associations between moral injury and the outcomes of PTSD symptoms, alcohol misuse, and drug abuse symptoms in a sample of military personnel. Participants were 244 military personnel (the majority were former military members) who had been deployed at least once during the Iraq War, War in Afghanistan, other wars, or humanitarian missions. The study results indicated that nonjudging, ß = -.22, and awareness, ß = -.25, had significant attenuating effects on the association between moral injury and drug abuse symptoms. However, observing, ß = .17; nonreactivity, ß = .23; and describing, ß = .15, had significant synergistic effects (i.e., they strengthened the association between moral injury and drug abuse symptoms). There were no significant moderation effects on the associations between moral injury and PTSD symptoms or between moral injury and alcohol misuse. Our results provide initial evidence that not all facets of mindfulness may protect against the challenges of coping with moral injury. Directions for future research and implications for practice are discussed.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Daño moral, uso de sustancias y síntomas de TEPT entre el personal militar: un examen de la atención consciente de los rasgos como moderador MINDFULNESS Y DAÑO MORAL EN VETERANOS Se han sugerido enfoques basados ​​en la atención plena (o mindfulness en inglés) como posibles métodos para tratar el daño moral en el personal militar. Sin embargo, la investigación empírica aún debe evaluar si la atención plena actúa como un factor protector para los posibles efectos negativos del daño moral, como el consumo de alcohol, el uso de drogas o los síntomas del trastorno de estrés postraumático (TEPT). En este estudio, investigamos si cinco facetas de la atención plena (es decir, observar, no juzgar, no reaccionar, conciencia y describir) moderaron las asociaciones entre daño moral y los resultados de los síntomas del TEPT, el uso indebido del alcohol y los síntomas del abuso de drogas en una muestra de personal militar. Los participantes eran 244 militares (la mayoría de ellos ex militares) que habían sido desplegados al menos una vez durante la Guerra de Irak, la Guerra en Afganistán, otras guerras o misiones humanitarias. Los resultados del estudio indicaron que el no juzgar, ß = −.22, y la conciencia ß = −.25, tuvieron efectos atenuantes significativos en la asociación entre daño moral y síntomas de abuso de drogas. Sin embargo, observar, ß = .17; no reactividad, ß = .23; y describir, ß = .15, tuvo efectos sinérgicos significativos (es decir, fortalecieron la asociación entre daño moral y los síntomas de abuso de drogas). No hubo efectos significativos de moderación en las asociaciones entre el daño moral y los síntomas del TEPT o entre el daño moral y el abuso del alcohol. Nuestros resultados proporcionan evidencia inicial de que no todas las facetas de la atención plena pueden proteger contra los desafíos de enfrentar el daño moral. Se discuten lineamientos para futuras investigaciones y las implicaciones para la práctica.

Coping trajectories in emerging adulthood: The influence of temperament and gender.

OBJECTIVE: The study of coping has far-reaching implications for understanding psychopathology and resilience, as well as for the treatment of psychological disorders. Developmental work has examined how the ability to cope changes across time in children and adolescents; however, work in emerging adulthood is still lacking. Coping is thought to emerge from basic biological and psychological processes, such as temperament and gender, which may influence the trajectory of coping use over time. METHOD: Using a sample of college students (N = 1,000), our 4-year longitudinal study with yearly assessments sought to (a) examine the trajectory of coping styles in emerging adulthood and to (b) examine the influence of temperament and gender on these coping trajectories. RESULTS: Our findings suggest that young adults' use of avoidance strategies decreased slightly over college, whereas the use of approach strategies and social support seeking remained stable. Temperament (BIS/BAS) and gender were related to certain coping styles at baseline and appeared to have an influence on some of these trajectories over time, though these associations were complex. CONCLUSIONS: This work may inform intervention research attempting to promote adaptive coping because it may help identify young adults most in need of such interventions.

Trajectories of College Alcohol Involvement and Their Associations with Later Alcohol Use Disorder Symptoms.

Little is known about what differentiates individuals whose drinking patterns escalate into problematic use following the transition out of college compared to those who learn to drink in a way that is consistent with independent adult roles. Patterns of alcohol use and problems during college may pre-sage progression toward problem drinking in adulthood. The present study sought to examine such patterns in an effort to delineate those at greatest risk. Research has not yet elucidated whether, when, and how these groups diverge. Our results indicate that students who report AUD symptoms one year following graduation reported greater alcohol involvement from the first semester and escalated their involvement with alcohol at a more rapid pace. We observed marked and measurable differences in drinking patterns between those who go on to exhibit AUD symptoms following college and those who do not. A close inspection of these differences reveals that relatively small absolute differences in alcohol consumption add up to large differences in alcohol-related consequences. Thus, markers of longer-term risk are present early in college, and greater escalation of drinking across college is an indicator that intervention is needed. Brief Motivational Interventions could help students to anticipate some of the challenges ahead as they transition from the college environment, as well as the potential deleterious effects of immoderate alcohol use on making a successful transition into adult roles. In addition to the beginning of college, our findings also point to critical periods during which screening and brief intervention may be optimally timed.