Childhood Aggressive Behavior and Adolescent Substance Use Initiation.

BACKGROUND: Drug and alcohol use before the age of 14 is associated with adverse outcomes over the life course. While previous studies have identified numerous sociodemographic characteristics associated with youth substance use initiation, few have examined the relationship between behavioral characteristics, such as childhood aggression, and substance use initiation in adolescence. METHODS: This longitudinal study consisted of 2985 children from the Future of Families and Child Wellbeing Study. Aggression was measured using primary caregiver report when the children were about the age of 9 and cigarette, alcohol, and marijuana use was measured using the child report when the children were age 9 and age 15. Separate multivariable Poisson regression models were fitted for each substance use initiation outcome. RESULTS: Childhood aggression was positively associated with the initiation of cigarette and marijuana use in adolescence (aRR = 2.3 [95% CI = 1.5,3.4] and aRR = 1.3 [95% CI = 1.1,1.6], respectively). Childhood aggression was not associated with adolescent alcohol use initiation (aRR = 1.2 [95% CI = 0.9,1.5]). CONCLUSIONS: The presence of aggressive behavior in childhood was associated with the initiation of cigarette and marijuana use in adolescence. These results may be used to identify children at higher risk of cigarette and marijuana use, who may benefit from additional monitoring for substance use initiation.

Associations of parental and peer cross-substance use with 12-17-year-old adolescents' problematic alcohol use: A parent-child dyadic gender analysis.

BACKGROUND: Adolescent alcohol use was found to be influenced by parental and peer alcohol use. Drinking behaviors also differed by gender. However, previous studies mainly focused on adolescents' substance use in relation to the same substance use among their salient others. Hence, this study investigated the cross-substance relationships of alcohol and tobacco use of parents and peers with adolescents' problematic alcohol use, separately by gender. METHODS: Data were derived from 4445 adolescents aged 12-17 years from the 2014 National Survey of Substance Use, a nationally representative survey in Taiwan. Problematic alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Multivariate multinomial logistic regression was used, stratified by gender. RESULTS: For males, maternal (adjusted odds ratio [aOR] = 1.73) and peer (aOR = 2.57) alcohol use was related to social drinking (AUDIT < 2); paternal (aOR = 3.58), maternal (aOR = 2.18), peer alcohol use (aOR = 5.37), and their own tobacco use (aOR = 4.72) were related to problem drinking (AUDIT ≥ 2). For females, maternal (aOR = 2.26) and peer (aOR = 2.84) alcohol use was related to social drinking; maternal (aOR = 2.35) and peer tobacco use (aOR = 3.48), and paternal (aOR = 4.56) and peer alcohol use (aOR = 3.36) were linked to problem drinking. CONCLUSIONS: Both male and female adolescents' alcohol use was associated with their peer alcohol use, and gender differences were found in relation to their parental and peer substance use. Specifically, the parental role-modeling of smoking was only significant in mother-daughter dyads. These findings could inform multifaceted adolescent alcohol prevention programs, tailoring for males and females and also targeting their parental and peer substance use.

Prospective associations of e-cigarette use with cigarette, alcohol, marijuana, and nonmedical prescription drug use among US adolescents.

BACKGROUND: As e-cigarette use continues to increase in the U.S., research is needed to understand its prospective risk for cigarette smoking and other substance use in young adulthood, including alcohol, marijuana, and nonmedical prescription drugs (NMPDs). METHODS: This study used data from the Monitoring the Future (MTF) study a nationally representative annual survey of 12th graders (modal age 18) in the US. The analytic sample included 2014-2016 MTF cohorts that were selected and completed follow up one year later (modal age 19; n = 717). Using logistic regression, we examined cross-sectional and prospective associations of past 30-day e-cigarette use with past 30-day cigarette, alcohol, marijuana, and NMPD use. We examined prospective associations among the full sample and associations with incidence of each of these substances among those who reported no history of use in 12th grade. RESULTS: In cross-sectional analysis, those who reported past 30-day e-cigarette use at age 18 were more likely to report past 30-day cigarette use, alcohol use, marijuana use, and NMPD use at age 19. In multivariable longitudinal analysis, past 30-day e-cigarette users at age 18 were more likely to report past 30-day cigarette, marijuana, and NMPD use at age 19, including e-cigarette users who had no history of using these substances at age 18. CONCLUSIONS: This study suggests that e-cigarette use may be an indicator of future substance use risk in young adulthood. Adolescent e-cigarette users may benefit from secondary prevention efforts to mitigate this risk.

The Well-Being Index (WBI) for schools: A brief measure of adolescents' mental health.

Schools are increasingly concerned with the well-being of the whole child - likely, more so since the COVID-19 pandemic - and goals here were to document the psychometric properties of a brief new measure of adolescent mental health, the Well-Being Index (WBI). The measure assesses 4 symptom areas, 2 each of internalizing and externalizing symptoms-Depression, Anxiety, Rule-Breaking, and Substance Use-and an optional scale on Isolation at School. A total of 2,444 students from 2 high schools completed the WBI, the Youth Self-Report (YSR), and other related measures. Alpha coefficients showed acceptable internal consistency, with values for the 5 WBI subscales at .83, .84, .78, .79, and .74, respectively. Both exploratory and confirmatory factor analyses demonstrated consistent factorial validity. Correlations with corresponding YSR subscales indicated good convergent and discriminant validity. The WBI Substance Use and Isolation at School subscales, similarly, had high correlations with subscales from preexisting measures. Criterion-related validity was indicated in significant correlations between WBI subscales and conceptually related dimensions of close relationships. Also examined was the percentage of youth falling above clinical cutoffs on both the WBI and YSR, and findings demonstrated high concurrent validity. Collectively, results suggest the promise of the WBI as a brief, psychometrically sound measure to assess the adjustment of adolescents, along with perceptions of school climate that can be modified toward fostering their overall well-being. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Autonomy, competence and relatedness and cannabis and alcohol use among youth in Canada: a cross-sectional analysis. / Autonomie, compétence et appartenance sociale et consommation de cannabis et d'alcool chez les jeunes au Canada : une analyse transversale.

INTRODUCTION: There has been increasing attention on preventing problematic youth substance use in light of concerns about rates of use and policy changes in Canada. Strengths-based approaches that emphasize protective factors, including positive mental health, are at the forefront of current prevention recommendations. However, there is a dearth of research on the association between positive mental health and substance use among youth. This study examines the associations between cannabis and alcohol use among youth and positive mental health as measured through the lens of self-determination theory. METHODS: Secondary analyses of the 2014/2015 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS) were conducted. Participating Grade 7 to 12 students residing in Canada completed the Children's Intrinsic Needs Satisfaction Scale (CINSS), which measures autonomy, competence and relatedness, and answered questions that measure past 30-day and more frequent cannabis use, alcohol use and binge-drinking. The associations between autonomy, competence and relatedness and substance use, stratified by sex, were examined using logistic regression. RESULTS: Fully adjusted models revealed that relatedness and competence were associated with lower odds of 30-day and more frequent cannabis use, alcohol use and binge-drinking. Higher autonomy was associated with higher odds of these behaviours. All associations were significant with the exception of competence and more frequent cannabis use among boys, and autonomy and more frequent alcohol use among girls. CONCLUSION: The findings offer new evidence on the associations between positive mental health and substance use among youth, specifically how autonomy, competence and relatedness are associated with cannabis use, alcohol use and binge-drinking. This evidence can be used to inform health promotion and substance use prevention programs.

Characterizing profiles of polysubstance use among high school students in Baltimore, Maryland: A latent class analysis.

BACKGROUND: Adolescent drug use has long term health consequences, like substance use disorders and psychiatric illnesses. Proximal health risks, especially for overdose, are amplified when multiple substances are combined. Existing literature on polysubstance use among adolescents has largely focused on alcohol, tobacco, and marijuana, but has largely excluded other drugs like opioids. Understanding how adolescents combine illicit drugs is essential for intervening to prevent poor health outcomes. METHODS: We aimed to explore patterns of lifetime polysubstance use among adolescents in Baltimore City. We used data on 9th-12th graders recruited to participate in the 2017 local Baltimore Youth Risk Behavior Survey who reported any lifetime drug use (n = 387; 60 % female, 77 % non-Hispanic Black). We then conducted a latent class analysis using 10 indicators of lifetime drug and alcohol use. After selecting the class model, we tested for associations between the class profiles and race, sex, school grade, and lifetime injection drug use. RESULTS: We identified three profiles of lifetime polysubstance use in our sample: alcohol and marijuana (68.6 % of sample), polysubstance (22.0 %), and alcohol/pain medication/inhalant use (9.4 %). Members of the polysubstance use class were more likely to be male and to report injection drug use. CONCLUSIONS: Understanding broader patterns of drug use beyond alcohol, tobacco and marijuana among adolescents is a crucial step towards preventing adverse drug and health-related outcomes later in life. More research is needed to characterize the full health impact of youth polysubstance use patterns and related risk behaviors like injection drug use.

Association between preference for using alcohol beverage-named e-liquids and alcohol use among high school youth.

BACKGROUND: There are thousands of e-liquid flavors available, and some are named after alcohol beverages (e.g., "pina colada"). It is unclear whether use of e-liquids with alcohol beverage names is associated with adolescent alcohol use. E-cigarettes and alcohol are co-used in adolescents; therefore, it is important to investigate these associations. METHODS: Eight Southeastern Connecticut high schools were surveyed in Spring 2015 (N = 7045). We examined the association between preference for using e-liquid flavors and alcohol drinking status (i.e., no past month alcohol use, past month alcohol use but no binge drinking, and past month binge drinking) in ever e-cigarette users (N = 1311). RESULTS: Among ever e-cigarette users who preferred using e-liquids with alcohol beverage names (N = 111), 30.6 % had no past month alcohol use, 19.8 % had past month alcohol use but did not binge drink in the past month, and 49.5 % binge drank in the past month. Multinomial logistic regression (controlling for demographics and including other e-cigarette flavors that were highly endorsed, i.e., fruit and candy) revealed that the preferences of alcohol beverage-named-e-liquid (OR: 2.84, CI: 1.70-4.75) and fruit flavored e-liquids (OR: 1.55, CI: 1.14-2.11), but not candy flavored e-liquids was associated with past-month binge drinking compared to no past-month alcohol use. CONCLUSION: This evidence suggests that the preference for using alcohol beverage- and fruit-named e-liquid flavors is associated with past-month binge drinking among adolescents. Understanding the associations between alcohol beverage-named e-liquids and alcohol use in adolescents may help inform tobacco regulatory strategies that aim to decrease the use/appeal of e-cigarettes.

Similarities Between Alcohol and Tobacco Advertising Exposure and Adolescent Use of Each of These Substances.

OBJECTIVE: Underage alcohol use is a major public health problem and substantial corporate money supports alcohol advertising across multiple venues. A diverse research literature demonstrates that adolescent exposure to such advertising is associated with drinking attitudes and behavior, but no scientific body has determined these associations to be causal. The objective of this study was to assess the association between alcohol advertising and teen drinking in the context of the "Analogy" criterion of the Bradford Hill criteria and consider a determination that the association between exposure to alcohol advertising and alcohol use is causal. METHOD: This study was a narrative review on the association between adolescent exposure to alcohol advertising and subsequent alcohol use in the context of domains utilized in the Surgeon General's 2012 Report, Preventing Tobacco Use Among Youth and Young Adults, which concluded, "Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults." RESULTS: In every aspect compared (i.e., adolescent knowledge; attitudes toward; initiation of use; continuation of use; mediums of advertisement; the use of mascots, celebrities, and themes; and frequency and density of advertisements and retailers), the findings for both tobacco and alcohol and their association with exposure to advertising are analogous. CONCLUSIONS: Application of the Analogy criterion of the Bradford Hill criteria comparing alcohol and tobacco supports a judgment that the association between exposure to alcohol advertising and increased adolescent knowledge, attitudes toward, initiation, and continuation of alcohol use are causal in nature.

Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents.

Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.

Examining the internalizing pathway to substance use frequency in 10 cultural groups.

Use of alcohol, tobacco, and drugs (i.e., substance use) is a leading cause of global health burden for 10-to-24-year-olds, according to the World Health Organization's index of number of years of life lost, leading international health organizations to prioritize the prevention of substance use before it escalates in adolescence. Pathways defined by childhood externalizing symptoms and internalizing symptoms identify precursors to frequent substance use toward which interventions can be directed. However, these pathways are rarely examined beyond the United States and Europe. We investigated these pathways in our sample of 1083 children from 10 cultural groups followed from ages 8-14. We found that age-10 externalizing symptoms predicted more frequent mother-reported age-13 and self-reported age-14 substance use. We also found that a depressive pathway, marked by behavioral inhibition at age 8 and subsequent elevation in depressive symptoms across ages 8-12 predicted more frequent substance use at age 13 and 14. Additionally, we found a combined externalizing and internalizing pathway, wherein elevated age-9 depressive symptoms predicted elevated externalizing symptoms at age-10 which predicted greater peer support for use at age-12, which led to more frequent substance use at age-13 and -14. These pathways remained significant within the cultural groups we studied, even after controlling for differences in substance use frequency across groups. Additionally, cultures with greater opportunities for substance use at age-12 had more frequent adolescent substance use at age-13. These findings highlight the importance of disaggregating between- and within-culture effects in identifying the etiology of early adolescent substance use.

Overweight in adolescents: food insecurity and multifactoriality in semiarid regions of pernambuco / Excesso de peso em adolescentes: insegurança alimentar e multifatorialidade no cenário do semiárido de pernambuco

ABSTRACT Objective: To investigate context of overweight adolescents from the semiarid and rural areas of Pernambuco, considering the multifactorial nature of the determinants of being overweight, and the food and nutritional insecurity conditions of the region. Methods: A population based cross-sectional study was conducted from September to October 2015. The nutritional status of adolescents was assessed by body mass index (BMI) and classified by the BMI/Age indicator, according to sex. To analyze the factors associated with being overweight, the variables were grouped into: socioeconomic, demographic, environmental, lifestyle, psychological, biological and food and nutritional security. Poisson regression was used to verify the association between being overweight and independent variables. Results: The prevalence of excessive weight found was 20.1%, namely: 13.4% overweight and 6.7% obese. After adjusting for the confounding variables, the variables: occupancy situation (rented house), alcohol consumption, food security and light food insecurity, body perception (overweight and obese) and age range (10 to 14 years), were associated with being overweight. High food and nutritional insecurity was identified in 80.4% of the population. The moderate and severe forms were more frequent, and precarious social conditions were still prevalent in the region. Conclusions: The prevalence of being overweight was high, exceeding the expected for a population with better living conditions. The determinants of being overweight were: alcohol consumption, occupancy situation, self-perceived weight, age and food security/mild food insecurity.

RESUMO Objetivo: Investigar o excesso de peso em adolescentes do Sertão e Agreste de Pernambuco, considerando a multifatoriedade dos determinantes do excesso de peso e as condições de insegurança alimentar e nutricional da região. Métodos: Estudo transversal, de base populacional, realizado no período de setembro a outubro de 2015. O estado nutricional dos adolescentes foi avaliado pelo índice de massa corpórea (IMC) e classificado pelo indicador IMC/idade, segundo o sexo. Para analisar os fatores associados ao excesso de peso, as variáveis foram agrupadas em: socioeconômicas, demográficas, ambientais, de estilo de vida, psicológicas, biológicas e segurança alimentar e nutricional. A regressão de Poisson foi utilizada para verificar a associação entre o excesso de peso e as variáveis independentes. Resultados: A prevalência de excesso de peso encontrada foi de 20,1%, sendo 13,4% de sobrepeso e 6,7% de obesidade. Após o ajuste para as variáveis de confusão, as variáveis regime de ocupação (casa cedida, alugada), consumo de álcool, segurança alimentar, insegurança alimentar leve, percepção corporal (sobrepeso e obesidade) e faixa etária (10 a 14 anos) mostraram-se associadas ao excesso de peso. Destaca-se a elevada insegurança alimentar e nutricional, em 80,4% da população, sendo as formas moderadas e graves as mais frequentes, como também as precárias condições sociais ainda prevalentes na região. Conclusões: A prevalência de excesso de peso foi elevada, superando o esperado para uma população com melhores condições de vida. Os determinantes do excesso de peso foram: consumo de álcool, regime de ocupação, autopercepção do peso, faixa etária e segurança alimentar/insegurança alimentar leve.

Identifying trajectories of alcohol use in a sample of secondary school students in Ontario and Alberta: longitudinal evidence from the COMPASS study. / Établissement des trajectoires de consommation d'alcool chez un échantillon d'élèves du secondaire de l'Ontario et de l'Alberta : données probantes longitudinales tirées de l'étude COMPASS.

INTRODUCTION: Despite evidence indicating a rapid progression in use of alcohol during adolescence, little is known about the ways patterns of drinking develop over time. This study investigated patterns of alcohol use within a cohort of youth in Ontario and Alberta and the probability of changes between patterns. METHODS: The sample consists of two-year linked longitudinal data (school year 2013/14 to 2014/15) from 19 492 students in Grades 9 to 12 in 89 secondary schools across Ontario and Alberta, Canada, who participated in the COMPASS study. The latent class analysis used two self-reported items about the frequency of drinking (measured as none, monthly, weekly, or daily use) and the frequency of binge drinking (measured as none, less than or once a month, 2-4 times a month, or more than once week) to characterize patterns of alcohol use. The effects of gender, ethnicity and cannabis and cigarette use on alcohol use patterns were examined. RESULTS: The study identified four drinking patterns: non-drinker, periodic drinker (reported monthly drinking and no binge drinking), low-risk drinker (reported monthly drinking and limited binge drinking) and high-risk regular drinker (reported drinking 1-3 times a week and binge drinking 2-4 times a month). Non-drinker was the most prevalent pattern at baseline (55.1%) and follow-up (39.1%). Periodic drinkers had the highest likelihood of an increase in alcohol consumption, with 40% moving to the low-risk pattern. A notable proportion of participants returned to a lower severity pattern or transitioning out of drinking. CONCLUSION: There are four distinct youth alcohol-use patterns. The high probability of transitioning to drinking during the secondary school years suggests the need for preventive interventions in earlier stages of use, before drinking becomes habitual.

The relative importance of perceived substance misuse use by different peers on smoking, alcohol and illicit drug use in adolescence.

BACKGROUND: Substance use by young people is strongly associated with that of their peers. Little is known about the influence of different types of peers. We tested the relationship between perceived substance use by five types of peers and adolescents' use of illicit drugs, smoking, and alcohol consumption. METHODS: We used data collected from 1285 students aged 12-13 as part of a pilot cluster randomized controlled trial (United Kingdom, 2014-2016). The exposures were the perceived use of illicit drugs, smoking and alcohol consumption by best friends, boy or girlfriends, brothers or sisters, friends outside of school and online. Outcomes were self-reported lifetime use of illicit drugs, smoking and alcohol consumption assessed 18-months later. RESULTS: The lifetime prevalence of illicit drug use, smoking and alcohol consumption at the 18-month follow-up were 14.3%, 24.9% and 54.1%, respectively. In the fully adjusted models, perceived substance use by friends outside of school, brothers or sisters, and online had the most consistent associations with outcomes. Perceived use by friends online was associated with an increased risk of ever having used illicit drugs (odds ratio [OR] = 2.43, 95% confidence interval [CI] = 1.26, 4.69), smoking (OR = 1.61, 95% CI 0.96, 2.70) and alcohol consumption (OR = 2.98, 95% CI = 1.71, 5.18). CONCLUSIONS: Perceived substance use by friends outside of school, brothers and sisters and online could be viable sources of peer influence. If these findings are replicated, a greater emphasis should be made in interventions to mitigate the influence of these peers.

Predicting hazardous drinking in late adolescence/young adulthood from early and excessive adolescent drinking - a longitudinal cross-national study of Norwegian and Australian adolescents.

BACKGROUND: Research has consistently shown that early onset of drinking (EOD) is associated with alcohol-related problems in adulthood. However, recent reviews have identified several limitations in the early onset literature, including the use of retrospective reports, insufficient control for potential confounders, ambiguous definitions of the concept, and an assumption that early onset is independent of cultural norms and national alcohol policies. This study addresses these limitations by examining whether EOD, independent of early onset of excessive drinking (EOE), prospectively predicts hazardous drinking in late adolescence/young adulthood in Norway and Australia, two countries with different drinking cultures. METHODS: Data were drawn from two population-based longitudinal studies; the Norwegian Tracking Opportunities and Problems Study (n = 329) and the Australian International Youth Development Study (n = 786). Data were collected prospectively from mid adolescence (14-16 years) to late adolescence/young adulthood (18-25 years) and a modified Poisson regression approach was used to estimate prevalence ratios. Adolescent self-reports included measures of EOD and EOE. Young adults completed the Alcohol Use Disorders Identification Test (AUDIT). The results were adjusted for adolescent factors; age, gender, impulsivity, hyperactivity, conduct problems, smoking, early sexual intercourse and friends' substance use, and family factors; alcohol and drug use in the family, maternal education, family management and monitoring. RESULTS: Hazardous drinking was identified in 46.8 and 38.9% of young adults in Norway and Australia, respectively. Both EOD and EOE in adolescence were significantly related to an increased risk of alcohol-related problems in late adolescence/young adulthood in both studies, even when adjusting for possible confounders. CONCLUSION: Our findings indicate that adolescent drinking behaviour is an indicator of alcohol-related problems in late adolescence/young adulthood, even when controlling for a variety of covariates. This finding is in contrast to previous research on older adults, where no association between adolescent drinking and later alcohol-related problems were found when controlling for covariates. The divergence in findings may suggest that the impact of EOD/EOE is limited to the late adolescent and young adult period. Preventing drinking in early adolescence may thus have some impact on the drinking patterns in late adolescence/young adulthood.

A risk model for addictive behaviors in adolescents: interactions between personality and learning.

BACKGROUND AND AIMS: To determine whether transdiagnostic risk, represented as elevations in one high-risk personality trait, interacts with behavior-specific risk, represented as elevated expectancies for reinforcement from either drinking or smoking, to account partly for early adolescent drinking and smoking behavior. DESIGN: Multiple regression analysis. SETTING: Twenty-three public schools in two school systems in the United States. PARTICIPANTS: A sample of 1897 adolescents tested in the spring of 5th, 6th, 7th, 8th and 9th grades. MEASUREMENTS: Transdiagnostic risk was measured as negative urgency, the tendency to act rashly when distressed, using the UPPS-P child version. Drinking-specific and smoking-specific risk were measured as expectancies for reinforcement from drinking and smoking, using the Memory Model-Based Expectancy Questionnaire (alcohol) and the Adolescent Smoking Consequences Questionnaire (smoking). FINDINGS: There was consistent concurrent prediction from the interactions of (a) negative urgency and alcohol reinforcement expectancies to early adolescent drinking and (b) negative urgency and smoking reinforcement expectancies to early adolescent smoking, above and beyond prediction from the main effects of those variables. In each case, expectancies were more predictive at higher levels of negative urgency. Incremental R2 values for main effects ranged from 0.07 to 0.26, and for interactions ranged from 0.01 to 0.03. Prospectively, the main effects predicted subsequent behavior but the interaction effects did not, except in one case. CONCLUSIONS: Among elementary and high school students in the United States, the joint effects of negative urgency and behavior-specific expectancies help to explain drinking and smoking behavior. Joint elevations on the trait and the learning variable account for drinking and smoking behavior beyond the main effects of each predictor. However, there is reason to doubt whether the joint effects predict subsequent increases in drinking and smoking beyond the main effects of those variables.

The Relationship Between Parent Drinking and Adolescent Drinking: Differences for Mothers and Fathers and Boys and Girls.

BACKGROUND: Gender differences in the relationship between parent drinking and adolescent drinking are poorly understood. As parental alcohol use is a primary early exposure to alcohol for adolescents, it is important to understand how consequences may differ for adolescent males and females. OBJECTIVES: The aim of this paper was to examine gender differences in the relationship between mother's and father's heavy episodic drinking, and its combination, and adolescent drinking. METHODS: The sample included 2,800 14-15 year olds (48.9% female) living in two-parent households from the Longitudinal Study of Australian Children. The adolescent outcome measure was having had an alcoholic drink in the past year. Mothers and fathers self-reported their frequency of heavy episodic drinking. Covariates included parents' education, smoking, non-English-speaking background, and symptoms of psychological distress. Logistic regression was used to examine the hypotheses. RESULTS: After adjustment for covariates, both mothers' and fathers' heavy episodic drinking significantly increased the likelihood of adolescent drinking. Moreover, fathers' heavy drinking was more strongly related to adolescent drinking for girls. However, there were no gender differences in the relationship between mothers' drinking and adolescent drinking, and the combination of mothers' and fathers' drinking was not more risky than heavy drinking in either parent alone. CONCLUSIONS: Parent heavy episodic drinking is a risk factor for adolescent drinking, after controlling for potential confounding variables. Results suggest that girls may be especially vulnerable to parent heavy drinking in early adolescence. This variation should be considered in the design and evaluation of family-based interventions to prevent adolescent drinking.

Substance Use and School Characteristics in Lesbian, Gay, Bisexual, and Heterosexual High School Students.

BACKGROUND: Tobacco, alcohol, and illicit drug use among lesbian, gay, and bisexual (LGB) high school students as well as related environment and school-level risk and protective factors were examined. METHODS: Data was acquired from the 2015 CDC's Youth Behavior Risk Survey for Kentucky (N = 2577). Prevalence of substance use was calculated for all high school respondents by reported sexual orientation. Multivariate analyses estimated the relationship between school and environmental-level factors (eg, having an adult to talk to) and tobacco, alcohol, and illicit drug use via logistic regressions. Sexual orientation, gender, age, and race/ethnicity were covariates. RESULTS: LGB students used tobacco, alcohol, and illicit drugs more frequently than their heterosexual counterparts. More LGB teens report facing school risk factors (eg, 37% LGB vs 20% heterosexual bullied at school, p ≤ .001; 17% LGB vs 5% heterosexual ever threatened or injured at school, p < .001; 13% LGB vs 7% heterosexual involved in a school fight, p = .001). Adjusting for school related risk factors, having an adult to talk to was associated with a reduced likelihood of daily smoking (adjusted odds ratio [aOR]: 0.43; 95% confidence interval [CI]: 0.26-0.73), past 30-day alcohol use (aOR: 0.71; 95% CI: 0.50-0.95), and ever marijuana use (aOR: 0.71; 95% CI: 0.50-1.00). CONCLUSION: Innovative strategies are needed to create safe, supportive school environments. These strategies are particularly needed in predominately rural states like Kentucky.

Relative influence of perceived peer and family substance use on adolescent alcohol, cigarette, and marijuana use across middle and high school.

PURPOSE: Substance use by peers and family may affect adolescent substance use, yet the relative influence may shift during adolescence as youth differentiate themselves from family and more closely affiliate with peers. This study examined trends in concordance of adolescent cigarette, alcohol and marijuana use and corresponding perceived use by friends and family members during middle and high school. METHODS: Data are from a longitudinal cohort of 12,038 youth who completed up to five surveys during grades 6-12. At each wave, adolescents reported past month use of cigarettes, alcohol and marijuana, as well as perceived use by their best friend, older sibling and most important adult figure. For each substance, we used time-varying effect models to estimate how associations between adolescent use and perceived use varied across grade. RESULTS: For all substances, concordance with best friend use was positive and stronger than concordance with older sibling or adult use at all grades. Concordance with both best friend and older sibling use of all substances was pronounced in 6th grade. Concordance peaked again during mid-high school for smoking (best friend, older sibling) and marijuana (best friend). Concordance with adult marijuana use peaked in middle school, yet associations with adult alcohol and cigarette use were relatively stable. CONCLUSIONS: Substance use prevention efforts that seek to counter peer normative pressures should begin prior to middle school and span high school. Such efforts should address the role of peer and family environments, as both were found to be relevant during middle and high school.

Developmental pathways of adolescent cannabis use: Risk factors, outcomes and sex-specific differences.

BACKGROUND: Characterizing patterns of adolescent cannabis use (CU), as well as risk factors and outcomes uniquely associated with these pathways is essential for informing treatment and prevention efforts. Yet, few studies have examined these issues among youth at-risk of engaging in problematic cannabis use. Further, research accounting for use of other substances or sex differences in patterns of CU remains exceedingly sparse. METHODS: Trajectory-based modeling was used to identify underlying CU pathways among a predominantly Hispanic (90%) sample of at-risk youth (n = 401; 46% female) across adolescence (ages∼14-18), controlling for baseline substance use and participant demographics. Adolescent psychopathology (i.e., conduct disorder, attention deficit hyperactivity disorder, anxiety, and depression) was examined as a predictor and outcome of CU. RESULTS: Three trajectories of adolescent CU were identified, with most youth (74%) engaging in relatively "low" levels of use, followed by ∼12% exhibiting an early-initiating "chronic" course, and 14% "escalating" in use. Although boys and girls both experienced increased levels of CU across adolescence, boys were more likely to exhibit escalating and chronic patterns of use. Findings revealed unique associations between adolescent CU pathways and facets of psychopathology; most notably, the relatively robust and bidirectional association between CU trajectories and conduct problem symptoms. CONCLUSIONS: Specific facets of psychopathology may confer unique associations with CU across development, including the initiation and exacerbation of CU during adolescence.

Alcohol, tobacco, and marijuana expectancies as predictors of substance use initiation in adolescence: A longitudinal examination.

Outcome expectancies have been found to be predictive of substance use. While development of expectancies may be dynamic during adolescence, it is unknown whether the rate of change (slope) in substance use expectancies is a risk factor for use onset across multiple substance use domains. The present study tested the hypothesis that the slope of positive and negative alcohol, tobacco, and marijuana use expectancies during mid-adolescence (9th-10th grade) would predict use onset of each respective substance during late adolescence (11th-12th grade). Data from 3,396 ethnically diverse high school students were collected across eight waves of assessment and analyzed within a latent growth modeling framework. Results revealed that the slopes of positive substance use expectancies among never-users of each respective substance predicted increased odds of onset (Alcohol: ORB = 7.73, p < .001; Tobacco: ORB = 5.58, p < .001; Marijuana: ORB = 2.49, p = .001). Only the slope of negative marijuana expectancies predicted increased odds of onset (Marijuana: ORB = .44, p = .04). Baseline level of positive and negative substance use outcome expectancies were also generally found to be associated with onset. For three common drugs used by adolescents, change in substance use expectancies during the first two years of high school may be a marker of risk propensity for substance use onset. Change in expectancies may be an important target in substance use prevention, with research indicating that expectancy challenge and life skills interventions being potentially efficacious. (PsycINFO Database Record (c) 2019 APA, all rights reserved).