Cross-substance patterns of alcohol, cigarette, and cannabis use initiation in Black and White adolescent girls.

Characterizing variations in the timing of alcohol, cigarette, and cannabis use onset both among and between Black and White youth can inform targeted prevention. The current study aimed to capture cross-substance initiation patterns in Black and White girls and characterize these patterns with respect to substance use related socioeconomic, neighborhood, family, community, and individual level factors. Data were drawn from interviews conducted at ages 8 through 17 in an urban sample of girls (n = 2172; 56.86% Black, 43.14% White). Discrete-time multiple event process survival mixture modeling was used to identify patterns (i.e., classes) representing timing of alcohol, cigarette, and cannabis use initiation, separately by race. Class characteristics were compared using multinomial logistic regression. Among both Black and White girls, four classes, including abstainer and cross-substance early onset classes, emerged. Two classes characterized by mid-adolescence onset (Black girls) and variation in onset by substance (White girls) were also observed. Class differences centered around cannabis for Black girls (e.g., preceding or following cigarette use) and alcohol for White girls (e.g., (in)consistency over time in greater likelihood of initiation relative to cigarette and cannabis use). Several factors distinguishing the classes were common across race (e.g., externalizing behaviors, friends' cannabis use); some were specific to Black girls (e.g., intentions to smoke cigarettes) or White girls (e.g., primary caregiver problem drinking). Findings underscore the need to recognize a more complex picture than a high-risk/low-risk dichotomy for substance use initiation and to attend to nuanced differences in markers of risky onset pathways between Black and White girls.

Not Just Service Attendance: Associations of Religious Community Social Connections with Alcohol Use among Black Adults Header: Religious Community Social Connections and Alcohol Use among Black Adults.

Background: Religious involvement is a well-documented protective factor against alcohol use among Black adults, but the extent to which social connections to the religious community can explain those effects remains largely unknown. The current study was designed to capture contributions of religious community support and demands - independent of religious service attendance - to alcohol use among three age cohorts of Black adults. Methods: Data were drawn from 18- to 65-year-old Black participants in the National Survey of American Life (n = 4,462; 29.4% Afro Caribbean, 70.6% African American; 63.20% female). Ordinal logistic regression analyses, conducted separately for each age cohort (18-29, 30-44, and 45-65), were used to model frequency of alcohol use as a function of religious community support and demands in two stages: (1) prior to and (2) after accounting for religious service attendance. Results: Religious community support accounted for differences in alcohol use frequency over and above religious service attendance (in Stage 2 models) for adults aged 30-44 (OR = 0.85, CI: 0.74-0.96) and 45-65 (OR = 0.77, CI: 0.64-0.93) but not 18-29 (OR = 0.85, CI: 0.71-1.03). The association of religious community demands with alcohol use frequency was specific to the age 30-44 cohort in both stage models (Stage 2: OR = 1.33, CI: 1.06-1.68). Conclusions: Study findings suggest that in addition to attending religious services regularly, developing supportive social connections to the religious community may reduce risk for frequent drinking among Black adults, particularly during middle adulthood, when demands from the religious community may increase risk.

Profiles of young women's alcohol and cannabis use linked to risk for sexually transmitted infection highlight the importance of multi-level targeted interventions: Findings from the Pittsburgh girls study.

Background: Social ecological models designed to understand disparities in sexually transmitted infection (STI) prevalence highlight understudied structural and community risk factors. Guided by a social ecological model, this study identified profiles based on substance use-related STI risk, and examined associations of the profiles with selected indicators of structural-, community-, and individual-level STI risk factors. Methods: Repeated measures latent class analysis was applied to Pittsburgh Girls Study data (n = 2,138; 58% Black, 42% White) at ages 18-20. Profile indicators included: women's and partner's alcohol and cannabis use, women's sexual risk behavior, and self-reported STI. Profile predictors included racial background, structural-, community-, and individual-level risk factors. Results: Two of the five identified profiles had low STI likelihood: "Low Use" of alcohol and cannabis (25.5%; overrepresented by Black women), and "Alcohol Only" (19.1%; overrepresented by White women). Three profiles, all representing co-use of alcohol and cannabis, had higher STI likelihood: "Co-Use: Increasing Alcohol and Occasional Cannabis use" (16.5%; overrepresented by White women), "Co-Use: Occasional Alcohol and Cannabis use" (26.1%; overrepresented by Black women), and "Co-Use: Frequent Cannabis and Occasional Alcohol use" (12.8%; overrepresented by Black women). Structural STI risk (household use of public assistance at wave 1) was associated with "Low Use" and "Co-Use: Frequent Cannabis and Occasional Alcohol use" profiles. STI risk at multiple levels (structural, neighborhood, individual) was associated with the "Co-Use: Frequent Cannabis and Occasional Alcohol use" profile. Conclusions: Co-use of alcohol and cannabis is an important target for STI prevention efforts. Results also highlight structural- and community-level STI risk factors that disproportionately impact Black women, and the importance of multi-level interventions that are targeted to profile of risk to optimize the effectiveness of interventions.

Profiles of substance use related protective and risk factors and their associations with alcohol and tobacco use initiation among black adolescents.

Insufficient attention to protective and risk factors of particular salience for Black youth (e.g., racial identity and racial discrimination) in population-based substance use studies has left gaps in our understanding of alcohol and tobacco use development in Black adolescents. The current study aimed to capture the clustering of such understudied factors and their collective influence on alcohol and tobacco use initiation among Black adolescents. Data were drawn from The National Survey of American Life (n = 1,170; age range = 13-17; 6.9% Afro Caribbean, 93.1% African American; 50.0% female). Latent profile analysis applied to 11 indicators representing family, community, and individual level protective and risk factors revealed (1) High Vulnerability (high risk, low protective factors; 17.5%), (2) Moderate Vulnerability (moderate on both; 63.2%), and (3) Low Vulnerability (high protective, low risk factors; 19.3%) classes. Classes differed significantly by religious community support, school bonding, quality of relationship with mother, religious involvement, and interpersonal trauma. Relative to Class 2, Class 1 had higher odds of alcohol (OR = 1.518, CI:1.092-2.109) and tobacco use (OR = 1.998, CI:1.401-2.848); Class 3 had lower odds of alcohol (OR = 0.659, CI:0.449-0.968) but not tobacco use (OR = 0.965, CI:0.611-1.523). Findings suggest that alcohol and tobacco use initiation among Black adolescents is shaped by the collective influence of community and family level support, with commonly experienced risk factors such as non-interpersonal trauma distinguishing liability to a lesser degree. The equally modest prevalence of tobacco use among low and moderate vulnerability classes further indicates that fostering these connections may be especially effective in reducing tobacco use risk.

Social class discrimination as a predictor of first cigarette use and transition to nicotine use disorder in Black and White youth.

PURPOSE: To characterize the association of social class discrimination with the timing of first cigarette use and progression to DSM-IV nicotine dependence (ND) in Black and White youth, examining variation by race, parent vs. youth experiences of discrimination, socioeconomic status (SES), and stage of smoking. METHODS: Data were drawn from 1461 youth (55.2% Black, 44.8% White; 50.2% female) and mothers in a high-risk family study of alcohol use disorder and related conditions. Cox proportional hazard regression analyses were conducted, using youth's and mother's social class discrimination to predict first cigarette use and progression to ND, stratifying by race. Interactions between discrimination and SES indicators (parental education and household income) were tested. Adjusted models included psychiatric covariates. RESULTS: In the adjusted first cigarette use models, neither youth's nor mother's social class discrimination was a significant predictor among Black youth, but mother's discrimination was associated with increased risk [HR = 1.53 (1.18-1.99)] among White youth. In the adjusted ND models, mother's discrimination was associated with reduced ND risk for Black youth in middle-income families [HR = 0.29 (CI 0.13-0.63)], but neither youth's nor mother's discrimination predicted transition to ND among White youth. CONCLUSIONS: The observed race and smoking stage-specific effects suggest that social class discrimination is more impactful on early stages of smoking for White youth and later stages for Black youth. The robustness of links with mother's discrimination experiences further suggests the importance of considering family-level effects and the need to explore possible mechanisms, such as socialization processes.

Relational Peer Victimization Interacts With Depression Severity to Predict the Timing of Alcohol Use Initiation in Adolescent Girls.

BACKGROUND: Peer victimization is consistently linked to adolescents' alcohol use. However, the relative influence of relational and physical peer victimization on alcohol use, and timing of drinking initiation, is not well understood. In this study, we evaluate the impact of both relational and physical peer victimization on adolescent girls' alcohol use initiation, and the extent to which depression severity moderates these associations. METHODS: Participants were 2,125 girls in the Pittsburgh Girls Study, a longitudinal community-based study. Participants reported experiences of relational and physical peer victimization, depression severity, and alcohol use each year from ages 10 to 17. Cox proportional hazards (PH) regression analyses predicting the timing of first drink were conducted in 2 stages, testing for main effects of peer victimization in Model 1 and moderation by depression severity in Model 2. RESULTS: Analyses were split at age 14 to adjust for PH violations. Model 1 results supported a main effect for relational (Hazards ratio [HR] = 1.83, CI: 1.46 to 2.28 ≤ age 13; HR = 1.23, CI: 1.05 to 1.45 ≥ age 14) but not physical victimization on timing of alcohol use onset (HR = 1.10, CI: 0.88 to 1.39). Model 2 results show that depression severity moderates the association between relational victimization and alcohol use initiation: the association between relational victimization and early alcohol use onset was stronger for lower depression severity (-1 SD HR = 2.38, CI: 1.68 to 3.39 ≤ age 13; -1 SD HR = 1.48, CI: 1.10 to 1.52 ≥ age 14). CONCLUSIONS: Results demonstrate that relational (and not physical) victimization predicts earlier drinking among adolescent girls. Relational peer victimization conferred greater risk for alcohol use initiation when depression severity was lower, whereas girls with high depression severity engaged in early alcohol use regardless of peer victimization. Results suggest that interventions focused on relational peer victimization may have spillover effects for delaying girls' alcohol use initiation, particularly in early adolescence, when this association is most robust.

Public and private religious involvement and initiation of alcohol, cigarette, and marijuana use in Black and White adolescent girls.

PURPOSE: This longitudinal study aimed to identify variation by race in the associations between religious involvement and initiation of alcohol, cigarette, and marijuana use, including distinctions by substance or type of religious involvement, in Black and White adolescent girls. METHODS: Data were drawn from interviews conducted at ages 11 through 17 with 2172 Pittsburgh Girls Study participants (56.8% Black; 43.2% White). Two indicators of public religious involvement, religious service attendance and participation in other religious activities, and two indicators of private religious involvement, prayer, and importance of religion were queried. A series of Cox proportional hazards regression analyses were conducted to identify independent effects of religious involvement indicators on initiation of each substance. RESULTS: Prior to adjusting for socioenvironmental and psychosocial factors (e.g., parental monitoring), importance of religion predicted initiation of alcohol use across race and cigarette and marijuana use in White but not Black girls. Participation in other religious activities also predicted marijuana use initiation only in White girls. In adjusted models, importance of religion remained significant for cigarette use initiation in White girls (hazard ratio [HR] = 0.68, 95% confidence intervals [CI]: 0.53-0.88) and participation in other religious activities remained significant for marijuana use initiation in White girls (HR = 0.63, CI: 0.47-0.83). CONCLUSIONS: The protective effects of religious involvement against cigarette and marijuana use initiation are more robust for White than Black adolescent girls and overall relatively weak for alcohol use initiation. Furthermore, importance placed on religion may be a better indicator than religious service attendance of risk for adolescent substance use initiation.

Longitudinal Reciprocal Associations Between Anxiety, Depression, and Alcohol Use in Adolescent Girls.

BACKGROUND: Depression, anxiety, and alcohol misuse predict adverse social, academic, and emotional outcomes, and their relations to one another increase during adolescence-particularly in girls. However, evidence on the directions of these relations is mixed. Longitudinal models of internalizing problem-alcohol use links may identify promising prevention targets. Accordingly, we examined reciprocal associations between anxiety severity and alcohol use, as well as between depression severity and alcohol use, in adolescent girls. METHODS: Data were drawn from a population-based longitudinal study of female adolescents. The current sample comprised 2,100 participants (57.1% Black, 42.9% White) assessed annually between ages 13 and 17. Girls self-reported depression severity, anxiety severity, and frequency of alcohol use (consumption of ≥1 full drink) in the past year. Primary caregivers reported on socioeconomic and neighborhood factors; these were included with race, early puberty, and conduct problems (youth-report) as covariates. Anxiety and depression severity were included within a single cross-lagged panel model, along with alcohol use, to isolate their independent and reciprocal links to drinking behavior. RESULTS: Higher depression severity modestly predicted increased likelihood of subsequent alcohol use from ages 13 to 17. However, inconsistent relations emerged for the reverse pathway: Alcohol use modestly predicted decreased depression severity at ages 14 and 16; associations were nonsignificant in other lagged associations. Anxiety severity and alcohol use were not consistently associated. CONCLUSIONS: Results highlight the key role of depression, relative to anxiety, in predicting later alcohol use. Future studies may examine whether depression prevention programs yield secondary reductions in alcohol use in adolescent girls.

Childhood interpersonal violence and adult alcohol, cannabis, and tobacco use disorders: variation by race/ethnicity?

BACKGROUND: Exposure to child maltreatment has been shown to increase lifetime risk for substance use disorders (SUD). However, this has not been systematically examined among race/ethnic groups, for whom rates of exposure to assaultive violence and SUD differ. This study examined variation by race/ethnicity and gender in associations of alcohol (AUD), cannabis (CUD), and tobacco (TUD) use disorders with three types of childhood interpersonal violence (cIPV): physical abuse, sexual abuse, and witnessing parental violence. METHOD: Data from the National Epidemiologic Survey of Alcohol-Related Conditions-III (N: 36 309), a US nationally representative sample, was utilized to examine associations of DSM-5 AUD, CUD and TUD with cIPV among men and women of five racial/ethnic groups. Models were adjusted for additional risk factors (e.g. parental substance use problems, participant's co-occurring SUD). RESULTS: Independent contributions of childhood physical and sexual abuse to AUD, CUD, and TUD, and of witnessing parental violence to AUD and TUD were observed. Associations of cIPV and SUD were relatively similar across race/ethnicity and gender [Odds Ratios (ORs) ranged from 1.1 to 1.9], although associations of physical abuse with AUD and TUD were greater among males, associations of parental violence and AUD were greater among females, and associations of parental violence with AUD were greater among Hispanic women and American Indian men. CONCLUSIONS: Given the paucity of research in this area, and the potential identification of modifiable risk factors to reduce the impact of childhood interpersonal violence on SUDs, further research and consideration of tailoring prevention and intervention efforts to different populations are warranted.

Longitudinal Associations Between Alcohol-Related Cognitions and Use in African American and European American Adolescent Girls.

BACKGROUND: African American (AA) girls initiate alcohol use later and drink less than European American (EA) girls, potentially reflecting differences in the development of drinking behaviors. This study examined alcohol-related cognitions: expectancies, attitudes, and intention to drink, as possible sources of variation by race in alcohol use. The aim of this study was to characterize the nature and degree of association between cognitions and use over time and by race in EA and AA girls. METHODS: Data were drawn from the longitudinal Pittsburgh Girls Study (N = 2,450), an urban population-based sample of girls and their caregivers recruited when girls were between ages 5 and 8, and assessed annually through adolescence. Cross-lagged panel models were conducted separately by race (56.2% AA, 43.8% EA) to identify patterns of association between alcohol use and cognitions from ages 12 to 17 in 2,173 girls. RESULTS: Endorsement of cognitions and use was higher overall in EA than AA girls but the magnitude of cross-lagged path coefficients did not differ significantly by race. In both groups, bidirectional effects emerged between intentions and use, and alcohol use largely predicted cognitions across ages. However, intention to drink was the only alcohol-related cognition that consistently predicted subsequent use (odds ratios ranged from 1.55 to 2.71). CONCLUSIONS: Although rates of alcohol use and endorsement of cognitions were greater in EA than AA girls, the anticipated racial differences in longitudinal associations between cognitions and use did not emerge, indicating that variation in associations between use and cognitions does not account for the lower prevalence of alcohol use in AA compared with EA girls. Furthermore, our finding that intention to drink is a consistent, robust predictor of subsequent alcohol use suggests the need to investigate potentially modifiable factors that influence intention to drink across racial groups.

The relationship between childhood trauma and alcohol use initiation in Black and White adolescent girls: considering socioeconomic status and neighborhood factors.

PURPOSE: To assess whether the higher prevalence of childhood trauma exposure but lower prevalence of alcohol use in Black vs. White adolescent girls reflects a lower magnitude of association between trauma and alcohol use initiation in Black girls; and additionally, whether low socioeconomic status (SES) and neighborhood factors account in part for the link between trauma and early alcohol use. METHODS: Data were drawn from annual interviews conducted with an urban sample of girls and their primary caregivers from ages 5-8 (baseline) through age 17 (n = 2068, 57.7% Black, 42.3% White). Cox proportional hazards regression analyses using race and childhood trauma to predict alcohol use initiation were conducted in two stages, with SES and neighborhood factors added in the second stage. RESULTS: Childhood trauma was more prevalent (29.0 vs. 17.5%) and alcohol use initiation less prevalent (37.7 vs. 54.4%) in Black vs. White girls, but we found no evidence for differences in liability conferred by trauma. However, significant changes in hazards ratios (HRs) from the unadjusted to adjusted models were observed for Black race (HR = 0.57, CI 0.50-0.65 to HR = 0.66, CI 0.54-0.80) and childhood trauma (HR = 1.70, CI 1.46-1.99 to HR = 1.34, CI 1.05-1.71). CONCLUSIONS: Findings indicate that childhood trauma is an equally potent risk factor for early drinking onset for Black and White girls; the risk for early alcohol use in Black girls who have experienced traumatic events should not be underestimated. Results further indicate that low SES and neighborhood factors contribute to the associations of childhood trauma and race with alcohol use initiation.

Correction to: The relationship between childhood trauma and alcohol use initiation in Black and White adolescent girls: considering socioeconomic status and neighborhood factors.

In the original article, in Table 3, the sentence "Primary caregiver education ≤  12 years" should be "Primary caregiver education < 12 years". The original article was corrected.

Childhood Trauma and Two Stages of Alcohol Use in African American and European American Women: Findings from a Female Twin Sample.

The current investigation assessed for moderating effects of childhood trauma on genetic and environmental contributions to timing of alcohol use initiation and alcohol use disorder in African American (AA) and European American (EA) women. Data were drawn from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a longitudinal female twin study. Childhood trauma was defined alternately as child maltreatment and more broadly to include other events (e.g., witnessing violence). Phenotypic associations between childhood trauma and alcohol outcomes were estimated using logistic regression analyses. Twin modeling was conducted to test for moderating effects of childhood trauma on the contributions of genetic and environmental factors to timing of initiation and alcohol use disorder. Under both definitions, childhood trauma was associated with early initiation (relative risk ratios: 1.90, 1.72) and alcohol use disorder (odds ratios: 1.92, 1.76). Yet gene by environment effects were observed only for child maltreatment and timing of initiation in EA women, with heritable influences less prominent in those who had experienced child maltreatment (0.35, 95% CI: 0.05-0.66 vs. 0.52, 95% CI: 0.30-0.73). We found more similarities than differences in the association of childhood trauma with alcohol outcomes across racial/ethnic groups, trauma type, and stages of alcohol use. However, findings suggest that the relative contribution of genetic factors to alcohol outcomes differs by childhood maltreatment history in EA women specifically in the earliest stage of alcohol use.

Impulsivity interacts with momentary PTSD symptom worsening to predict alcohol use in male veterans.

BACKGROUND: Posttraumatic stress disorder (PTSD) is prevalent among veterans who served post-9/11, and co-occurs with problem alcohol and substance use. Studies using ecological momentary assessment have examined the temporal association between time-varying PTSD symptoms and alcohol use. Results suggest individual differences in these associations. OBJECTIVES: We tested hypotheses that alcohol use measured by momentary assessment would be explained by acute increases in PTSD symptoms, and the PTSD-alcohol association would be moderated by trait impulsivity. METHODS: A sample of 28 male post-9/11-era veterans who reported past-month PTSD symptoms and risky alcohol use were enrolled. On a quasi-random schedule, participants completed three electronic assessments daily for 28 days measuring past 2-h PTSD symptoms, alcohol, and substance use. At baseline, trait impulsivity was measured by the Barratt Impulsiveness Scale. Past-month PTSD symptoms and alcohol use were measured. Using three-level hierarchical models, number of drinks recorded by momentary assessment was modeled as a function of change in PTSD symptoms since last assessment, controlling for lag-1 alcohol and substance use and other covariates. A cross-level interaction tested moderation of the within-time PTSD-alcohol association by impulsivity. RESULTS: A total of 1,522 assessments were completed. A positive within-time association between PTSD symptom change and number of drinks was demonstrated. The association was significantly moderated by impulsivity. CONCLUSION: Results provide preliminary support for a unique temporal relationship between acute PTSD symptom change and alcohol use among veterans with trait impulsiveness. If replicated in a clinical sample, results may have implications for a targeted momentary intervention.

Parental Monitoring and Alcohol Use Across Adolescence in Black and White Girls: A Cross-Lagged Panel Mixture Model.

BACKGROUND: The link between parental monitoring and adolescent alcohol use is well established, but the directionality of this relationship is somewhat elusive. The literature suggests that parental engagement serves a protective function with respect to alcohol use, but that parental monitoring may also diminish in response to recurrent risk behavior. The lower rate of alcohol use despite evidence of lower levels of parental monitoring in Black versus White youth raises the question of for whom and under what conditions parental monitoring and alcohol use are associated. METHODS: Data were drawn from a community sample of 1,634 female adolescents (954 Black, 680 White) from 4 age cohorts, assessed annually in an accelerated longitudinal design. This study uses data spanning ages 12 to 17; parental monitoring and alcohol use were assessed via self-report, while demographic and adolescent psychosocial risk factors were derived from parent reports when the girls were age 12. An autoregressive cross-lagged panel mixture model was used to identify discrete patterns of parental monitoring and alcohol use associations across adolescence, and psychosocial factors that differentiate between them. RESULTS: Two discrete patterns of codeveloping alcohol use and parental monitoring emerged: one with stable bidirectional and autoregressive links (79%) and another differing from the majority profile in terms of the absence (alcohol use to parental monitoring) and direction (parental monitoring to alcohol use) of cross-construct influences (21%). Those in the minority profile were, at age 12, more likely to have received public assistance, resided in single-parent households, reached puberty, and manifest more severe conduct problems. CONCLUSIONS: Identifying subgroups of girls with distinct patterns of codeveloping alcohol use and parental monitoring is particularly relevant to the development and implementation of family-level interventions, both in terms of targeting those with known demographic risk factors, and tailoring programs to address behavioral correlates, such as conduct problems.

Differences between White and Black young women in the relationship between religious service attendance and alcohol involvement.

BACKGROUND AND OBJECTIVES: We examined the associations of religious attendance during childhood (C-RA) and adulthood (A-RA) with alcohol involvement (ever drinking, timing of first alcohol use, and alcohol use disorder [AUD]) in White and Black female twins. As genetic and environmental factors influence religious attendance and alcohol involvement, we examined the extent to which they contribute to their association. METHODS: Data on 3,234 White and 553 Black female twins (18-29 years) from the Missouri Adolescent Female twin Study. Significant correlations between C-RA or A-RA and alcohol involvement were parsed into their additive genetic, shared environmental, and individual-specific environmental sources. RESULTS: C-RA was associated with ever drinking and timing of first alcohol use in Whites. A-RA was associated with ever drinking and AUD in both Whites and Blacks. Shared environmental influences did not contribute to alcohol or religiosity phenotypes in Blacks. In Whites, the association between C-RA and alcohol was due to shared environmental influences, whereas the association between A-RA and alcohol was attributable to additive genetic, shared environmental, and individual-specific environmental sources. Individual-specific environment and genetics contributed to associations between A-RA and ever drinking and AUD, respectively, in Blacks. CONCLUSIONS: Factors other than C-RA contribute to lower rates of alcohol involvement in Blacks. Shared environment does not contribute to links between A-RA and alcohol involvement in Blacks. SCIENTIFIC SIGNIFICANCE: The protective impact of childhood religiosity on alcohol use and misuse is important in Whites and is due to familial factors shared by religiosity and alcohol involvement. (Am J Addict 2017;26:437-445).

Progression from First Drink, First Intoxication, and Regular Drinking to Alcohol Use Disorder: A Comparison of African American and European American Youth.

BACKGROUND: Differences between African Americans (AAs) and European Americans (EAs) in the prevalence and age at onset of alcohol use and alcohol use disorder (AUD) have been documented, but distinctions in the timing of early stage transitions and contribution of various psychiatric and psychosocial risk factors to the progression from initiation to AUD have yet to be investigated. The current study characterized progression from alcohol use initiation-defined alternatively as first drink, first intoxication, and regular drinking onset-to AUD in AA and EA youth. METHODS: Psychiatric interviews were administered via telephone to 1,461 participants (56% AA, 44% EA) in a high-risk family study (50.3% female, mean age = 17.6 [SD = 3.8]). Cox proportional hazards regression analyses were conducted separately for the AA and EA subsamples to predict DSM-5 AUD as a function of age at alcohol use initiation, with age at first drink, age at first intoxication, and age at regular drinking onset as the point of origin in separate models. RESULTS: Across race/ethnicity, regardless of how it was measured, early alcohol use initiation predicted AUD, but hazard ratios (HRs) were lowest for first drink. Regular smoking and social anxiety disorder were significant predictors in both racial/ethnic groups, but associations with conduct disorder (all 3 models: HR range = 2.07 to 4.15) and major depressive disorder (regular drinking: HR = 4.51, confidence interval [CI]: 1.60 to 12.69 for AUD onset ≥ age 20) were specific to AAs. Posttraumatic stress disorder (HR = 5.38, CI: 1.44 to 20.08) and generalized anxiety disorder (HR = 7.35, CI: 2.31 to 23.34 for AUD onset ≤ age 17) were strongly associated with progression from regular drinking to AUD exclusively in EAs. CONCLUSIONS: Early alcohol use initiation is a marker of risk for AUD in both AA and EA youth, but the contributions of various psychiatric risk factors to the development of AUD are not universal across racial/ethnic groups.

Association of Specific Traumatic Experiences With Alcohol Initiation and Transitions to Problem Use in European American and African American Women.

BACKGROUND: The aims of this study were to (i) characterize racial differences in alcohol involvement and (ii) examine the risk conferred by specific trauma exposures and posttraumatic stress disorder (PTSD) for different stages of alcohol involvement in European American (EA) and African American (AA) women. METHODS: Data are from the Missouri Adolescent Female Twins Study (N = 3,787, 14.6% AA; mean age at most recent interview = 24.5 [SD 2.8]). Trauma exposures (e.g., sexual abuse [SA], physical abuse [PA], witnessing another person being killed or injured, experiencing an accident, and experiencing a disaster) were modeled as time-varying predictors of alcohol initiation, transition to first alcohol use disorder (AUD) symptom, and transition to AUD diagnosis using Cox proportional hazards regression while taking into account other substance involvement, parental characteristics, and commonly co-occurring psychiatric disorders. RESULTS: In EA women only, SA was associated with alcohol initiation prior to the age of 14, PA predicted transition from initiation to first AUD symptom, and PA, witnessing injury or death, and SA predicted transition to AUD diagnosis. No association was discovered between trauma exposures or PTSD for any stage of alcohol involvement in AA women. CONCLUSIONS: Results reveal trauma experiences as important contributors to all stages of alcohol involvement in EA women only, with different trauma types conferring risk for each stage of alcohol involvement. PTSD was not revealed as a significant predictor of AUD in EA or AA women, suggesting trauma, independent of PTSD, directly contributes to alcohol involvement. Findings highlight the importance of considering racial differences when developing etiologic models of the association of traumatic experiences with alcohol involvement.

Brief Report: A web-based pilot study of childhood sexual abuse, recent stressful events, and alcohol use in women.

BACKGROUND AND OBJECTIVES: Childhood sexual abuse (CSA) is a well-documented risk factor for problem drinking, but the possibility that recent stressful events exacerbate risk conferred by CSA has rarely been examined, and the few studies to do so have limited their investigations to negative events. The aim of the current study was to examine the associations between CSA, recent positive and negative stressful events, and women's alcohol consumption. METHODS: Eighty-nine women (42.7% reporting CSA) completed weekly web-based alcohol use surveys and a stressful event inventory assessing negative and positive events over a 12 week period. RESULTS: Independent of CSA history, experiencing negative events was associated with elevated likelihood of drinking to intoxication. DISCUSSION AND CONCLUSIONS: Proximal distressing events are more closely linked than CSA history to short-term drinking patterns. SCIENTIFIC SIGNIFICANCE: Tracking stressful negative events may be informative for identifying precipitants of heavy drinking.

Reflections on a Community Psychology Setting and the Future of the Field.

The 50th anniversary of the Swampscott Conference offers an opportunity to reflect on a community psychology setting, The Consultation Center at Yale, that was formed in response to the 1963 Community Mental Health Act and the 1965 Swampscott Conference. The Center has flourished as a community psychology setting for practice, research, and training for 39 of the 50 years since Swampscott. Its creation and existence over this period offers an opportunity for reflection on the types of settings needed to sustain the field into the future.