Prospective Association of Digital Media Use with Alcohol Use Initiation and Progression Among Adolescents.

BACKGROUND: Although adolescents commonly use digital media and consume alcohol , longitudinal evidence of the association between these behaviors is scant. This study examined the association between the frequency of digital media use and the subsequent initiation or progression of alcohol use. We also examined whether these associations were moderated by gender and race/ethnicity. METHODS: The study included 2,473 adolescents from a prospective cohort in the Los Angeles, CA area who were surveyed in fall 2015 (11th grade, baseline for the current study) and every 6 months through the end of high school (Spring 2017, 12th grade). At baseline, youth self-reported the total number of 14 digital media activities (e.g., checking social media, streaming music/videos, texting) they engaged in at a high frequency (i.e., many times a day) over the past week. Scores ranged from 0 (i.e., no reported high-frequency digital media use) to 14 (i.e., reported engagement in all 14 digital media activities at a high frequency). Self-report measures of ever using alcohol, number of days of alcohol use in the past 30 days (0 to 30), binge drinking (yes/no), and covariates (i.e., demographics and measures of behavioral health and other substance use) were assessed at each time point. RESULTS: Among respondents who at baseline reported never using alcohol (n = 1,214), high-frequency engagement in each additional digital media activity was associated with 4% higher odds of initiating alcohol use (aOR = 1.04, 95% CI: 1.01 to 1.07) across follow-up. Among respondents who at baseline reported ever using alcohol (n = 1,259), baseline high-frequency engagement in each additional digital media activity was associated at follow-up with 3% more days of alcohol use in the past 30 days (aIRR = 1.03, 95% CI: 1.00 to 1.06). Digital media use and binge drinking were not statistically significantly associated at follow-up. There was no evidence of moderation by gender or race/ethnicity. CONCLUSIONS: Digital media use frequency was modestly associated with increased risk of initiation and progression of alcohol use in adolescence. Additional research is needed to determine potential mechanisms for these associations.

The Relationship Between Dating Status and Academic and Social Functioning in Middle Adolescence.

Dating relationships are normative in middle adolescence, but the academic and social implications of different types of dating involvement remains unclear. To address this gap, this longitudinal study evaluates the association between dating status (i.e., never date, rarely date, casually date, steady relationship) and academic and social functioning in a sample of adolescents. Across two school years, 455 adolescents (53.8% female; 56.5% Asian American, 43.5% Latinx; T1 Mage = 15.04 years) reported on their dating status and peers provided nominations of popularity and aggression. Grades and standardized test scores were obtained from school records. For Asian American youth, abstaining from dating was negatively associated with subsequent popularity. Casual dating and being in a steady relationship were associated with relational and overt peer aggression over time. Gender moderated this association, such that boys in steady relationships, and girls in casual relationships were more relationally aggressive one year later. Implications are discussed in terms of problem behavior theory and adolescent intersexual competition.

Distinct Modalities of Electronic Communication and School Adjustment.

Social media platforms and instant messaging applications have a widespread presence in today's secondary schools. However, the implications of these ubiquitous communication technologies for adolescent's social functioning with peers and academic competence in the classroom are not well understood. In fact, research on adolescents' digital lives has only rarely incorporated direct assessments of adjustment in school environments. The current study addressed these limitations with a school-based data collection. 376 adolescents (Mage = 14.4; 209 girls; including 29.2% Latino/Hispanic, 27.3% White, 28.2% mixed) were recruited from an urban high school and followed for one year. Social reputations were indexed via peer nominations and electronic communication tendencies were assessed using self-report questionnaires. Grade point averages, disciplinary events, and attendance data were obtained from school records. On a cross-sectional basis, frequent use of fashionable social networks (i.e., Instagram, Snapchat, and Twitter) was associated with popular-aggressive social reputations, poor achievement, and rule-breaking behavior. E-mail use, in contrast, was associated with academic competence. Longitudinal analyses were less conclusive because the examined constructs were highly stable across the period of data collection. The full pattern of findings indicates that electronic communication patterns can be a powerful marker of academic and social functioning at school.

Cross-Ethnic Friendships, Intergroup Attitudes, Intragroup Social Costs, and Depressive Symptoms among Asian-American and Latino-American Youth.

As American school districts become increasingly diverse, understanding the processes that promote positive intergroup relations is a critical task. The role of cross-ethnic friendships is one important factor, given the significance of these reciprocated peer relationships for social development. The current study examines the short-term longitudinal impact of cross-ethnic friendships on peer group attitudes and emotional adjustment. 524 student participants (54.8% female; Mage = 15.06 years, SD = 0.75; 47% Latino, 53% Asian-American) were followed for one year with two spring data collections. Students completed a self-report inventory assessing depressive symptoms and a peer nomination inventory assessed friendship, liking, disliking, popularity, and unpopularity. Cross-ethnic friendships were predictive of positive attitudes toward peers from other ethnic/racial groups and were also linked to declines in depressive symptoms for boys. Moreover, these positive effects did not come at a social cost, as cross-ethnic friendships were not associated with rejection by same-ethnic peers. Cross-ethnic friendships provide a unique environment that contributes to positive intergroup attitudes and beneficial socioemotional development for some youth.

Adolescent, Parent, and Provider Perspectives of a Social-Media-Based Support Tool for Parents of Teens in Treatment for Substance Use.

ABSTRACT: Adolescent substance use disorder contributes to negative psychosocial and physical health outcomes. Parents best support their child's treatment and recovery when they are equipped with knowledge and skills; however, barriers hinder parental engagement. Social-media-based groups present an opportunity for parents who may not otherwise seek support. Qualitative data were collected via focus groups to examine the opinions of adolescents, parents, and treatment providers on the potential utility and possible concerns of a Facebook-based parent support group; input constituted the development phase for an online group (PURPOSE). Fifty-eight participants, recruited through adolescent treatment programs, took part in six focus groups: two parent ( n = 18), two adolescent ( n = 21), and two provider ( n = 19) groups. Groups were audio recorded and transcribed, and themes were extracted. Three main themes emerged: (a) traditional support groups and treatment services, (b) PURPOSE intervention content and delivery, and (c) issues related to PURPOSE implementation. Traditional treatment/support groups can be helpful, but participation in them is limited. Emotional support offered by peers is valuable, but parents also need and seek out psychoeducation, parenting skills, and self-care support. PURPOSE could offer easy access to skills and real-time peer support.

Associations of cannabis product source and subsequent cannabis use among adolescents.

BACKGROUND: Cannabis is obtained from a variety retail and illicit sources, with unknown implications for youth cannabis use. This study assessed whether source of obtaining cannabis was associated with future cannabis use among adolescents. METHODS: High-schoolers (N = 835) completed 3 semiannual surveys, reporting use of 7 cannabis sources (i.e., free, bought from someone, from an online dispensary, with a [valid/invalid] medical card, self-grown, or other; separate dichotomous exposure variables) at wave 1 (n = 621; M[SD] age=17.14[.40]) or wave 2 (n = 622; M[SD] age=17.51[.39]). Past-6-month (yes/no) and number of past-30-day (0-30) non-medical use of any cannabis product, combustible, edible, and vaporized cannabis, blunts, and concentrates (i.e., dabs) were reported at waves 2-3. Random-effect time-lagged repeated-measures regression was used to test longitudinal associations of youth's cannabis source (waves 1-2; time-varying exposure) with cannabis use outcomes 6 months later (waves 2-3). RESULTS: Most youth (72.1%) received cannabis for free; 50.9% bought cannabis from someone, 15.9% used a valid medical card at a brick-and-mortar dispensary, and 3.9% grew cannabis. Buying cannabis from someone (OR=1.46, 95% CI: 1.07-1.99, p = .02) or using a valid medical card (OR=1.99, 95% CI: 1.20-3.31, p = .008) conferred greater odds of any cannabis product use 6 months later. Buying from someone predicted subsequent past-30-day use frequency (RR=1.25, 95% CI:1.05-1.48, p = .01). Some associations between particular cannabis sources and products were observed. CONCLUSIONS: Adolescents may access cannabis from several sources. Those who purchase cannabis illicitly from someone or from a brick-and-mortar dispensary using a valid medical card may be at increased risk for more persistent and frequent patterns of non-medical cannabis use.

Long-term follow-up assessment of opioid use outcomes among individuals with comorbid mental disorders and opioid use disorder treated with buprenorphine or methadone in a randomized clinical trial.

AIMS: To investigate whether reduction in opioid use differs when treated by either buprenorphine-naloxone (BUP) or methadone (MET) among adults with comorbid opioid use disorder (OUD) and mental disorders. DESIGN, SETTING AND PARTICIPANTS: In a randomized controlled trial, adults with OUD were randomized to 24 weeks of either BUP or MET treatment and were followed up in 3-yearly assessments. The present secondary analyses were based on 597 participants who completed all assessments. MEASUREMENTS: The outcome measure was the number of days of using opioids per month during the follow-up period. The Mini-International Neuropsychiatric Interview (MINI) was used to classify participants into three groups: life-time mood disorder (n = 302), life-time mental disorder other than mood disorder (n = 114) and no mental disorder (n = 181). Medication treatment (BUP, MET, no treatment) during the follow-up period was a time-varying predictor. FINDINGS: Based on zero-inflated Poisson (ZIP) mixed regression analysis, it was found that relative to no treatment, opioid use during the follow-up was significantly reduced by BUP [odds ratio (OR) = 0.12, 95% confidence interval (CI) = 0.07-0.21 for any use; risk ratio (RR) = 0.77, 95% CI =0.66-0.89 for days of use] and by MET [OR = 0.33, 95% CI = 0.25-0.45 for any use; RR = 0.78, 95% CI = 0.72-0.84 for days of use]. Relative to MET, BUP was associated with a lower likelihood of any opioid use among participants with mood disorders (OR = 0.52, 95% CI = 0.36-0.74) and for participants without mental disorder (OR = 0.37, 95% CI = 0.21-0.66) and fewer number of days using opioids (RR = 0.37, 95% CI = 0.25-0.56) among participants with other mental disorders. CONCLUSIONS: Among adults with comorbid opioid use disorder and mental disorders, treatment with buprenorphine-naloxone produced greater reductions in opioid use than treatment with methadone.

Psychiatric comorbidity and treatment outcomes in patients with opioid use disorder: Results from a multisite trial of buprenorphine-naloxone and methadone.

BACKGROUND: Individuals treated for opioid use disorder (OUD) have high rates of psychiatric disorders potentially diminishing treatment outcomes. We examined long-term treatment experiences and outcomes by type of psychiatric disorder among participants who participated in the Starting Treatment with Agonist Replacement Therapies (START) study and its follow-up study. METHODS: We categorized the 593 participants who completed the Mini-International Neuropsychiatric Interview (MINI) during the START follow-up study into four mutually exclusive groups to indicate current psychiatric diagnosis: 1) bipolar disorder (BPD; n = 51), 2) major depressive disorder (MDD; n = 85), 3) anxiety disorder (AXD; n = 121), and 4) no comorbid mental disorder (NMD; n = 336). We compared participants' baseline characteristics and treatment outcomes. RESULTS: Groups with mental disorders had worse substance use outcomes and poorer psychosocial functioning than the NMD group. Participants with BPD had significantly more self-reported days using opioids (Mean: 8.6 for BPD vs. 3.4 days for NMD, p < 0.01) and heroin (Mean: 6.4 for BPD vs. 2.0 for MDD, 3.1 days for NMD, p < 0.05) in the 30 days prior to the final interview. Compared to patients without mental disorders, patients with MDD spent more time engaged with OUD pharmacotherapy during the ∼16-month period between MINI and final interview (mean: 71.6 % vs. 50.6 %; p < 0.001). CONCLUSIONS: Our results show that treatment outcomes in individuals with OUD vary by psychiatric comorbidity groups, which supports the need for mental health assessment and treatment for psychiatric conditions in the context of pharmacotherapy for patients with OUD.

Bidirectional associations between e-cigarette use and alcohol use across adolescence.

INTRODUCTION: Evidence on prospective bidirectional associations between e-cigarette and alcohol use among adolescents can inform prevention and policy but is largely absent from the literature. METHODS: Data were drawn from a prospective cohort of students attending 10 Los Angeles high schools (N = 3396; baseline mean age = 14.1, SD = 0.4). Students completed surveys every 6-months from 2013 to 2017; 8 total waves. Analyses were restricted to (a) individuals who were never users of alcohol (N = 2394) or (b) individuals who were never users of e-cigarettes (N = 2704) at baseline. Repeated-measures, generalized linear mixed models were used to estimate the adjusted odds of past 6-month alcohol and e-cigarette initiation, in separate models. RESULTS: Among alcohol never-users at baseline, 15.7 % (N = 375) initiated alcohol use over the study period. Compared to never-users of e-cigarettes, those who reported use of e-cigarettes had 3.5 times the odds of subsequently initiating alcohol use in the following wave (OR = 3.54; 95 % CI: 2.81, 4.47). Stronger associations were observed for males (OR = 4.94; 95 % CI: 3.78, 6.45) than for females (OR = 3.21; 95 % CI: 2.33, 4.41; pinteraction = 0.04). Among e-cigarette never-users at baseline, 26.3 % (N = 709) initiated e-cigarette use over the study period. Compared to never-users of alcohol, those who reported use of alcohol had 3.2 times the odds of subsequently initiating e-cigarette use in the following wave (OR = 3.23; 95 % CI: 2.68, 3.89). This association did not differ by gender. CONCLUSIONS: E-cigarette and alcohol use can be markers to identify youth at risk for future alcohol and e-cigarette use, respectively. Research examining mechanisms underlying these associations is needed to infer causality.

Digital media use and subsequent cannabis and tobacco product use initiation among adolescents.

BACKGROUND: Digital media engagement, such as browsing the internet or social media posting, may be associated with cannabis and tobacco product use initiation among adolescents. Whether certain digital media exposure confers greater - or reduced - risk for specific cannabis or tobacco products is unknown. METHODS: Adolescents completed surveys on digital media and substance use every 6 months from 2015 to 2017 (4 waves). Self-reported digital media use (14 items) was classified into six subcategories (e.g., "social media posting," "reading news/articles & browsing photos"). Random-effect repeated-measures regression models examined the association of exposure to each digital media subcategory with subsequent cannabis or tobacco product use initiation in the next 6 months, among baseline cannabis and tobacco never-users (n = 1841; n = 1558, respectively). RESULTS: High frequency digital media use (multiple times/day) of "social media posting" (vs. no high frequency use; OR = 1.95; 95%CI:1.20-3.17) and "checking in" (OR = 1.71; 95%CI:1.23-2.38) was associated with greater odds of any cannabis product use initiation 6 months later. "Reading news/articles & browsing photos" was associated with decreased odds of initiation (OR = 0.52; 95%CI:0.34-0.79). "Checking in" and "reading news/articles & browsing photos" were similarly associated with any tobacco use initiation. "Chatting and shopping" was associated with greater odds (OR = 4.63; 95%CI:1.53-14.06) of e-cigarette initiation, but not of other product use initiation. CONCLUSIONS: Some subcategories of digital media use conferred increased odds, others conferred reduced odds, and others were not associated with cannabis and tobacco use initiation. Research exploring mechanisms that put users of specific digital media at greater risk for substance use initiation is warranted.