Childhood maltreatment disrupts HPA-axis activity under basal and stress conditions in a dose-response relationship in children and adolescents.

BACKGROUND: This study investigates the impact of childhood maltreatment (CM) on hypothalamic-pituitary-adrenal (HPA)-axis functioning and on anxiety perception. Moreover, the influence of CM severity and frequency was also explored. METHODS: In total, 187 participants aged 7-17 were assessed for CM history using validated questionnaires and ad hoc interviews to be classified according to the criteria of the Tool for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV). Psychopathology was ascertained using the K-SADS-PL5. To assess HPA-axis functioning, salivary cortisol samples were collected throughout a normal day and during an acute psychosocial stressor, the Trier Social Stress Test for children (TSST-C). Subjective anxiety was evaluated using STAI/-C. RESULTS: Youth with a CM history had higher overall diurnal cortisol levels (p = 0.001), blunted cortisol response to acute psychosocial stress (p = 0.002) and greater perceived anxiety (p = 0.003), than those without CM. Specifically, participants exposed to moderate/severe or often/frequent CM showed the greater diurnal cortisol output (pseverity = 0.002; pfrequency = 0.003), and blunted cortisol response during the TSST-C (pseverity = 0.006; pfrequency = 0.008). Meanwhile, youth with low CM severity/frequency exhibited a similar cortisol response to those without CM. However, perceived anxiety was higher in those exposed to CM (p < 0.001), regardless of its severity/frequency. CONCLUSIONS: Disturbances in HPA-axis functioning are already evident early after CM exposure, while psychological and physiological responses to an acute stressor are dissociated in youth exposed to CM. The dose-response relationship described in this paper highlights the need to comprehensively evaluate CM so that vulnerable children can be identified and assigned to proper interventions.

Cognitive training with modern board and card games in healthy older adults: two randomized controlled trials.

OBJECTIVES: The aim of this study was to assess the effectiveness of a cognitive intervention based on modern board and card games. METHODS: We conducted two two-arm parallel-group, randomized controlled trials. The first one (pilot study) was nonblind. The second one (main study) was a double-blind design. Participants (14 in a pilot study and 35 in the main study) were healthy older adults over 65 years old who were assisting to adult care institutions. In the pilot study, participants in the experimental group (n = 6) played modern board and card games which activated cognitive processes; whereas the control group (n = 6) was in the wait-list condition. In the main study, participants in the experimental group (n = 12) also played modern board and card games; whereas the control group (n = 15) performed standardized paper-and-pencil cognitive tasks. Psychologists specialized in older-people conducted all the interventions. In both studies, intervention sessions were bi-weekly for 5 weeks. The outcomes of both studies were cognitive status and executive functioning, depressive symptomatology, and quality of life measures. All assessment and intervention sessions took place in their habitual centers. RESULTS: In the pilot study, participants in the games intervention showed a significant improvement in semantic verbal fluency. In the main study, both interventions showed significant improvements in phonemic verbal fluency. Whilst board and card games maintained motor impulsivity control, paper-and-pencil tasks improved speed in an inhibition task. CONCLUSIONS: Modern board and card games could be an effective cognitive intervention to maintain some cognitive functions.

Violent aggression predicted by multiple pre-adult environmental hits.

Early exposure to negative environmental impact shapes individual behavior and potentially contributes to any mental disease. We reported previously that accumulated environmental risk markedly decreases age at schizophrenia onset. Follow-up of matched extreme group individuals (≤1 vs. ≥3 risks) unexpectedly revealed that high-risk subjects had >5 times greater probability of forensic hospitalization. In line with longstanding sociological theories, we hypothesized that risk accumulation before adulthood induces violent aggression and criminal conduct, independent of mental illness. We determined in 6 independent cohorts (4 schizophrenia and 2 general population samples) pre-adult risk exposure, comprising urbanicity, migration, physical and sexual abuse as primary, and cannabis or alcohol as secondary hits. All single hits by themselves were marginally associated with higher violent aggression. Most strikingly, however, their accumulation strongly predicted violent aggression (odds ratio 10.5). An epigenome-wide association scan to detect differential methylation of blood-derived DNA of selected extreme group individuals yielded overall negative results. Conversely, determination in peripheral blood mononuclear cells of histone-deacetylase1 mRNA as 'umbrella mediator' of epigenetic processes revealed an increase in the high-risk group, suggesting lasting epigenetic alterations. Together, we provide sound evidence of a disease-independent unfortunate relationship between well-defined pre-adult environmental hits and violent aggression, calling for more efficient prevention.

Stressful life events during adolescence and risk for externalizing and internalizing psychopathology: a meta-analysis.

The main objective of the present research was to analyze the relations between stressful life events and the externalizing and internalizing spectra of psychopathology using meta-analytical procedures. After removing the duplicates, a total of 373 papers were found in a literature search using several bibliographic databases, such as the PsycINFO, Medline, Scopus, and Web of Science. Twenty-seven studies were selected for the meta-analytical analysis after applying different inclusion and exclusion criteria in different phases. The statistical procedure was performed using a random/mixed-effects model based on the correlations found in the studies. Significant positive correlations were found in cross-sectional and longitudinal studies. A transactional effect was then found in the present study. Stressful life events could be a cause, but also a consequence, of psychopathological spectra. The level of controllability of the life events did not affect the results. Special attention should be given to the usage of stressful life events in gene-environment interaction and correlation studies, and also for clinical purposes.

Intergenerational effects of maternal childhood maltreatment on newborns' stress regulation: The role of maternal depressive symptoms.

BACKGROUND: Maternal childhood maltreatment (CM) has been repeatedly associated with negative offspring's emotional outcomes. The dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis has emerged as the main underlying physiological mechanism. OBJECTIVE: To explore the association between maternal CM and newborns' physiological and neurobehavioral stress responses, considering the role of perinatal maternal depression and bonding. PARTICIPANTS AND SETTING: 150 healthy women were followed throughout pregnancy. 79 mother-infant dyads were included in the final analyses. Maternal CM was evaluated using the Childhood Trauma Questionnaire and depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS) at each trimester. At 7 weeks postpartum, the EPDS and the Postpartum Bonding Questionnaire were administered. Newborns' behavioral responses were assessed using "States Organization" (SO) and "States Regulation" (SR) subdomains of the Neonatal Behavioral Assessment Scale (NBAS). Newborns' salivary samples were collected before and after the NBAS to study cortisol reactivity. METHODS: A cross-lagged panel model was employed. RESULTS: Infants born to mothers with higher CM presented more optimal scores on SO (ß (0.635) = 0.216, p ã€ˆ001) and SR (ß (0.273) = 0.195, p = .006), and a higher cortisol reactivity after NBAS handling (ß(0.019) = 0.217, p = .009). Moreover, newborns of mothers with higher CM and postpartum depressive symptoms exhibited a poorer performance on SR (ß (0.156 = -0.288,p = .002). Analyses revealed non-significant relationships between mother-infant bonding, newborns' cortisol reactivity and SO. CONCLUSIONS: Newborns from mothers with greater CM present higher cortisol reactivity and more optimal behavioral responses, which may reflect a prenatal HPA axis sensitization. However, those exposed to maternal postnatal depressive symptoms present poorer stress recovery.

Benefits of Playing at School: Filler Board Games Improve Visuospatial Memory and Mathematical Skills.

The aim of the study was to test the effectiveness of cognitive interventions based on modern board games in school settings to improve memory outcomes and math skills. A parallel, quasi-experimental study was carried out with children (n = 234) into third and fourth grades (8-10 years old). School centres were allocated into a general domain intervention (playing memory board games), a specific domain intervention (playing mathematical board games) or a control group (regular classes without playing). Teachers carried out bi-weekly sessions during the last 30 min of mathematical lessons (8 weeks, 15 sessions). Before and after intervention, we individually measured verbal and visuospatial memory outcomes (short-term memory and working memory updating) and mathematical skills (number operations, number ranking, number production and problem solving). The results showed significant transfer effects of both memory and math trainings. In third grade, we found that playing math games showed medium-large effect sizes in visuospatial short-term memory and updating memory, number operations and number ranking compared to the control group. In fourth grade, we found that playing memory games showed significant small effect sizes in problem solving compared to the control group. Playing board games could be a methodology that enhances cognitive and mathematical development in children.

Chedoke-McMaster attitudes towards children with handicaps scale for traditional sporting games (CATCH-TSG): initial validation in 7 different languages in adult and young populations.

Introduction: Measuring attitudes towards disability is meant to assess which interventions are most likely to create changes in population attitudes. Physical activities, such as Traditional Sports Games, are an excellent methodology to fight against the stigma of disabled people. Thus, the main aim of this study was to validate the Chedoke-McMaster Attitudes towards Children with Handicaps Scale (CATCH) adapted to a physical activity environment. Methods: Additionally, we implemented this process in a combined way, 7 languages and 2 versions (adult and youth) at the same time. Results: The results showed that the CATCH-TSG scale provides the scientific community with a valid and reliable tool for professionals who want to assess the change in attitudes towards people with disabilities after receiving a psychoeducational intervention that includes physical activity (TSG). Discussion: Researchers will compare respective results from different countries and ages using different versions of the scale, jointly validated.

Just Play Cognitive Modern Board and Card Games, It's Going to Be Good for Your Executive Functions: A Randomized Controlled Trial with Children at Risk of Social Exclusion.

Modern board and card games are usually used for leisure. Few studies have focused on the type of game played in vulnerable populations. Therefore, the main aim of this study was to test the effectiveness of playing modern board and card games to enhance updating, inhibition, and flexibility in children at risk of social exclusion using games that activated specific basic executive functions. We developed a quadruple-blind randomized clinical trial during the COVID-19 pandemic. Sixty-eight participants (7-12 years old) were divided into two experimental groups: 35 children played games that directly activated basic executive functions, and 33 played games that directly triggered other cognitive domains. The primary statistical analysis consisted of mixed models. We found significant time effects in cognitive flexibility and inhibition and, to a lesser extent, in working memory in both gaming groups. We analyzed the cognitive profile of the games and found that all the games activated basic executive functions significantly, irrespective of the experimental group. Therefore, it is possible that playing any type of modern board and card game (excluding games with a high incidence of luck) could be beneficial for children at risk of social exclusion.

Board game-based intervention to improve executive functions and academic skills in rural schools: A randomized controlled trial.

INTRODUCTION: This research intends to increase the knowledge about the use of board games in the classroom to train executive functions and academic skills. 99 children from rural schools were assessed in executive functions and academic skills. METHODS: Through a randomized controlled trial, they were assigned to a playing group (n = 51) and an active control group (regular classes without games, n = 48). Play program consisted of 12 sessions for 6 weeks with eight commercial board games. RESULTS: In flexibility, the playing group was significantly faster after the program (p= = .01, d = 0.76), but not the control group (p = .23; d = 0.35). Both groups improved in the academic tasks, but the significance in calculus was greater in the playing group (p = .00; d = 2.19) than in the control group (p = .01; d = 0.97). DISCUSION: The use of board games during school hours could be as good or better methodology for cognitive training and learning academic skills than regular classes.

A Proxy Approach to Family Involvement and Neurocognitive Function in First Episode of Non-Affective Psychosis: Sex-Related Differences.

Schizophrenia spectrum disorders (SSD) often show cognitive deficits (CD) impacting daily life. Family support has been shown to be protective against CD, yet the relationship between these in psychotic patients remains complex and not fully understood. This study investigated the association between a subdomain of family support, namely, family involvement (estimated through a proxy measure), cognitive functioning, and sex in first-episode psychosis (FEP) patients. The sample included 308 patients enrolled in the Program for Early Phases of Psychosis (PAFIP), divided into 4 groups based on their estimated family involvement (eFI) level and sex, and compared on various variables. Women presented lower rates of eFI than men (37.1% and 48.8%). Higher eFI was associated with better cognitive functioning, particularly in verbal memory. This association was stronger in women. The findings suggest that eFI may be an important factor in FEP patients' cognitive functioning. This highlights the importance of including families in treatment plans for psychotic patients to prevent CD. Further research is needed to better understand the complex interplay between family support, sex, and cognitive functioning in psychotic patients and develop effective interventions that target these factors.

Intelligence quotient changes over 10 years: Diversity of cognitive profiles in first episode of psychosis and healthy controls.

OBJECTIVE: This study aimed to analyse whether intelligence quotient (IQ) improves, declines, or remains stable over 10 years among FEP patients and healthy subjects. METHODS: A group of FEP patients enrolled in a Program of First Episode Psychosis in Spain called PAFIP, and a sample of Healthy Controls (HC) completed the same neuropsychological battery at baseline and approximately 10 years later, which included the WAIS vocabulary subtest to estimate premorbid IQ and 10-year IQ. Cluster analysis was performed separately in the patient group and the HC group to determine their profiles of intellectual change. RESULTS: One hundred and thirty-seven FEP patients were grouped into five clusters: "Improved low IQ" (9.49 % of patients), "Improved average IQ" (14.6 %), "Preserved low IQ" (17.52 %), "Preserved average IQ" (43.06 %), and "Preserved high IQ" (15.33 %). Ninety HC were grouped into three clusters: "Preserved low IQ" (32.22 % of the HC), "Preserved average IQ" (44.44 %), and "Preserved high IQ" (23.33 %). The first two clusters of FEP patients, characterized by a low IQ, earlier age at illness onset, and lower educational attainment, showed a substantial cognitive improvement. The remaining clusters demonstrated cognitive stability. CONCLUSIONS: The FEP patients showed intellectual improvement or stability, but no decline post-onset of psychosis. However, their profiles of intellectual change are more heterogeneous than that of HC over 10 years. Particularly, there is a subgroup of FEP patients with a significant potential for long-term cognitive enhancement.

Complex post-traumatic stress disorder (CPTSD) of ICD-11 in youths with childhood maltreatment: Associations with age of exposure and clinical outcomes.

BACKGROUND: Exposure to childhood maltreatment (CM) increases the risk of psychiatric morbidity in youths. The new Complex Post-Traumatic Stress Disorder (CPTSD) diagnosis captures the heterogeneity and complexity of clinical outcomes observed in youths exposed to CM. This study explores CPTSD symptomatology and its association with clinical outcomes, considering the impact of CM subtypes and age of exposure. METHODS: Exposure to CM and clinical outcomes were evaluated in 187 youths aged 7-17 (116 with psychiatric disorder; 71 healthy controls) following the Tools for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV) structured interview criteria. CPTSD symptomatology was explored by confirmatory factor analysis, considering four subdomains: post-traumatic stress symptoms, emotion dysregulation, negative self-concept and interpersonal problems. RESULTS: Youths exposed to CM (with or without psychiatric disorders) showed greater internalizing, externalizing and other symptomatology, worse premorbid adjustment and poorer overall functioning. Youth with psychiatric disorder and exposed to CM reported more CPTSD symptomatology, psychiatric comorbidity and polypharmacy and earlier onset of cannabis use. Different subtypes of CM and the developmental stage of exposure differentially impact CPTSD subdomains. LIMITATIONS: Small percentage of resilient youths was studied. It was not possible to explore specific interactions between diagnostic categories and CM. Direct inference cannot be assumed. CONCLUSIONS: Gathering information on type and age of exposure to CM is clinically useful to understand the complexity of psychiatric symptoms observed in youths. Inclusion of the CPTSD diagnosis should increase the implementation of early specific interventions, improving youths' functioning and reducing the severity of clinical outcomes.

Impact on Executive Dysfunctions of Gamification and Nongamification in Playing Board Games in Children at Risk of Social Exclusion.

Objective: Modern board and card game-based cognitive interventions and gamification practices showed effectiveness in boosting executive functions and decreasing behavioral problems in children. However, the combination of both game-based methods has not been tested. Therefore, the main aim of this study was to test the effectiveness of gamification in modern board and card game-based cognitive interventions in Spanish schoolchildren at risk of social exclusion. Materials and Methods: In this multicenter single-blind study with a quasi-experimental design, 176 schoolers (6-13 years old) were assigned to a gamified group (with a narrative context and a rewarding system) and 107 to a nongamified group (with no narrative context or rewarding system). The interventions were implemented in regular classes. Behavioral executive dysfunction was assessed using the Behavior Rating Inventory of Executive Function, Second Revision (BRIEF-2) (Teacher form), pre- and postintervention. Results: We found significant time effects in all BRIEF-2 domains with small and medium effect sizes (d = -0.35 to d = -0.62). The nongamified group showed significantly higher decreases in all measures than those who used gamification. Conclusions: It is possible that playing for the joy of playing in the nongamified group was enough motivation to focus on the task, while adding gamification elements did not favor greater effectiveness of the program.

The Cognitive Processes Behind Commercialized Board Games for Intervening in Mental Health and Education: A Committee of Experts.

Background: The use of modern board games has been growing past years in education, research, and mental health attendance. Often one professional selects games by his/her criteria depending on his/her objective with them. We evaluated the cognitive processes inherent to each modern board game to obtain a consensus of the cognitive profile of each. We explain how to choose the most suitable board games in future interventions. Materials and Methods: Fifteen education, mental health, and neuroscience research professionals with board games experience participated in an online assessment of 27 modern board games. Experts received a virtual neuroeducation formation and played the games selection for further analysis. Participants answered a Likert scale about 12 cognitive processes activated with each game. Results: All modern board games obtained a high level of agreement (intraclass correlation [ICC] > 0.75). Besides, most cognitive processes reached a high agreement, except for cognitive flexibility and problem-solving (moderate range: 0.5 > ICC > 0.75). Differentiated cognitive profiles have been obtained for each game, some of which could work on more than one cognitive domain at a time. Finally, initial evidence about which board game mechanisms activate with cognitive domain was found. Conclusion: To conclude, this expert consensus methodology became a useful tool for assessing the cognitive profile behind modern board and card games. The results obtained may facilitate the choice of games to be used in future studies depending on the objective cognitive domain to be trained under a criterion based on the observations of a group of experts and not just the researcher's individual criteria.

Traditional Sporting Games as an emotional induction procedure.

Experimental designs to induct emotional states have frequently used still procedures. However, more naturalistic methods of emotional induction by letting participants move and interact freely with other participants should be considered. Traditional Sporting Games (TSG) have the above-mentioned characteristics. The general aim of this study was to determine whether the different roles which allowed executing ambivalent interactions induced different emotional states in college students. We developed three studies with three paradoxical TSG (Sitting Ball Game, Four Corners Game, and Pitcher's Game). Before beginning to play, all the participants answered the Positive and Negative Affect Schedule (PANAS) in a mood version. After playing, participants were asked to report retrospectively the emotional state they were feeling in each role of the game, responding to the Self-Assessment Manikin, PANAS, and Games and Emotion Scale-II. Statistical analyses were performed by ANOVA, calculating corresponding effect sizes. Consistently, but specifically, in each game, roles still induced less positive and more negative emotions. Regarding the active roles, more positive and less negative emotions were kindled when the role allowed catching other players. On the contrary, when developing an active role that implied an increased likelihood of being caught, more negative and less positive emotions were experienced. We found some significant interaction effects between the moods and the role played before playing. To conclude, TSG could be an adequate procedure to induct emotional states and to study emotional conditions in a naturalistic way, showing ecological validity.

Risk of Suicidal Behavior in Children and Adolescents Exposed to Maltreatment: The Mediating Role of Borderline Personality Traits and Recent Stressful Life Events.

Childhood maltreatment (CM) is associated with increased non-suicidal self-injury (NSSI) and suicidal behavior (SB), independently of demographic and mental health conditions. Self-Trauma Theory and Linehan's Biopsychosocial Model might explain the emergence of Borderline Personality Disorder (BPD) symptoms as mediators of the association between CM and the risk of SB. However, little is known regarding such relationships when the exposure is recent for young persons. Here, we study 187 youths aged 7-17, with or without mental disorders. We explore CM experiences (considering the severity and frequency of different forms of neglect and abuse), recent stressful life events (SLEs), some BPD traits (emotion dysregulation, intense anger and impulsivity), and the risk of SB (including NSSI, suicide threat, suicide ideation, suicide plan and suicide attempt). We study the direct and mediating relationships between these variables via a structural equation analysis using the statistical software package EQS. Our findings suggest that youths exposed to more severe/frequent CM have more prominent BPD traits, and are more likely to have experienced recent SLEs. In turn, BPD traits increase the risk of SLEs. However, only emotion dysregulation and recent SLEs were found to be correlated with SB. Therefore, targeted interventions on emotion dysregulation are necessary to prevent NSSI or SB in children and adolescents exposed to CM, as is the minimization of further SLEs.

Recent Stressful Life Events (SLE) and Adolescent Mental Health: Initial Validation of the LEIA, a New Checklist for SLE Assessment According to Their Severity, Interpersonal, and Dependent Nature.

The main aim of the present study was to develop and validate a checklist for adolescents, the Life Events Inventory for Adolescents (LEIA), for screening stressful life events (SLEs) of different nature (major-minor, dependent-independent, and personal-interpersonal). The LEIA was administered together with another SLE checklist (Escala de Acontecimientos Vitales [Life Events Scale], EAV), and with measures of life satisfaction and externalizing and internalizing symptoms. The results showed that the kappa and the percentage agreement reliability indices were adequate. Regarding validity evidences, the correlations found between the LEIA and the EAV ranged from .65 to .69, and between the LEIA and the psychopathological symptoms ranged from .26 to .38. Specifically, major dependent noninterpersonal SLEs were the best predictors of externalizing psychopathology; while major independent noninterpersonal SLEs were the best predictors of internalizing symptoms and low life satisfaction. To conclude, the LEIA could be considered an adequate checklist to screen for SLEs in adolescents.

A Pilot Study of the Efficacy of a Cognitive Training Based on Board Games in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial.

Objective: The main aim of this study was to prove the efficacy of an intervention based on board games on executive functions (EFs) and clinical symptoms in children with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A nonblinded randomized controlled trial was conducted with a sample of children with a diagnosis of ADHD (diagnosed by psychiatrists and clinical psychologists in a mental health center). Children were randomly allocated by matching age and sex, into two groups: experimental EF training group (n = 13; mean [M]age = 9.46, standard deviation [SD] = 1.20; boys = 53.8%) or a wait-list control group (n = 14; Mage = 9.50, SD = 1.09; boys = 71.4%). Measures assessed individually at pretest, posttest, and follow-up intervention included EFs and clinical symptoms. Results: Analysis of covariance repeated measures analysis showed that linguistic short-term memory, F(1,28) = 7.45, p = 0.02, and conduct problems, F(1,28) = 12.51, p = 0.00, significantly improved with larger effects in the board games training group after intervention when compared to the wait-list group. Although nonsignificant effects were reported at the follow-up, large effect sizes were actually found. Conclusion: Although future studies are needed, the results of this study highlight the importance of board games and its efficacy as a possible therapeutic and/or preventive intervention on ADHD.

Contribution of the Five Factors of Personality and Peers on Adolescent Alcohol Use: A Cross-National Study.

Personality characteristics such as extraversion, low agreeableness and low conscientiousness are relevant for alcohol use during adolescence. In addition, having friends who use alcohol is one of the strongest predictors of adolescent alcohol consumption and its negative outcomes. The selection model posits that friends display similar alcohol consumption when their friendships are formed on the basis of common characteristics as, among others, personality. Thus, the aim of this study was to examine the mediation role of peers in the association between the five-factor model of personality and adolescent alcohol use in two cultures. One hundred and twenty Scottish and 221 Spanish respondents, all aged 12-15 years, answered the Alcohol Intake Scale (AIS). Adolescents were asked about the alcohol used at the weekend and also about the alcohol consumed by their friends. Scottish adolescents' personality was measured by the NEO Personality Inventory-3 (NEO-PI-3). The Junior Spanish version of the Revised NEO Personality Inventory (JS NEO) was used to assess personality in the Spanish sample. Low agreeableness and low conscientiousness correlated with own alcohol quantity in both countries. We performed an independent structural equation modeling for each country. Extraversion (ß = .205, p < .05) and low agreeableness (ß = -.196, p < .01) for Scottish adolescents, and low conscientiousness (ß = -.175, p < .05) for Spanish youths, predicted alcohol use through peer alcohol consumption at weekends. These findings support the relevance of personality traits and peer affiliation in relation to alcohol consumption in adolescence.

Alcohol Expectancies Mediate and Moderate the Associations between Big Five Personality Traits and Adolescent Alcohol Consumption and Alcohol-Related Problems.

Personality and expectancies are relevant psychological factors for the development of adolescent alcohol use and misuse. The present study examined their direct, mediated and moderated effects on different drinking behaviors in adolescence. Personality domains of the five-factor model, positive and negative alcohol expectancies (AEs), alcohol use during the week and the weekend, and alcohol-related problems were assessed in a sample of 361 adolescents. Different personality dimensions were directly associated with specific alcohol outcomes: Extraversion, low Conscientiousness and low Openness were associated with weekend alcohol use; low Agreeableness was related to weekday use; whereas low Agreeableness, low Conscientiousness and Extraversion were associated with alcohol-related problems. In addition, positive AEs mediated the relationship between Extraversion and alcohol use, whereas both positive and negative expectancies mediated the association between Neuroticism and alcohol consumption and alcohol-related problems. Finally, both types of expectancies interacted with Extraversion to predict alcohol problems. Our results highlight the importance of examining the complex interplay of comprehensive personality models and AEs to gain a better understanding of the development of different alcohol use and misuse patterns in adolescence.