A reverse translational study of PPAR-α agonist efficacy in human and rodent models relevant to alcohol use disorder.

Alcohol Use Disorder (AUD) is a chronic relapsing disorder affecting an estimated 283 million individuals worldwide, with substantial health and economic consequences. Peroxisome proliferator-activated receptors (PPARs), particularly PPAR-α and PPAR-γ, have shown promise in preclinical studies as potential therapeutic targets for AUD. In this human laboratory study, we aimed to translate preclinical findings on the PPAR-α agonist fenofibrate to a human population with current AUD. We hypothesized that, relative to placebo, fenofibrate at the highest FDA-approved dose of 145 mg/d would attenuate responsiveness to in vivo alcohol cues in the lab and reduce drinking under natural conditions. However, the results did not show significant differences in craving and alcohol consumption between the fenofibrate and placebo groups. Reverse translational studies in rodent models confirmed the lack of fenofibrate effect at human-equivalent doses. These findings suggest that inadequate translation of drug dose from rodents to humans may account for the lack of fenofibrate effects on alcohol craving and consumption in humans with AUD. The results highlight the need for new brain-penetrant PPAR-α agonists to adequately test the therapeutic potential of PPAR-α agonists for AUD, and the importance of reverse translational approaches and selection of human-equivalent doses in drug development.

Maneuvering through Life with Positivity: Estimating the Effects of Foster Youth's Appraisal on Coping Styles.

Youth in foster care tend to experience a disproportional number of adverse life experiences and demonstrate high rates of emotional and behavioral difficulties. According to the transactional model of stress and coping, how youth appraise their experiences influences the type of coping strategies they use in response to adversity, and these relations are key components to understanding later adjustment. However, few studies have examined potential effects of appraisal on coping for youth in foster care. Furthermore, it is not well understood if or how such interaction may vary across age. To address this gap, this study examined potential age moderation of contemporaneous primary, threat-based appraisal effects on coping in a large sample of 490 youth in foster care (48% female, ages 8 to 18) using a series of statistical models which were capable of detecting very general forms of effect moderation. Results indicated that primary appraisal positively predicted direct and prosocial coping, and negatively predicted asocial coping. The linear effects of appraisal on coping did not vary based on age of the youth. The findings suggest that primary appraisals of life events for youth in foster care does have a unique influence on certain coping styles, suggesting perhaps new directions for research on youth exposed to multiple adversities. To promote wider use of the non-parametric time-varying effect model in R, the analysis syntax is also included in the appendix.

House Level Latent Classes as Predictors of Recovery and Evictions.

The current study explored whether substance abuse recovery houses could be categorized into meaningful classes, which might be associated with house evictions as well as changes in individual-level recovery capital. A total of 602 individuals from 42 recovery homes were followed for up to 6 data collection periods over 2 years. House level latent class analyses were based on house-level data. A 3-class model fit very well (entropy 0.94) and better than a 2-class model. Class profiles examined concurrent (averaged across waves 1 and 2) house and resident-level variables (e.g., gender, race, age, employment, education). Class was then used to prospectively predict outcomes of the hazard of eviction and improvement in a recovery index over waves 3-6. One latent class representing 45% of the recovery houses had the highest density of members willing to loan, able to pay their rent, active involvement in outside chapter activities-this group of houses had the best outcomes including the lowest eviction rate and highest mean recovery factor. The two other classes had higher eviction rates, with one having the lowest density of friendship, selectivity of residents, and ability to pay rent. The other of the higher eviction-rate classes surprisingly had the highest density of friendship and advice seeking, but the lowest density of willingness to loan. These findings suggest that there are meaningful differences in types of recovery homes, and that house characteristics appear to influence recovery changes and eviction outcomes.

Discrepancies in youth self-report and case file report of maltreatment and association with internalizing and externalizing symptoms.

BACKGROUND: Childhood maltreatment is a potential risk factor for the later development of psychopathology (Jaffee, 2017). However, there is no gold standard for identifying victims of child maltreatment, and when multiple informants - such as case files and youth self-report - are used, these sources often disagree (Cooley & Jackson, 2022). OBJECTIVE: The current study aimed to explore discrepancies between youth self-report and case file report of maltreatment and examine how these discrepancies related to internalizing and externalizing symptoms. PARTICIPANTS/SETTING: Participants were 470 youth living in foster care between the ages of 8 and 18 and their caregivers. METHODS: Latent class analysis (LCA) was used to create novel groups based on informant discrepancies. RESULTS: Agreement between informants was in the poor-to-fair agreement range for all types of maltreatment. Latent class analysis identified a 3-class solution with significant group differences on both externalizing (Χ2 (2, N = 470) = 6.16, p = 0.05) and internalizing symptoms (Χ2 (2, N = 470) = 6.10, p = 0.05). Specifically, those in the "self-report only" class had significantly higher symptoms than those in the "neither informant/case file only" class for both internalizing and externalizing behavior. CONCLUSIONS: Case files and youth self-report of maltreatment are discrepant. Youth self-report of maltreatment history may be more closely linked to psychopathology than case file report of maltreatment. Researchers and practitioners should look to youth self-report rather than relying solely on case files when determining risk for psychopathology.

Individual and Contextual Protective and Risk Characteristics for Residents of Recovery Homes.

Some recovery homes have facilitating relationships and organizational characteristics, and there are also social capital differences among residents of these recovery homes. It is important to better understand the impact of protective and risk individual and house factors on recovery issues among residents of these community-based settings. Individuals from 42 recovery homes were followed for up to six data collection periods over two years. House level latent class analyses tapped relationship and organizational domains and individual level latent class analyses were from derived from elements of recovery capital. Houses that manifested protective factors provided most residents positive outcomes, except those with elevated self-esteem. Houses that were less facilitating had more negative exits, except for those residents who were the highest functioning. Both individual and house characteristics are of importance in helping to understand risk factors associated with eviction outcomes for residents in recovery homes.

Latent profile analysis in recovery homes: A single quantitative dimension captures most but not all of the important details of the recovery process.

Background: Our study explored whether latent classes adequately represented the social capital recovery indicators at the resident level and whether latent class membership predicted subsequent exits from the recovery homes. Method: Our sample included about 600 residents in 42 recovery homes. Over a 2-year period of time, every 4 months, data were collected on eight elements of recovery capital. Results: We found 5 latent classes were optimal for representing 8 elements of recovery capital. Representing 79% of the sample, 3 of the 5 latent class profiles of the means of the 8 recovery indicators were roughly parallel and differed only in level, but the remaining 2 latent class profiles, representing 21% of the sample, were not parallel to the first 3, suggesting that a single quantitative dimension of perceived recovery may capture most but not all of the important details of the recovery process. Next, using longitudinal data from homes, the distal outcomes of resident eviction and voluntary exit were found to be related to latent class membership. Resident level pre-existing predictors (e.g., employment status, educational attainment, gender, Latinx ethnicity) and house level pre-existing predictors (e.g., financial health, poverty level of typical population served, new resident acceptance rate) significantly discriminated the classes. In a model that combined both pre-existing predictors and distal outcomes, latent class membership was still the strongest predictor of evictions controlling for the pre-existing predictors. Conclusions: These classes help to clarify the different aspects of the recovery latent score, and point to classes that have different ethnic and gender characteristics as well as outcomes in the recovery homes. For example, the high levels of self-confidence found in class 3 suggest that Latinx might be at higher risk for having some difficulties within these recovery communities.

First E-Cigarette Flavor and Device Type Used: Associations With Vaping Persistence, Frequency, and Dependence in Young Adults.

INTRODUCTION: Type of e-cigarette flavoring and device during first use might differentiate later e-cigarette use and dependence. This retrospective cross-sectional study examined associations of recalled first nicotine vaping device and flavor used with current vaping frequency/dependence. AIMS AND METHODS: A young adult cohort from Los Angeles, California, USA completed web-based surveys (N = 2553). Using cross-sectional data from 971 reporting ever vaping nicotine, multivariable hurdle regressions tested associations between recalled first flavor (fruit/sweet, menthol/mint, other) and device (Juul, disposable, mod, box, pod, pen, other) vaped with past-30-day vaping status (yes/no) and frequency (1-30 days), and with any vaping dependence symptoms (yes/no) and count (1-10 symptoms). RESULTS: The most common first-flavor was sweet (71%); the most common first-device was a vape pen (37%), then Juul (22%). First-flavor of mint/menthol (vs. other; adjusted odds ratio [AOR]: 2.22[95% CI = 1.16 to 4.25]), and first-device mod (AOR = 2.40[95% CI = 1.34 to 4.31]) and non-Juul pod (2.64[95% CI = 1.41 to 4.92]) (vs. pen) were associated with past-30-day vaping, and twice as many vaping days (adjusted rate ratios [ARRs] range: 1.96-2.12; ps < .05). First flavor of mint/menthol (vs. other; AOR: 1.95[95% CI = 1.003 to 3.79) and first device mod, box, non-Juul pod, and other (AORs range: 2.36-4.01; ps < .05) were associated with nicotine dependence. First device Juul, mod, box, and non-Juul pod were also associated with more dependence symptoms (ARRs range:1.38-1.59; ps < .05). CONCLUSIONS: Exposure to mint/menthol and certain devices (mod, box, Juul, and non-Juul pods) at first e-cigarette use may be associated with more frequent e-cigarette use and nicotine dependence symptoms in young adulthood. Mint/menthol and certain devices warrant consideration in regulation of e-cigarettes based on product characteristics. IMPLICATIONS: Characteristics (flavor and device type) of first e-cigarette product used were associated with higher usage and more dependence. Pending replication with prospective designs, the findings suggest certain flavors (mint/menthol) and devices (pods, mods) merit consideration in regulation because of their possible link with continued use and dependence among young people.

Personal and Environmental Social Capital Predictors of Relapse Following Departure from Recovery Homes.

Substance use recovery homes represent the largest residential, community-based post-treatment option for those with substance use disorders in the United States. It is still unclear what unique factors predict relapse after residents leave such homes. This study presents results of a longitudinal study of 497 residents who departed from 42 Oxford House recovery houses. We hypothesized that the predictors of post-departure relapse would be a multi-item measure of latent recovery, length of stay, and reason for departure from the home (voluntary vs. involuntary). Predictor effects were estimated as part of a two-step model with two outcomes: (a) lack of follow-up data after departure from the house, and (b) the likelihood of relapse. Determinants of missing follow-up data included less education, less time in residence, and involuntary departure. Relapse was more likely for individuals who were younger, had involuntarily left the house, and had lower values on the latent recovery factor. The implications of these important factors related to relapse following departure from residential recovery home settings are discussed.

Advice seeking and loaning of money related to relapse in recovery homes.

Recovery homes help individuals who have completed substance use treatment programs re-integrate back into the community. However, it is unclear what factors determine who will succeed in these settings and how these factors may be reinforced or undermined by the social interactions and social networks between residents living in the Oxford House recovery homes. In an effort to better understand these factors, the current study evaluated (a) the extent to which the density of social networks (i.e., friendship, willingness to loan money, and advice-seeking relationships) is associated with social capital (i.e., sense of community, quality of life, hopefulness, self-efficacy), and (b) whether the density of social networks predicts relapse over time. Among the findings, willingness to loan money was positively associated with all four individual-level social capital variables, suggesting that availability of instrumental resources may be important to ongoing recovery. To test whether these house-level social network factors then support recovery, a survival analysis was conducted, finding associations between relapse risk and the network densities over a 28-month span. In particular, more dense advice-seeking networks were associated with higher rates of relapse, suggesting that the advice-seeking might represent a sign of organisational house problems, with many residents unsure of issues related to their recovery. In contrast, more dense loaning networks were associated with less relapse, so willingness to lend money could be measuring a willingness to help those in need. The implications of these findings are discussed.

Context Matters: Home-level But Not Individual-Level Recovery Social Capital Predicts Residents' Relapse.

The purpose of this study is to contribute to the literature on the prediction of substance use relapse, using sophisticated systems' approaches to individuals and their contexts. In the current study of 42 recovery homes, we investigated the construct of social capital from the perspective of both recovery home residents and the house level. A confirmatory factor analysis found a latent recovery factor (including elements of recovery capital, comprising resources such as wages, self-efficacy, stress, self-esteem, quality of life, hope, sense of community, and social support) at both the individual and the recovery house level. Next, using longitudinal data from homes, an individual's probability of relapse was found to be related to house rather than individual-level latent recovery scores. In other words, an individual's probability of relapse was primarily related to the average of the "recoveries" of his or her recovery home peers, and not of his or her own personal "recovery" status. The finding that resident relapse is based primarily upon the total recovery capital available in the homes highlights the importance of the social environment for recovery.

Network measures of advice-seeking and resource sharing are related to well-being in recovery homes.

BACKGROUND: There is a need to better understand the extent to which social capital (reflected in social networks tapping friendship, financial support, advice/informational support) can aid recovery for those residents living in abstinence-based recovery homes. METHODS: Social network characteristics of 42 recovery homes (Oxford Houses) were examined, including friendship, willingness to loan money, and advice-seeking to assess the extent to which house network patterns were related to house-level resident measures of proximal recovery outcomes of well-being (e.g. social support, self-esteem, stress) and financial health (e.g. earned wages). RESULTS: We found that the density of the willingness to loan money network within a house was positively associated with house-level earned wages, social support, and self-esteem, and negatively associated with stress. Conversely, the density of house advice-seeking relationships was positively related to house-level stress. CONCLUSIONS: Houses in which residents are willing to share resources with other members who may be in need showed higher rates of well-being at the house-level. Advice-seeking in itself may signal stress, as stress may motivate residents to seek advice from more peers. The implications of these findings are discussed.

Reducing health disparities among black individuals in the post-treatment environment.

An important step in reducing health disparities among racial and ethnic minorities with substance use disorders involves identifying interventions that lead to successful recovery outcomes for this population. The current study evaluated outcomes of a community-based recovery support program for those with substance use disorders. Participants included 632 residents of recovery homes in three states in the US. A multi-item recovery factor was found to increase over time for these residents. However, rates of improvement among Black individuals were higher than for other racial/ethnic groups. Black Americans perhaps place a higher value on communal relationships relative to all other racial/ethnic groups, and by adopting such a communitarian perspective, they might be even more receptive to living in a house that values participation and involvement. The implications of these findings for health disparities research are discussed.

A New Recall of Alcohol Marketing Scale for Youth: Measurement Properties and Associations With Youth Drinking Status.

OBJECTIVE: Adolescents are exposed to alcohol marketing through traditional advertising and through newer digital media channels. Cumulative marketing exposure across channels is of concern but has been insufficiently studied. This study explores the measurement of alcohol marketing exposure across channels and whether cumulative recalled exposure is independently associated with underage drinking. METHOD: Two hundred two New England adolescents (ages 12-17 years) were recruited from a general pediatrics clinic and completed an online survey. Recall of alcohol marketing across channels (e.g., Internet, magazines) was assessed, along with drinking behavior and relevant covariates (i.e., demographics, parental/peer drinking, smoking status, sensation seeking, Internet use, social media use, television use, and parental Internet monitoring). Confirmatory factor analysis was used to establish a latent construct of alcohol marketing exposure recall. Logistic regression tested associations between alcohol marketing recall and adolescent drinking, with covariates controlled for. RESULTS: Adolescents reported recall of alcohol marketing across all marketing channels. Alcohol marketing recall items were significantly correlated, with α = .83. The latent measurement model of alcohol marketing recall provided excellent fit to the data, χ2(17, n = 202) = 27.402, p = .052; root mean square error of approximation (.000-.092) = .055; Tucker-Lewis Index = .960; comparative fit index = .976; standardized root mean square residual = .037). Adjusted cross-sectional logistic regression analyses demonstrated that the latent alcohol marketing recall construct was significantly associated with underage drinking (adjusted odds ratio = 4.08, 95% CI [1.15, 14.46]) when relevant covariates were accounted for. CONCLUSIONS: The final measurement model provided support for construct validity of a novel alcohol marketing recall construct assessing cumulative cross-channel marketing exposure. Adolescent recall of alcohol marketing across channels was significantly associated with underage drinking, while associated factors such as peer/parental drinking were accounted for.

Student Practice Opportunities in Core Mathematics Instruction: Exploring for a Goldilocks Effect for Kindergartners With Mathematics Difficulties.

Opportunities for practice play a critical role in learning complex behaviors. In the context of explicit mathematics instruction, practice facilitates systematic opportunities for students with mathematics difficulties (MD) to learn new mathematics content and apply such knowledge and skills to novel mathematics problems. This study explored whether there is an optimal amount of student practice that teachers should provide in core mathematics instruction to maximize the mathematics achievement of kindergarten students with MD, a so called "Goldilocks effect," as opposed to simply "more is better." Results from observation data collected in a large-scale efficacy trial supported the latter rather than the former. Specifically, we found that three individual practice opportunities for every explicit teacher demonstration of mathematical content was associated with increased mathematics achievement for students with MD relative to fewer practice opportunities. Implications for facilitating frequent student practice opportunities during core mathematics instruction and designing professional development for teachers who work with students with MD are discussed.

Childhood problem behaviours as precursors of drinking to intoxication trajectories - from age 1.5 to 19.

OBJECTIVE: We examined behaviour problem precursors (i.e. internalising and externalising) in childhood (ages 1.5 to 8.5) and early adolescence (age 12.5) and consequences (i.e. harmful alcohol use) in emerging adulthood (age 19), of developmental trajectories of drinking to intoxication across adolescence (ages 14.5-19). DESIGN AND OUTCOME MEASURES: Data from 921 children and their parents followed for 18 years from the population-based Tracking Opportunities and Problems (TOPP) Study were used to examine adolescent trajectories of drinking to intoxication. Logistic regression was used to examine predictors of trajectory group membership. RESULTS: We identified 3 trajectory classes: low / abstainer (41%), late onset high (31%) and early onset high (28%) using latent class analyses. Logistic regression analyses showed that childhood high externalising characterised early onset of intoxication vs. other classes, while early adolescence externalising discriminated both early and late onset of intoxication. High early childhood internalising characterised those consistently low or abstinent on alcohol intoxication, while early adolescent internalising characterised those having an early onset of intoxication. However, after additional adjustment for co-occurring externalising, there were no evidence for a link between early adolescent internalising and intoxication. CONCLUSIONS: The findings suggest that both child and early adolescent-focused prevention efforts may be warranted.

The Role of Sensation Seeking and R-rated Movie Watching in Early Substance Use Initiation.

Adolescence is a time of heightened impulsivity as well as substantial exposure to the effects of popular media. Specifically, R-rated movie content and sensation seeking have been shown to be individually and multiplicatively associated with early alcohol initiation, as well as to mutually influence one another over time. The present study attempts to replicate and extend these findings to cigarette and marijuana use, considering several peer, parental, and individual correlates, as well as substance-specific movie exposure, among 1023 youth (mean age 12.4 years, 52% female), using a combination of cross-lagged path models, latent growth models, and discrete-time survival models. Changes over time were associated between R-rated movie watching and sensation seeking, and both individually, not multiplicatively, predicted earlier alcohol initiation. R-rated movie watching (but not sensation seeking) also predicted earlier smoking and marijuana initiation. Parental R-rated movie restriction may thus potentially delay smoking and marijuana initiation as well as adolescent drinking.

Did limits on payments for tobacco placements in US movies affect how movies are made?

OBJECTIVE: To compare how smoking was depicted in Hollywood movies before and after an intervention limiting paid product placement for cigarette brands. DESIGN: Correlational analysis. SETTING/PARTICIPANTS: Top box office hits released in the USA primarily between 1988 and 2011 (n=2134). INTERVENTION: The Master Settlement Agreement (MSA), implemented in 1998. MAIN OUTCOME MEASURES: This study analyses trends for whether or not movies depicted smoking, and among movies with smoking, counts for character smoking scenes and average smoking scene duration. RESULTS: There was no detectable trend for any measure prior to the MSA. In 1999, 79% of movies contained smoking, and movies with smoking contained 8 scenes of character smoking, with the average duration of a character smoking scene being 81 s. After the MSA, there were significant negative post-MSA changes (p<0.05) for linear trends in proportion of movies with any smoking (which declined to 41% by 2011) and, in movies with smoking, counts of character smoking scenes (which declined to 4 by 2011). Between 1999 and 2000, there was an immediate and dramatic drop in average length of a character smoking scene, which decreased to 19 s, and remained there for the duration of the study. The probability that the drop of -62.5 (95% CI -55.1 to -70.0) seconds was due to chance was p<10-16. CONCLUSIONS: This study's correlational data suggest that restricting payments for tobacco product placement coincided with profound changes in the duration of smoking depictions in movies.

Industry Television Ratings for Violence, Sex, and Substance Use.

OBJECTIVE: To examine whether the industry-run television (TV) Parental Guidelines discriminate on violence, sexual behavior, alcohol use, and smoking in TV shows, to assess their usefulness for parents. METHODS: Seventeen TV shows (323 episodes and 9214 episode minutes) across several TV show rating categories (TVY7, TVPG, TV14, and TVMA) were evaluated. We content-coded the episodes, recording seconds of each risk behavior, and we rated the salience of violence in each one. Multilevel models were used to test for associations between TV rating categories and prevalence of risk behaviors across and within episodes or salience of violence. RESULTS: Every show had at least 1 risk behavior. Violence was pervasive, occurring in 70% of episodes overall and for 2.3 seconds per episode minute. Alcohol was also common (58% of shows, 2.3 seconds per minute), followed by sex (53% of episodes, 0.26 seconds per minute), and smoking (31% of shows, 0.54 seconds per minute). TV Parental Guidelines did not discriminate prevalence estimates of TV episode violence. Although TV-Y7 shows had significantly less substance use, other categories were poor at discriminating substance use, which was as common in TV-14 as TV-MA shows. Sex and gory violence were the only behaviors demonstrating a graded increase in prevalence and salience for older-child rating categories. CONCLUSIONS: TV Parental Guidelines ratings were ineffective in discriminating shows for 3 out of 4 behaviors studied. Even in shows rated for children as young as 7 years, violence was prevalent, prominent, and salient. TV ratings were most effective for identification of sexual behavior and gory violence.

Exposure to Movie Reckless Driving in Early Adolescence Predicts Reckless, but Not Inattentive Driving.

OBJECTIVE: We examine the association between exposure to depictions of reckless driving in movies and unsafe driving, modeling inattentive and reckless driving as separate outcomes. METHODS: Data were obtained by telephone from 1,630 US adolescents aged 10 to 14 years at baseline who were drivers at a survey 6 years later. Exposure to movie reckless driving was measured based on movies seen from a randomly selected list of 50 movie titles that had been content coded for reckless driving among characters. Associations were tested with inattentive and reckless driving behaviors in the subsequent survey-controlling for baseline age, sex, socioeconomic status, parental education, school performance, extracurricular activities, daily television and video/computer game exposure, number of movies watched per week, self-regulation and sensation seeking. RESULTS: Exposure to movie reckless driving was common, with approximately 10% of movie characters having driven recklessly. Confirmatory factor analysis revealed a significant distinction between items tapping reckless and inattentive driving at the 6th wave. Age and exposure to movie reckless driving at baseline were directly associated with wave-6 reckless (but not inattentive) driving. Additionally, growth in sensation seeking mediated a prospective relation between the total number of movies watched per week at baseline and reckless driving, independent of exposure to movie reckless driving. Males and high sensation seekers reported lower seatbelt usage and more reckless driving, whereas lower self-regulation predicted inattentive driving. DISCUSSION: In this study, exposure to movie reckless driving during early adolescence predicted adolescents' reckless driving, suggesting a direct modeling effect. Other aspects of movies were also associated with reckless driving, with that association mediated through growth in sensation seeking. Predictors of reckless driving were different from predictors of inattentive driving, with lower self-regulation associated with the latter outcome. Making a clear distinction between interventions for reckless or inattentive driving seems crucial for accident prevention.

Embedding multilevel survival analysis of dyadic social interaction in structural equation models: hazard rates as both outcomes and predictors.

OBJECTIVE: Demonstrate multivariate multilevel survival analysis within a larger structural equation model. Test the 3 hypotheses that when confronted by a negative parent, child rates of angry, sad/fearful, and positive emotion will increase, decrease, and stay the same, respectively, for antisocial compared with normal children. This same pattern will predict increases in future antisocial behavior. METHODS: Parent-child dyads were videotaped in the fall of kindergarten in the laboratory and antisocial behavior ratings were obtained in the fall of kindergarten and third grade. RESULTS: Kindergarten antisocial predicted less child sad/fear and child positive but did not predict child anger given parent negative. Less child positive and more child neutral given parent negative predicted increases in third-grade antisocial behavior. CONCLUSIONS: The model is a useful analytic tool for studying rates of social behavior. Lack of positive affect or excess neutral affect may be a new risk factor for child antisocial behavior.