Trajectories of adolescent poly-substance use and their long-term social and economic outcomes for males from low-income backgrounds

European Child & Adolescent Psychiatry - Substance abuse is a significant public health concern that disproportionately burdens males and low-income communities. This study examined (1)...     

Moderators of the association between peer and target adolescent substance use

Associating with substance using peers is generally considered as one of the most important predictors of adolescent substance use. However, peer association does not affect all adolescents in the same way. To better understand when and under what conditions peer association is most linked with adolescent substance use (SU), this review focuses on the factors that may operate as moderators of this association. The review highlighted several potential moderators reflecting adolescents' individual characteristics (e.g., pubertal status, genes and personality), peer and parental factors (e.g., nature of relationships and parental monitoring), and contextual factors (e.g., peer, school and neighborhood context). As peer association is a broad concept, important methodological aspects were also addressed in order to illustrate how they can potentially bias interpretation. Taking these into account, we suggest that, while the effects of some moderators are clear (e.g., parental monitoring and sensation seeking), others are less straightforward (e.g., neighborhood) and need to be further examined. This review also provides recommendations for addressing different methodological concerns in the study of moderators, including: the use of longitudinal and experimental studies and the use of mediated moderation. These will be key for developing theory and effective prevention.     

Adolescent bullying victimisation and alcohol-related problem behaviour mediated by coping drinking motives over a 12 month period

BackgroundDespite the adverse externalising risks associated with bullying victimisation, no study has investigated the underlying mechanisms of adolescent victims' engagement with alcohol. This current study investigated the development of risky coping drinking motives as a mediator in the relationship between adolescent school victimisation and alcohol-related problem behaviour using a longitudinal design over 12 months.MethodWe recruited 324 participants, aged 13 to 15 from schools across London, England. Participants were surveyed during class time at 2 time points: baseline and 12 months. At both time points participants answered questions related to bullying victimisation, alcohol-related problem behaviour, drinking motives and the quantity by frequency of alcohol consumption.ResultsThe relationships between victimisation, drinking and drinking motives were investigated using Pearson correlations. Path analysis showed that victimisation leads both directly and indirectly, through coping motives to alcohol-related problems, rather than to the quantity and frequency of alcohol use. Significance of mediation was tested using 5000 bias corrected and accelerated bootstrapped intervals. Baseline victimisation was significantly correlated with baseline alcohol-related problem behaviour and predictive of future problems at 12 months. Drinking to cope at 12 months partially mediated the relationship between baseline victimisation and alcohol-related problems at 12 months.ConclusionsResults show that victims of bullying are drinking alcohol in a risky style, partly due to the development of self medicating drinking behaviour. Victims of bullying could therefore benefit from coping skills interventions targeting negative affect regulation in order to reduce the risk for future alcohol misuse.     

Response inhibition and reward response bias mediate the predictive relationships between impulsivity and sensation seeking and common and unique variance in conduct disorder and substance misuse

Background: Disinhibited traits, assessed both at the self‐report and at the cognitive/behavioral levels, have been frequently implicated in externalizing behaviors, such as conduct disorder (CD), binge drinking, and drug use. However, self‐report measures of disinhibition, such as impulsivity (IMP) and sensation seeking (SS), and cognitive measures of disinhibition are not often studied together in the same participants. Thus, it is still unclear how cognitive measures such as response inhibition and reward response bias relate to self‐report measures of IMP and SS, and whether they can explain some of the association found between these self‐report measures and specific facets of externalizing problems. Methods: The aim of this study was to assess whether cognitive measures of disinhibition relate to self‐report measures of disinhibition and can mediate the specific relationships between self‐report measures of disinhibition and CD symptoms, binge drinking and drug use in adolescence. Seventy‐six adolescents were assessed on personality, substance use, and conduct problems every 6 months from 14 to 16 years of age and completed a test battery that included a Stop task, rewarded go/no–go task, digit span, and intelligence quotient tests at 16 years of age. Results: Multiple regression analyses showed that self‐report IMP at 14 and deficits in response inhibition were associated with a 2‐year average CD symptoms score and that deficits in response inhibition partially mediated the association between self‐report IMP and CD symptoms (ab = 0.018 CI: 0.00002 to 0.04827). In contrast, SS and reward response bias were significantly associated with the unique variance in binge drinking, and that part of the overlap between SS and binge drinking was mediated by reward response bias (ab = 0.019, CI: 0.00131 to 0.04662). Conclusions: Findings show a dissociation between inhibitory measures associated with CD symptoms and those associated with binge drinking, with “cool” inhibitory and executive functions being associated with CD but “hot,” reward‐related disinhibition measures being specific mediators between SS and binge drinking. The findings support the theoretical conceptualization for dual cognitive/motivational pathways of disinhibition, in this case IMP and SS, and their unique association with externalizing behavior in adolescence.     

Personality moderates the longitudinal relationship between psychological symptoms and alcohol use in adolescents

Background: A great deal of research has emerged on the comorbidity between alcohol misuse and psychological symptoms (e.g., depression, anxiety, and antisocial behavior or conduct disorder) in adolescence. Research has also shown that personality traits underlie vulnerability to alcohol use and psychological symptoms, but how personality moderates this association has not been comprehensively examined. The goals of this study are to clarify (i) whether early alcohol use effects the rate of change of psychological symptoms and vice versa, (ii) whether initial levels and rate of change in both domains vary according to individual differences in personality traits, and (iii) whether personality moderates the relationship between alcohol use and psychological symptoms. Methods: Self‐reported alcohol use, depression, anxiety, and antisocial behavior were collected from 393 adolescents at four separate time points across an 18‐month period. Parallel growth models were used to assess the main objectives of the study. Personality traits [anxiety sensitivity (AS), hopelessness (H), impulsivity (IMP), and sensation seeking (SS)] were included as time‐invariant predictors of initial levels and rates of change of each construct. Results: The results indicated that elevated levels of depression predicted faster rates of increase in alcohol use. Personality‐specific relationships were demonstrated across all models. IMP was shown to moderate the relationship between alcohol use and depression, suggesting that adolescents who showed a susceptibility to elevated levels of IMP, and heavier drinking were less likely to demonstrate a normative decline in depression. Adolescents with higher levels of AS and anxiety were more likely to show a faster rate of increase in alcohol use. Conclusions: These results highlight the importance of examining personality traits in studying the associations between alcohol use and psychological symptoms.     

Externalizing Risk Pathways for Adolescent Substance Use and Its Developmental Onset: A Canadian Birth Cohort Study: Trajectoires de comportements extériorisés et le risque pour l’initiation et l’usage de substances des adolescents : Une étude de cohorte de naissance canadienne

Objective:Only a minority of drug and alcohol users develops a substance use disorder. Previous studies suggest that this differential vulnerability commonly reflects a developmental trajectory characterized by diverse externalizing behaviors. In this study, we examined the relation between child and adolescent externalizing behaviors and adolescent substance use in a prospectively followed Canadian birth cohort, accounting for the temporal sequence of a wide variety of contributing factors.Methods:Two hundred and forty-two adolescents followed since birth (date range: 1996 to 2012) were assessed on externalizing behavior (age 17 months to 16 years), alcohol and cannabis use at age 16, age of alcohol use onset, family history of substance use problems, family functioning (age 11 to 15), sensation seeking (age 16), prenatal substance exposure, socioeconomic status (age 1 to 9), and sex.Results:Age of alcohol use onset was predicted by a family history of substance use problems, externalizing traits from ages 6 to 10 and 11 to 16, sensation seeking at age 16, prenatal alcohol and tobacco exposure and family functioning at ages 11 to 15. High frequencies of alcohol and cannabis use at age 16 were both predicted by externalizing traits from ages 11 to 16, a family history of substance use problems and sensation seeking after controlling for other individual, environmental and familial variables. The association between familial substance use problems and substance use during adolescence was partially mediated by externalizing traits from age 11 to 16.Conclusions:The present findings provide prospective evidence for a developmental risk pathway for adolescent substance use, potentially identifying those who could benefit from early interventions.