Alcohol Prevalence and Attitudes Among Adults and Adolescents: Their Relation to Early Adolescent Alcohol Use in Rural Communities

Although research has identified numerous neighborhood mechanisms influencing urban adolescent risk behaviors, less is known about how community contexts influence rural adolescents. This study explores perceived controls against adolescent drinking (i.e., tolerance of community adolescent alcohol use), adolescent perceptions of community supportiveness, and the prevalence of community alcohol use exhibited by adolescents and adults. Multilevel analyses were applied to 1,424 sixth- through eighth-grade students residing in 22 rural communities in the Northern Plains. Perceptions of tolerance, prevalence, and support from 790 parents, teachers, and community leaders were also collected. Analyses revealed that community supportiveness and controls against drinking reduced both the decision to try alcohol and past-month use among early adolescents. Adolescents were more likely to have ever tried alcohol if they lived in a community with higher peer prevalence than higher levels of adult alcohol prevalence, but in communities where peer drinking was lower; adolescents were more likely to have tried alcohol if they lived in a high adult-prevalence community. Perceived peer drinking was not related to past-month use.     

Functioning of Alcohol Use Disorders Criteria Among Middle-Aged and Older Adults: Implications for DSM-5

This study explored dimensionality and rank-order severity of the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) alcohol use disorder (AUD) criteria among adults 50+ years old. Secondary analysis was performed on data from individuals 50+ (N = 3,412) from the 2009 National Survey of Drug Use and Health. Confirmatory factor analyses (CFA) and item response theory (IRT) analyses were performed on the 11 AUD criteria. DSM-IV and DSM fifth edition (DSM-5) classifications were compared. CFA revealed a one-factor model. IRT analyses revealed that AUD criteria identify only severe cases of AUD. Overall, 5.8% met criteria for a DSM-IV AUD; 7.5% met criteria for DSM-5 AUD.     

Medical Student Judgments of Adolescents With Alcohol Use Disorders (AUD)

The clinical encounter presents opportunities for detection and intervention of adolescent alcohol use disorders (AUDs). Aims: Investigate (a) identification rate of AUDs, (b) whether AUD identification predicts clinical judgment, and (c) patient characteristics influences on clinical judgment. Medical students (n = 123) read a case study and completed questions on diagnosis and clinical judgment. Twenty-five percent of participants identified AUD adolescents, who were more negatively rated than non-AUD adolescents. Prior clinical experience and addiction training predicted AUD identification. Patient race and gender influenced clinical judgment ratings. Addictions training is needed to improve identification rates. Study limitations are noted.     

Creating a Developmentally Sensitive Measure of Adolescent Alcohol Misuse: An Application of Item Response Theory

This study, funded by the US National Institute of Drug Abuse, evaluates the usefulness of item response theory (IRT) to create a developmental alcohol misuse scale. Data were collected during 1997–2006 from 5,828 Midwestern US students who completed annual surveys at grades 7 through 11 and 2 and 4 years after high school. Seventeen alcohol misuse items were calibrated with IRT and examined for differential item functioning (DIF) across 5 study waves. Eight items displayed DIF; in most cases, properties for items assessed 2 years after high school were different from those assessed in grades 8–11. Implications and suggestions for future research are discussed.     

Factors Predicting Alcohol Consumption in Adolescents Attending a Faith-Based School System in Australia: A Multigroup Structural Equation Analysis

Abstract

Structural equation modeling was used to explore the direct and indirect association of childhood experiences, attitudes, subjective norms, and intentions on the alcohol consumption of adolescents attending faith-based Seventh-day Adventist schools in Australia. Data were collected on 1,266 adolescents and the structural model developed explained 48% of the variance for alcohol consumption. Intentions had the highest degree of association with Alcohol Consumption Status (ACS) (β?=?0.52). Attitudes were more strongly associated to ACS (β_total = 0.36) than subjective norms (β_total = 0.17). Adverse Childhood Experiences (ACEs) were associated with every variable in the model and had a combined direct and indirect association with ACS of β_total = 0.14. Multigroup analysis found significant pathway differences in the model for gender and age with regards to the association of intentions, attitudes, ACEs, and Childhood Family Dynamics with alcohol consumption status. The study fills a gap in the alcohol literature by presenting a model describing the complex network of factors that predict alcohol consumption in a low-ACS population. The outcomes of the study highlight the importance of early intervention for children and their families to delay or minimize alcohol consumption in adolescents.     

Gender Differences in Early Alcohol and Tobacco Use as a Risk Factor in Spanish Adolescents

The sample is made up of 1,190 adolescents (52.8% boys; mean age = 16.81) from 37 random schools in the urban and rural areas of Asturias (northern Spain). The survey was conducted in 2008, assessing the use and patterns of use of alcohol and other drugs, age at onset of use, and psychosocial consequences. Items from the ESPAD and FRIDA questionnaires were employed. Univariate analyses and binary logistic regression analyses were carried out to determine the different predictive value for boys and girls of early-onset alcohol and tobacco use. The study's limitations and implications are noted.     

Acceptability and Impact of Measures Regulating Alcohol Consumption Among Adolescents in Spain: Opinions of Adolescents,Parents, and Teachers

This article describes the acceptability and opinion on the impact of measures regulating alcohol consumption among minors in Spain, from the point of view of the adolescents, parents, and teachers. The participants—123 students, teachers, and parents from 6 Spanish autonomous communities—take part in a qualitative survey (focal groups and interviews) and in a quantitative part measuring levels of agreement with 17 anti-alcohol measures. The study shows the existence of widespread agreement with the measures, although the impact of regulations is considered to be low. Adolescents welcome administrative measures, and parents and teachers prefer the regulation of sales, consumption, and advertising. Collaboration between the social actors involved in the prevention and control of alcohol consumption among minors and regulations based on heightening the sense of responsibility of all groups forms the basis for effective anti-alcohol regulations.     

Development and initial validation of the Worry-Reduction Alcohol Expectancy Scale

Recent research on the relation between generalized anxiety and heavy drinking highlighted a need for a measure of worry-reduction alcohol expectancies. The current study aimed to develop and to assess the psychometric properties of the Worry-Reduction Alcohol Expectancy Scale. The development and initial validation of the WRAES occurred across two phases with two separate non-clinical undergraduate samples. Phase I was focused on scale construction and item selection, while Phase II included an assessment of the WRAES' reliability, validity and cross-validation of factor structure. Results from both study phases support a two-factor model. Cronbach's alpha for the total scale was .96 and Pearson r test-retest reliability was .75. Additionally, the mean correlation between the WRAES and convergent measures was significantly higher than the mean correlation between the WRAES and discriminant measures. Overall, the results provide initial support for the WRAES as a measure of worry-reduction alcohol expectancies.     

Psychometric assessment of the Temptations to Try Alcohol Scale

Effective interventions require an understanding of the behaviors and cognitions that facilitate positive change as well as the development of psychometrically sound measures. This paper reports on the psychometric properties of the Temptations to Try Alcohol Scale (TTAS), including factorial invariance across different subgroups. Data were collected from 3565 6th grade RI middle school students. Structural equation modeling was used to determine the appropriate factorial invariance model for the 9-item TTAS. The measure consists of three correlated subscales: Social Pressure, Social Anxiety, and Opportunity. Three levels of invariance, ranging from the least to the most restrictive, were examined: Configural Invariance, which constrains only the factor structure and zero loadings; Pattern Identity Invariance, which requires factor loadings to be equal across the groups; and Strong Factorial Invariance, which requires factor loadings and error variances to be constrained. Separate analyses evaluated the invariance across two levels of gender (males vs. females), race (white vs. black) ethnicity (Hispanic vs. Non-Hispanic) and school size (small, meaning <200 6th graders, or large). The highest level of invariance, Strong Factorial Invariance, provided a good fit to the model for gender (CFI: .95), race (CFI: .94), ethnicity (CFI: .94), and school size (CFI: .97). Coefficient Alpha was .90 for Social Pressure, .81 for Social Anxiety, and .82 for Opportunity. These results provide strong empirical support for the psychometric structure and construct validity of the TTAS in middle school students.     

Preliminary Psychometric Evaluation of the Hamilton Depression Rating Scale in Methamphetamine Dependence

Objective: The purpose of this study was to test the initial psychometric properties of the 17-item Hamilton Depression Rating Scale (HAM-D) in individuals with and without major depressive disorder who use methamphetamine. We used data from two completed studies and two ongoing clinical trials. The HAM-D has well established reliability and validity in a variety of populations. However, there are no published reports of reliability and validity of the HAM-D in a methamphetamine-using population. Methods: HAM-D and depression status data were extracted from four separate studies for this psychometric assessment. Using these data, we evaluated three measures of construct validity: internal consistency, contrasted group validity, and factorial validity. Results: We found potential concerns with the construct validity of the HAM-D in users of methamphetamine. Intercorrelations between items were primarily less than 0.20 and the Cronbach's alpha value in this sample was 0.58, indicating potential issues with internal consistency. The results of two-sample t-tests suggest concerns with contrasted group validity, as no significant difference in average scores were found for nine items. Consistent with previous studies, a principal component analysis indicates that the HAM-D is multidimensional. Conclusions: The 17-item HAM-D might not reliably and validly measure depression severity in a methamphetamine-using population. Given our small sample, additional research is needed, though, to further test the psychometric properties of the HAM-D in individuals who use methamphetamine.     

A Survey Analysis of Alcohol Use at a Black University in the Deep South

This article describes preferred places of drinking and ways of obtaining alcohol beverages by 1,480 jewish, Moslem, Christian and Druze adolescent drinkers from 29 schools in 13 locations in the north of Israel in winter 1994. The pub is the primary source of alcohol for Jewish adolescents, whereas the home is the main alcohol source for non-Jewish teenagers. Most Jew and Druze teenagers obtain alcohol by themselves. Most Moslems get their drinks from same-age friends. Most Christians get alcohol from their parents. This article presents gender and grade differences, sa well as cultural-oriented suggestions for preventive initiatives.     

Alcohol Consumption Among Turkish Adolescents: An Empirical Test of General Strain Theory

Using data drawn from the 2008 Youth in Europe Survey, the current study examined alcohol consumption among Turkish adolescents through the lens of Agnew's general strain theory (GST). Although considerable attention has been paid to alcohol consumption among adolescents, extant research has remained limited to Western countries. Similarly, much of the support for GST was derived from research conducted in the United States. The current study explores factors associated with alcohol consumption in Turkey and tests the generalizability of GST. Results from ordinal logistic regression analyses indicated that, except for family strain, specific kinds of strain were significantly associated with drinking behavior without any mediating effect that could emanate from students’ negative affective states.     

Psychometric Properties of the Adjective Rating Scale for Withdrawal across treatment groups,gender, and over time

The Adjective Rating Scale for Withdrawal (ARSW) is commonly used to assess opiate withdrawal in clinical practice and research. The aims of this study were to examine the factor structure of the ARSW, test measurement invariance across gender and treatment groups, and assess longitudinal measurement invariance across the clinical trial. Secondary data analysis of the National Drug Abuse Treatment Clinical Trials Network 000–3, a randomized clinical trial comparing two tapering strategies, was performed. The ARSW was analyzed at baseline, end of taper and 1-month follow-up (N=515 opioid-dependent individuals). A 1-factor model of the ARSW fit the data and demonstrated acceptable reliability. Measurement invariance was supported across gender and taper groups. Longitudinal measurement invariance was not found across the course of the trial, with baseline assessment contributing to the lack of invariance. If change over time is of interest, change from post-treatment through follow-up may offer the most valid comparison.     

Validation of the Comprehensive Effects of Alcohol Questionnaire in Older Adults

Background: Alcohol expectancies have been established as an important construct in the prediction of alcohol use among younger adults, but there is little understanding about the perceived expected effects of consuming alcohol in older adults. Beliefs about the expected effects of alcohol may be quite different in older adults compared to young adults, which may also play a different role in their drinking behavior. In older cohorts there may be stigma may be associated with drinking and the nature of drinking experiences may differ to those of younger adults. Existing measures of expectancies are based on the perspectives of younger adults and therefore warrant validation in an older sample. Objectives: The aim of this study is to validate the comprehensive effects of alcohol questionnaire (CEOA) in a sample of older adults, and to investigate the relationships between alcohol expectancies, their evaluations and alcohol use. Methods: A sample of community dwelling older adults (N?=?473) completed self-report measures assessing drinking behavior and alcohol expectancies. Exploratory factor analysis, confirmatory factor analysis, and hierarchical multiple regressions were conducted. Results: The final model of the CEOA supported two global dimensions of positive and negative expectancies, and showed excellent goodness-of-fit and internal consistency. Male drinkers were more likely to endorse positive expectancies and favorable evaluations of positive and negative expectancies. Favorable evaluations of positive expectancies were the strongest predictors of drinking frequency and quantity. Conclusions/Importance: The results support for the empirical validity of a two-factor expectancy model consisting of a 10-item negative expectancy factor and a 10-item positive expectancy factor. This more concise version could offer a more acceptable and time efficient measure of expectancies and valuations for older adults. Furthermore, the study provides important findings for the role of evaluations in their prediction of alcohol use.     

The Effect of Alcohol Abuse and Dependence and School Experiences on Depression: A National Study of Adolescents

ABSTRACT

The study purpose was to examine the effect alcohol abuse/dependence and school experiences have on depression among a nationwide sample of adolescents. A secondary analysis of the 2013 National Survey on Drug Use and Health was conducted. The results of the final multivariable logistic regression model revealed that adolescents who reported having past-year alcohol abuse/dependence and negative school experiences were at increased odds for reporting past-year depression. This study adds to the existing literature by revealing the association of alcohol dependence/abuse, negative school experiences, and adolescent depression above and beyond demographic covariates. Recommendations for future studies are included.     

Social Problem Solving and Adolescent Alcohol Use Within the Context of Well-Established Risk Factors for Adolescent Alcohol Use

Social problem solving has been associated with alcohol use in adolescents, but has not been examined within the context of well-established risk factors, such as childhood conduct problems, parental history of alcohol use, association with deviant peers, and behavior undercontrol. This study surveyed 120, 18-year-old first-year college students to examine whether poor social problem solving is a risk factor for adolescent alcohol use above and beyond the other well-established risk factors and to examine whether social problem solving is a moderator between behavior undercontrol and alcohol use in adolescents. Hierarchical multiple regressions found that social problem solving was not a significant risk factor above and beyond well-established risk factors for adolescent alcohol use. Furthermore, social problem solving was not a significant moderator between behavior undercontrol and adolescent alcohol use. The results also indicated that association with deviant peers and family income accounted for significant variance in adolescent alcohol use, suggesting association with deviant peers and family income are the risk factors that are most strongly related to adolescent alcohol use.     

What Is it About Perceived Discrimination That Can Lead Immigrant Adolescents to Alcohol Use and Delinquency? The Mediating Role of Feelings of Alienation

Background: Despite research examining the relationship between discrimination and alcohol use and delinquency among adolescents, little is understood about the mechanism behind the relationship. Objectives: On the basis of Strain Theory, the current study examined a new theoretical model in which feelings of alienation (from the self, peers, and Israeli society) mediate the relationship between discrimination and alcohol use and delinquency. Methods: A one-year follow-up study was conducted with 146 at-risk youth from the Former Soviet Union and Ethiopia in Israel (63% male), from disadvantaged low socioeconomic neighborhoods. At Time 1 (T1), adolescents were asked about their experiences of discrimination, feelings of alienation, and levels of problem alcohol use (past month/ever drunkenness, past month binge drinking, and regular daily drinking). At time 2 (T2), the participants were again asked as to their experiences of alienation, alcohol use, and delinquency. Results: Perceived discrimination at T1 significantly predicted feelings of alienation at T2, when controlling for the relationship with alienation at T1. Feelings of alienation (from the self and Israeli society) fully mediated the relationship between discrimination and alcohol use. However, there was a direct relationship between discrimination and delinquency. Conclusions: Findings emphasize the negative impact of discrimination on adolescents. They suggest that during the critical developmental period of adolescence, feelings of discrimination may be internalized into negative emotions which may lead to involvement in deviant behaviors. Results suggest a need to help adolescents process and make sense of the discriminatory experiences they perceive.     

Time Trends and Policy Gaps: The Case of Alcohol Misuse Among Adolescents in Lebanon

Background: Monitoring studies are crucial for informing and reforming local policies. Objectives: Using the Lebanon 2005 and 2011 Global School-based Student Health Surveys (GSHS), alcohol time trends were described, policy gaps were identified, and harm reduction policy recommendations were made. Methods: In 2005 and 2011, 100 (n = 5109 students) and 44 (n = 2784 students) middle schools were surveyed, respectively. Self-reported cross-sectional data on alcohol use among 7–9th graders in private and public schools was collected including 30-day prevalence, lifetime drunkenness, alcohol-related problems, and sources of alcohol. Results: In 2011, the majority (87%) had alcohol before turning 14. Between 2005 and 2011, past 30-day alcohol use had increased by 40% and lifetime drunkenness by 50% in the total sample (122% among females with a narrowing in the gender gap). Drinking was regular for more than a third of the past 30-day drinkers (drank two or more drinks on the days they drank). Male adolescents were more likely to obtain alcohol from “stores” or “through their friends” whereas females’ main source was their “family.” One in twenty reported experiencing alcohol-related problems (e.g., getting into fights with family/friends and skipping school). Conclusion/Importance: Evidence-informed policy implications include enforcing a minimum legal drinking age, regulating alcohol advertising, and marketing particularly those targeting youth and women, and ensuring the availability of youth-friendly services. Public messages to increase awareness among all stakeholders including youth, their parents, and larger community are also needed.