The role of parenting styles and alcohol expectancies in teen binge drinking: A preliminary investigation among Italian adolescents and their parents

General practitioners (GPs) have been increasingly encouraged to become involved with the treatment of opiate misusers. Barriers to greater GP involvement have been recognized, but little is known about why some GPs are willing to have a higher degree of involvement with these patients. This study aimed to explore why some GPs are willing to work with opiate misusers and find out how GPs might be supported to become more involved with opiate misusers. Twenty-six 'high activity' GPs and 26 'low activity' GPs identified from a previous study in South London were interviewed about how they felt about their work with opiate misusers. Factors appearing to help GPs work with opiate misusers included a more holistic view of the opiate misuser as a person, a belief that treatment was benefiting the patient or the community and a perception of being supported to do the work. These doctors tended to have their practice geared up to facilitate working with opiate misusers. All GPs who prescribed for opiate misusers used 'shared care' arrangements, but these were not always satisfactory. Viewing abstinence as the main goal of treatment seemed to be associated with disillusionment and dissatisfaction with working with opiate misusers even among highly involved GPs.     

The teaching of pharmacology in Italian medical schools: the point of view of Italian doctors

Objective: A survey was carried out to gather the opinions of doctors about the current method of teaching pharmacology in Italy. Methods: A questionnaire was mailed to 3860 doctors, who were asked a series of questions regarding the teaching of pharmacology to medical students in Italian universities. Results and conclusions: The great majority of those who replied considered the teaching they received to be mainly theoretical. The doctors thought that much more time and attention should be dedicated to those pharmacology subjects that are more closely connected to physiopathology and clinical practice (clinical pharmacology).     

Co-occurrence of alcohol and cigarette use among adolescents

Concurrent use of alcohol and cigarettes among adolescents is a serious public health issue. Trends in concurrent use of alcohol and cigarettes were determined using data from three comparable large statewide samples of 7-12th-grade students in New York State, from surveys conducted in 1983, 1990, and 1994. The prevalence of use of alcohol and cigarettes decreased from 1983 (23%) to 1990 (19%), and increased by 1994 (22%). Logistic regression analysis showed that these trends are highly significant, and that the probability of use of alcohol and cigarettes is higher for females than males, increases with age, and is lower for most ethnic minorities than for Whites. In the 1990s, Blacks, Hispanics, and Asians increased in their probability of concurrent use more than did Whites. Users of both alcohol and cigarettes are at increased risk of personal and social problems, as well as increased risk of delinquency. Drinking and smoking show synergistic effects on illicit drug use and drug problems.     

Cultural identification and alcohol use among "Black" adolescents.

This study examined the relationship between cultural identification and alcohol use among Black adolescents--77 African-American and 185 Haitian Black adolescents. The Orthogonal Cultural Identification Scale assessed cultural identification. A logistic regression analysis was used to evaluate the association between cultural identification association between cultural identification, friendships, and alcohol use. Results indicate no relationship between cultural identification and alcohol use. Drinking during the past six months was significantly associated with having close friends who drink. Although the direction of friend influence is unclear. Differences were observed in the context of drinking between the two groups and, importantly, youths in both groups reported drinking alone and to relax/because of stress. Sociocultural factors, context and the basis of drinking need to be addressed in programs for youth.     

Social network effects in alcohol consumption among adolescents

In this paper we seek to empirically quantify the role of peer social networks in explaining drinking behavior among adolescents. Using data from a nationally representative sample of adolescents we utilize a multivariate structural model with school-level fixed effects to account for the problems of contextual effects, correlated effects and peer selection to purge the potential biases from the estimates of peer influence. Our peer group measures are drawn not only from the nomination of close friends, but also from classmates. Drinking behavior among the peer groups was constructed using the peers' own report of their alcohol consumption. Controlling for parent level characteristics, and other demographic parameters, we find that a 10% increase in the proportion of classmates who drink will increase the likelihood of drinking participation and frequency by approximately four percentage points. We also find evidence to show that the influence of close friends, while still significant, diminishes in magnitude after accounting for unobserved environmental confounders. Our findings support the literature that peer effects are important determinants of drinking behavior even after controlling for potential biases. Effective policy aimed at reducing alcohol consumption among adolescents would consider these significant peer effects.     

Diagnosis and assessment of alcohol use disorders among adolescents

The diagnostic criteria for alcohol use disorders (AUDs) (i.e., alcohol abuse and alcohol dependence) as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) were developed largely from research and clinical experience with adults. Little is known about the validity of these criteria when applied to adolescents. Recent epidemiological and clinical studies of AUDs and their symptoms among adolescents have indicated that the DSM-IV criteria have significant limitations when applied to this age group. Diagnostic interviews and screening tools for adolescent AUDs are discussed. Numerous instruments are available that have shown moderate-to-high reliability and validity in assessing AUDs among adolescents.     

Participation in sports and alcohol consumption among French adolescents

Using an anonymous self-report questionnaire (N=816 participants), we examined the relation between participation in sports and alcohol consumption and identified the risk factors associated with alcohol consumption among French high-school students. Univariate analysis showed that sport involvement was related to higher alcohol use (P<.05). Participants who participated in group sports drank significantly more than those who participated as individuals (P<.01). Multivariate analysis underlined factors associated with alcohol consumption, but these varied considerably according to the level of alcohol consumption. Three factors were associated with weekly and daily alcohol use: male gender, daily cigarette use, and perception of poor health.     

Socioeconomic differences in alcohol and drug use among Ghanaian adolescents

Socioeconomic differences in experimental alcohol use, drunkenness, marijuana use and other drug uses among adolescents in Ghana was investigated using multiple socioeconomic indicators. A school-based cross-sectional survey of a representative sample of 12-18-year-olds (N = 1195, response rate = 89.7%) was conducted in Ghana in 2008. Logistic regression analysis was applied to model the associations between substance use and socioeconomic status. Use of marijuana and drugs was associated with lower material affluence while experimental alcohol use was associated with higher material affluence. Living in non-nuclear family was predictive of other drug uses and drunkenness. Other drug uses were associated with lower paternal education and occupation while drunkenness was associated with lower paternal education. Individual anticipated future social position measured by plans after graduation was the strongest predictor of experimental alcohol use, drunkenness, marijuana and other drug uses. Interventions are need to prevent adolescence substance use especially among those in danger of discontinuing schooling and those in less affluence families.     

Assessment of alcohol tolerance in adolescents.

OBJECTIVE: To improve assessment of the DSM-IV alcohol tolerance criterion in adolescents, this study tested the performance of a minimum percentage increase in drinking quantity, and a proxy measure of tolerance (i.e., average heavy-drinking quantity per occasion) in identifying adolescents with alcohol dependence. METHOD: Two adolescent samples were examined. In one sample (N = 415, 58% male, 79% white, 57% clinical), a modified version of the SCID was used to determine DSM-IV alcohol diagnoses, and lifetime drinking history data were collected by interview. In the second sample (N = 470, 60% male, 76% white, 100% clinical), the Adolescent Diagnostic Interview was used to determine DSM-IV alcohol diagnoses and to collect data on initial- and current-drinking quantities needed to become intoxicated. The performance of a percentage increase and average heavy-drinking quantity in identifying those with dependence was evaluated using receiver operating characteristic analysis. RESULTS: The utility of a percentage increase definition was limited by the high degree of variability in initial-drinking quantities. Percentage increase may underassign the tolerance symptom when initial-drinking quantities are high and overassign the symptom when initial-drinking quantities are low. Average heavy-drinking quantity per occasion, combined with a minimum frequency of drinking, demonstrated better performance than any percentage increase definition. CONCLUSIONS: Alternatives to a change-based (e.g., percentage increase) definition of tolerance warrant study due to limits of change-based definitions when initial-drinking quantity shows a high degree of variability. The variability in initial-drinking quantity may reflect individual differences in initial sensitivity that need to be considered in tolerance assessment.     

Antecedents of drinking among young adolescents with different alcohol use histories

Testing separate path analytic models for 7th-grade users and nonusers, we assess the impact of cognitive, social influence and behavioral antecedents on adolescent drinking 3 and 12 months later. For the group that had not tried alcohol by grade 7, we found that social influence factors--exposure to peers who drink or use marijuana and to adults who drink--foster more frequent alcohol use and binge drinking in the near future (3 months later). The key peer influences on binge drinking were marijuana-specific. After 12 months, the child's own drinking experience during grade 7 and peer and parental attitudes toward drugs emerge as important explanatory variables. For children who had already started drinking by grade 7, cognitive--as well as social and behavioral factors--affect near- and longer-term alcohol involvement. While the child's prior drinking habits have the strongest impact, baseline expectations of using alcohol also predict frequency of alcohol use and binge drinking after 3 and 12 months. Believing that alcohol use is harmful helps hold down increases in frequency of use (but not excessive use) as long as 12 months later. Engaging in deviant behavior or doing poorly in school did not predict future drinking among baseline nonusers, but did foretell which of the 7th-grade initiates were most likely to engage in binge drinking during grade 8. The study's implications for prevention are discussed.     

Opposite social gradient for alcohol use and misuse among French adolescents

BackgroundThis study investigates the association of the family occupational category (F-OC) with adolescent alcohol use and its potential variation according to the frequency of use.MethodsA national survey representative of adolescents aged 17 living in continental France conducted in 2005 (n = 29,393). Three outcomes were considered: overall use describes the drinking status (lifetime abstinence, use before the month prior the survey, use in the month prior the survey) without considering the frequency of use; last month use and binge drinking detail the frequency of use (1–5 uses, 6–9, 10–19 and 20+ uses) and of binge drinking (0, 1–2, 3–5, 6+ episodes of 5+ glasses in a single occasion) of the previous month users. F-OC was described in 7 categories based on the highest occupational category of the parents (from managers/professionals to unemployed). Analysis used generalised logistic regressions, controlling for gender, F-OC, parental separation, autonomy, other substance use, being out of school and sociability.ResultsThere was a double gradient: adolescents from high F-OC families were more often experimenters and drinkers during the previous month whereas those of low F-OC families were more often binge drinkers. Adolescents from farmers’ families were the most at risk for frequent use and binge drinking in the last month. Interactions tests show that the effect of F-OC was not significantly related to gender.ConclusionsExcept for gender, adolescents’ patterns of use reflect those observed in the adult population. Mechanisms that favour and hinder progression in alcohol use should be studied in various socioeconomic groups.     

Alcohol intake and binge drinking among Italian adolescents: The role of drinking motives

Binge drinking, a pattern associated with worse outcome, is becoming increasingly popular among youths, thus negatively impacting social life. To investigate drinking patterns and their underlying motives in Italian adolescents, the Alcohol Use Questionnaire and the Drinking Motive Questionnaire Revised Short Form were administered to 332 school-age teenagers (16–19 years; 139 girls, 193 boys) from a single Roman school, recruited at their classrooms through the intermediation of their teachers. Boys scored higher than girls on all drinking and binge measures. They also scored higher on the Enhancement, Social, and Conformity Drinking Motive Questionnaire–Revised Short Form subscales. Binge drinking scores positively correlated with gender, alcohol consumption, and with all Drinking Motive Questionnaire Revised Short Form subscales. In the two-step hierarchical model, Drinking Motive Questionnaire–Revised Short Form enhancement and conformity predicted alcohol use and Drinking Motive Questionnaire–Revised Short Form coping motives significantly predicted binge drinking. Binge drinking is prevalent among Italian adolescents, who mainly drink to enhance perceived positive effects of alcohol, conform to their social groups, and face their problems. Boys binge more than girls.     

Risk factors for alcohol and marijuana use among adolescents in foster care

This study examined the influences of individual and social risk factors on alcohol and marijuana use among a sample of foster care adolescents. Data were collected through baseline structured interviews with 320 adolescents (aged 15-18 years) who resided in foster care placements and participated in a larger evaluation study of an independent living program. Approximately 40% of the adolescents reported alcohol use, 36% reported marijuana use, and 25% reported both alcohol and marijuana use during the 6 months prior to the interview. Final logistic regression models indicated that having friends who used marijuana and other substances and having skipped school remained most predictive of using alcohol, marijuana, or both alcohol and marijuana. Recommendations for substance abuse prevention and treatment for these vulnerable adolescents are proposed.     

The relationship between birth order and acute alcohol intoxication among Dutch adolescents

Abstract

Background: Prior research demonstrated the relationship between birth order and adolescent risky behavior. The possible connection between the presence of siblings and birth order and underage alcohol abuse is unknown. Methods: Our study involves 10 years of data collection on underage alcohol intoxication in Dutch hospitals. A total of 2,234 patients were included in the current study. Results: Adolescents treated for alcohol intoxication less often have no siblings (6.7%) than the population has (14.8%). Furthermore, middle and youngest children are overrepresented in the patient population. Conclusion: The presence of older siblings is a risk factor for acute alcohol intoxication.     

Impact of social influences and problem behavior on alcohol use among inner-city Hispanic and black adolescents.

OBJECTIVE: Inner-city black and Hispanic adolescents might be at great risk for alcohol use. Yet the etiology of drinking among these adolescents receives little attention. The purpose of this study was to examine the impact of social influences and problem behavior on alcohol use among Hispanic and black adolescents. The impact of these factors was also tested separately for girls and boys to determine the differences in etiology of alcohol use depending on gender. METHOD: A large sample of black and Hispanic seventh-grade students (N = 4,847, 52% female) self-reported alcohol use, demographic characteristics (gender, family structure, age, ethnicity and socioeconomic status), social influences to drink (peer norms, adult norms, their friends' use, their mother's use, their father's use, their siblings' use, and perceived availability of alcohol), and problem behaviors (cigarette smoking, marijuana use, getting into trouble). Teams of three to five data collectors administered the questionnaire following standardized protocol. These data were collected in class during a regular 40-minute period. RESULTS: Logistic regressions indicated that social influences to drink from friends, peers, and family and problem behaviors including cigarette smoking and marijuana use were related to alcohol use across and within gender. Getting into trouble predicted drinking for boys but not girls. CONCLUSIONS: Based on these findings, adolescent alcohol prevention programs need to include an awareness of the many social influences to drink, modify incorrectly perceived peer norms for drinking, involve family members in the prevention program and address an array of problem behaviors within one prevention intervention.     

Sleep patterns and problems among early adolescents: Associations with alcohol use

IntroductionSleep and sleep-related problems are associated with alcohol use and related problems among adults. However, existing research on associations between sleep and alcohol use among early adolescents is minimal, and potential individual and family factors that may affect this association remain largely unexplored. We examined potential associations between frequency of alcohol use and initial insomnia, subjective daytime sleepiness, sleep irregularity, and disturbed sleep among a low-income, ethnic minority sample of early adolescents; we also considered whether psychopathology symptoms and/or parental monitoring accounted for any associations found.Methods127 youth who participated in the Camden Youth Development Study (64 male; mean age = 13.2; 71% Hispanic, 32% African-American) were assessed using self-report measures of sleep, alcohol use, psychopathology symptoms (depressive and conduct disorder), and parental monitoring; in addition, teacher reports of attention-deficit hyperactivity disorder were used.ResultsInitial insomnia and daytime sleepiness (but not sleep irregularity or disturbed sleep) were associated with frequency of alcohol use. The association between initial insomnia and alcohol use remained significant when each form of psychopathology and parental monitoring were adjusted for.ConclusionsAmong early adolescents, frequency of alcohol use is associated with initial insomnia, even once symptoms of psychopathology and family environment (parental monitoring) are adjusted for. Longitudinal research investigating the direction of this effect and other possible mediators and moderators would be useful in developing preventative and treatment interventions.     

Serious alcohol and drug problems among adolescents with a family history of alcoholism

Data concerning adolescents' alcohol- and drug-using behaviors, as well as the drinking patterns of their parents, were obtained from a sample of 1,380 New Jersey youth born between 1961 and 1969. Initially tested between 1979 and 1981 at ages 12, 15 or 18, these subjects were retested two additional times at 3-year intervals (retest rate = 92%). We wished to determine if offspring of families exhibiting a positive history of alcoholism (FH+) reported a serious alcohol or drug problem (including seeking treatment) at a higher rate than those without such backgrounds (FH-). Analyses indicated that FH+ rates for a self-reported alcohol and/or drug problem were about twice the rate for FH- individuals and about 1.5 times as high as the base rate for the entire sample. However, there were no significant differences between the two groups of troubled youth in terms of alcohol or marijuana use patterns or the frequency of use-related negative consequences. Our data also illustrated that FH+ females were as likely as FH+ males to report a serious problem and that FH+ families reported a higher rate of having more than one troubled offspring. It is of special import that these results are based upon observations of a community-based sample of adolescents and young adults in contrast to studies relying upon clinical samples and retrospective reports.