Childhood and adolescent predictors of alcohol abuse and dependence in young adulthood

OBJECTIVE: To provide a comprehensive examination of childhood and adolescent predictors of alcohol abuse and dependence at age 21, theoretically guided by the social development model. METHOD: Data were taken from an ethnically diverse urban sample of 808 students (51% male), surveyed at age 10 and followed prospectively to age 21 in 1996. Potential predictors of alcohol abuse and dependence at age 21 were measured at ages 10, 14 and 16. Relationships between these predictors and alcohol abuse and dependence were examined at each age, to assess changes in their patterns of prediction over time. RESULTS: Strong bonding to school, close parental monitoring of children and clearly defined family rules for behavior, appropriate parental rewards for good behaviors, high level of refusal skills and strong belief in the moral order predicted a lower risk for alcohol abuse and dependence at age 21. Of these, strong bonding to school consistently predicted lower alcohol abuse and dependence from all three ages (10, 14 and 16). By contrast, youths who had a higher risk of alcohol abuse and dependence at age 21 engaged in more problem behaviors, had more opportunities to be involved with antisocial individuals and spent more time with and were more bonded to those individuals, viewed fewer negative consequences from antisocial behaviors and held more favorable views on alcohol use. Of these, prior problem behaviors and antisocial opportunities and involvements at ages 10, 14 and 16 consistently predicted alcohol abuse and dependence at age 21. CONCLUSIONS: These important malleable predictors, identifiable as early as age 10, provide potential intervention targets for the prevention of alcohol abuse and dependence in early adulthood.     

Childhood predictors of first chance to use and use of cannabis by young adulthood

Aims

To prospectively examine the linkage between childhood antecedents and progression to early cannabis involvement as manifest in first chance to try it and then first onset of cannabis use.

Methods

Two consecutive cohorts of children entering first grade of a public school system of a large mid-Atlantic city in the mid 1980s (n = 2311) were assessed (mean age 6.5 years) and then followed into young adulthood (15 years later, mean age 21) when first chance to try and first use were assessed for 75% (n = 1698) of the original sample. Assessments obtained at school included standardized readiness scores (reading; math) and teacher ratings of behavioral problems. Regression and time to event models included covariates for sex, race, and family disadvantage.

Results

Early classroom misconduct, better reading readiness, and better math readiness predicted either occurrence or timing of first chance to try cannabis, first use, or both. Higher levels of childhood concentration problems and lower social connectedness were not predictive.

Conclusions

Childhood school readiness and behavioral problems may influence the risk for cannabis smoking indirectly via an increased likelihood of first chance to use. Prevention efforts that seek to shield youths from having a chance to try cannabis might benefit from attention to early predictive behavioral and school readiness characteristics. When a youth's chance to try cannabis is discovered, there are new windows of opportunity for prevention and intervention.     

Reasons for alcohol use in young adulthood: validation of a three-dimensional measure

OBJECTIVE: To evaluate the reliability and validity of a measure of reasons for use, which is based on a cognitive mediational view of alcohol use as a means for affect regulation. METHOD: Data for this study were obtained from the Rutgers Health and Human Development Project. Self-reports of young men and women aged 25 to 31 years (N = 1,176; 598 women) were used to obtain measures of reasons for use, coping use, sex-enhancing use, use intensity and use problems. Regression analyses and structural equation modeling were used to assess a hypothesized model of relationships between these variables. RESULTS: Factor analysis of 33 reasons for use yielded three hypothesized dimensions: social reasons, disinhibition reasons and suppression reasons. Although moderately correlated with each other, they exhibited distinct relationships with other use variables. Increases in social reasons were related to decelerating increases in use intensity, but increases in disinhibition and suppression reasons were associated with accelerating increases in use intensity Social reasons did not relate to use problems, whereas suppression reasons were strongly related to use problems even when controlling for use intensity. CONCLUSIONS: Suppression reasons not only motivate reactive coping use in response to the appraisal of stressful situations, they are also likely to instigate "prophylactic" or proactive coping use in anticipation of the possible occurrence of stressors, thereby blunting the emotional impact of encounters that would otherwise have been appraised as stressful and aversive.     

Gender differences in the prediction of problem alcohol use in adulthood: exploring the influence of family factors and childhood maltreatment

OBJECTIVE: The purpose of this study was to contrast men and women in prospective relationships among family-oriented and alcohol-related variables obtained during adolescence, childhood physical, emotional and sexual abuse collected retrospectively, and later adult problem alcohol use. METHOD: In structural equation models, early family processes (support/bonding, parent drug-use problems, parental divorce and childhood maltreatment) and prior alcohol use simultaneously predicted adult problem alcohol use at two later time points in a longitudinal community sample of 426 (305 female) adults. RESULTS: Significant relationships were found among family processes, childhood maltreatment, and problem alcohol use within time and longitudinally for both men and women. Greater family support/bonding during adolescence predicted less problem alcohol use in adulthood. Men and women who experienced sexual abuse as a child reported more problem alcohol use in adulthood. Problem alcohol use was stable across time. Men reported more problem alcohol use in adolescence and adulthood, and women reported more early sexual abuse. These results contradict those that find no significant relationships between childhood abuse and subsequent alcohol-related problems. Parental drug use problems during the participant's adolescence did not directly predict problem alcohol use in adulthood. The relationship was more indirect in that parental drug use was associated with family-related concomitants that in turn were significant predictors of more problem alcohol use in adulthood. CONCLUSIONS: The strong stability for problem alcohol use across the three time periods is a signal that alcohol use in adolescence should not be ignored; furthermore, family dynamics need attention in addressing problem alcohol use.     

The long-term effects of childhood maltreatment experiences on subsequent illicit drug use and drug-related problems in young adulthood

ObjectivesThe objective of this study was to examine the associations between (a) childhood maltreatment (i.e., physical abuse, sexual abuse, and neglect) and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood.MethodsWave 1 and Wave 3 public-use data from the National Longitudinal Study of Adolescent Health were used. Logistic regressions, controlling for adolescent drug use and other important family and peer contextual processes, were estimated to determine the associations between (a) childhood maltreatment experiences and subsequent illicit drug use and (b) childhood maltreatment and drug-related problems in young adulthood.ResultsAmong the participants, 31.9% reported some form of childhood maltreatment. Childhood physical abuse was associated with a 37% (OR = 1.37; 95% CI = 1.04, 1.80) increase in illicit drug use during the 30 days prior to the Wave 3 survey, a 48% (OR = 1.48; 95% CI = 1.16, 1.89) increase in illicit drug use during the year prior to the Wave 3 survey, and a 96% (OR = 1.96; 95% CI = 1.40, 2.76) increase in drug-related problems in young adulthood. The latter two associations persisted even after controlling for illicit drug use in adolescence. Neglect among females was associated with a higher likelihood of past year illicit drug use in young adulthood (OR = 1.31; 95% CI = 1.002, 1.71). However, this association was not significant once the effect of illicit drug use in adolescence was statistically controlled for.ConclusionsThe present findings suggest that childhood maltreatment is related to subsequent illicit drug use and drug-related problems in young adulthood and that some of these associations differ by gender. Implications for preventive intervention are discussed.     

Effects of early and later marriage on women's alcohol use in young adulthood: a prospective analysis

OBJECTIVE: Previous research shows that marriage leads to reductions in alcohol use, especially for women. Because marriage prior to age 20 (early marriage) is a marker for deviance, the protective effects of marriage may not extend to those who marry in adolescence. We compared the effects of marriage in adolescence versus young adulthood on alcohol consumption, negative alcohol-related consequences and heavy episodic drinking at age 29. METHOD: We analyzed data from 1,138 women in a longitudinal cohort followed from ages 18 to 29. The original sample was recruited from 30 California and Oregon middle schools and first surveyed at age 13. RESULTS: Women who had not married, had married early or had married between ages 20 and 29 did not differ on alcohol use at age 18. Women who married as young adults were less likely than singles to engage in any alcohol use, heavy episodic drinking or experience negative consequences and reported less alcohol use at age 29. Women who married in adolescence reported fewer negative consequences at age 29 than did singles and (if they had not divorced) were less likely to engage in heavy episodic drinking or experience any negative consequences, reported fewer consequences and consumed less alcohol. The protective effects of marriage in young adulthood were observed whether or not women divorced. Parenthood and college attendance before age 23 did not explain the marriage effect. CONCLUSIONS: Results support role theory, which posits that individuals who marry are socialized into conventional adult roles that discourage deviant behavior.     

Characterizing alcohol dependence: transitions during young and middle adulthood

Community and high-risk sample studies suggest that alcohol dependence is relatively stable and chronic. By contrast, epidemiological studies demonstrate a strong age-graded decline whereby alcohol dependence tends to peak in early adulthood and declines thereafter. The authors identified the latent trajectory structure of past-year alcohol dependence to investigate (a) whether the syndrome is characterized by symptom profiles and (b) the extent to which the syndrome is stable and persistent. Data from current drinkers (N = 4,003) in the National Longitudinal Survey of Youth were analyzed across two waves: 1989 (ages 24-32 years) and 1994 (ages 29-37 years). Three classes of alcohol dependence were observed; symptom endorsement probabilities increased across successively severe classes. Latent transition analyses showed high rates of stability, supporting alcohol dependence as a relatively chronic condition. Although there was evidence of progression to more severe dependence, there was greater syndrome remission. Trajectory classes and transition probabilities were generalizable across race and sex and, to a lesser extent, age cohort and family history of alcoholism.     

Early adolescent psychopathology as a predictor of alcohol use disorders by young adulthood

Few prospective studies have examined the relation between early adolescent conduct disorder (CD) symptoms and the development of alcohol use disorders (AUD) by young adulthood. The relative contribution of other forms of adolescent psychopathology (i.e., attention-deficit hyperactivity disorder, depression, anxiety/withdrawal) to the development of AUD also remains poorly understood. There is some suggestion that the co-occurrence of conduct disorder symptoms with other forms of psychopathology may interact synergistically in predicting later alcohol use problems. The current study explores these issues using data on 506 boys from the oldest sample of the Pittsburgh Youth Study (PYS). Consistent with prior research, early conduct disorder symptoms emerged as a consistent predictor of increased AUD symptoms and an alcohol dependence diagnosis by young adulthood. In contrast, adolescent boys with high levels of anxiety/withdrawal had lower levels of AUD symptoms and were less likely to develop alcohol dependence by young adulthood. Increased depression in early adolescence was associated with higher AUD symptoms and alcohol abuse and dependence diagnoses by young adulthood, but only for boys with high levels of conduct disorder symptoms. No evidence was found for a relation between attention-deficit hyperactivity disorder symptoms and AUD symptoms or diagnoses after controlling for co-occurring psychopathology.     

Developmental pathways to alcohol abuse and dependence in young adulthood

OBJECTIVE: To determine if people who were diagnosed with alcohol abuse or dependence (AAD) at age 21 had different developmental patterns of alcohol use in adolescence than non-AAD individuals. METHOD: An ethnically diverse urban sample of 808 children was surveyed at age 10 in 1985 and followed prospectively to age 21 in 1996. AAD at age 21 was assessed following DSM-IV criteria. Latent Transition Analysis (LTA) was used to identify four statuses of alcohol use (nonuse, initiation only, current use only, heavy episodic drinking), as well as transition probabilities between these four statuses from elementary school to middle school and from middle school to high school among the AAD and non-AAD group. RESULTS: The prevalence of alcohol use statuses during elementary school was similar in the two groups. Differences in alcohol use emerged in middle school and became more pronounced in high school. In middle school, AAD individuals were more likely to have initiated or been current drinkers than non-AAD individuals. However, the two groups did not differ in the prevalence of heavy episodic drinking in middle school. In high school, most AAD individuals were in the heavy episodic drinking status (54%), while most non-AAD individuals were in the initiation only (33%) or current use only (34%) statuses. CONCLUSIONS: These findings suggest preventive intervention targets for different developmental periods. Alcohol abuse and dependence at age 21 may be prevented by delaying alcohol initiation, by reducing current use in middle school and by reducing heavy episodic drinking in high school.     

Dimensionality of alcohol dependence in young adulthood: current versus lifetime symptomatology

OBJECTIVE: The factor structure of alcohol dependence was investigated using exploratory factor analysis, specifically contrasting models of alcohol dependence based on lifetime symptom endorsement to models based on current (i.e., past-year) symptom endorsement. METHOD: Data from the 1989 National Longitudinal Survey of Youth were analyzed. DSM-IV alcohol dependence was assessed in this large community sample of current drinkers and lifetime drinkers, representative of both men and women, and ranging in age from 24 to 32. Sixteen items assessing the seven criteria of DSM-IV alcohol dependence were employed. RESULTS: A single-factor model accounted for most of the observed relationships. However, evidence of additional dimensions, characterized by tolerance and impaired control symptoms, was also identified. CONCLUSIONS: Our findings do not support the historical tendency of distinguishing physiological (as indicated by tolerance or withdrawal symptoms) from nonphysiological dependence. Most importantly, factor solutions derived from items based on past-year symptom endorsement were consistent with those derived from items based on lifetime symptom endorsement in samples of both current drinkers and lifetime drinkers.     

Caffeinated and non-caffeinated alcohol use and indirect aggression: The impact of self-regulation

Research shows that heavier alcohol use is associated with physical aggression. Scant research has examined the way in which alcohol relates to other forms of aggression, such as indirect aggression (e.g., malicious humor, social exclusion). Given the possible negative consequences of indirect aggression and the limited evidence suggesting alcohol use can elicit indirectly aggressive responses, research is needed to further investigate the association between drinking behavior and indirect aggression. Additionally, specific alcoholic beverages, such as caffeinated alcoholic beverages (CABs; e.g., Red Bull and vodka), may potentiate aggression above the influence of typical use, and thus warrant examination with regard to indirect aggression. One factor that may impact the strength of the alcohol-indirect aggression and CAB-indirect aggression relationships is one's level of self-regulation. Consequently, our study examined the relationships between (1) alcohol use and indirect aggression, (2) CAB use and indirect aggression, and (3) self-regulation as a moderator. Participants were 733 (67.6% female) undergraduate students who reported their CAB and alcohol use, self-regulation, and aggressive behaviors. Results revealed that heavier alcohol use was associated with more frequent indirect aggression after controlling for dispositional aggression. Heavier CAB use was related to more frequent indirect aggression after accounting for typical use and dispositional aggression. Self-regulation moderated these associations such that for those with lower self-regulation, greater alcohol and CAB consumption was associated with greater indirect aggression. Our findings suggest that heavier alcohol and CAB consumption may be risk factors for engaging in indirect aggression and this risk is impacted by one's regulatory control.     

Concurrent use of alcohol and cigarettes from adolescence to young adulthood: an examination of developmental trajectories and outcomes

Concurrent use of alcohol and tobacco is common among adolescents, yet little is known about the developmental patterns of concurrent use, or the consequences associated with such patterns during young adulthood. Using data collected at six time points during 1985-1995 as part of an evaluation of a school-based substance abuse prevention program in California and Oregon, this study used latent growth mixture modeling to identify five distinct developmental trajectories of concurrent use of alcohol and tobacco from ages 13-23 in a cohort of 5873 individuals and compared these distinct groups with respect to demographic characteristics and young adult outcomes (at age 23 and age 29). Results suggest that while it is common during adolescence to drink but not smoke, it is very unusual to smoke and not drink. Compared to young people who smoked and drank consistently throughout their teens and early twenties, those who drank consistently but smoked only occasionally or dramatically decreased their smoking over time had lower rates of deviant behavior and predatory violence at age 23 and were less likely to have a history of arrest and substance use problems by age 29. This close examination of concurrent use of alcohol and cigarette use from ages 13-23 further accentuates the importance of curbing smoking behavior among adolescents before it becomes habitual.