Disaggregating within- and between-person associations to test the aversive transmission of alcohol use in late adolescence through adulthood.

Problematic alcohol use and mental health problems co-occur frequently. However, the longitudinal, reciprocal relationship between depressive symptoms and problematic alcohol use is not fully understood. This study examined the bidirectional longitudinal association between depressive symptoms and problematic alcohol use. A total of 14,569 adults participated in a panel survey, with data collected annually at three time points (2022, 2023, and 2024). Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CES-D) scale (11-item version). Problematic alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT) (10-item version). A random intercept cross-lagged panel model (RI-CLPM) with three time points was used to determine the reciprocal relationship between depressive symptoms and problematic alcohol use. The sample consists of 6,406 men and 8,134 women, with a mean (standard deviation) age of 57.7 (19.5) years. At the between-person level, random intercepts of depressive symptoms and problematic alcohol use showed no significant correlations (B = 0.117, P = .566). At the within-person level, depressive symptoms at a given time point were positively associated with problematic alcohol use in the following year (B = 0.050, P = .005). Similarly, problematic alcohol use at a given time point was positively associated with depressive symptoms in the following year (B = 0.062, P = .012). Significant covariance between depressive symptoms and problematic alcohol use were observed across the survey waves. This study found a bidirectional longitudinal relationship between depressive symptoms and problematic alcohol use at the within-individual level. Policy interventions should adopt an integrated approach that addresses mental health issues and problematic alcohol use simultaneously.

Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is under-studied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation. Prospective adolescent and young adult cohort of a high-risk family study, the Collaborative Study on the Genetics of Alcoholism (COGA). Six sites in the United States. A total of 3257 offspring (aged 14-33years) first assessed in 2004 and sought for interview approximately every 2years thereafter; 1945 (59.7%) offspring had a parent with an AUD. Diagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental life-time AUD was based on their own self-report when parents were interviewed (1991-2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17years. Parental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.19 to 2.71. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.19 to 2.34. The strength of association of parental separation with substance initiation was equal to that of having two AUD-affected parents, and its association with sexual debut was stronger than the association of parental AUD in one or both parents. Parental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.

To assess whether parental alcohol use disorder (AUD) is associated with higher risks of living in a non-intact family and assess whether non-intact family structure is associated with higher risks of AUD in the offspring. Prospective cohort study. Danish nation-wide registries. A total of 9948 parental AUD offspring and 98 136 reference offspring from the Danish population. Family structure assessed at birth and at each birthday until age 15 as intact or non-intact (with mother only, father only or neither parent); years lived in an intact family defined as total number of years lived with both parents from birth until the 15th birthday; AUD defined as registration in medical, treatment and cause of death registries. Data were analyzed by Cox regression. At birth, 30.9% [95% confidence interval (CI) = 29.1-32.6] of parental AUD offspring and 10.7% (95% CI = 10.3-11.0) of reference offspring lived in a non-intact family. At age 15, the numbers were 84.6% (95% CI = 83.9-85.3) and 38.4% (95% CI = 38.1-38.7). Parental AUD was associated with a higher risk of offspring AUD [hazard ratio (HR) = 1.88, 95% CI = 1.74-2.02]. Offspring were at lower risk of AUD if they lived 15 years in an intact family compared with offspring who never lived in an intact family (HR = 0.67, 95% CI = 0.52-0.87 for those with parental AUD, and HR = 0.53, 95% CI = 0.48-0.59 for those whose parents did not have AUD). Findings were inconclusive as to whether or not an association was present between family structure and AUD among offspring with parental AUD and reference offspring. The prevalence of non-intact family structure appears to be higher in offspring of parents with alcohol use disorder (AUD) than among offspring from the general population. Parental AUD appears to be associated with increased risk of offspring AUD, and non-intact family structure appears to be associated with increased risk of offspring AUD regardless of parental AUD.

The Association of Harsh Parenting, Parent-Child Communication, and Parental Alcohol Use With Male Alcohol Use Into Emerging Adulthood

To examine the association between parental alcohol use disorder (AUD) with and without other mental disorders and offspring AUD. Using data from Danish nationwide registers, we identified 15477 offspring with parental AUD and 154392 reference individuals from the general population. Parental AUD was defined as registration for AUD treatment. Parental mental disorders were identified in medical registers and comprised psychotic, mood, anxiety, personality, drug use, and other non-alcohol-related mental disorders. AUD in offspring was identified from medical, pharmacy, treatment and cause of death registers. Hazard ratios (HRs) of AUD were estimated using Cox regression models. AUD in one or both parents was associated with higher risks of AUD in offspring compared with reference individuals. Paternal AUD plus other mental disorder (HR=2.27, 95% confidence interval (CI): 2.10-2.46) and paternal AUD alone (HR=2.21, 95% CI: 2.07-2.36) were associated with higher offspring AUD risk. Similarly, maternal AUD plus other mental disorder (HR=3.02, 95% CI: 2.66-3.43) and maternal AUD alone (HR=2.57, 95% CI: 2.20-3.01) were associated with higher offspring AUD risk. Offspring with parental AUD are at increased risk of AUD irrespective of exposure to other parental mental disorders.

We tested the hypothesis that there is a mediational pathway from parental alcohol use during the participants' adolescence to the participants' psychological symptoms in young adulthood. This pathway includes the participants' alcohol use and their psychological symptoms, both during adolescence. The participants are inner city African American and Puerto Rican early adolescents followed until young adulthood. They reported their own and their parents' behavior. Structural equation modeling showed that parental alcohol use was related to early adolescent alcohol use, which was associated with late adolescent alcohol use. Late adolescent alcohol use was related to psychological symptoms in late adolescence, which predicted young adult psychological symptoms. Males reported more alcohol use and more psychological symptoms than females in late adolescence and more psychological symptoms in young adulthood. Findings suggest that parents' and adolescents' alcohol use should be a focus in interventions designed to prevent or treat psychological symptoms in late adolescence and young adulthood.

The relation of parent alcohol disorder to young adult drinking outcomes mediated by parenting: Effects of developmentally limited versus persistent parent alcohol disorder

The substantial literature showing that offspring of parents with alcohol use disorder (AUD) is at increased risk for externalizing psychopathology rarely examines the differential effects of parental and offspring sex. This literature also has other important limitations, such as modest sample sizes and use of unrepresentative samples. Using a large, nationwide Swedish sample, we aim to investigate the roles of parental and offspring sex in externalizing psychopathology among offspring with parental AUD. AUD diagnosis and externalizing measures were obtained from national registries. Associations between outcomes and parental AUD were examined using logistic regressions. Parental and offspring sex effects were examined with interaction terms. Risks for externalizing disorders were increased in sons and daughters with parental AUD, with significant differences between sons and daughters for criminal behavior; maternal AUD had a greater impact than paternal AUD (regardless of offspring sex), but having two parents with AUD increased risk for all outcomes substantially more than having one parent; and maternal AUD increased risk of drug abuse for daughters more than sons, while paternal AUD increased risk of AUD and criminal behavior for sons more than daughters. Offspring of parents with AUD areat increased risk for externalizing psychopathology. Maternal and paternal AUD differentially affected sons' vs. daughters' risks for AUD, drug abuse, and criminal behavior. The transmission of psychopathology within the externalizing spectrum appears to have sex-specific elements.

Polygenic risk score for problematic alcohol use predicts heavy drinking and alcohol use disorder symptoms in young adulthood after accounting for adolescent alcohol use and parental alcohol use disorder

We tested whether parental alcohol use disorder (AUD) predicted adult offspring's likelihood of marriage and marriage to an AUD-affected spouse; whether effects differed as a function of the sex or number of affected parents; and whether they were robust to confounders. Sex-stratified Cox and logistic regression models. Sweden. A total of 1 171 070 individuals (51.40% male) born 1965-75. Obtained from legal, medical and pharmacy registries. Predictor was parent AUD. Outcomes were marriage and spouse AUD. Adjustments included offspring birth year and AUD; and parental education, marriage, divorce, criminal behavior and drug abuse. Male and female offspring of AUD-affected parents were more likely to marry at younger ages (<25), illustrative unadjusted hazard ratio (HR)age 20 =1.22 (1.17, 1.28) and 1.34 (1.20, 1.39) and were less likely to marry at older ages (>25), HRage 30 =0.79 (0.78, 0.81) and 0.82 (0.81, 0.84). Parental AUD was associated with higher odds of having an affected spouse for males and females, odds ratio (OR)=1.47 (1.38, 1.57) and 1.63 (1.56, 1.70). Effects were more pronounced for those with two versus one AUD-affected parent and adjustments attenuated effects negligibly. Daughters of affected mothers (versus fathers) were more likely to have AUD-affected husbands, OR=1.68 (1.54, 1.84) versus 1.56 (1.48, 1.64), while there was no difference in sons. In Sweden, parental alcohol use disorder (AUD) is associated with a higher probability of marriage at younger ages, a lower probability of marriage at older ages and a higher likelihood of marriage to an affected spouse compared with no parental AUD. Most of these effects become stronger when the number of AUD-affected parents increases from one to two, and most effects hold after controlling for parents' socio-economic status, marital history, other externalizing disorders and offspring's own AUD status. Daughters of affected mothers are more likely to have an affected spouse.

Heavy drinking is common among men who have sex with men (MSM) and significantly increases HIV acquisition risk. MSM who report heavy drinking also report higher cannabis use, which has also been associated with sexual behaviors known to elevate HIV transmission risk. Despite evidence of associations at the between-subjects level, the effects of alcohol and cannabis use on sexual risk behavior among MSM who engage in heavy drinking are largely unknown. The current study used ecological momentary assessment to examine the between- and within-subject associations of heavy drinking, cannabis use, and sexual behavior. This is a secondary data analysis of a study on alcohol intoxication and sexual decision making that included 115 MSM who reported cannabis use and were not using pre-exposure prophylaxis (PrEP) at baseline. Participants reported daily alcohol and cannabis use and sexual activities over 6 weeks. Multilevel multinomial regression was used to evaluate how alcohol and cannabis use were associated with sexual behaviors. Higher alcohol use was associated with higher rates of intercourse at the between-persons level and a higher likelihood of all sexual behaviors at the event level. In contrast, cannabis use at the between-person level was associated with an increased rate of condomless anal intercourse relative to both anal intercourse with a condom as well as no sex. At the within-person level, cannabis was associated with an increased likelihood of anal sex with or without a condom relative to no sex. Cannabis and alcohol may have independent effects on sexual risk behavior among MSM. Interventions addressing sexual health among MSM who engage in heavy drinking should also consider the additive risks of cannabis use.

Previous research has found that impulsivity and deviant peer affiliation predict alcohol use among adolescents. However, it remains unclear to what extent these risk factors predict alcohol use in conjunction with one another, and to what extent they predict over and above correlated risk factors, such as pre-existing externalizing problems and sociodemographic characteristics. The present study tested the hypothesis that deviant peer affiliation would mediate the prospective association between impulsivity and alcohol use in adolescence (ages 13-18 years), controlling for a wide range of family and child-level covariates. Analyses were conducted using data from 2318 participants from the Longitudinal Cohort Study of the Project on Human Development in Chicago Neighborhoods. Participants were approximately 9, 12, or 15 years of age at wave 1 of the study, with waves 2 and 3 taking place at approximately 2-year intervals. The sample composition was 50.3% male, 46.1% Hispanic, 35.6% Black, non-Hispanic, 14.4% White, non-Hispanic, and 3.9% other race/ethnicity. Results from path analyses indicated that the prospective association between impulsivity and alcohol use was mediated by peer deviance, but only for the oldest (age 15) cohort. Findings from the present study suggest that despite impulsivity being a dispositional characteristic, its effects on alcohol use in later adolescence are achieved through a social pathway, via affiliation with deviant peers. It further suggests that this pathway, especially the link from impulsivity to affiliation with deviant peers, may not operate until late adolescence. Findings suggest that alcohol use may be prevented or reduced among impulsive adolescents by reducing their exposure to delinquent peers.

BACKGROUND: College students in the United States widely report using alcohol and cannabis as a sleep aid. Given the prevalence of sleep problems and insufficient sleep in this population, the high incidence in use and co-use of cannabis and alcohol is unsurprising. Current evidence does not support alcohol as an effective sleep aid and research on the relationship of cannabis to sleep is limited and inconsistent. Furthermore, the majority of current cannabis and sleep studies are limited to retrospective, person-level analyses even though there is a wide range of individual and day-level differences in reactivity to intoxication. PURPOSE: The aim of this study is to examine cannabis and alcohol use and their associations with sleep at both the between-person level (i.e., between-subjects comparison of chronic use behaviors) and within-person level (i.e., day-level comparison of use behaviors). METHOD: This study is a secondary analysis of longitudinal data obtained from a study characterizing the effects of simultaneous alcohol and cannabis use. Participants (n=341) completed surveys up to five times per day during two bursts of 4 weeks (54 days total) that occurred during two consecutive college semesters. Self-reported quantities of cannabis use (as number of uses) and alcohol use (as number of drinks), as well as bedtimes (night) and wake times (morning) were reported. Linear mixed models were conducted in SAS 9.4 to characterize between-person and within-person (person-mean centered) correlations of cannabis or alcohol use and sleep duration. RESULTS: Significant main effects of within-person cannabis (Estimate: 0.019, SE: 0.007, t=2.86, p=0.004) and alcohol (Estimate: -0.0402, SE: 0.0076, t=-5.28, p&lt;0.001) use were found, as was a between-person main effect of average cannabis use (Estimate: 0.038, SE: 0.012, t=3.28, p=0.001) across the full study period. The between-person main effect of average alcohol use was not significant. CONCLUSIONS: The results suggested that generally heavier cannabis users sleep more than their non-using/generally light using counterparts and that they sleep more on nights following heavier use days. Interestingly, the relationship between alcohol and sleep differed between the between-person and within-person levels: alcohol use was dose-dependently associated with reduced sleep duration; however, in this sample, generally heavier alcohol users did not appear to differ in overall sleep duration compared to generally lighter alcohol users. Importantly, this sample included a wide range of substance users, none of whom were in treatment for a cannabis use disorder (CUD) or alcohol use disorder (AUD). Whether these patterns of dose-dependence would be observed over longer time periods or in individuals who meet criteria for CUD or AUD remains to be studied. Future studies will assess the effects of alcohol and cannabis co-use patterns as well as timing of consumption.

Alcohol, still the forgotten drug

Background: The additive effect of parental alcohol use disorders (AUD) is conventionally defined as an increasing risk of the offspring developing AUD relative to family history negative, < family history positive with 1 parent (FHP1), < FHP2. The few studies on the additive effect of parental AUD have focused on the risk of development of offspring AUD and not on the degree of multidimensional AUD addiction severity. Aims: The aims of the present study were to examine the frequency of treatment-seeking outpatients exposed to FHP1 and FHP2 and whether addiction severity was impacted by the additive effect of parental AUD among AUD female and male offspring. Methods: This cross-sectional study was based on 3,361 consecutive treatment-seeking outpatients from 2006 to 2016, assessed by means of the ­European Addiction Severity Index (EUROP-ASI). The ­EUROP-ASI assessed multidimensional addiction severity, comprising alcohol and other drug use, somatic and psychiatric health status, family and other social status, economy and employment-related problems and criminal status composite scores at treatment entry. Results: Among females, 40.38% had FHP1 and 15.68% FHP2, whereas males had 40.90% FHP1 and 13.24% FHP2. No conventional additive effect was found on the composite scores among both genders. However, another type of synergistic additive effect, only manifesting with exposure to FHP2, was found for employment-related problems and psychiatric status composite scores among male offspring. Conclusions: Exposure to parental AUD is strikingly high among treatment-seeking outpatients. Nonetheless, the additive effect has a modest impact on multidimensional addiction severity and is mostly related to psycho-social impairment among treatment-seeking male offspring.