Alcohol Use Disorders In Young Adulthood Research Articles

The effect of parental alcohol use on alcohol use disorder in young adulthood: Exploring the mediating roles of adolescent alcohol expectancies and consumption.

Parental alcohol use and problems are risk factors for alcohol use disorder (AUD), and these effects may be mediated by adolescent alcohol expectancies and consumption. In the present study, we tested the direct effects of mothers' and fathers' alcohol consumption on young adult AUD, as well as the indirect effects through adolescent maximum alcohol use, alcohol consumption, and alcohol expectancies. Participants were 5160 individuals (49.1% female) and their biological parents from the Avon Longitudinal Study of Parents and Children, a cohort study of children born in southwestern England during 1991 and 1992. Structural equation modeling (SEM) was used to test associations of mothers' and fathers' alcohol use (assessed when children were 12 years old) with age 24 AUD. Potential mediator variables included the maximum number of alcoholic drinks consumed within a 24-h period by age 13.5 and alcohol expectancies and alcohol consumption at ages 17 and 20. Higher maternal and paternal alcohol use were associated with higher levels of alcohol consumption at age 17. Greater alcohol consumption, in turn, was related to a more severe presentation of AUD. The overall indirect effects of mothers' (b = 0.033, 95% confidence interval [CI] = 0.006, 0.059) and fathers' drinking (b = 0.041, 95% CI = 0.018, 0.064) on AUD were modest but significant, and were primarily comprised of adolescent alcohol consumption rather than alcohol expectancies. Our findings underscore the importance of both mothers' and fathers' drinking for the development of alcohol use and problems across adolescence and young adulthood.

Anterior cingulate cortex metabolites and white matter microstructure: a multimodal study of emergent alcohol use disorder.

Multimodal imaging is increasingly used to address neuropathology associated with alcohol use disorder (AUD). Few studies have investigated relationships between metabolite concentrations and white matter (WM) integrity; currently, there are no such data in AUD. In this preliminary study, we used complementary neuroimaging techniques, magnetic resonance spectroscopy (MRS), and diffusion weighted imaging (DWI), to study AUD neurophysiology. We tested for relationships between metabolites in the dorsal anterior cingulate cortex (dACC) and adjacent WM microstructure in young adult AUD and control (CON) subjects. Sixteen AUD and fourteen CON underwent whole-brain DWI and MRS of the dACC. Outcomes were dACC metabolites, and diffusion tensor metrics of dACC-adjacent WM. Multiple linear regression terms included WM region, group, and region × group for prediction of dACC metabolites. dACC myo-inositol was positively correlated with axial diffusivity in the left anterior corona radiata (p < 0.0001) in CON but not AUD (group effect: p < 0.001; region × group: p < 0.001; Bonferroni-corrected). In the bilateral anterior corona radiata and right genu of the corpus callosum, glutamate was negatively related to mean diffusivity in AUD, but not CON subjects (all model terms: p < 0.05, uncorrected). In AUD subjects, dACC glutamate was negatively correlated with AUD symptom severity. This is likely the first integrative study of cortical metabolites and WM integrity in young individuals with AUD. Differential relationships between dACC metabolites and adjacent WM tract integrity in AUD could represent early consequences of hazardous drinking, and/or novel biomarkers of early-stage AUD. Additional studies are required to replicate these findings, and to determine the behavioral relevance of these results.

The Feasibility, Tolerability, and Safety of Administering a Very High Alcohol Dose to Drinkers with Alcohol Use Disorder.

There remains a paucity of research quantifying alcohol's effects in drinkers with alcohol use disorder (AUD), particularly responses to very high alcohol doses (≥0.8g/kg). As drinkers with AUD frequently engage in very heavy drinking (8 to 10 drinks/occasion), doses of ≤0.8g/kg may lack ecological validity. The present study examined the feasibility, tolerability, and safety of administering a very high alcohol dose (1.2g/kg) to non-treatment-seeking AUD participants. Sixty-one young adult AUD drinkers enrolled in the Chicago Social Drinking Project and completed 3 laboratory sessions at which they consumed a beverage with 1.2, 0.8, and 0.0g/kg alcohol. Physiological responses (vital signs, nausea and vomiting, breath alcohol concentrations [BrAC]) were monitored throughout the sessions. After each session, participants completed a next-day survey of substance use, engagement in risky behaviors, and related consequences. Overall, the sample demonstrated good compliance with study procedures; 93% of participants adhered to presession alcohol abstinence requirements (indicated by BrAC<0.003g/dl), with no participants exhibiting serious alcohol withdrawal symptoms at arrival to study visits. The 1.2g/kg alcohol dose achieved an expected mean peak BrAC of 0.13g/dl at 60minutes after drinking, which was well tolerated; the majority of the sample did not experience nausea (70%) or vomiting (93%), and dose effects on vital signs were not clinically significant. Finally, we demonstrated that the 1.2g/kg alcohol dose is safe and not associated with postsession consequences, including reduced sleep time, atypical substance use, accidents or injuries, and severe hangovers. Results support the feasibility, tolerability, and safety of administering a very high alcohol dose to young adult drinkers with AUD within the context of a well-validated laboratory alcohol challenge paradigm. Utilizing an alcohol dose more consistent with naturalistic drinking patterns may foster greater ecological validity of laboratory paradigms for persons with moderate to severe AUD.

Personality, romantic relationships, and alcohol use disorder symptoms in adolescence and young adulthood: An evaluation of personality × social context interplay.

Prior research has shown that person-level characteristics (e.g., temperament, personality) correlate and interact with social-contextual factors (e.g., parent-child relationship quality, antisocial peer affiliation) to predict adolescent substance use, but less research has examined similar processes for adult substance use problems. We addressed this gap by testing for personality × romantic partner context interplay in relation to symptoms of alcohol use disorder (AUD) at ages 24 and 29. Participants were twins in the longitudinal Minnesota Twin Family Study (N = 2,769; 52% female). Results support the corresponsive principle of personality in that we found that key personality traits in late adolescence (low constraint, negative emotionality) predicted subsequent "selection" into key social contexts in early adulthood (poorer quality romantic relationships and greater romantic partner alcohol use), which subsequently reinforced those traits and associated outcomes (including correlated AUD symptoms) through late young adulthood. There were few meaningful gender differences in these associations. There was also no support for the personality × romantic partner context interaction as a significant predictor of AUD symptoms at ages 24 or 29. Taken together with prior studies, these results suggest that such interactions may be less relevant to the development of young adult AUD compared to adolescent substance use problems.

Predictors of Alcohol Use Disorders Among Young Adults: A Systematic Review of Longitudinal Studies.

Alcohol use disorders (AUDs) are highly disabling neuropsychiatric conditions. Although evidence suggests a high burden of AUDs in young adults, few studies have investigated their life course predictors. It is crucial to assess factors that may influence these disorders from early life through adolescence to deter AUDs in early adulthood by tailoring prevention and intervention strategies. This review aims to assess temporal links between childhood and adolescent predictors of clinically diagnosed AUDs in young adults. We systematically searched PubMed, Scopus, PsycINFO and Embase databases for longitudinally assessed predictors of AUDs in young adults. Data were extracted and assessed for quality using the Newcastle-Ottawa quality assessment tool for cohort studies. We performed our analysis by grouping predictors under six main domains. Twenty two studies met the eligibility criteria. The outcome in all studies was measured according to the Diagnostic Statistical Manual of Mental Disorders. Our review suggests strong links between externalizing symptoms in adolescence and AUDs in young adulthood, as well as when externalizing symptoms co-occur with illicit drug use. Findings on the role of internalizing symptoms and early drinking onset were inconclusive. Environmental factors were influential but changed over time. In earlier years, maternal drinking predicted early adult AUD while parental monitoring and school engagement were protective. Both peer and parental influences waned in adulthood. Further high-quality large longitudinal studies that identify distinctive developmental pathways on the aetiology of AUDs and assess the role of early internalizing symptoms and early drinking onset are warranted.

Time-specific and cumulative effects of exposure to parental externalizing behavior on risk for young adult alcohol use disorder

BackgroundPrevious studies indicate that parental externalizing behavior (EB) is a robust risk factor for alcohol use disorder (AUD) in their children, and that this is due to both inherited genetic liability and environmental exposure. However, it remains unclear whether the effects of exposure to parental EB vary as a function of timing and/or chronicity. MethodsWe identified biological parents with an alcohol use disorder, drug abuse, or criminal behavior, during different periods of their child's upbringing, using Swedish national registries. Logistic regression was used to determine whether the effect of parental EB exposure during different developmental periods differentially impacted children's risk for young adult AUD (ages 19–24). In addition, we tested how multiply affected parents and/or sustained exposure to affected parents impacted risk. ResultsWhile parental EB increased risk for young adult AUD, timing of exposure did not differentially impact risk. Having a second affected parent increased the risk of AUD additionally, and sustained exposure to parental EB across multiple periods resulted in a higher risk of young adult AUD than exposure in only one period. ConclusionsIn this well-powered population study, there was no evidence of “sensitive periods” of exposure to national registry-ascertained parental EB with respect to impact on young adult AUD, but sustained exposure was more pathogenic than limited exposure. These findings suggest developmental timing does not meaningfully vary the impact, but rather there is a pervasive risk for development of young adult AUD for children and adolescents exposed to parental EB.

Comorbidity and temporal relations of alcohol and cannabis use disorders from youth through adulthood

BackgroundAlcohol and cannabis are among the most widely used and abused drugs in industrialized societies. Investigations of patterns in comorbidity and temporal sequencing between alcohol use disorders (AUDs) and cannabis use disorders (CUDs) from childhood to adulthood are important for understanding the etiologies of these disorders. MethodsThe sample comprised 816 individuals (59% male, 89% white). Dichotomous measures indicated whether or not a participant was in an AUD or CUD episode during three developmental periods—youth (childhood through adolescence), early adulthood, and adulthood. Structural equation modeling was used to determine relations between AUDs and CUDs across the three developmental periods, and to test for gender differences. ResultsConcurrent associations between AUD and CUD were significant. Both AUD and CUD in previous developmental periods significantly predicted the same substance disorders in subsequent periods. Cross-lagged paths from youth AUD to young adult CUD and youth CUD to young adult AUD were both significant. However, only the cross-lagged path from youth CUD to adult AUD was significant. The cross-lagged paths from young adult AUD to adult CUD and young adult CUD to adult AUD were both nonsignificant. Males and females were mostly similar with only three differences found between genders. ConclusionsComorbidity of AUDs and CUDs was evident from youth through adulthood but the strength of the relationship lessened in adulthood. Temporal sequencing influences of AUDs and CUDs on each other were similar in youth and adulthood but not young adulthood. Same substance stability was greatest in adulthood.

Solitary Alcohol Use in Teens Is Associated With Drinking in Response to Negative Affect and Predicts Alcohol Problems in Young Adulthood.

Adolescent solitary drinking may represent an informative divergence from normative behavior, with important implications for understanding risk for alcohol-use disorders later in life. Within a self-medication framework, we hypothesized that solitary alcohol use would be associated with drinking in response to negative affect and that such a pattern of drinking would predict alcohol problems in young adulthood. We tested these predictions in a longitudinal study in which we examined whether solitary drinking in adolescence (ages 12-18) predicted alcohol-use disorders in young adulthood (age 25) in 466 alcohol-using teens recruited from clinical programs and 243 alcohol-using teens recruited from the community. Findings showed that solitary drinking was associated with drinking in response to negative affect during adolescence and predicted alcohol problems in young adulthood. Results indicate that drinking alone is an important type of alcohol-use behavior that increases risk for the escalation of alcohol use and the development of alcohol problems.

Predictors of Initial and Sustained Remission from Alcohol Use Disorders: Findings from the 30‐Year Follow‐Up of the San Diego Prospective Study

Individuals who report problematic drinking early in life often recover from alcohol-related disorders, with or without formal treatment. While risk factors associated with developing alcohol use disorders (AUDs), such as a family history of alcoholism and the genetically influenced low level of response (LR) to alcohol, have been identified, less is known about characteristics that relate to remission from AUDs. The male subjects (98% Caucasian) for this study were 129 probands from the San Diego Prospective Study who were first evaluated at age 20 as drinking but not alcohol-dependent young men, most of whom were college graduates by follow-up. The individuals evaluated here met criteria for an AUD at their first follow-up at ages 28 to 33 and were followed every 5 years for the next 2 decades. Discrete-time survival analysis was used to examine rates of initial and sustained AUD remission and to evaluate the relationships of premorbid characteristics and other risk factors to these outcomes. Sixty percent of the sample met criteria for an initial AUD remission of 5 or more years, including 45% with sustained remission (i.e., no subsequent AUD diagnosis). Higher education, lower drinking frequency, and having a diagnosis of alcohol abuse (rather than dependence) were associated with higher rates of initial AUD remission. A lower LR to alcohol at age 20, as well as lower drinking frequency, having received formal alcohol treatment, and older age at the first follow-up all predicted a greater likelihood of sustained AUD remission. This study identified key factors associated with initial and sustained AUD remission in subjects diagnosed with AUD in young adulthood. Characteristics associated with better outcomes early in the life span, such as lower drinking frequency and early treatment, appear to have a lasting impact on remission from AUD across adulthood.

The Epidemiology of DSM-IV Alcohol Use Disorders amongst Young Adults in the Australian Population

The aim of the study was to examine the descriptive epidemiology of 12-month alcohol use disorders (AUDs) amongst young adults in the Australian general population. The 2007 National Survey of Mental Health and Well Being, a nationally representative household survey of 8841 Australian adults (16-85 years), assessed participants for symptoms of the most prevalent DSM-IV mental disorders. Young adults were over-sampled to provide detailed information on this age group. 11.1% of young adults in the Australian population were diagnosed with an AUD. Compared with the rest of the young adult sample, young adults with AUDs were at greater risk of reporting another drug use disorder, an anxiety disorder, high levels of consumption, a medium or high score on the Kessler Psychological Distress Scale, and a moderate to severe score on the WHO Disability Assessment Schedule 2.0. Mental health services were rarely used by young adults with AUDs. Difficulties in differentiating young adults diagnosed with abuse and those diagnosed with dependence with the criteria we used supported accumulating evidence questioning the validity of the abuse-dependence distinction. AUDs in young adulthood are prevalent and associated with comorbid psychopathology, risky levels of alcohol consumption and disability. Despite the clinical significance of AUDs in this age group, few young adults with these disorders use mental health services. In this age group, the proposed changes for DSM-V regarding the classification of AUD would seem helpful.

Positive Functioning and Alcohol-Use Disorders From Adolescence to Young Adulthood

This research examined the longitudinal relationship between positive functioning and alcohol-use disorders from late adolescence into young adulthood. This study used prospective, longitudinal data from the Seattle Social Development Project on a contemporary sample of 808 young adult men and women interviewed multiple times since childhood. The analysis employed a longitudinal path analysis to examine the relationship between positive functioning and alcohol-use disorders across four time points between ages 15-18 and age 27. Positive functioning and alcohol-use disorders showed moderately strong continuity from adolescence through young adulthood. Positive functioning in adolescence predicts reduced likelihood of a diagnosis of alcohol abuse and dependence (as defined in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) at age 21, and positive functioning at age 21 predicts reduced likelihood of alcohol abuse and dependence at age 24 in this sample. These findings remain even after controlling for continuity in positive functioning and alcohol-use disorders, associations between positive functioning and alcohol use in adolescence, and sociodemographic differences attributable to gender, race/ethnicity, and poverty. Positive functioning in adolescence and early adulthood can decrease the probability of developing alcohol-use disorders in young adulthood. The data from this study suggest that promoting positive development in childhood, adolescence, and early adulthood should be a focus of programs seeking to prevent alcohol abuse and dependence. Providing continued support for the development of positive functioning through the transition from adolescence to adulthood could decrease the chance of the development of alcohol-use disorders in adulthood.

Physical and sexual abuse, depression and alcohol use disorders in adolescents: onsets and outcomes

Adolescents with alcohol use disorders (AUDs) often have major depressive disorder (MDD). While physical abuse and sexual abuse (PS Abuse) have been observed to be common in adolescents with AUDs, the influence of PS Abuse on comorbid MDD and AUD has not been determined. The effect of pre-existing PS Abuse on the young adulthood outcomes of adolescents with AUDs has also not been adequately explored. This study examined the relationships among PS Abuse, MDD, and AUD in adolescence, as well as related young adult outcomes. Adolescents (mean age: 16.4 years; range: 14–18 years) were recruited from clinical and community sources and classified into four groups: (1) AUD+PS Abuse ( n=154), (2) AUD only ( n=255), (3) PS Abuse only ( n=74), and (4) Controls ( n=268). Subjects were longitudinally assessed through young adulthood (age 19 years or older). Measures included interview assessments of DSM-IV AUD and MDD, classified as “primary” or “secondary”, and questionnaire measures of alcohol consumption and depression. Primary MDD preceded AUD whereas secondary MDD had a later onset than AUD. PS Abuse accelerated the onsets of primary MDD, secondary MDD and AUD. While affected adolescents had typically improved in both alcohol consumption and depression at the young adult assessment, the majority of those with adolescent AUD had AUDs in young adulthood, and MDD remained common in those with a history of PS Abuse. These results indicate that MDD among adolescents with AUD may be partly attributable to PS Abuse.