Alcohol Use Trajectories Research Articles

Depressive symptoms, conduct problems and alcohol use from age 13 to 19 in Norway: evidence from the MyLife longitudinal study

BackgroundEven though mental health problems and alcohol use remain major challenges facing adolescents, our understanding of their developmental progressions primarily stems from cohorts coming 1 of age in the early 2000’s. We aimed to examine and describe normative developmental trajectories of depression, conduct problems, and alcohol use across adolescent years among more recent cohorts of Norwegian youth born in the 21st century.MethodsMultilevel mixed linear models for symptoms of depression and conduct disorder, and multilevel mixed logistic models for depressive disorder, conduct problems, any alcohol use, and risky drinking, were estimated with longitudinal data from a nationwide sample N = 3436 (55% girls) of Norwegian adolescents (mean age 14.3 [SD = 0.85] in 2017). We compared models with linear, quadratic, and cubic change with age, and models that tested moderation by sex and centrality (rural vs. urban communities).ResultsAverage symptoms and the rate of depressive disorder increased sharply from age 13 to age 19, but both the initial levels and the rates of change were greater for girls than for boys. Average symptoms of conduct disorder and the rate of conduct problems increased in early adolescence and were greater for boys than girls. The rates of any alcohol use and risky drinking both increased sharply from age 14, but there were no notable sex differences either in the initial levels or rates of change over time. Adolescents from more rural communities had greater rates of any drinking in mid-adolescence, but there were no other effects of centrality.ConclusionsThis study provides a much-needed update concerning normative developmental trajectories of depression, conduct problems, and alcohol use among millennium cohorts. Consistent with prior studies, we observed significant increases in all outcomes across adolescence, with depression being both greater and more prevalent among girls and conduct problems being both greater and more prevalent among boys. Consistent with the emerging evidence, we observed no sex differences in alcohol use. Finally, there were no differences in the examined developmental trajectories as a function of centrality. These findings underscore the importance of early prevention and treatment of mental health and substance use problems.

Associations of childhood poly-adversity with alcohol problems among undergraduates: adolescent alcohol use trajectories and drinker self-schema

Objective Undergraduate drinking is associated with childhood adversity, early alcohol experience, and drinker self-schema. However, the pathway linking childhood adversity to undergraduate drinking problems remains undefined. This study aimed to identify the effects of childhood poly-adversity on the sequelae of adolescent alcohol-use trajectory, drinker self-schema, and alcohol problems among undergraduates. We also examined whether adolescent alcohol-use trajectory and drinker self-schema mediated the effects of childhood poly-adversity on undergraduate alcohol problems. Methods Baseline data from an ongoing prospective study, which included 851 first- and second-year full-time college students in Taiwan, were used. An anonymous online questionnaire was administered. Results The results showed that low poly-adversity and high poly-adversity were associated with the mean of initial alcohol use frequency during adolescence and further alcohol problems at college than those with no adversity. High poly-adversity was also associated with the increase in alcohol use frequency during adolescence. Both initial and increase in alcohol use frequency were associated with higher drinker self-schema scores and further alcohol problems. The indirect effects of high poly-adversity on undergraduate alcohol problems were mediated through adolescent alcohol-use trajectories and drinker self-schema. Conclusion Findings suggest that early identification of childhood poly-adversity and interventions to decrease adolescent drinking may prevent the formation of drinker self-schema and reduce undergraduate drinking problems.

Problematic Alcohol Use Trajectories in U.S. Military Veterans during a Public Health Crisis: Results from a 3-year, Nationally Representative, Longitudinal Study.

A growing number of studies have examined alcohol use during the COVID-19 pandemic. However, few longitudinal studies evaluated the prevalence and correlates of different trajectories of problematic alcohol use in vulnerable segments of the population, such as US veterans, over the 3-year course of the COVID-19 pandemic.Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 2,441 US veterans. Latent growth mixture modeling was used to identify the trajectories and correlates of problematic alcohol use.Four trajectories were identified: consistent (N = 170, weighted 7.2%), decreasing (N = 38, weighted 2.2%), increasing (N = 22, weighted 1.2%), and low (N = 2,211, weighted 89.4%) problematic alcohol use. Greater household income, pre-pandemic drug use disorder (DUD), lower social support, and COVID-19 infection to self or non-household members were associated with an increasing relative to decreasing problematic alcohol use trajectory. Greater household income, adverse childhood experiences (ACEs), pre-pandemic DUD, lower social support, and greater COVID-related social restriction stress were associated with an increasing relative to a low problematic alcohol use trajectory. Younger age, male sex, ACEs, pre-pandemic DUD, lower pre-pandemic and greater decline in protective psychosocial characteristics, COVID-19 infection to non-household member, and lower COVID-related financial stress were associated with a consistent relative to a low problematic alcohol use trajectory. Overall, pre-pandemic greater income, DUD, and lower social support were associated with an increase in problematic alcohol use among US veterans during the COVID-19 pandemic. Results may help inform prevention efforts to mitigate problematic alcohol use during prolonged crises in this population.

Trajectories of alcohol and cannabis use among emerging adults with a history of unstable housing: Associations with functioning over a two-year period

IntroductionResearch has documented high rates of alcohol and cannabis use among emerging adults experiencing homelessness. However, little is known about trajectories of use over time or how trajectories are associated with functioning (e.g., risk behaviors, mental and physical health, social functioning, economic well-being). MethodsData come from a cohort of 18–25 year olds experiencing homelessness who were surveyed 5 times over 24 months. Parallel process growth mixture models were used to model heterogeneity in alcohol and cannabis use across the 5 timepoints, which allowed for the extraction of classes based on both alcohol and cannabis use trajectories. Classes were compared on demographics and functioning at baseline and 24-months. ResultsTwo trajectory classes of alcohol and cannabis use emerged: moderate decreasing cannabis and low stable alcohol use (75% of the sample) and heavy cannabis and alcohol use (25% of the sample). The heavy cannabis and alcohol use class reported a significantly higher likelihood for any non-cannabis drug use at baseline and 24-months, as well as greater depression and physical ailments at 24-months. In addition, at 24-months this class had a marginally higher likelihood of a positive screen for at least moderate anxiety and being recently unhoused. ConclusionsThe effects of heavy continued cannabis and alcohol co-use on multiple domains of functioning (e.g., risk behavior, mental and physical health) highlight the importance of a coordinated systems approach that addresses the often complex and interrelated challenges facing emerging adults with a history of homelessness.

Does self-affirmation augment the effects of a mandated personalized feedback intervention? A randomized controlled trial with heavy drinking college students.

Theory and evidence indicate that affirming the value of the self before exposure to a threatening message fosters more open-minded appraisal of message content. We predicted that college students mandated to a computer-delivered personalized feedback intervention (PFI) and who engaged in a self-affirmation (SA) exercise would demonstrate reduce drinking and consequences relative to those who received an attention control. Participants were 484 undergraduates (age 18-24, 56% male, 78% White) mandated to participate in an alcohol intervention following a first-time alcohol policy violation. After a baseline assessment, each was randomized to SA (n = 256) or attention control (n = 227) prior to a computer-delivered PFI intervention. Posttest measures included an affirmation manipulation check; primary outcomes (past month weekly quantity, peak drinks, binge frequency, consequences) were assessed at 1-, 3-, 6-, 9-, and 12-month follow-ups. We used latent growth curve modeling to test study hypotheses. The SA exercise increased positive self-evaluation at posttest (p < .001). Overall reductions in drinking and consequences were observed at early follow-up (all p < .05), but the SA manipulation was not associated with intercept or slope factor differences in the models. Engaging in assessments during COVID restrictions was generally associated with reduced drinking and consequences. The SA exercise did not differentially affect trajectories of alcohol use and consequences, despite evidence that the exercise had the predicted effect on participant's self-evaluations. The lack of SA effects could be attributed to a nonthreatening PFI intervention that is generally accepted among mandated students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The intergenerational continuity of alcohol use in a population sample

IntroductionResearch shows that parental alcohol use predicts youths’ alcohol use, but this intergenerational continuity may vary across countries, and little is known about its moderators. This study examined for the first time the intergenerational continuity in alcohol use in a population sample of families in Canada, and tested whether it varied by youths’ sex, family income, or family structure. MethodsWe used prospective longitudinal data on 1632 families from the Quebec Longitudinal Study of Child Development (QLSCD), a representative sample from the province of Quebec, Canada. Youths self-reported alcohol use and binge drinking frequency at seven timepoints from early adolescence to early adulthood. Predictors were mothers’ and fathers’ self-reported alcohol use from youths’ infancy through age 13, and mother-reported socioeconomic variables. ResultsWe identified three trajectories of alcohol use from ages 13 to 21 years: normative, late-onset and early-onset. Maternal alcohol use increased the youths' risk of following the early-onset trajectory of alcohol use, while both parents’ alcohol use decreased the odds of the youths following the late-onset trajectory, compared to the normative trajectory. Insufficient family income increased youths' risk of following either the early-onset or late-onset trajectories. Mothers’ and fathers’ alcohol use did not interact in predicting youths’ trajectory, and we found no moderating effects of the youths’ sex, insufficient income, or years as a single-parent family. ConclusionThe results suggest modest intergenerational continuity of alcohol use in Quebec families which may be used, with income insufficiency, to help identify at-risk children for targeted interventions.

A - 105 Trajectories of Alcohol Use in Hispanic Individuals with TBI over the Ten Years Post-Injury: a Model Systems Study.

To examine alcohol consumption patterns and predictors of consumption across time among Hispanics with Traumatic Brain Injury (TBI) in the United States (U.S.) within ten years post-injury. Longitudinal cohort study. The sample included 1342 Hispanics (77.6% males) from the TBI Model Systems (TBIMS) database who had at least one complete data record at one of the follow-up data collections for average number of drinks consumed per episode of drinking in the previous month and one complete data record for number of times when five or more drinks were consumed in a single episode in the previous month. Across the full sample, alcohol consumption variables generally demonstrated quadratic movement characterized by an initial increase followed by a plateau or slight decrease over the 10years post-injury. Participants were more likely to consume a greater number of drinks per episode over time if they were men, single, with a history of excessive alcohol use, with a nonviolent mechanism of injury, shorter duration of PTA, and higher levels of education. Participants had a greater number of 5+ drinks/episode occurrences in the past month if they were men and had had a greater number of 5+ drinks/episode occurrences in the month before injury. There was no differential change in alcohol consumption over time as a function of these predictors. This study identified a profile of at-risk Hispanics with TBI for increased alcohol consumption. These individuals should be identified and targeted for early evidence-based alcohol intervention after TBI when results might be most favorable.

Identifying and describing trajectories of alcohol use frequency and binge drinking frequency among those age 15-30 in a national cohort of U.S. adolescents: a group-based trajectory modeling approach.

Analyzing long-term trajectories of alcohol use has the potential to strengthen policy and intervention priorities and timing. We identified and described trajectories of alcohol use and binge drinking frequency from mid-adolescence to early adulthood and measured the association of the role of early drinking initiation with trajectory membership. Longitudinal cohort study SETTING: United States PARTICIPANTS: The National Longitudinal Survey of Youth 1997 is a nationally representative cohort of youth age 12-16 at baseline. The analytic sample included individuals who participated in >2 annual interviews between age 15 and 30 (n=8,809). Participants self-reported the number of days in the past 30 days they: (1) drank alcohol and (2) binge drank [>5 drinks in one occasion]. We used group-based trajectory modeling to identify distinct trajectories from age 15-30 of past 30-day drinking and past 30-day binge drinking. Using multinomial logistic regression, we evaluated associations between early drinking initiation (≤14 years) and key demographics with trajectory membership. We identified 5 past 30-day drinking groups: late-escalating (16.0%), moderate-frequency (19.0%), high-frequency (11.1%), low-frequency (35.4%) and no/infrequent (18.4%). Early drinking initiation (versus later) was associated with higher odds of membership in the moderate (adjusted multinomial odds ratio [aMOR] = 4.32; 95% confidence interval [CI]: 3.65, 5.12) and high-frequency groups (aMOR = 4.17; 95%CI: 3.50, 4.97) than in the no/infrequent comparator trajectory. We identified 5 groups with distinct binge drinking frequency patterns: later escalating (9.9%), high-frequency (3.9%), low frequency (28.7%), earlier onset (9.5%), and no/infrequent (48.0%). Early initiation was associated with increased odds of membership in earlier onset and high-frequency groups compared with the no/infrequent group. For both outcomes additional differences in probability of group membership were identified by gender, racial identity, parental factors (religiosity, high school completion), and household characteristics (household size, income, and region of residence). Youth in the United States appear to follow heterogeneous drinking and binge drinking trajectories from adolescence into adulthood. These may include higher-use trajectories as well as trajectories with different escalation timing (e.g., earlier vs. later). Early initiation of drinking may increase risk of membership in higher- and earlier-use trajectory groups.

Developmental trajectories of alcohol and cannabis concurrent use in a nationally representative sample of United States youths

BackgroundPrevious studies have identified common trajectories of single type substance use over the course of adolescence; however, no study to date has examined joint trajectories of cannabis and alcohol concurrent use. Given that expansion of legal cannabis has increased availability, it is important to understand patterns of concurrent use in adolescents and factors that place male and female youth at risk for harmful trajectories of concurrent use. The current study sought to identify joint trajectories of cannabis and alcohol use – and predictors of harmful use trajectories – among male and female adolescents. MethodWe used 4 waves of data from 6997 early adolescent participants (age 12–14 years at Wave 1) in the Population Assessment of Tobacco and Health, a nationally representative longitudinal study in the United States. Participants reported their cannabis and alcohol use reassessed yearly for 5 years (2013–2018). We used joint trajectory growth mixture modeling to identify trajectory groups as defined by changes in alcohol and cannabis use over time. ResultsFive classes of alcohol and cannabis concurrent use trajectories were identified. Both internalizing and externalizing symptoms at Wave 1 increased the odds of membership in trajectory groups characterized by more harmful use trajectories. Internalizing symptomatology was a stronger predictor of membership in escalating use trajectories among girls, whereas externalizing symptomatology stronger predictor among boys. ConclusionsThese findings underscore the utility of jointly considering alcohol and cannabis use when describing common developmental trajectories of use and identifying risk factors for trajectories characterized by harmful use.

Maternal depression, alcohol use, and transient effects of perinatal paraprofessional home visiting in South Africa: Eight-year follow-up of a cluster randomized controlled trial

BackgroundSouth African mothers confront synergistic challenges from depression, alcohol use, and HIV/AIDS. The importance of maternal functioning for child development motivates interventions, yet long-term outcomes seldom are tracked. Furthermore, little is known about trajectories and the role of social-cultural factors in maternal depression and alcohol use across parenthood in low- and middle-income countries. MethodsWe examined maternal outcomes at 5- and 8-years’ post-birth, from the Philani Intervention Program (PIP), a randomized controlled trial of a prenatally-initiated home visiting intervention lasting through 6 months' post-birth which yielded some benefits for children and mothers through 3 years. Longitudinal Bayesian mixed-effects models assessed intervention effects for maternal depression and alcohol use from pre-birth through 8 years post-birth. We plotted trajectories of depression and alcohol use and analyzed their relationship over time. ResultsMaternal benefits appeared limited and intervention outcomes differed at 5 and 8 years. Reduced depression in PIP versus standard care (SC) mothers at 3 years disappeared by 5 and 8 years. Depression prevalence declined from 35.1% prenatally to 5.5% at 8 years, independent of intervention or alcohol use. Alcohol use in both groups rebounded from a post-birth nadir; fewer PIP than SC mothers drank alcohol and reported problematic use at 5 but not 8 years. HIV+ prevalence did not differ by condition and increased from 26% to 45% over the reported period. ConclusionsDissipation of early child benefits from home visiting by age 8 years likely reflects lack of durable change in maternal behaviors compounded by social-cultural factors and cumulative effects of community deprivation. High prenatal rates warrant screening and treatment for depression in standard antenatal care. Low-and-middle income countries may need sustained interventions, including alcohol use reduction, to capitalize on initial gains from targeted interventions and address community social-cultural factors. HIV/AIDS continues to spread in this population.

Trajectories of change in subclinical anxiety and alcohol use during alcohol treatment: A parallel process growth model

BackgroundAnxiety is implicated in the course and prognosis of alcohol use disorder (AUD); however, it is unclear how current AUD treatments affect the joint trajectories of anxiety and alcohol use. We used data from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study to examine the longitudinal relationship between subclinical anxiety symptoms and alcohol use during and following AUD treatment in adults with AUD and no comorbid anxiety disorders. MethodsUnivariate and parallel process growth models using five waves of COMBINE study data were analyzed from 865 adults randomized to medication (n = 429) or medication plus psychotherapy (n = 436). Weekly drinking quantity and average weekly anxiety symptoms were measured at baseline, mid-treatment, end-of-treatment, and three follow-up periods. ResultsSignificant positive associations of anxiety symptoms and drinking were found at mid-treatment and over time. Temporal associations revealed that higher mid-treatment anxiety predicted decreases in drinking over time. Baseline anxiety and drinking predicted mid-treatment anxiety and drinking. Only baseline anxiety predicted increases in drinking over time. Group differences revealed mid-treatment drinking predicted decreases in anxiety over time in the medication group. ConclusionsFindings demonstrate the influence of subclinical anxiety on alcohol use during and up to one year after AUD treatment. Baseline anxiety symptoms may influence drinking behavior over the course of treatment. Findings suggest that greater attention to negative affect in AUD treatment is warranted even for those individuals who do have a comorbid anxiety disorder.

Maturing out of alcohol and cannabis co-use: A test of patterns and personality predictors.

Reductions in substance involvement into adulthood are thought to represent a normative maturing out of substance use. However, patterns and predictors of maturing out of alcohol and cannabis co-use remain largely unstudied. Therefore, the current study tested developmental trajectories of alcohol and cannabis use from late adolescence into adulthood and whether late adolescent personality traits predicted trajectory class membership. Data come from a longitudinal study of family history of alcohol disorder (N=458). Age bands were created to model trajectories of drinking quantity, negative alcohol consequences, and cannabis use frequency from late adolescence (age 18-22) to young adulthood (age 23-28) and adulthood (age 29-36). Participants reported on their sensation seeking, conscientiousness, and neuroticism during late adolescence and their typical drinking quantity, negative alcohol consequences, and cannabis use frequency at each age band. Three trajectory classes were derived from an initial Parallel Process Growth Mixture Model: (1) low-risk maturing out of alcohol-only use, (2) high-risk maturing out of co-use, and (3) high-risk switchers who increased their cannabis use into adulthood. Late adolescent sensation seeking was associated with higher odds of being in both co-use trajectories, whereas a lack of conscientiousness was associated with higher odds of being a co-use switcher. We identified heterogeneity in trajectories of co-use, which suggests that a lack of maturing out of alcohol involvement may be accompanied by increased cannabis use. Moreover, late adolescent personality traits may predispose individuals toward riskier developmental trajectories of substance use into adulthood.

Personality and Alcohol Use across College: Examining Context-Dependent Pathways toward Alcohol Problems

Background College life is characterized by marked increases in alcohol consumption. Extraversion and neuroticism are associated with alcohol use problems in college and throughout adulthood, each with alcohol use patterns consistent with an externalizing and internalizing pathway respectively. Students higher in extraversion drink more frequently and consume more alcohol, while neuroticism is paradoxically not consistently associated with elevated alcohol use. Objective This study examined whether students higher in neuroticism may drink the day before stressors, namely tests and assignment deadlines. Method Multilevel generalized linear models were performed using data from a longitudinal study of first-time, first-year undergraduates assessing alcohol use across four years of college, with daily diary bursts each semester. Results Students higher in extraversion had heavier alcohol use and greater alcohol use problems in their fourth year of college. Neuroticism was not associated with drinking behaviors or with drinking before a test or assignment, but was associated with greater fourth year alcohol problems. Students lower in extraversion who reduced heavy drinking the day before academic events had fewer alcohol use problems at the fourth year of college relative to students higher in extraversion. Conclusions Students higher in extraversion appear to exhibit a continuity of established alcohol use patterns from adolescence, predisposing them to a more hazardous trajectory of college alcohol use. Characteristics of low extraversion may afford some protection from alcohol-positive college culture. High neuroticism appears associated with a hazardous trajectory of college alcohol use, but continued research into situational factors of alcohol use in high neuroticism is warranted.

Autistic traits and alcohol use in adolescents within the general population

It has been suggested that autistic traits are associated with less frequent alcohol use in adolescence. Our study seeks to examine the relationship between autistic traits and alcohol use in a large adolescent population. Leveraging data from the IMAGEN cohort, including 2045 14-year-old adolescents that were followed-up to age 18, we selected items on social preference/skills and rigidity from different questionnaires. We used linear regression models to (1) test the effect of the sum scores on the prevalence of alcohol use (AUDIT-C) over time, (2) explore the relationship between autistic traits and alcohol use patterns, and (3) explore the specific effect of each autistic trait on alcohol use. Higher scores on the selected items were associated with trajectories of less alcohol use from the ages between 14 and 18 (b = − 0.030; CI 95% = − 0.042, − 0.017; p < 0.001). Among adolescents who used alcohol, those who reported more autistic traits were also drinking less per occasion than their peers and were less likely to engage in binge drinking. We found significant associations between alcohol use and social preference (p < 0.001), nervousness for new situations (p = 0.001), and detail orientation (p < 0.001). Autistic traits (social impairment, detail orientation, and anxiety) may buffer against alcohol use in adolescence.

Trajectory and course of problematic alcohol use after the Great East Japan Earthquake: Eight-year follow-up of the Higashi-Matsushima cohort study.

Problematic alcohol use (PAU) after natural disasters is an unignorable public health issue. However, the long-term trajectory and course of PAU after an earthquake disaster remain unknown. The Higashi-Matsushima cohort study was conducted between 2012 (time 1) and 2019 (time 8) in areas affected by the Great East Japan Earthquake in 2011. In the annual health checks, participants responded to self-report questionnaires on PAU, traumatic experiences (e.g., house damage), resources (e.g., social support), and other covariates (e.g., gender, psychological distress). The trajectory and course of PAU were estimated by latent growth model and latent class analyses. Risk factors for the long-term course of PAU were calculated by multinomial logistic regression analysis with multiple imputation. The analytical sample comprised 8929 residents who participated in at least one survey across the eight time points. The trajectory of PAU showed a sustained trend (slope <0.001). Three potential courses of PAU (No PAU course: 84.3%, Subthreshold PAU course: 12.4%, and Persistent PAU course: 3.4%) were estimated. The long-term course of PAU, especially the persistent PAU course, was predicted by house damage (OR=1.43, 95% CI 1.06 to 1.92), less social support (OR=0.71, 95% CI 0.53 to 0.96), gender (male) (OR=16.86, 95% CI 9.42 to 30.20), and psychological distress (OR=1.15, 95% CI 1.09 to 1.20). Long-term support is needed after an earthquake disaster, especially for residents who in early phases of the disaster suffer from PAU, males, and those in vulnerable situations resulting from conditions such as severe house damage, low social support, or high psychological distress.

Alcohol and Cannabis Use Trajectories and Outcomes in a Sample of Hispanic, White, and Asian Sexual and Gender Minority Emerging Adults.

Substance use disproportionately affects health and psychosocial outcomes for some racial/ethnic groups, but few longitudinal studies examine the extent to which sexual and gender minority (SGM) emerging adults of different racial/ethnic groups may experience disparities in outcomes at similar levels of alcohol or cannabis use. This study used five waves of annual survey data (spanning 2015 (average age 18) to 2020 (average age 23)) from an ongoing longitudinal cohort study of emerging adults. In the subset of 359 SGM emerging adults, separate sequelae of change models assessed differences in trajectories of alcohol or cannabis use (past 30-day frequency) and multiple health and psychosocial outcomes across Hispanic, Asian, and White individuals. White SGM emerging adults showed higher baseline levels of alcohol and cannabis frequency compared to Hispanic and Asian peers, but all groups showed similar rates of change (slope) over time. We observed few racial/ethnic differences in SGM emerging adult outcomes at the same levels of alcohol or cannabis use; that is, racial/ethnic groups showed similar patterns on most health and psychosocial outcomes; however, some differences emerged. For example, Asian respondents reported less engagement in sex with casual partners after using alcohol, marijuana, or other drugs compared to their White peers, at the same levels of alcohol use (β = −0.579, p = 0.03) or cannabis use (β = −0.737, p = 0.007). Findings underscore a need to consider multiple outcome domains and factors beyond additive stress in examining the effects of substance use across different groups of SGM individuals. More longitudinal studies with large, contemporary, and diverse samples of SGM emerging adults are needed to better characterize similarities and differences in patterns of substance use and use-related consequences in relation to intersecting SGM, racial/ethnic, and other identities.

Multiple diverse drinking trajectories among sexual minority women: Unique and joint prediction by minority stress and social influence risk factors

BackgroundSexual minority populations are at heightened risk for alcohol use disorders compared to heterosexual populations, and these disparities are particularly pronounced for sexual minority women (SMW). Little research has examined the diversity of drinking trajectories among sexual minorities, despite evidence that such trajectories have high predictive utility and are useful in understanding how risk factors may be uniquely associated with specific trajectories. MethodWe utilized four waves of data (12 months between waves) from a sample of 1,057 SMW ages 18–25 at Wave 1. The goals were to (a) identify multiple distinct trajectories of alcohol use; (b) examine the predictive utility of these trajectories; and (c) test associations between minority stress (e.g., discrimination) and social influence (e.g., sexual minority community involvement) risk factors and alcohol trajectories. ResultsUsing growth mixture modeling, we identified five classes based on drinking patterns at Wave 1 and change over time (stable low, stable high drinking, stable high HED, low increasing, and high decreasing). These classes were differentially associated with Wave 1 levels and changes in alcohol consequences. Minority stressors uniquely predicted a low increasing trajectory, while social influences uniquely predicted a stable high trajectory. Both minority stress and social risk factors predicted high decreasing and stable high HED trajectories. ConclusionsFindings indicate that some drinking trajectories among SMW appear similar to those found in the general population, while others appear unique. Results provide insight into how minority stress and social influence risk factors may uniquely and jointly contribute to disparities affecting this population.

Trajectories of alcohol use and problems during the COVID-19 pandemic: The role of social stressors and drinking motives for men and women

IntroductionIncreased alcohol use coinciding with onset of the COVID-19 pandemic, particularly among women, has been documented among U.S. adults. This study examines trajectories of alcohol use and alcohol problems over a 9-month period during the pandemic, the extent to which these trajectories are predicted by social stress and drinking motives, and whether results differ for women and men. MethodsData come from three online surveys of a nationally representative sample of U.S. adults ages 30–80 conducted in May-July 2020, October-November 2020, and March 2021. The analytic sample consists of N = 1118 who initially reported any past year alcohol use. The early-COVID survey assessed demographics, social stressors, and drinking motives. All three surveys assessed average drinks per day in past month and drinking-related problems. ResultsAlcohol use declined for men, but remained stable for women. Alcohol problems increased for both sexes, especially for men. Level of alcohol use was associated with loneliness and social demands for men, and drinking motives for both sexes, with changes in use related to loneliness and social demands for men. Level of alcohol problems was associated with loneliness for women and drinking motives for both sexes, with changes in problems related to drinking motives for women. Interactions of social stress with drinking motives were not found. ConclusionsSex differences in alcohol use and alcohol problems during the pandemic—as well as their associations with indicators of social stress and drinking motives—highlight the importance of tailoring prevention and treatment efforts for men and women.

Racial Discrimination and Trajectories of Problematic Alcohol Use Among African American Emerging Adults: The Role of Organizational Religious Involvement.

Racial discrimination jeopardizes a wide range of health behaviors for African Americans. Numerous studies demonstrate significant negative associations between racial discrimination and problematic alcohol use among African Americans. Culturally specific contexts (e.g., organized religious involvement) often function protectively against racial discrimination's adverse effects for many African Americans. Yet organized religious involvement may affect the degree to which racial discrimination increases problematic alcohol use resulting in various alcohol use trajectories. These links remain understudied in emerging adulthood marked by when individuals transition from adolescence to early adult roles and responsibilities. We use data from 496 African American emerging adults from the Flint Adolescent Study (FAS) to (a) identify multiple and distinct alcohol use trajectories and (b) examine organizational religious involvement's protective role. Three trajectory classes were identified: the high/stable, (20.76% of sample; n = 103); moderate/stable, (39.52% of sample; n = 196); and low/rising, (39.72% of the sample; n = 197). After controlling for sex, educational attainment, and general stress, the interaction between racial discrimination and organized religious involvement did not influence the likelihood of classifying into the moderate/stable class or the low/rising class, compared with the high/stable class. These results suggest organized religious involvement counteracts, but does not buffer racial discrimination's effects on problematic alcohol use. Findings emphasize the critical need for culturally sensitive prevention efforts incorporating organized religious involvement for African American emerging adults exposed to racial discrimination. These prevention efforts may lessen the role of racial discrimination on health disparities related to alcohol use.

962Adolescent Alcohol Use Trajectories: A Prospective Study of Risk Factors and Adulthood AUD Outcomes

Abstract Background Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of drinking may be an important predictor of later harms. Previous attempts to conceptualise these trajectories lacked adjustment for known confounders of adolescent drinking, which our study has aimed to address by modelling dynamic changes in drinking whilst adjusting for parent, child, and peer factors. Methods Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over five annual follow-ups (Mage=13.9 and 17.8 years). Regression models determined whether child, parent, and peer factors at baseline (Mage =12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD in early adulthood (Mage =18.8 years). Results We identified a four-class solution: abstaining (n = 352); late-onset moderate drinking (n = 503); early-onset moderate drinking (n = 663); and early-onset heavy drinking (n = 295). Alcohol-specific household rules reduced risk of early-onset heavy drinking compared to late-onset moderate drinking (RRR: 0.31; 99.5% CI: 0.11, 0.83), whereas substance-using peers increased this risk (RRR: 3.43; 99.5% CI: 2.10, 5.62). Early-onset heavy drinking increased odds of meeting criteria for AUD in early adulthood (OR: 7.68; 99.5% CI: 2.41, 24.47). Conclusions Our study provides evidence that early initiation and heavy alcohol use throughout adolescence is associated with increased risk of alcohol-related harm compared to recommended maximum levels of consumption (late-onset, moderate drinking). Key messages Parenting factors and peer influences in early adolescence should be considered to reduce risk of early initiation and heavy drinking, which in turn reduces risk of later harm.