Lifetime Alcohol Use Research Articles

Drinking firsts at home and with parental knowledge: Racial/ethnic differences in associations with later alcohol outcomes among underage youth.

Prior research has shown that early alcohol experiences, such as age of initiation and speed of progression between drinking milestones, vary across racial/ethnic groups. To inform culturally tailored prevention efforts, this longitudinal study examined racial/ethnic differences in the associations of drinking firsts at home and with parental knowledge with alcohol use outcomes among underage youth. The study included baseline and five follow-up surveys, collected every 6 months, from California adolescents (ages 12-16 years at baseline). The analytic sample was composed of the 689 adolescents who reported lifetime alcohol use at baseline or a follow-up survey (5% Black, 37% Latinx, 46% White, and 12% other/mixed racial/ethnic group; 54% female). Participants who reported consumption of a full drink, intoxication, or heavy episodic drinking (HED) were asked ages and contexts of these drinking firsts, including whether the initiation was at their own home and whether their parents/guardians knew about this drinking event. Outcomes included past-6-month alcohol frequency, alcohol quantity, and number of alcohol-related problems. Multilevel negative binomial regression analyses were conducted, controlling for demographics and age of initiation by type of drinking behavior. Moderation analyses examined racial/ethnic differences. For consumption of the first full drink, both drinking at home and parental knowledge were negatively associated with all outcomes; associations did not vary by race/ethnicity. First intoxication at own home was negatively associated with the number of drinks for Latinx youth and with the number of problems for Black youth. For first HED, drinking at own home was positively associated with drinking frequency across groups, and for Black youth specifically, parental knowledge of their first HED experience was significantly associated with greater later alcohol frequency and quantity. Results suggest that the association of family contexts of drinking first with later alcohol outcomes among underage youth varied by stage of alcohol use and race/ethnicity.

Association of circulating adipokines with metabolic measures among people with HIV: Moderating effects of alcohol use.

People with HIV (PWH) are at increased risk for cardiometabolic comorbidities. We have reported that lifetime alcohol use among people with HIV (PWH) is associated with increased risk for metabolic syndrome. Dysfunctional adipose tissue and altered circulating adipokines mediate metabolic dysregulation. The objective of this study was to determine the associations of circulating adipokine concentration with metabolic measures, and the moderating effects of lifetime and recent alcohol use in PWH. This is a cross-sectional analysis of data from 357 PWH at their baseline visit of the longitudinal New Orleans Alcohol and HIV (NOAH) study. The concentrations of four circulating adipokines (adiponectin, leptin, resistin, and fatty acid-binding protein 4 [FABP4]) and their associations with five metabolic measures (triglycerides, cholesterol, Hemoglobin A1c, Homeostatic Model Assessment for Insulin Resistance, and metabolic syndrome) were examined. Higher circulating adiponectin was associated with increased odds of normal triglyceride, cholesterol, and Hemoglobin A1c levels. Increased leptin and FABP4 concentrations were associated with decreased odds of normal triglyceride and cholesterol levels. Increased leptin and FABP4 concentrations were associated with increased odds of insulin resistance and meeting criteria for metabolic syndrome. Increased circulating resistin concentration was associated with decreased odds of normal triglyceride levels and increased odds of meeting criteria for metabolic syndrome. Additionally, among PWH with increased lifetime alcohol use, higher adiponectin concentration was associated with decreased odds of meeting criteria for metabolic syndrome. These data suggest the interplay between adiponectin, leptin, FABP4, and resistin may contribute to metabolic stability among PWH. Moreover, lifetime, but not recent, alcohol use moderates the relationship between adipokines and metabolic measures. These data highlight the relevance of functional adipose tissue mass and associated circulating adipokine levels in maintaining metabolic homeostasis, and its moderation by lifetime alcohol consumption.

Levels and outcomes of 12-step participation among sexual and gender minority subgroups

IntroductionSexual minority (e.g., bisexual, gay, lesbian, queer) and gender minority (e.g., transgender, non-binary, gender expansive) individuals (SGMI) experience higher rates of alcohol and other substance use disorders than their heterosexual and cisgender (i.e., non-transgender) counterparts. 12-Step programs are currently the most common source of support for alcohol and other substance use-related problems in the United States. Little is known about rates and levels of participation and outcomes of SGMI in 12-Step programs. Examining SGMI with a lifetime alcohol or other substance use disorder, this study aims to: 1) describe lifetime attendance rates (any vs. none) and levels of participation (number of program activities) in 12-Step groups among SGMI overall and compare rates of attendance and levels of participation across sexual and gender minority identities and 2) determine how lifetime level of participation in 12-Step programs relates to past-year alcohol and other substance use outcomes. MethodsWe used data collected through The PRIDE Study, a national, large-scale, longitudinal health study of adult SGMI, administering supplemental questions to assess alcohol and other substance use disorders and 12-step participation. Zero-Inflated Negative Binomial models (N = 1353) run with sexual and gender identities as predictors of lifetime 12-step attendance (yes/no) and level of 12-Step participation determine if greater levels of 12-Step participation were associated with lower levels of past-year Alcohol and Substance Use Disorder (AUD & SUD) symptoms. The study ran models for those with lifetime AUD (n = 1074) and SUD (n = 659) separately. ResultsParticipants who engaged in greater levels of 12-Step participation had lower levels of past-year AUD and SUD symptoms. Gay and queer respondents with AUD were more likely and lesbian respondents with SUD were less likely than other participants to have ever participated in 12-Step programs. All other associations between sexual/gender identities and 12-Step participation disappeared when age was added to the model. ConclusionsThis study provides preliminary evidence that 12-Step participation may be an effective resource for reducing AUD and SUD symptoms among SGMI. Younger SGMI and SGMI holding sexual/gender identities other than gay and queer may require additional support to initiate participation in 12-Step programs.

P.A.V.I.A. Study: Pervasiveness and Associated Factors of Video Slot Machine Use in a Large Sample of Italian Adolescents.

Video slot machines (VSM) are considered a particularly harmful gambling format; however, scant data is available on their use among underage Italian individuals. Two surveys were conducted in 2018 and 2022 involving 7,959 underage high school students (57.8% female) in Pavia, Northern Italy. We estimated adjusted odds ratios (aOR) and corresponding 95% confidence intervals (CI) for lifetime experience and current regular (at least monthly) use of VSM, according to family, educational and behavioral factors. Overall, participants reporting lifetime VSM experience were 13.2% (95% CI: 12.5 - 13.9), 15.2% (95% CI: 14.0-16.4%) in 2018, and 12.0% (95% CI: 11.1-13.0%) in 2022. Current regular VSM users were 1.4% (95% CI: 1.1-1.7) in total, 1.2% (95% CI: 0.8-1.6%) in 2018 and 1.5% (95% CI: 1.1-1.8%) in 2022. VSM lifetime experience and current regular use were significantly more frequent in males (aORs: 1.55 and 4.81, respectively), students who failed a year (aORs: 2.07 and 3.44), or with daily gambling parents/siblings (aORs: 2.83 and 4.86). Lifetime use of alcohol, tobacco, or illicit substances was significantly directly associated with lifetime VSM use (aORs between 2.64 and 4.75); monthly alcohol, tobacco, or illicit substances use was significantly directly associated with current regular VSM use (aORs between 4.47 and 18.21). Sexting and voluntary self-injury were significantly more frequent among VSM lifetime/current regular users. VSM use, which is directly associated with other risky behaviors, may be pervasive among Italian minors. Such public health concern calls for legislative enforcements and integrated multidisciplinary health promotion and prevention strategies.

M45 - Differences in Psychopathology, Substance Use, and Social Support Among Adolescents With Versus Without Lifetime Alcohol Use

M45 - Differences in Psychopathology, Substance Use, and Social Support Among Adolescents With Versus Without Lifetime Alcohol Use

Alcohol Consumption and its Predictors among Medical Sciences Students in the Southeast of Iran

Background: There is increasing concern about the use of alcohol by medical science students in the world. This study aimed to assess the frequency and related factors of alcohol consumption among Kerman University of Medical Sciences students. Methods: This cross-sectional survey was carried out in 2020 on students from the Kerman University of Medical Sciences using the Quota sampling method. A valid and reliable questionnaire was used in this study, which included alcohol use frequency, sociodemographic characteristics, and alcohol use behaviors. Data were analyzed using SPSS version 26, which used multiple logistic regression analysis. Results: Lifetime, last-year, and last-month prevalence of alcohol use was 41.15%, 37.61%, and 15.91%, respectively. We found a significant association between older age (OR=1.61, P<0.001), male gender (OR=3.12, P=0.001), single marital status (OR=5.07, P=0.001), living in a dormitory (OR=2.97, P=0.025), non-governmental father’s job (OR=3.57, P=0.008), mother’s education level of 13 – 16 year (OR=6.69, P=0.013) and less than 13 years (OR=6.27, P=0.013), and high socioeconomic status (OR=2.38, P=0.019) with lifetime alcohol use. Conclusion: The prevalence of alcohol use among medical sciences students was high in this study, and alcohol use prevention programs should be designed and implemented for at-risk groups, including older students, male students, those living in dormitories, single students, good socioeconomic status, students with non-governmental father’s job and mothers’ low-level education.

Disaggregating trends in alcohol involvement among Hispanic, Black, and White female and male U.S. adolescents: 2002 to 2019.

Alcohol involvement is declining among U.S. adolescents, however studies examining population-level trends in alcohol involvement among females and males from diverse racial and ethnic backgrounds are scarce. Therefore, the current study examined alcohol involvement from 2002 to 2019 among Hispanic, Black, and White U.S. adolescent females and males. Data were from the National Survey on Drug Use and Health, years 2002-2019. Participants were between 12 to 17 years old and Hispanic, non-Hispanic Black, or non-Hispanic White. Annualized change estimates within each subgroup were analyzed separately for four alcohol variables: 1) lifetime alcohol use; 2) age at alcohol initiation; 3) past-year drinking days; 4) respondent's perceived risk of alcohol misuse. Lifetime alcohol use decreased for all groups, and the decrease was strongest for Hispanic males. Age at alcohol initiation similarly increased for Hispanic and White females and males, with no change in age at alcohol initiation for Black adolescents. Past-year drinking days declined for all groups but was not significant for Black females. Perceiving alcohol misuse as a "great risk" increased only for Hispanic males and females. Although alcohol involvement is declining among U.S. adolescents, results from this study highlight that engaging with alcohol is normative among many adolescent groups. Also, when considering sex as well as race and ethnicity, there are important distinctions in patterns of decline in alcohol involvement that should be accounted for to inform future research and screening.

Lifetime alcohol use disorder and gambling disorder: clinical profile and treatment response.

Gambling disorder affects 0.5-2.4% of the population and shows strong associations with lifetime alcohol use disorder. Very little is known regarding whether lifetime alcohol use disorder can impact the clinical presentation or outcome trajectory of gambling disorder. Data were pooled from previous clinical trials conducted on people with gambling disorder, none of whom had current alcohol use disorder. Demographic and clinical variables were compared between those who did versus did not have lifetime alcohol use disorder. Of the 621 participants in the clinical trials, 103 (16.6%) had a lifetime history of alcohol use disorder. History of alcohol use disorder was significantly associated with male gender (relative risk [RR] = 1.42), greater body weight (Cohen's D = 0.27), family history of alcohol use disorder in first-degree relative(s) (RR = 1.46), occurrence of previous hospitalization due to psychiatric illness (RR = 2.68), and higher gambling-related legal problems (RR = 1.50). History of alcohol use disorder was not significantly associated with other variables that were examined, such as severity of gambling disorder or extent of functional disability. Lifetime alcohol use disorder was not significantly associated with the extent of clinical improvement in gambling disorder symptoms during the subsequent clinical trials. These data highlight that lifetime alcohol use disorder is an important clinical variable to be considered when assessing gambling disorder because it is associated with several untoward features (especially gambling-related legal problems and prior psychiatric hospitalization). The study design enabled these associations to be disambiguated from current or recent alcohol use disorder.

Mode of mutual-help group attendance: Predictors and outcomes in a US national longitudinal survey of adults with lifetime alcohol use disorder

IntroductionAlthough attending substance use-focused mutual-help meetings online may reduce attendance barriers, associations of attendance mode with group participation and outcomes are unknown. Using longitudinal data from mutual-help group attendees, this study, after identifying differences in baseline characteristics by attendance mode, examined associations of attendance mode with mutual-help participation (number of meetings attended, involvement) and outcomes (alcohol abstinence, heavy drinking, alcohol problems). MethodsThe Peer Alternatives for Addiction Study 2021 Cohort sampled attendees of 12-step groups (e.g., Alcoholics Anonymous), Women for Sobriety, LifeRing Secular Recovery, and/or SMART Recovery in-person and/or online within 30 days before baseline. The baseline sample, recruited in fall 2021, was 531 adults with lifetime alcohol use disorder, followed at 6 (88 %) and 12 months (85 %). Differences in baseline characteristics by attendance mode were tested using Chi-squares and ANOVAs. GEE models examined associations of attendance mode, time, and their interactions with mutual-help group participation and alcohol outcomes. The in-person only mode was compared to the online-only, and to the in-person plus online, modes. ResultsAt baseline, 53.7 % of participants had attended only online meetings in the past 30 days, 33.7 % had attended both in-person and online meetings, and 12.6 % had attended only in-person meetings. Online meeting attendees were less likely to endorse lifetime abstinence as an alcohol recovery goal than in-person-only meeting attendees. In adjusted models (including for recovery goal), those attending online meetings only, or both online and in-person meetings, attended a greater number of meetings compared to those attending only in-person meetings. However, online-only attendance was associated with less involvement than in-person-only attendance. In adjusted models, compared to baseline, involvement increased and outcomes improved at follow-ups. Adjusted models examining alcohol outcomes found that no attendance at mutual-help groups at follow-ups was associated with more heavy drinking compared to in-person-only attendance. ConclusionsFindings inform efforts to ascertain benefits of mutual-help group participation by suggesting that online attendance is associated with attending more meetings, less involvement, and lower endorsement of abstinence as a recovery goal, and is comparable to in-person attendance on alcohol outcomes. In-person attendance may be more beneficial for less heavy drinking than terminating attendance.

The role of monitoring skills in mediating the association between parent's hazardous alcohol consumption and adolescents' drinking.

This study aimed to investigate whether parental monitoring skills mediate the effect of hazardous parental alcohol consumption on adolescents' lifetime alcohol use. This three wave longitudinal study was conducted with 884 families (n = 1,768 participants) to evaluate the effectiveness of a family-based drug prevention program for adolescents and parents across 12 Brazilian cities. We used structural equation mediation modeling to analyze the effect of hazardous parental alcohol consumption at baseline on adolescents' lifetime alcohol use at 12-month follow-up, mediated by parental monitoring skills latent dimension at 6-month follow-up. We found a significant indirect effect of parents' hazardous alcohol use on adolescents' alcohol use through parental monitoring (OR:1.18, 95%CI:1.02;1.36). Our finding underscores the importance of comprehensive preventive family alcohol approaches targeting adolescent alcohol use, which should consider both parental drinking behavior and monitoring practices.

Influence of childhood trauma and traumatic stress on a woman's risk of having a child with a fetal alcohol spectrum disorder.

Maternal risk factors for having a child diagnosed on the fetal alcohol spectrum disorders (FASD) continuum are complex and include not only the quantity, frequency, and timing of alcohol use but also a woman's physical stature, socio-economic status, and pregnancy-related factors. Exposure to trauma may predispose women to a range of physiological and mental disorders. A woman's mental and physical health may in turn influence her probability of having a child with FASD. This study investigated the role of maternal childhood trauma and lifetime traumatic stress on prenatal alcohol consumption and on the risk of having a child with FASD. A nested, case-control study was conducted for maternal risk assessment. Study participants were mothers of first-grade learners from five rural communities in the Western Cape Province of South Africa who were assessed for FASD. Face-to-face surveys were conducted, which included mental health and trauma assessment questionnaires. In logistic regression analyses, higher maternal childhood trauma scores were associated with an increased likelihood of having a child diagnosed with FASD, although the increase in risk was modest (OR = 1.014, p = 0.015). In addition, structural equation modeling investigated relationships between maternal drinking, childhood trauma, traumatic stress, and a child's FASD diagnosis. Traumatic stress and drinking during pregnancy, but not lifetime alcohol use, were associated with maternal childhood trauma. Lifetime alcohol use influenced drinking during pregnancy, which in turn was significantly associated with having a child diagnosed on the continuum of FASD. No direct influence of maternal childhood trauma on FASD diagnosis could be demonstrated. However, maternal trauma may indirectly contribute to the risk of having a child diagnosed with FASD.

Implications of alcohol use for aging-associated skeletal muscle dysfunction

Background: Alcohol use decreases skeletal muscle (SKM) strength and function. Alcohol use is disproportionately on the rise among older individuals, with 25% engaging in heavy drinking and 11% reporting binge drinking. The significant increase in life expectancy in the United States leads us to predict that alcohol use will be an important factor exacerbating SKM function in chronological aging, increasing the risk of poor physical performance and frailty. The objective of the study was to assess the impact of recent alcohol use on measures of physical performance and on muscle differentiation and bioenergetic capacity among people over the age of 60. Methods: We conducted a prospective cross-sectional study. Sedentary people over the age of 60 years were recruited from the Greater New Orleans Area. Participants were assessed for physical performance and vastus lateralis muscle biopsies taken for biochemical analysis. Recent alcohol misuse was defined as phosphatidyl ethanol (PEth), a biomarker of alcohol use, levels >20 ng/ml. Results: Preliminary analysis of data from 13 participants (PEth> 20 ng/ml, n=5) showed no differences in hand grip strength (Means± SD-31.08±9.8 and 33.17±8.4 kg respectively), 30-sec sit to stand test (10.5± 1.8 and 10.6± 3.9 number respectively), and Timed up and go Test (13.5± 2.6 and 11.4± 3.1 seconds respectively) among participants with PEth < 20 ng/ml compared to those with PEth >20ng/ml. Data collected from myotubes derived from myoblasts isolated from SKM biopsies from participants with PEth >20 ng/ml showed increased proton leak (indicator of poor mitochondrial bioenergetic health) and lower myotube density (p=0.06, Cohen’s d = 1.9) compared to myotubes from participants with PEth <20 ng/ml. Conclusions: Preliminary analysis indicates that recent alcohol use dysregulates muscle bioenergetic and differentiation capacity that are not associated with significant differences in physical performance tests. Ongoing analysis will identify confounding factors, and whether cumulative lifetime alcohol use contributes more significantly to physical performance and frailty measures among older people. R21AA030869, Pilot funding Department of Physiology LSUHSC-NO, P60AA009803. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Even worse for Black girls: the longitudinal association of racial bullying with the initiation of alcohol and tobacco use.

We used Poisson's linear regression to examine the association between racial bullying (RB) and the initiation of alcohol and tobacco uses after 9 months. Two cluster-randomized controlled trials were conducted in 2019 with children in grades five (girls: 50.0%; 10 years old: 82.0%; White: 36.8%; Black: 58.7%; others: 4.5%) and seven (girls: 49.5%; 12 years old: 78.1%; White: 33.2%; Black: 60.4%; others: 6.4%) from 30 public schools in the municipality of São Paulo, Brazil. We restricted our analyses to 2 subsets of students in each grade: those who reported no lifetime alcohol use at baseline and those who reported no lifetime baseline tobacco use. At baseline, 16.2% of fifth and 10.7% of seventh graders reported suffering from RB in the 30 days before data collection. After 9 months, 14.9% of fifth graders started using alcohol and 2.5%, tobacco. Among seventh graders, the figures were 31.2% and 7.7%, respectively. RB predicted the initiation of use of alcohol (risk ratio [RR]= 1.36; 95% CI, 1.07-1.70) and tobacco (RR= 1.81; 95% CI, 1.14-2.76) among seventh graders, with race-gender differences, particularly in Black girls (alcohol: RR= 1.45; 95% CI, 1.07-1.93; tobacco: RR= 2.34; 95% CI, 1.31-3.99). School-based programs and policies must explicitly address issues related to racism and gender in alcohol and tobacco prevention strategies.

Exploring perceptions of self-stigma of substance use and current alcohol and marijuana use patterns among college students.

While research has examined the effect of stigma from others towards individuals with substance use disorders, few studies have examined the relationship between perceived self-stigma and engagement in substance use more broadly, especially among non-clinical samples. The present study examined the relationships between perceptions of self-stigma if one were to develop a substance use disorder, consisting of negative self-esteem and negative self-efficacy, and alcohol or marijuana use behaviors and outcomes. Participants (n = 2,243; 71.5% female) were college students within the U.S. recruited to participate in an online survey on substance use with a special focus on alcohol and marijuana. Results indicated no significant differences in stigma scores across individuals with different lifetime alcohol and marijuana use. Stigma ratings did differ between individuals with different profiles of last 30-day alcohol and marijuana use where, generally, individuals with lifetime use but no use in the last 30-day reported higher levels of self-stigma. Correlation analyses indicated that perceived impact of substance use disorder on sense of self-efficacy and self-esteem related negatively to nearly all observed factors of alcohol and marijuana use. Though self-stigma, and stigma more broadly, has been shown to have negative implications for people with substance use disorders, the present study suggests that for non-clinical populations there may be some protective association between perceived self-stigma and alcohol or marijuana use engagement. This is not to say that self-stigma is a positive clinical intervention. Rather, we interpret these findings to indicate that negative perceptions of substance use disorder on the sense of self may be associated with distinct alcohol and marijuana use behaviors among young adults.

Problem Opioid Use Among US Military Veterans: Prevalence, Correlates, and Psychiatric Characteristics.

Problem opioid use (POU) is a serious public health crisis in the United States. However, little research has examined the prevalence, correlates, and psychiatric characteristics of POU in vulnerable segments of the population, such as US military veterans. Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 2441 US veterans. Multivariable logistic regression models were conducted to identify correlates and psychiatric correlates of POU (defined as a positive screen on the Tobacco, Alcohol, Prescription Medication, and Other Substance Use Tool). A total 3.0% (95% confidence interval, 2.0%-4.5%) of US veterans screened positive for POU. Black, non-Hispanic race/ethnicity (odds ratio [OR], 3.83), lifetime alcohol use disorder (OR, 3.38), major depressive disorder (MDD; OR, 2.52), greater number of medical conditions (OR, 1.15), and disability in instrumental activities of daily living (IADL); OR, 1.86) were independently associated with POU. A significant interaction between IADL disability and MDD was observed (OR, 10.73)-among veterans with IADL disability, those with MDD had more than 6-fold greater POU than those without MDD (20.6% vs 3.2%). Furthermore, POU was associated with 2- to 3-folds greater odds of current generalized anxiety disorder and current posttraumatic stress disorder, and lifetime suicide attempt. POU affects 3.0% of US veterans and is associated with Black race/ethnicity, lifetime physical and mental health morbidities, as well as current psychiatric disorders and lifetime suicide attempts. Results underscore the importance of assessing physical and mental health disorders in veterans at-risk for POU and addressing co-occurring psychiatric disorders associated with POU in this population.

Different measures of alcohol use as predictors of DSM-5 alcohol use disorder among adolescents – A cohort study from Sweden

Background and aimsThis study addresses a significant gap in existing research by investigating the longitudinal relationship between various measures of alcohol use and the development of alcohol use disorders (AUDs) in a cohort of Swedish adolescents. MethodsA prospective longitudinal survey was conducted on 3999 adolescents in Sweden who were in 9th grade in 2017 and were followed up in 2019. Baseline assessments included lifetime alcohol use, recent use (past 30 days), risky drinking (AUDIT-C), and heavy episodic drinking (HED). Follow-up assessments comprised eleven items measuring DSM-5 AUD criteria. The study explores prospective associations between these diverse alcohol use measures and the occurrence of AUD, while also calculating population attributable fractions (PAF). FindingsThe proportion of alcohol consumers who met the criteria for AUD at follow-up was 31.8%. All baseline measures of alcohol use exhibited associations with subsequent AUD. Notably, the HED group demonstrated the highest prevalence of AUD at 51.4% (p<.001). However, when calculating PAFs, any lifetime alcohol use emerged as the most substantial contributor, accounting for 10.8% of all subsequent AUD cases. ConclusionsThis study underscores that alcohol use during mid-adolescence heightens the risk of developing AUD in late adolescence. Among the various measures, heavy episodic drinking presents the highest risk for later AUD. From a public health perspective, preventing any alcohol use emerges as the most effective strategy to mitigate the population-level burden of disease of AUD.

Behavioral economic and wellness-based approaches for reducing alcohol use and consequences among diverse non-student emerging adults: study protocol for Project BLUE, a randomized controlled trial

BackgroundEmerging adults (EAs) who are not 4-year college students nor graduates are at elevated risk for lifetime alcohol use disorder, comorbid drug use, and mental health symptoms, compared to college graduates. There is a need for tailored brief alcohol intervention (BAI) approaches to reduce alcohol risk and to facilitate healthy development in this high-risk population. Most BAIs include a single session focused on discussing risks associated with drinking and correcting normative beliefs about drinking rates. EAs may benefit from additional elements that enhance general wellness. The substance-free activity session (SFAS) aims to clarify life goals and values and increase goal-directed activities that provide alternatives to alcohol use, and the relaxation training (RT) session teaches relaxation and stress reduction skills.MethodsThe present study is a randomized 3-group (BAI + SFAS vs. RT + SFAS vs. education control) trial with 525 EAs (175 per group; estimated 50% women and 50% African American) who report recent risky drinking and who are not students or graduates of 4-year colleges. Participants will have the option of completing the intervention sessions in person or via a secure video teleconference. Levels of drinking and alcohol-related problems will be evaluated at baseline and 1, 3, 6, and 12 months post-intervention. The primary hypothesis is that both BAI + SFAS and RT + SFAS participants will report significantly greater reductions in alcohol use and problems relative to education control participants, with no differences in outcomes between the two active treatment conditions.DiscussionThe results of this study will inform alcohol prevention efforts for high-risk community dwelling emerging adults.Trial registrationClinicalTrials.gov Identifier: NCT04776278.

Prevalence and factors associated with depression and anxiety among young school-going adolescents in the Western Cape Province of South Africa

IntroductionBetween 10 and 20% of children and adolescents globally experience common mental health conditions such as depression or anxiety. Given the dearth of mental health services in low- and middle-income countries, most mental health conditions among adolescents remain undiagnosed and untreated. In South Africa, few studies have explored the prevalence of depression and anxiety among young adolescents aged 10–14 years. This study examined the prevalence of, and factors associated with depression and anxiety among young school-going adolescents in the Western Cape Province of South Africa. MethodsA cross-sectional study was conducted in 10 schools in the Western Cape Province from February to July 2022. Data were collected using a tablet-based survey and included sociodemographic items, the Generalized Anxiety Disorder 7-item scale (GAD-7), the Patient Health Questionnaire for Adolescents (PHQ-A) and other psychosocial measures. The prevalence of depression and anxiety was estimated based on cut-off scores for the GAD-7 and PHQ-A. Multivariable logistic regression models were used to investigate the associations between sociodemographic and psychosocial factors, and depression and anxiety. ResultsOf the 621 adolescents, 33.5% (n = 208) reported experiencing symptoms of depression and 20.9% (n = 130) symptoms of anxiety potentially indicative of a diagnosis. The results of the multivariable logistic regression model indicate that being in a higher grade in school (AOR = 1.65, CI:1.43–1.92), any lifetime alcohol use (AOR = 1.62, CI:1.04–2.64), other drug use (AOR = 2.07, CI:1.06–4.04), and witnessing violence among adults at home (AOR = 2.12, CI:1.07–1.41) were significantly associated with experiencing depressive symptoms. Being in a higher grade in school (AOR = 1.69, CI: 1.42–2.01), poor emotional regulation skills (AOR = 1.03, CI: 1.00–1.07), and the use of cannabis (AOR = 1.03, CI: 1.00–1.07) were significantly associated with experiencing anxiety symptoms. ConclusionThese findings add to our understanding of school-going adolescents' pressing mental health needs and suggest that mental health adolescent and caregiver interventions may be required to address mental health symptoms and associated risk factors.

Relationship Between Sexual Abuse and Substance Use Among Students from Caribbean Colombian

ABSTRACT Sexual abuse is a public health problem due to its negative impact on physical and mental health. This study aimed to determine the association between sexual abuse and the use of psychoactive substances among high-school adolescents in Colombia. A cross-sectional analytical study was designed in which tenth and eleventh-grade students were included. Overall, a history of sexual abuse was explored with the Trauma Symptom Checklist, and lifetime substance use was assessed with the United States Centers for Disease Control Youth Risk Behavior Questionnaire. The prevalence of sexual abuse was 17.4%, lifetime alcohol use was 77.4%, cigarette 22.4%, cannabis 11.6%, cocaine 2.7%, and other substances 5.1%. History of sexual abuse was associated with alcohol use (OR = 1.59, 95% CI 1.10–2.30), cigarette (OR = 2.08, 95% CI 1.51–2.85), cannabis (OR = 2.43, 95% CI 1.66–3.56), cocaine (OR = 2.51, 95% CI 1.25–5.04) and use of other substances (OR = 2.33, 95% CI 1.31–4.13). The history of sexual abuse is related to the use of substances in high school adolescents in the Caribbean Region of Colombia. More studies are needed to identify the impact of sexual abuse on short-term and lifelong mental health.

An ecological examination of early adolescent e-cigarette use: A machine learning approach to understanding a health epidemic.

E-cigarette use among adolescents is a national health epidemic spreading faster than researchers can amass evidence for risk and protective factors and long-term consequences associated with use. New technologies, such as machine learning, may assist prevention programs in identifying at risk youth and potential targets for intervention before adolescents enter developmental periods where e-cigarette use escalates. The present study utilized machine learning algorithms to explore a wide array of individual and socioecological variables in relation to patterns of lifetime e-cigarette use during early adolescence (i.e., exclusive, or with tobacco cigarettes). Extant data was used from 14,346 middle school students (Mage = 12.5, SD = 1.1; 6th and 8th grades) who participated in the Utah Prevention Needs Assessment. Students self-reported their substance use behaviors and related risk and protective factors. Machine learning algorithms examined 112 individual and socioecological factors as potential classifiers of lifetime e-cigarette use outcomes. The elastic net algorithm achieved outstanding classification for lifetime exclusive (AUC = .926) and dual use (AUC = .944) on a validation test set. Six high value classifiers were identified that varied in importance by outcome: Lifetime alcohol or marijuana use, perception of e-cigarette availability and risk, school suspension(s), and perceived risk of smoking marijuana regularly. Specific classifiers were important for lifetime exclusive (parent's attitudes regarding student vaping, best friend[s] tried alcohol or marijuana) and dual use (best friend[s] smoked cigarettes, lifetime inhalant use). Our findings provide specific targets for the adaptation of existing substance use prevention programs to address early adolescent e-cigarette use.