Seattle Social Development Project Research Articles

Associations of attention problems and family context in childhood and adolescence with young adult daily smoking: General and smoking-specific family contexts

BackgroundThe potential heterogeneity in daily smoking across young adulthood has been relatively understudied. Relatedly, the unique and joint associations of earlier risk factors with young adults’ daily smoking largely remain unknown. To address these gaps, this work identified subgroups of daily smoking trajectories during young adulthood and linked them to earlier attention problems and smoking-specific and general family context. MethodsData came from the Seattle Social Development Project, a longitudinal study following a community sample (N = 808). Participants’ daily smoking was measured from ages 21–33. Earlier attention problems were assessed at ages 14–16 and 18. Earlier smoking-specific and general family factors were assessed at ages 10–16 and 18. ResultsGrowth mixture models produced four profiles: chronic daily smokers, increasers, decreasers, and no-daily smokers. Results from multinomial logistic regressions revealed that earlier attention problems and smoking-specific family factors may contribute to daily smoking in the early 20 s, whereas earlier general family context provided protection for trajectories of daily smoking characterized by changes in the late 20 s and early 30 s DiscussionSelective prevention strategies that expand people’s repertoire of healthy options to address attention problems might be helpful, considering the possibility of using tobacco as means to mitigate attention problems. Our findings also highlight the importance of nurturing earlier general family context, a relatively overlooked dimension in smoking prevention efforts, to facilitate young adult smokers’ desistence from daily smoking, particularly those who have attention problems in adolescence.

Is e-cigarette use associated with better health and functioning among smokers approaching midlife?

IntroductionMany adult smokers have tried electronic cigarettes (e-cigarettes) as a less harmful alternative to combustible cigarettes. There is limited evidence, however, for the extent to which switching to e-cigarettes is associated with better health and functioning among nicotine users approaching their 40s—the beginning of midlife—when many health issues become more evident. This study examined the adoption of e-cigarette use (“vaping”) among smokers in their 30s, and its association with diverse measures of healthy and successful aging at age 39. MethodsData were from the Seattle Social Development Project, a panel study of 808 diverse participants with high retention (88%−91%). A subsample of 156 who used combustible cigarettes (smoked) at age 30 and smoked or vaped at age 39 was selected for analysis. A measure of vaping frequency, relative to combustible cigarette use, was computed from self-reports of past-month vaping and smoking at age 39. Nine measures of health and functioning in the past year were computed at age 39, with nine corresponding measures at age 30. ResultsAmong smokers at age 30, 36% adopted vaping some or all of the time by age 39. Higher relative vaping frequency was related to 4 of 9 outcomes examined, including significantly more exercise, more constructive engagement, better physical health, and higher SES at age 39, accounting for prior behaviors at age 30. ConclusionsFindings suggest that, among smokers in their 30s, replacing combustible cigarettes with vaping may be associated with key markers of healthy and successful aging to age 39.

Parent ENDS use predicts adolescent and young adult offspring ENDS use above and beyond parent cigarette use

PurposePrior research has showed that parent combustible cigarette use predicts cigarette use among their offspring. This study used prospective longitudinal data from parents and offspring to test whether parent electronic nicotine delivery system (ENDS) use predicted a higher probability of ENDS use among their offspring. MethodsData were drawn from the Seattle Social Development Project – The Intergenerational Project (SSDP-TIP). Analyses included 295 families; 7% of parents were Native American/Alaskan Native, 18% were Asian American, 28% were African American, and 47% were European American. Multilevel modeling (in 2020) of data collected in 2015, 2016, and 2017 tested associations between parent self-reported ENDS use and concurrent self-reported ENDS use among offspring ages 10–25 years (53% female). Parent combustible cigarette use was controlled. Analyses also examined the role of parent and offspring perceptions of the safety of ENDS in predicting offspring ENDS use. ResultsAbout 12% of offspring and 8% of parents reported past-month ENDS use. Parent ENDS use predicted a higher probability of child ENDS use (Odds Ratio 5.68, p = .01), even after controlling parent past month cigarette use. Beyond parent nicotine product use, offspring perceptions of ENDS safety – but not parent perceptions of ENDS safety – contributed independently to offspring probability of past-month ENDS use. ConclusionsIt is important for parents, health providers, and policymakers to focus on preventing ENDS use among offspring of parents who use ENDS.

The role of electronic cigarette use for quitting or reducing combustible cigarette use in the 30s: Longitudinal changes and moderated relationships

BackgroundEvidence for use of electronic cigarettes (e-cigs) as a potential aid in quitting or reducing combustible cigarette (c-cig) use is mixed. This study examined the extent to which e-cig initiation among smokers in their 30 s predicted quitting or reducing smoking or nicotine dependence symptoms by age 39, and whether the role of e-cigs in quitting differed by prospectively assessed moderators. MethodsData were from the Seattle Social Development Project (SSDP), a panel study of 808 diverse participants with high retention. A subsample of 221 smokers at age 33 was selected for analysis. Self-reports of c-cig use and dependence were assessed longitudinally at ages 33 and 39. Sixteen potential moderators were examined, including social demographics, smoking attitudes and desire to quit, other health behaviors and status, and adolescent and early adult assessments of smoking history. ResultsThe use of e-cigs was consistently associated with a lower likelihood of quitting c-cigs by age 39, after accounting for frequency of prior c-cig use at age 33. This negative association persisted across all moderators examined, although it was nonsignificant among those with a definite desire to cut down. Among those who did not quit smoking, e-cig use had no association with decreases in either quantity of c-cigs used or dependence symptoms. ConclusionsResults indicate that e-cigarette use was not helpful for quitting or reducing combustible cigarette use in the 30 s. Rather, across extensive tests of moderation, e-cig initiation consistently predicted less quitting during this important age period for successful cessation.

Applying the Social Development Model in Middle Childhood to Promote Healthy Development: Effects From Primary School Through the 30s and Across Generations.

This paper describes the origins and application of a theory, the social development model (SDM), that seeks to explain causal processes that lead to the development of prosocial and problem behaviors. The SDM was used to guide the development of a multicomponent intervention in middle childhood called Raising Healthy Children (RHC) that seeks to promote prosocial development and prevent problem behaviors. This paper reviews and integrates the tests of the SDM and the impact of RHC. While the original results of both model and intervention tests have been published elsewhere, this paper provides a comprehensive review of these tests. As such this integrative paper provides one of the few examples of the power of theory-driven developmental preventive intervention to understand impact across generations and the power of embedding controlled tests of preventive intervention within longitudinal studies to understand causal mechanisms. Application of the SDM in the RHC intervention was tested in a quasi-experimental trial nested in the Seattle Social Development Project (SSDP). SSDP is a longitudinal study of 808 students who attended 18 public schools in Seattle, WA, and whose parents consented for their participation in longitudinal research when they were in Grade 5 (77% of the eligible population in participating schools). Students assented at each survey administration and consented to longitudinal follow-up when they turned 18. Panel subjects were followed and surveyed 15 times from Grade 5 through age 39, with most completion rates above 90%. We describe effects of the full multicomponent RHC intervention delivered in Grades 1 through 6 by comparing outcomes of those children assigned to the full RHC intervention condition to controls from middle childhood through age 39. We also report the effects of the full RHC intervention on the firstborn children of participants compared with the firstborn children of controls. We discuss use of the theory to guide development and testing of preventive interventions and the utility of nesting intervention tests within longitudinal studies for testing both theory and interventions.

Identifying and predicting criminal career profiles from adolescence to age 39.

Few longitudinal studies are capable of identifying criminal career profiles using both self-report and official court data beyond the 30s. The current study aims to identify criminal career profiles across three developmental periods using self-report data, validate these profiles with official court records and determine early childhood predictors. Data came from the Seattle Social Development Project (n = 808). Latent Class Analysis was used to examine criminal careers from self-reported data during adolescence (aged 14-18), early adulthood (aged 21-27) and middle adulthood (aged 30-39). Official court records were used to validate the classes. Childhood risk and promotive factors measured at ages 11-12 were used to predict classes. Findings revealed four career classes: non-offending (35.6%), adolescence-limited (33.2%), adult desister (18.3%) and life-course/persistent (12.9%). Official court records are consistent with the description of the classes. Early life school and family environments as well as having antisocial beliefs and friends differentiate membership across the classes. The results of this study, with a gender-balanced and racially diverse sample, bolster the current criminal career knowledge by examining multiple developmental periods into the 30s using both self-report and official court data.

Parents’ Perceptions of Adolescent Exposure to Marijuana Following Legalization in Washington State

Parents in Washington State face new challenges related to the non-medical marijuana legislation that was passed in 2012. We asked parent focus group participants about changes they have observed in their environment, how their children are exposed to marijuana, and how this exposure might affect youth marijuana use. We conducted 6 focus groups with parents of youth ages 8 to 15 (N = 54). Parents were recruited from the Seattle Social Development Project, a multi-ethnic, longitudinal panel study that originated in Seattle in 1985. Thematic content analysis was used to analyze qualitative data. Parents agreed that they did not want their children using marijuana, and were concerned that their children were exposed to marijuana more often and in many different contexts. Parents said they now need to monitor their children's environment more carefully, especially the other adults that spend time around their children. Edible marijuana products were particularly concerning for parents, as they offer a new set of challenges for parents in monitoring their children's exposure to and use of marijuana. Parents were concerned that marijuana exposure would increase risk of marijuana use in adolescents. Parents' experiences in Washington State provide valuable lessons for social work practitioners, policymakers and those developing preventive interventions. Prevention efforts and public health messaging should begin before legalization takes effect to support parents in preparing for changes in their social and physical environments, and should seek to incorporate parenting strategies to monitor and intervene when children are exposed to marijuana.

Adult Social Environments and the Use of Combustible and Electronic Cigarettes: Opportunities for Reducing Smoking in the 30s.

Reducing cigarette use is a major public health goal in the United States. Questions remain, however, about the potential for the social environment in the adult years-particularly in the 30s and beyond-to influence cigarette use. This study tested pathways hypothesized by the social development model to understand the extent to which social environmental factors at age 33 (eg, involvement with smokers or with physically active people) contribute to changes in cigarette use from age 30 to age 39. Both combustible and electronic cigarette use were investigated. Data were from the Seattle Social Development Project, a longitudinal study of 808 diverse participants with high retention. Self-reports assessed social developmental constructs, combustible and electronic cigarette use, and demographic measures across survey waves. At age 30, 32% of the sample reported past-month cigarette use. Using structural equation modeling, results showed high stability in cigarette use from age 30 to 39. After accounting for this stability, cigarette-using social environments at age 33 predicted personal beliefs or norms about smoking (eg, acceptability and social costs), which in turn predicted combustible cigarette use at age 39. Cigarette-using environments, however, directly predicted electronic cigarette use at age 39, with no significant role for beliefs about smoking. Cigarette use was highly stable across the 30s, but social environmental factors provided significant partial mediation of this stability. Pathways were different for combustible and electronic cigarette use, however, with personal smoking norms playing an important role for the former but not the latter. This study addresses the need for longitudinal investigation of social mechanisms and cigarette use in the 30s. Findings reinforce efforts to prevent the uptake of cigarettes prior to the 30s because, once started, smoking is highly stable. But social environmental factors remain viable intervention targets in the 30s to disrupt this stability. Addressing personal norms about smoking's acceptability and social costs is likely a promising approach for combustible cigarette use. Electronic cigarettes, however, present a new challenge in that many perceived social costs of cigarette use do not readily translate to this relatively recent technology.

Neighborhood Structural Factors and Proximal Risk for Youth Substance Use.

This study examined associations of neighborhood structural factors (census-based measures, socioeconomic disadvantage, and residential stability); self-reported measures of general and substance use-specific risk factors across neighborhood, school, peer, and family domains; and sociodemographic factors with substance use among 9th grade students. Data drawn from the Seattle Social Development Project, a theory-driven longitudinal study originating in Seattle, WA, were used to estimate associations between risk factors and past month cigarette smoking, binge drinking, marijuana use, and polysubstance use among students (N = 766). Results of logistic regression models adjusting for neighborhood clustering and including all domains of risk factors simultaneously indicated that neighborhood socioeconomic disadvantage was associated with a significantly higher likelihood of cigarette smoking, binge drinking, and polysubstance use, but not marijuana use. In fully controlled models, substance use-specific risk factors across neighborhood, school, peer, and family domains were also associated with increased likelihood of substance use and results differed by the outcome considered. Results highlight substance-specific risk factors as an intervention target for reducing youth substance use and suggest that further research is needed examining mechanisms linking neighborhood socioeconomic disadvantage and youth substance use.

Time-varying effects of family smoking and family management on adolescent daily smoking: The moderating roles of behavioral disinhibition and anxiety

BackgroundFamily smoking environment and family management are associated with risk of teen smoking behaviors. However, less is known about whether these associations increase or decrease in strength across adolescence, and whether there are person-environment interactions. The current study examined 1) the age-varying main effects of family smoking and family management on adolescent daily smoking from ages 12–18 and tested 2) whether behavioral disinhibition and anxiety moderated these relationships. MethodsData were drawn from the Seattle Social Development Project (SSDP; N = 808), a longitudinal study examining prosocial and antisocial behavior. Analyses used time-varying effect modeling (TVEM), which tested the stability of the relationship between family smoking and family management and youth daily smoking across adolescence. ResultsGreater family smoking increased the likelihood of adolescent daily smoking, whereas greater family management reduced the likelihood of daily smoking. Significant interactions between family management and youth behavioral disinhibition and anxiety during early and mid-adolescence indicated that family management was more protective for adolescents with low (compared to high) behavioral disinhibition and anxiety. The effect of family smoking was not moderated by behavioral disinhibition or anxiety. ConclusionsFamily smoking and family management are key risk and protective factors that may be targeted for adolescent smoking prevention. Our interaction results for individual differences in behavioral disinhibition and anxiety suggest that certain types of youth may respond differently to family management practices. Findings also show periods during adolescence where family-centered preventive interventions could be optimally timed to prevent or reduce persistent adolescent smoking.

The Seattle Social Development Project: An Implementation of the Raising Healthy Children Intervention

The Seattle Social Development Project: An Implementation of the Raising Healthy Children Intervention

Effects of Social Development Intervention in Childhood on Adult Life at Ages 30 to 39.

Elementary schools can be effective sites for universal preventive interventions. Less is known about how long effects of intervention in elementary grades last. Can they improve outcomes in adulthood? To test effects of a social developmental intervention in the elementary grades on adult life through the 30s, the Seattle Social Development Project, a nonrandomized controlled trial, followed all consenting 5th-grade students (N = 808) from 18 Seattle public elementary schools from age 10 (in 1985) to age 39 (in 2014), with 88% retention. The sample was gender balanced and ethnically and economically diverse. The full intervention, called Raising Healthy Children, continued from Grades 1 through 6 and consisted of teacher in-service training in classroom management and instructional methods; cognitive, social, and refusal skills training for children; and parent workshops in child behavior monitoring and management, academic support, and anticipatory guidance. Using structural equation modeling, we examined intervention effects from age 30 to age 39 across 9 constructs indicating 3 domains of adult life: health behavior, positive functioning, and adult health and success. An omnibus test across all 9 constructs indicated a significant positive overall intervention-control difference. Examined individually, significant intervention effects included better health maintenance behavior, mental health, and overall adult health and success. Significant effects were not found on substance use disorder symptoms, sex-risk behaviors, or healthy close relationships in the 30s. Results indicate that sustained, theory-based, multicomponent intervention in the elementary grades can produce lasting changes in health maintenance, mental health, and adult functioning through the 30s.

The link between parental smoking and youth externalizing behaviors: Effects of smoking, psychosocial factors, and family characteristics.

This study examined the associations between parental cigarette smoking and youth externalizing behaviors (i.e., oppositional and conduct problems) both concurrently and 1 year later, and tested whether parental smoking predicted youth externalizing over and above parent psychosocial, family, and demographic characteristics linked to smoking and externalizing behaviors. Data were drawn from the Seattle Social Development Project (SSDP) and The Intergenerational Project (TIP), a prospective longitudinal study aimed toward understanding the intergenerational transmission of substance use, mental health, and risky behaviors. The current study used multilevel modeling to examine both concurrent and lagged associations from 325 families, which included parents and youth (Aged 6-19) across seven waves of data. In concurrent analyses, both parental smoking and several family characteristics independently predicted higher levels of child externalizing behaviors, even after controlling for parent age at child birth and demographic correlates of smoking. However, parental depressive symptoms reduced the association between smoking and externalizing behaviors to nonsignificance in concurrent models. In lagged analyses, only harsh parenting, low monitoring, and low parent-child bonding predicted externalizing behaviors 1 year later; parental smoking did not predict externalizing behaviors over time. Results showed that parental smoking, mental health, parenting, and family relationships all are associated with externalizing problems and constitute potential intervention targets in the short term, though poor parenting and parent-child bonding, rather than smoking, predicted externalizing behaviors over time. The robust association between concurrent parental depressive symptoms and youth conduct problems may suggest prioritizing parental mental health (e.g., via mental health screening) for improving both parent and child well-being. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

General and Specific Predictors of Comorbid Substance Use and Internalizing Problems from Adolescence to Age 33.

The current study examines the continuity in comorbidity between substance use and internalizing mental health problems from adolescence to adulthood and investigates the general and specific predictors of comorbidity across development. Participants were drawn from the Seattle Social Development Project (N= 808), a gender-balanced, ethnically diverse longitudinal panel. Structural equation modeling was used to examine risk factors for comorbid substance use and internalizing problems in family and peer social environments; substance use- and mental health-specific social environments (family tobacco, alcohol, and marijuana use; family history of depression); and individual risk factors (behavioral disinhibition). Latent factors were created for comorbid substance use and mental health problems at ages 13-14 and comorbidity of substance abuse and dependence symptoms and mental health disorder symptoms at ages 30-33 and included indicators of anxiety, depression, alcohol, tobacco, and marijuana problems. Comorbid problems in adolescence predicted later comorbidity of disorders in adulthood. In addition, family tobacco environment and behavioral disinhibition predicted adolescent comorbidity, while family history of depression was associated with adult comorbidity. Finally, family and peer substance use in adolescence predicted substance use (alcohol, tobacco, and marijuana) both in adolescence and adulthood. The pattern of results suggests that comorbidity in adolescence continues into adulthood and is predicted by both general and behavior-specific environmental experiences during adolescence. Findings clarify the etiology of comorbid internalizing and substance use problems and suggest potential preventive intervention targets in adolescence to curb the development of comorbidity in adulthood.

Neighborhood Poverty Increases Risk for Cigarette Smoking From Age 30 to 39.

Lower socioeconomic status (SES) has been associated with higher rates of smoking. Few longitudinal studies have examined indicators of SES at both the neighborhood- and individual-level over time in conjunction with proximal risk factors of cigarette smoking. To examine associations of time-varying measures of SES, demographic factors, and proximal risk factors for smoking net of average trajectories of smoking behavior from ages 30 to 39 in a community sample. Data from the Seattle Social Development Project (N = 752), a theory-driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of smoking from age 30 to 39. Time-varying measures of neighborhood poverty, coworker smoking, partner smoking, depression, anxiety, education, income, marital status, and parenthood were associated with smoking over time using latent growth curve modeling. Results indicated that living in higher poverty neighborhoods was uniquely associated with a greater likelihood of smoking net of average trajectories of smoking from age 30 to 39, gender and race/ethnicity, time-varying measures of SES and demographics, and time-varying measures of proximal risk factors for smoking. Living in higher poverty neighborhoods presents a unique risk for smoking among adults aged 30 to 39 above and beyond multiple aspects of SES and other potential mechanisms relating SES to smoking.

Childhood neighborhood context and adult substance use problems: the role of socio-economic status at the age of 30 years

To examine whether the (a) childhood neighborhood context predicts alcohol use disorder, nicotine dependence, and cannabis use disorder symptoms at the age of 39 years; and (b) socio-economic status during young adulthood mediates these relationships. Gender differences were also examined. The Seattle Social Development Project is a prospective longitudinal study of 808 individuals followed up from ages 10 to 39 years in Seattle, Washington, United States. The sample was gender balanced (51% were men). Alcohol, nicotine, and cannabis use disorder symptoms were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV-based Diagnostic Interview Schedule. Childhood neighborhood data consisted of 10 neighborhood-level variables from the 1990 national census, which were consolidated using principal component analyses. Two components with eigenvalues greater than 1 were extracted-neighborhood disadvantage and neighborhood stability. Educational attainment and employment status represented socio-economic status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and childhood socio-economic status at the family level. Negative binomial regression was used as the primary modeling strategy. Six models for each outcome measure were estimated. The first three models examined associations between two neighborhood components and each substance use outcome measure. Next, we tested the second research question by adding unemployment and college graduate indicators at the age of 30 years as potential mediators underlying the link between the childhood neighborhood context and three substance use measures. Study findings revealed that childhood neighborhood stability significantly reduced alcohol and cannabis use disorder symptoms nearly 3 decades later. Path analyses suggested that socio-economic status during the transition to adulthood did not influence these relationships but rather had independent effects on problematic nicotine and cannabis use. Furthermore, the effects of childhood neighborhood factors on problematic nicotine use were stronger for men. Neighborhood characteristics during childhood may be important factors for alcohol and cannabis use disorder symptoms among adults and nicotine dependence disorder symptoms among men. Prevention efforts that address community stability and disadvantage can and should start in childhood, with a focus on intervention targets that might gain salience later in life to discourage the development and persistence of problematic substance use in adulthood.

Longitudinal associations among depression, substance abuse, and crime: A test of competing hypotheses for driving mechanisms

PurposeCrime, depression, and substance abuse, often co-occur. This study examined competing models considering each problem domain individually as a driving mechanism for the other problems to better understand etiology and inform prevention efforts. Gender differences were also examined. MethodsData were drawn from the Seattle Social Development Project, a multiethnic and gender-balanced urban panel of 808 participants constituted in 1985. Cross-lagged models examined prospective assessments of early (grades 7 & 8) and late (grades 9–12) adolescent internalizing problems, substance use, and delinquency, as well as measures of depression, substance dependence, and crime at early adulthood (ages 21–24) and later adulthood (ages 27–30). ResultsComparisons of nested models by gender showed (a) continuity in internalizing behaviors/depression, substance use/dependence, and delinquency/crime for both women and men; (b) accounting for continuity, depression did not consistently drive other problems for either women or men; (c) among women, both substance abuse and crime appeared to be important driving mechanisms; and (d) among men, crime emerged as the most pertinent driving mechanism. ConclusionFindings suggest that externalizing problems may be more important driving mechanisms for depression than vice versa. Preventing crime and substance abuse may have the important added benefit of reducing early adult depression.

Racial Differences in Mechanisms Linking Childhood Socioeconomic Status With Growth in Adult Body Mass Index: The Role of Adolescent Risk and Educational Attainment

PurposeThe present study examined whether risk factors during adolescence, including substance use, depression, overweight status, and young adult educational attainment, mediated the association between low childhood socioeconomic status (SES) and higher body mass index (BMI) in adulthood. We also evaluated whether the hypothesized pathways differed based on racial group status. MethodsParticipants from the Seattle Social Development Project were followed from ages 10 to 39years. Thepresent study included white (n = 381), African American (n = 207), and Asian American (n = 171) participants. Structural equation models tested pathways linking low childhood SES to BMI from ages 24 to 39 years. Multiple-group modeling was used to test potential racial differences. ResultsAnalyses indicated racial differences in the pathways linking low childhood SES with adult BMI. For whites, overweight status and educational attainment were significant mediators. For Asian Americans, there was an unmediated and significant pathway between low childhood SES and low adult BMI. For African Americans, there were no significant mediated or unmediated pathways. ConclusionsResults stress that the pathways that link childhood SES with adult BMI may operate differently based on race. Research is particularly needed to identify mechanisms for African Americans in order to better inform obesity prevention efforts.

Adolescent Age of Sexual Initiation and Subsequent Adult Health Outcomes

To examine the mechanisms of the association between age of sexual initiation and adult health. Data from the Seattle Social Development Project (n = 808), in Seattle, Washington, included outcomes when participants were in their 30s (2005-2014): substance use disorders, depression, poor health, and obesity. Sexual consequence mediators included sexually transmitted infection, adolescent pregnancy, and a high number of sexual partners. We used linear logistic regression to model main effect and mediated associations. Age of sexual initiation was related to nicotine and marijuana disorders, physical health, and obesity, but not alcohol disorder or depression. Mediated association with nicotine disorder was not significant; association with marijuana disorder was reduced; significant relationships with poor health and obesity remained. The relationship between age of sexual initiation and substance use was largely explained by consequences of sexual behavior. Earlier sexual initiation was linked to poorer physical health outcomes, though the nature of the association remains unclear. Public Health Implications. Prevention approaches need to address multiple risk factors and emphasize contraceptive methods to avoid sexual consequences. For physical health outcomes, broad prevention approaches, including addressing early sexual initiation, may be effective.

An Examination of Alcohol Use Disorder Symptoms and Neighborhood Disorganization from Age 21 to 39.

Living in disorganized neighborhoods characterized by high levels of poverty, crime, violence, and deteriorating buildings has been associated with increased alcohol consumption and mental health problems. Data drawn from the Seattle Social Development Project (N=790), a theory-driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of Alcohol Use Disorder (AUD) symptoms from age 21 to 39. Time-varying measures of neighborhood disorganization, psychological distress, and sociodemographic factors were associated with deviations from average AUD symptoms at each wave. Results indicated that, on average, AUD symptoms decreased as individuals got older. Living in more disorganized neighborhoods and experiencing psychological distress was associated with increased AUD symptoms after accounting for average reductions from AUD symptoms over time and time-varying measures of relevant sociodemographic factors. Results of mediation analysis suggested that psychological distress is a mechanism by which disorganized neighborhoods increased risk of AUD from age 21 to 39.