Youth Alcohol Use Research Articles

Is harmonizing to social drinking norms associated with alcohol use in Danish high school students?

Abstract Background Alcohol use is positively linked with perceived drinking norms within the peer group and the social plasticity hypothesis proposes that youth are very good at harmonizing to social norms (social attunement). Youth with high social attunement may adjust their drinking habits to the perceived drinking norms of the peer group to a higher extent potentially leading to a larger impact on personal alcohol use. This study examined if frequency of personal alcohol use was associated with perceived peer approval of drinking and the role of social attunement in Danish high school students aged 15-19 years. Methods An online survey was administered to 2977 first-year students from 16 public high schools in Denmark. Students reported past month alcohol use (drinking days, using TLFB) and perceived approval of alcohol use among peers of their grade. Social attunement was calculated as a sum score of the 11-item Dutch Social Attunement Questionnaire (SAQ) (range: 11-77; α = 0.81). Number of drinking days was analysed as dependent variable, with age, gender, perceived peer approval and SAQ-score as independent variables. Results Older students were more likely to perceive peers to approve drinking (β = 0.25; p = 0.004) and getting drunk (β = 0.22; p = 0.003). More females (83.2%) than males (81.8%; p = 0.003) perceived peers to approve youth getting drunk. Multilevel regressions showed increased drinking days for students perceiving peers to approve of drinking (β = 1.68; p < 0.001) and getting drunk (β = 1.80; p < 0.001). We found interaction between SAQ-score and perceived drinking norms (β=-0.10; p < 0.001) indicating that perceived peer approval had less effect on drinking days for students with high SAQ-score. Conclusions Social attunement explained additional variance in the association between personal alcohol use and perceived drinking norms. Our findings stress the importance of addressing the influence of behavioural adaptation in e.g. school-based health promotion programs. Key messages • Students perceiving peers to approve of youth alcohol use drink more frequent, but the link is weakened when the need to harmonize to perceived drinking norms are high. • Social attunement needs to be considered when examining the link between individual alcohol consumption and perceived drinking norms and should be addressed in e.g. school health programs.

Internalizing Pathways to Adolescent Substance Use from Adverse Childhood Experiences

The mediating role of anxious, depressive, and somatic symptoms was examined in the association between adverse childhood experiences (ACEs) and adolescent substance use, with attention to the unique effects of each set of symptoms within the same model. Adolescents (n = 701) were assessed over time (ages 3–17) in a majority male (70.5%) and white (89.9%) sample. Findings indicate that depressive symptoms mediated the association between ACEs and adolescent cigarette and marijuana use. Although significant indirect effects remained when accounting for externalizing behavior, a novel protective pathway emerged through parent-reported youth anxiety and alcohol use. Assessing internalizing symptoms as separate facets within the same model is critical if we are to inform prevention programs that are tailored to the individual needs of youth who have experienced ACEs.

Universal substance use care for adolescents with chronic medical conditions: a protocol to examine equitable implementation determinants and strategies for SBIRT at a pediatric hospital

BackgroundAdolescents with chronic medical conditions (CMC) use alcohol and marijuana at levels equal to or even greater than their peers without CMC and are more likely to initiate substance use at 14 years or younger. Approximately 33% of adolescents with CMC binge drink alcohol and 20% use marijuana. When using substances, adolescents with CMC are at elevated risk for problem use and adverse consequences given their medical conditions. Although there has recently been progress integrating substance use services into adult hospitals, there has been almost no implementation of standardized substance use services into pediatric hospitals for adolescents with CMC. Screening, Brief Intervention, and Referral to Treatment (SBIRT) for adolescents is an evidence-based, public health approach to promote the early detection and intervention of risky alcohol use in high-risk youth. This paper describes a study protocol combining two leading implementation science frameworks, the Consolidated Framework for Implementation Research (CFIR) and the Health Equity Implementation framework (HEIF), to engage pediatric hospital partners (hospital staff and clinicians, patients with CMC, and caregivers) to identify and specify contextual determinants of SBIRT implementation, which can be used to derive implementation strategies to optimize SBIRT adoption, reach, and fidelity.MethodThis study will use semi-structured interviews and focus groups with pediatric hospital partners (e.g., hospital staff and clinicians, adolescent patients, and caregivers) to identify SBIRT implementation determinants, using semi-structured interview and focus group guides that integrate CFIR and HEIF dimensions.DiscussionUnderstanding implementation determinants is one of the first steps in the implementation science process. The use of two determinant frameworks highlighting a comprehensive set of determinants including health equity and justice will enable identification of barriers and facilitators that will then map on to strategies that address these factors. This study will serve as an essential precursor to further work evaluating the feasibility of and the degree of engagement with SBIRT among this vulnerable pediatric population.

Neurocognitive Latent Factors Associate With Early Tobacco and Alcohol Use Among Adolescent Brain Cognitive Development Study Youth

PurposeProspective associations between preadolescent neurocognitive structure and onset of substance use in adolescence have not been examined. This study investigated associations between cognitive structure among youth aged 9 – 10 years and the likelihood of experimentation with tobacco and alcohol by ages 13–14 years. MethodsA principal component (PC) analysis of nine neurocognitive assessments was used to identify the cognitive structure of unrelated adolescent brain cognitive development study participants (n = 9,655). We modeled associations between neurocognitive PCs and odds of tobacco or alcohol use by ages 13–14 years using generalized linear mixed models with a logit link and random intercept for recruitment sites. Demographics, family conflict, neighborhood safety, and externalizing and internalizing behavior were considered covariates. ResultsFour neurocognitive PCs were identified and labeled general ability, executive function, learning and memory, and mental rotation. Mental rotation [odds ratio [OR] = 0.88, p-value = .013] was associated with lower odds of youth tobacco use; the association was stronger among female youth. General ability [OR = 1.20, p-value < .0001] among both males and females, and learning and memory [OR = 1.11, p-value = .024] among females, were associated with increased odds of youth alcohol use. DiscussionAmong youth, higher neurocognitive performance was protective for tobacco use but increased the likelihood of alcohol use. Potential sex differences were identified. The role of cognition in processing the social contexts surrounding tobacco and alcohol use in the United States may contribute to the formation of disparate youth expectancies for tobacco and alcohol use.

Gender Differences in the Relationship Between PTSD and Youth Alcohol Use

Gender Differences in the Relationship Between PTSD and Youth Alcohol Use

How Religiosity Reduce the Intention of Alcohol Consumption in Muslim Undergraduate Students: Evidence from Indonesia

This study investigates the effect of intrinsic and extrinsic religiosity on youth alcohol use intention in Indonesia using Theory Planned Behavior (TPB) framework. The purposive sampling technique was employed. The criteria of respondents are active undergraduate students who study in Surakarta. The sample comprised of 362 undergraduate students, with 63.56 percent identifying as female. A total of 53 students have ever consumed alcoholic beverages, with 90.56 percent of them identifying as male. The average age of our respondent is 19.5 years old, with a maximum of 26 years old and a minimum of 17 years old. Structural Equation Model-Partial Least Squares, or SEM-PLS is the method that we employ to estimate the relationship of each variable. Our study shows intrinsic religiosity has negative effect on intention to consume alcohol (β= -0.168, p&lt;0.10, t = 1.945). In addition, intrinsic religiosity also has negative significant effect on all TPB factors, such as alcohol-supported attitude (β= -0.444, p&lt;0.01, t = 4.099), alcohol-supported subjective norm (β= -0.436, p&lt;0.01, t = 4.205), and internal perceived behavioral control (β= -0.271, p&lt;0.05, t = 2.464). Partial mediation exists between the relationship of intrinsic religiosity, alcohol-supported attitude and intention of alcohol drinking (β= -0.165, p&lt;0.05, t = 2.263). Thus, It implies that intrinsic religiosity is able to affect intention of alcohol drinking through attitude and intrinsic religiosity itself are able to affect intention of alcohol drinking directly. This study could provide support for the inclusion of religion as a discipline in the curriculum for undergraduates. Nonetheless, the religion course should encompass not only religious values that emphasize the expectation of a reward for completing specific actions, but also values that emphasize the act of worshiping and honoring God without expecting too much reward in return.

S3 - Sex Differences in Adversity and Risk for Future Alcohol Use in Youth in the ABCD Study

S3 - Sex Differences in Adversity and Risk for Future Alcohol Use in Youth in the ABCD Study

Mobile apps to reduce depressive symptoms and alcohol use in youth: A systematic review and meta-analysis: A systematic review.

Mobile apps to reduce depressive symptoms and alcohol use in youth: A systematic review and meta-analysis: A systematic review.

Mother-child dynamics: Examining reciprocal relations between parental knowledge, child disclosure, parental legitimacy beliefs, and adolescent alcohol use.

Early adolescent alcohol use is associated with adverse developmental and health outcomes. Parental knowledge can prevent or delay substance use, while youth behaviors may concurrently influence parenting. More research is needed to examine the role of youth's perceptions of legitimacy of parental authority. This multi-informant study examined prospective bidirectional effects between parental knowledge and child disclosure alongside youth-reported alcohol use and perceived legitimacy of parental authority. Data were analyzed across three waves in a community sample of 304 mother-child dyads. A cross-lagged panel model was estimated using repeated measures of adolescent alcohol use, perceived legitimacy of parental authority, parental knowledge, and child disclosure. Positive reciprocal associations were found in early adolescence between child disclosure and both parental knowledge and perceived legitimacy of parental authority. Legitimacy of parental authority negatively predicted alcohol use across adolescence. Child alcohol use also negatively predicted parental knowledge among mothers in later adolescence. Effects were not reciprocated nor sustained. Novel findings demonstrate that the parental legitimacy beliefs predict reduced alcohol use and have a reciprocal association with child disclosure. Clinical implications to mitigate youth alcohol use initiation, by enhancing parental self-efficacy and positive parenting, are discussed.

Active tracking measures: Providing targets for youth alcohol use and health behavior interventions.

This study seeks to use examine the utility of recently published, developmentally informed measures of parental active tracking for work on youth health behaviors. Information on parental active tracking and health behaviors were collected in six independent survey studies (n's = 157-408). A series of empirical questions regarding parental active tracking were examined. The recently published measures of parental active tracking in high school and college were shown to have sufficient internal consistency, to be well described by single latent factors, to be empirically distinct from helicopter parenting, to be inconsistently linked with youth risk behaviors, and to demonstrate closer linkages with youth substance use when accounting for parental motivations for tracking. The measures of parental active tracking employed provide face valid, psychometrically sound, and empirically supported indices for use examining parental influences during adolescence and young adulthood.

Beyond the Laws: Parental Monitoring, Perceived Acceptability of Underage Drinking and Alcohol Use Among Belgian Youth.

Parental monitoring behaviors are negatively associated with adolescent substance use. Yet, the processes explaining these associations are still unclear. The current study examined adolescents' knowledge of minimum legal drinking age laws and their perceived acceptability of underage drinking as potential mediators of the links between parental monitoring behaviors and youth alcohol use. The sample included 1154 Belgian adolescents (Mage = 16.34, SD = 1.33; 71% girls), who were recruited in Wallonia (54.9%) and in Flanders (45.1%). Path analyses revealed that higher parental rule setting, but not solicitation, was related to lower alcohol use. Acceptability of underage drinking mediated this link, but not knowledge of the laws. Results suggest that beyond laws regulating the minimum legal drinking age, alcohol use prevention programs should consider the importance of parental rule setting and youth's perceived acceptability of underage drinking.

Sleep quality impacts the link between reactivity to uncertain threat and anxiety and alcohol use in youth.

Individual differences in reactivity to unpredictable threat (U-threat) have repeatedly been linked to symptoms of anxiety and drinking behavior. An emerging theory is that individuals who are hyper-reactive to U-threat experience chronic anticipatory anxiety, hyperarousal, and are vulnerable to excessive alcohol use via negative reinforcement processes. Notably, anxiety and alcohol use commonly relate to disruptions in sleep behavior and recent findings suggest that sleep quality may impact the link between reactivity to U-threat and psychiatric symptoms and behaviors. The aim of the current study was to examine the unique and interactive effects of reactivity to U-threat and sleep quality on anxiety symptoms and drinking behavior in a cohort of youth, ages 16-19 years. Participants (N = 112) completed a well-validated threat-of-shock task designed to probe individual differences in reactivity to U-threat and predictable threat (P-threat). Startle eyeblink potentiation was recorded during the task as an index of aversive reactivity. Participants also completed well-validated self-report measures of anxiety and depression symptoms, lifetime alcohol use, and current sleep quality. Results revealed significant startle reactivity to U-threat by sleep quality interactions on anxiety symptoms and lifetime drinking behavior. At high levels of sleep disturbance (only), greater reactivity to U-threat was associated with greater anxiety symptoms and total number of lifetime alcoholic beverages. These results suggest that sensitivity to uncertainty and chronic hyperarousal increases anxiety symptoms and alcohol use behavior, particularly in the context of poor sleep quality.

Engagement of adolescents with ADHD in a narrative-centered game-based behavior change environment to reduce alcohol use

BackgroundAttention deficit hyperactivity disorder (ADHD) affects about 13% of adolescents and is associated with substance use-related morbidity and mortality. While evidence on effective interventions to reduce alcohol use among adolescents with ADHD is limited, parent-teen communication about alcohol use has been found to be protective. Other approaches, such as educational interventions, hold promise to reduce alcohol-related harms in adolescents with ADHD. Digital technology offers an innovative approach to health behavior change, expanding access to services and may promote learning for neurodiverse youth, including teens with ADHD. INSPIRE, a narrative-centered game-based behavior change environment designed to promote self-regulation and self-efficacy to prevent risky alcohol use has been found to engage a general adolescent population. The goals of this pilot study are (1) to examine the engagement of youth with ADHD in INSPIRE; and (2) to examine if INSPIRE fosters parent-teen communication.MethodAdolescents diagnosed with ADHD aged 14–16 were recruited from developmental medicine clinics and invited to a focus group offered via Zoom. Participants completed a pre-survey, interacted with the INSPIRE game, and answered a post-survey as well as open-ended questions about their gaming experience during the focus group. Engagement was measured through both self-report using subscales from the User Engagement Scale and computer data; survey and qualitative data collected information on parent-teen communication. Univariate statistics described adolescent characteristics, Rank-sum and Fisher’s exact tests examined relationships among variables, and qualitative analysis identified themes in open-ended questions.ResultsOf adolescent participants (N = 40), 45% identified as female, 17.5% Black, 7.5%, Hispanic, and 62.5% White. Post-survey mean engagement subscales of Usability (on a 5-point scale) was 3.67 (SD = 0.74), and Satisfaction was 3.63 (SD = 0.75). Computer data indicated that participants played the game for a median of 24 min. Adolescents shared that playing the game strengthened refusal skills and their ability to navigate social gatherings with alcohol. Post-survey, 63% planned to share information from INSPIRE with a parent.ConclusionFindings suggest that INSPIRE may support facilitating youth with ADHD to learn the developmental competencies needed to mitigate risk and thrive. INSPIRE warrants further testing to explore its impact on alcohol use in youth with ADHD.

Effects of A Family-Based Program for Reducing Risk for Youth Alcohol Use in Mexico

Effects of A Family-Based Program for Reducing Risk for Youth Alcohol Use in Mexico

Parent-Youth Relationships and Youth Alcohol Use: The Moderating Role of Parental Alcohol Use

AbstractPrevious studies have shown that strong parent-youth relationships serve as a protective factor inhibiting early alcohol use onset among youth, while parental alcohol use as a risk factor. However, little is known about the moderating effect of parental alcohol use on the relationship between parent-youth relationships and youth alcohol use. Using a nationally representative sample of 2,667 junior high school students entering eighth grade (aged 14 to 15) in Taiwan, this study examined the moderating role of parent use of alcohol on the relationship between parent-youth relationships and youth alcohol use. Results show that parent-youth relationship only remains a protective factor for youths whose parents do not drink alcohol; parent-youth relationship increases the likelihood of youth alcohol use if the parents use alcohol. Results suggest that parents and practitioners aiming to prevent early alcohol use onset among junior high school students should be aware of the potential influence of parental alcohol use behaviors and educate youths to assess their health behaviors regardless of their parents’ alcohol use behaviors.

6.8 Alcohol Use in Youth With ASD and Associations With Social Functioning

6.8 Alcohol Use in Youth With ASD and Associations With Social Functioning

Parental openness and communication regarding cannabis and alcohol use with their children.

Given increases in youth cannabis and alcohol use and changes in the cannabis market, we examined parental openness and communication about cannabis and alcohol. Among 197 participants who had children ≤18 years old and lived in six US metropolitan areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle), we examined sociodemographic and use correlates of parental openness (i.e., acceptability of child use, rules regarding use in the home or around children, communication) about cannabis and alcohol, as well as being more open about cannabis versus alcohol. In this sample (Mage = 32.30, 70.1% female, 30.5% sexual minority, 33.0% racial/ethnic minority, 41.6% in recreational cannabis state), 33.5% reported past-month cannabis use, and 59.9% alcohol (22.8% used both, 29.4% used neither). Multivariable regression indicated that cannabis users (vs. nonusers) and sexual minority (vs. heterosexual) individuals were more open about cannabis use; alcohol users (vs. nonusers) were more open about alcohol use. Additionally, older parental and child age correlated with greater cannabis- and alcohol-related communication, and females (vs. males) reported greater cannabis-related communication. Those married/cohabitating and reporting past-month alcohol use were less likely to allow cannabis versus alcohol in the home or near children. Parents in legalized recreational (vs. nonlegalized) states, females, and heterosexual individuals reported greater cannabis- versus alcohol-related communication. Interventions are needed to support parental communication regarding substance use, particularly cannabis. This study addressed parenting and youth substance use during evolving cannabis legislation and can inform youth substance use prevention interventions targeting parent-child communication.

Alcohol use in multiracial American youth compared with monoracial youth: A meta-analysis.

Although multiracial people comprise the fastest growing population in the United States, multiracial youth are nearly invisible in alcohol research. This meta-analysis synthesized the youth alcohol literature to estimate the magnitude of difference in alcohol use as a function of multiracial status. Empirical studies reporting multiracial and monoracial comparisons in youth (aged 10-24 years) alcohol use were identified through a systematic literature search. A random-effects meta-analysis was conducted using 85 effect sizes extracted from 16 studies assessing life-time, past-year, past-month and binge alcohol use. A total of n=1 555 635 youth were assessed in the United States. Multiracial youth are suggested to be more likely to endorse life-time alcohol use than Asian youth [number of studies (k) = 3; odds ratio (OR) = 1.81, 95% confidence interval (CI) = 1.01, 3.24; p = 0.04], with significant between-study heterogeneity (Q = 8.42; p < 0.001; I2 = 76%) in effect size comparisons. Multiracial youth are suggested to be more likely to endorse past-month alcohol use than Black (k = 6; OR = 1.54, 95% CI = 1.38, 1.71; p < 0.001) and Asian (k = 4; OR = 2.09, 95% CI = 1.52, 2.88; p < 0.001) youth, but less likely than White (k = 6; OR = 0.87, 95% CI = 0.84, 0.91; p < 0.001) youth, with significant between-study heterogeneity for Black youth (Q = 11.94; p =0.03; I2 = 58%) in effect size comparisons. Lastly, multiracial youth are suggested to be more likely to endorse binge alcohol use than Black (k = 4; OR = 1.98, 95% CI = 1.62, 2.44; p < 0.001) and Asian (k = 4; OR = 2.82, 95% CI = 2.28, 3.48; p < 0.001) youth, but less likely than White (k = 5; OR = 0.75, 95% CI = 0.70, 0.81; p < 0.001) and American Indian/Alaska Native (k = 3; OR = 0.78, 95% CI = 0.71, 0.85; p < 0.001) youth, with significant between-study heterogeneity among Black (Q = 23.99; p < 0.001; I2 = 87%) and Asian (Q = 17.76; p < 0.001; I2 = 83%) youth in effect size comparisons. In the United States, multiracial youth report distinct alcohol use patterns compared with monoracial youth and may be at elevated alcohol use risk compared with Black and Asian youth.

Adolescent alcohol use: use of social network analysis and cross-classified multilevel modeling to examine peer group, school, and neighborhood-level influences

ABSTRACT Background: Neighborhood-, school-, and peer-contexts play an important role in adolescent alcohol use behaviors. Methodological advances permit simultaneous modeling of these contexts to understand their relative and joint importance. Few empirical studies include these contexts, and studies that do typically: examine each context separately; include contexts for the sole purpose of accounting for clustering in the data; or do not disaggregate by sex. Objectives: This study takes an eco-epidemiologic approach to examine the role of socio-contextual contributions to variance in adolescent alcohol use. The primary parameters of interest are therefore variance rather than beta parameters (i.e. random rather than fixed effects). Sex-stratified models are also used to understand how each context may matter differently for male and female adolescents. Method: Data come from the National Longitudinal Study of Adolescent to Adult Health (n = 8,534 females, n = 8,102 males). We conduct social network analysis and traditional and cross-classified multilevel models (CCMM) in the full and sex-disaggregated samples. Results: In final CCMM, peer groups, schools, and neighborhoods contributed 10.5%, 10.8%, and 0.4%, respectively, to total variation in adolescent alcohol use. Results do not differ widely by gender. Conclusions: Peer groups and schools emerge as more salient contributing contexts relative to neighborhoods in adolescent alcohol use for males and females. These findings have both methodological and practical implications. Multilevel modeling can model contexts simultaneously to prevent the overestimation of variance in youth alcohol use explained by each context. Primary prevention strategies addressing youth alcohol use should focus on schools and peer networks.

137. Parent Guidance on Alcohol Use for Youth with Chronic Medical Conditions

137. Parent Guidance on Alcohol Use for Youth with Chronic Medical Conditions