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Journal of drug education  2010;40(3):265-280.
Alcoholic beverage consumption among high school students has shifted from beer to liquor. The current longitudinal study examined the effects of beverage-specific alcohol use on drinking behaviors among urban youth. Data included 731 adolescents who participated in Project Northland Chicago and reported consuming alcohol in 7th grade. Logistic regression tested the effects of beverage-specific use on consequences (e.g., alcohol use in the past month, week, heavy drinking, and ever drunkenness). Compared to wine users, adolescents who reported drinking hard liquor during their last drinking occasion had increased odds of alcohol use during the past month (OR = 1.44; 95% CI = 1.01–2.05), past week (OR = 3.37; 95% CI = 1.39–8.18), and ever drunkenness (OR = 1.56; 95% CI = 1.07–2.29). Use of hard liquor was associated with increased risk of alcohol-related consequences. Early selection of certain alcoholic beverages (e.g., hard liquor) may result in negative health outcomes and problematic alcohol use over time.
PMCID: PMC3721330  PMID: 21313986
2.  Relationships Between Alcohol-Related informal Social Control, Parental Monitoring and Adolescent Problem Behaviors Among Racially Diverse Urban Youth 
Journal of community health  2008;33(6):425-433.
The purpose of the present study is to investigate the relationships between alcohol-related informal social control and parental monitoring on alcohol use, behavior and intentions; violent behavior; and delinquent behavior in a racially diverse population of young urban adolescents. Baseline surveys were administered to 6th grade male and female students in 61 urban Chicago schools as part of Project Northland Chicago, a group randomized trial for the prevention/reduction of substance use. A subset of their parents (n=3034) was also surveyed regarding alcohol use, violence, and delinquency and related issues. Structural equation modeling was used to assess relationships between alcohol-related informal social control (as measured by parental perceptions of neighborhood action regarding youth drinking) and parental monitoring (as reported by parents), and three adolescent outcomes (alcohol use, behaviors and intentions; violent behavior; and delinquent behavior; as reported by teens). Associations between alcohol-related informal social control and parental monitoring were positive and significant (p<.001). Direct paths from parental monitoring to all three adolescent outcomes were negative and statistically significant (alcohol use, behaviors and intentions, p<.001; violent behavior, p<.001; and delinquent behavior, p<.001). Alcohol-related informal social control was not significantly associated with adolescent outcomes. Efforts to engage parents to be more active in monitoring adolescents’ activities may be related to lower levels of underage drinking, violence and delinquency among both female and male urban youth. Neighborhood norms and action against teenage drinking may be too distal to adolescent outcomes to be directly associated.
PMCID: PMC2603288  PMID: 18607698
Parental monitoring; Alcohol-related informal social control; Adolescent behaviors; Alcohol; Delinquency; Violence
3.  Do High Risk Urban Youth also have Older Friends? 
The purpose of this study was to explore how behavioral, intra-personal and socio-environmental factors were associated with the likelihood of having at least one older friend.
Participants included 3709 ethnically-diverse 8th grade students in the Project Northland Chicago intervention trial. Socio-demographic characteristics included gender, family composition, language spoken at home, race/ethnicity, and age. Behavioral factors included cigarette, alcohol, and marijuana use, depressed feelings, willingness to wear alcohol-branded merchandise, and violent and delinquent behavior. Intrapersonal factors included low refusal self efficacy and outcome expectations and expectancies. Socio-environmental factors included alcohol offers and access, normative estimates and expectations, and peer alcohol use. Having an older friend was defined as having at least one friend aged 16 or older (students’ mean age=14.2). Logistic mixed-effects regression models were used and controlled for gender, race/ethnicity, treatment status, and age.
Females and older eighth graders were significantly more likely to have at least one older friend. Students who scored higher on all of the behavioral, intra-personal and socio-environmental risk factors were significantly more likely to have at least one older friend. Significant gender interactions were found for several of the relationships.
Overall this study found multiple risk-related factors are associated with having older friends in eighth grade. Particularly important factors appear to be cigarette, marijuana and alcohol use, having friends who use alcohol, having increased alcohol offers, and being willing to wear or use alcohol-branded merchandise.
PMCID: PMC3079854  PMID: 21501805
Peers; Friends; Risk Behaviors; Risk Factors; Adolescence
4.  Early Adolescent Exposure to Alcohol Advertising and Its Relationship to Underage Drinking 
To determine whether early adolescents who are exposed to alcohol marketing are subsequently more likely to drink. Recent studies suggest that exposure to alcohol ads has a limited influence on drinking in mid-adolescence. Early adolescents may be more vulnerable to alcohol advertising effects.
Two in-school surveys of 1,786 South Dakota youth measured exposure to television beer advertisements, alcohol ads in magazines, in-store beer displays and beer concessions, radio-listening time, and ownership of beer promotional items during sixth grade, and drinking intentions and behavior at seventh grade. Multivariate regression equations predicted the two drinking outcomes using the advertising exposure variables and controlling for psychosocial factors and prior drinking.
After adjusting for covariates, the joint effect of exposure to advertising from all six sources at Grade 6 was strongly predictive of Grade 7 drinking and Grade 7 intentions to drink. Youth in the 75th percentile of alcohol marketing exposure had a predicted probability of drinking that was 50% greater than that of youth in the 25th percentile.
Although causal effects are uncertain, policy makers should consider limiting a variety of marketing practices that could contribute to drinking in early adolescence.
PMCID: PMC2845532  PMID: 17531759
advertising; alcohol marketing; children; drinking; television
5.  Influence of Grade-Level Drinking Norms on Individual Drinking Behavior 
To investigate which points of the middle-school drinking distribution are the most influential in the social contagion of drinking across the middle-school years, in order to identify potential social multipliers.
We measured drinking intentions and behaviors by gender, school, and grade among urban middle-school students who participated in Project Northland Chicago in a longitudinal cohort design.
Individual drinking behaviors were consistently influenced by extreme (80th percentile) drinking intentions and behaviors. This effect was mediated through normal or average levels of drinking, over time.
Interventions can target extreme drinkers as the influential persons in middle-school grades.
PMCID: PMC3707398  PMID: 22943103
social norms; drinking; middle school; gender; mediation
6.  Co-use of Alcohol and Tobacco Among Ninth-Graders in Louisiana 
Preventing Chronic Disease  2009;6(3):A85.
The co-use of alcohol and tobacco by adolescents is a public health problem that continues well into adulthood and results in negative behavioral, social, and health consequences. The purpose of this study was to examine the co-use of alcohol and tobacco among ninth-graders in south-central Louisiana.
We created a health habits survey to collect data from 4,750 ninth-grade students, mean age 15.4 years. Cross-sectional analysis used χ 2, 1-way analysis of variance, and logistic regression methods.
Almost 20% of students were co-users. Students who were white, performed poorly in school, did not expect to graduate high school, and had more discretionary money to spend were more likely to be co-users. Co-users had friends who got drunk weekly and were more likely to approve of alcohol use among friends than among adults. Significant differences in attitudes toward drinking and smoking were observed between co-users and nonusers. For adolescent drinkers, including girls, hard liquor was the preferred beverage.
These data for high school students are applicable for prevention strategies at a critical age when harmful health behaviors can mark the start of lifelong habits. Intervention efforts will be successful only if they account for multiple levels of influence.
PMCID: PMC2722390  PMID: 19527586
7.  A Multi-Level Approach to Investigating Neighborhood Effects on Physical Aggression among Urban Chicago Youth 
The current study evaluates neighborhood effects, individual-level effects, and demographic characteristics that influence physically aggressive behavior among urban youth. Using data derived from 5,812 adolescents from Project Northland Chicago (PNC) and Heirarchical Linear Modeling (HLM) techniques, the results suggested that neighborhood problems significantly predicted physical aggression, before and after adjustment for individual-level risk factors (alcohol use, peer alcohol use, lack of adult supervision, and depression) and demographics. After accounting for baseline physical aggression, however, neighborhood problems were no longer a significant predictor of physical aggression. Implications for intervention at both the neighborhood and individual-level and study limitations are also discussed.
PMCID: PMC3774046  PMID: 24049432
Aggression; Neighborhood; Urban; Adolescence; Multilevel
8.  Neurotoxic Effects of Alcohol in Adolescence 
Annual review of clinical psychology  2012;9:10.1146/annurev-clinpsy-050212-185610.
This review examines neuroimaging and neurocognitive findings on alcohol-related toxicity in adolescents. Teens who meet criteria for alcohol use disorders, as well as those who engage in subdiagnostic binge drinking behaviors, often show poorer neurocognitive performance, alterations in gray and white matter brain structure, and discrepant functional brain activation patterns when compared to nonusing and demographically matched controls. Abnormalities are also observed in teens with a family history of alcoholism, and such differences in neuromaturation may leave youths at increased risk for the development of an alcohol use disorder or increased substance use severity. More prospective investigations are needed, and future work should focus on disentangling preexisting differences from dose-dependent effects of alcohol on neurodevelopment. Intervention strategies that utilize neuroimag-ing findings (e.g., identified weaknesses in particular neural substrates and behavioral correlates) may be helpful in both prevention and intervention campaigns for teens both pre- and postinitiation of alcohol use.
PMCID: PMC3873326  PMID: 23245341
adolescence; alcohol; development; imaging
9.  The Longitudinal Impact of HIV+ Parents' Drug Use on their Adolescent Children 
The impact of parental substance use on the emotional and behavioral adjustment of their adolescent children was examined over five years. A representative sample of 220 parents with HIV (PWH) and 330 adolescent children in New York City were repeatedly assessed. Some parents never used marijuana or hard drugs over the 5 years (nonusers). Among those who were users, substance use varied over time. PWH who used substances during a specific 3-month period were classified as active users and those who abstained from substance use were classified as inactive users. Longitudinal regression analyses were used to analyze the impact of variations in patterns of substance use over time on their adolescent children's emotional adjustment and behavioral problems. PWH relapse exacerbated adolescent substance use, trouble with peers, and adolescent emotional distress. Even time-limited reductions in parents' substance abuse can have a significant positive impact on their adolescent children's emotional and behavioral adjustment. Interventions which address parental substance use among PWH should be developed to ameliorate the impact of substance use relapse on their adolescents.
PMCID: PMC2843584  PMID: 19290725
Addiction; HIV; problem behavior; adolescent development; relapse
10.  Association between sex partner meeting venues and sexual risk-taking among urban adolescents 
To increase understanding of the association between sexual partner meeting venue types (school, through friends or family, organized groups, public places, or on the street) and sexual risk-taking among urban youth.
Data were from 17-18 year olds who reported having had sex (n=1,656) by the time they participated in the 2008-2009 follow-up of a multi-component alcohol preventive intervention, Project Northland Chicago. We used logistic regression to assess the association between partner meeting venue and sexual risk-taking.
Approximately 20% of Chicago adolescents met their most recent sex partner on the street or in public places. Adolescents who met their partner in a public place rather than school were more likely to report having ≥ 3 years age discordant partner [women Odds Ratio (OR) = 7.7, 95% Confidence Interval (CI) = 3.3-17.7, men OR=2.7, 95% CI=1.1, 6.6], alcohol use prior to sex (women OR=3.4, 95% CI 1.8-6.5, men OR=2.4, 95% CI=1.3-4.4), casual partner (women OR = not significant, men OR=2.4, 95% CI=1.3-4.5), anal sex (women OR = not significant, men OR=2.4, 95% CI=1.2-4.9), and unprotected sex (women OR=1.7, 95% CI 1.0-2.7, men OR=1.9, 95% CI=1.1-3.4). Meeting partners on the street was associated with increased probability of alcohol use prior to sex (women OR=2.2, 95% CI 1.1, 4.3, men OR=2.1, 95% CI=1.0-4.6), age discordant partnerships among women (OR=14.2, 95% CI 6.4-31.4), and casual sex partners among men (OR=2.5, 95% CI 1.4-4.8).
Targeting sexual risk-taking with partners selected from public places or the street may improve adolescent HIV preventive interventions.
PMCID: PMC3505279  PMID: 23174466
age discordance; venue; sexual partners; alcohol use; urban adolescents
11.  Parents’ and children’s self report of parenting factors 
Health education journal  2010;69(1):31-42.
The purpose of this study was to determine if parents’ and children’s reports of parenting practices were correlated, if the reports were differentially associated with alcohol use, and which report had the strongest association with alcohol use.
Cross-sectional and longitudinal.
Public schools, Chicago, Illinois.
Participants included 1373 ethnically-diverse students and parents involved in an alcohol use prevention intervention. Surveys were conducted in sixth grade and eighth grade. Mixed-effects regression analyses were used to model relationships cross-sectionally and longitudinally.
Parents’ and children’s perceptions of parenting practices, while significantly correlated, were not strongly associated. Analyses within each parenting domain found parents’ report of parental monitoring and children’s reports of alcohol-specific communication, general communication, and relationship satisfaction were associated with alcohol use behaviors and intentions. After adjusting for all other parenting practices, parents’ report of parental monitoring and children’s report of alcohol-specific communication were most strongly related to alcohol use behaviors and intentions both cross-sectionally and longitudinally.
When comparing results across studies, it is important to identify whose report was used, parent or child, as the results may differ based on reporter. Studies with limited resources may consider using parents’ reports about parental monitoring and using children’s reports for alcohol-specific communication, general communication, and relationship satisfaction.
PMCID: PMC2885720  PMID: 20563227
Parenting; parent-child relationships; alcohol use; early adolescence
12.  Receptivity to alcohol marketing predicts initiation of alcohol use 
This longitudinal study examined the influence of alcohol advertising and promotions on the initiation of alcohol use. A measure of receptivity to alcohol marketing was developed from research about tobacco marketing. Recall and recognition of alcohol brand names were also examined.
Data were obtained from in-class surveys of 6th, 7th, and 8th graders at baseline and 12-month follow-up. Participants who were classified as never drinkers at baseline (n=1,080) comprised the analysis sample. Logistic regression models examined the association of advertising receptivity at baseline with any alcohol use and current drinking at follow-up, adjusting for multiple risk factors, including peer alcohol use, school performance, risk taking, and demographics.
At baseline, 29% of never drinkers either owned or wanted to use an alcohol branded promotional item (high receptivity), 12% students named the brand of their favorite alcohol ad (moderate receptivity) and 59% were not receptive to alcohol marketing. Approximately 29% of adolescents reported any alcohol use at follow-up; 13% reported drinking at least 1 or 2 days in the past month. Never drinkers who reported high receptivity to alcohol marketing at baseline were 77% more likely to initiate drinking by follow-up than those were not receptive. Smaller increases in the odds of alcohol use at follow-up were associated with better recall and recognition of alcohol brand names at baseline.
Alcohol advertising and promotions are associated with the uptake of drinking. Prevention programs may reduce adolescents’ receptivity to alcohol marketing by limiting their exposure to alcohol ads and promotions and by increasing their skepticism about the sponsors’ marketing tactics.
PMCID: PMC2175037  PMID: 18155027
13.  Parenting Practices as Predictors of Substance Use, Delinquency, and Aggression Among Urban Minority Youth: Moderating Effects of Family Structure and Gender 
This study examined how parenting factors were associated with adolescent problem behaviors among urban minority youth and to what extent these relationships were moderated by family structure and gender. Sixth-grade students (N = 228) reported how often they use alcohol, smoke cigarettes, or engage in aggressive or delinquent behaviors; a parent or guardian reported their monitoring and other parenting practices. Findings indicated that boys and those from single-parent families engaged in the highest rates of problem behavior. More parental monitoring was associated with less delinquency overall, as well as less drinking in boys only. Eating family dinners together was associated with less aggression overall, as well as less delinquency in youth from single-parent families and in girls. Unsupervised time at home alone was associated with more smoking for girls only. Implications for prevention interventions are discussed.
PMCID: PMC3962786  PMID: 10860116
14.  Expectancy Change and Adolescents’ Intentions to Use Marijuana 
Drug prevention campaigns commonly seek to change outcome expectancies associated with substance use, but the effects of violating such expectancies are rarely considered. This study details an application of the expectancy violation framework in a real world context by investigating whether changes in marijuana expectations are associated with subsequent future marijuana intentions. A cohort of adolescents (N = 1,344; age range = 12-18 years) from the National Survey of Parents and Youth was analyzed via secondary analysis. Nonusers at baseline were assessed 1 year later. Changes in expectancies were significantly associated with changes in intentions (p < .001). Moreover, in most cases, changes in expectancies and intentions had the strongest relationship among those who became users. The final model accounted for 31% of the variance (p < .001). Consistent with laboratory studies, changes in marijuana expectancies were predictive of changes in marijuana intentions. These results counsel caution when describing negative outcomes of marijuana initiation. If adolescents conclude that the harms of marijuana use are not as grave as they had been led to expect, intentions to use might intensify.
PMCID: PMC2628596  PMID: 19071982
adolescence; marijuana use; expectancy violations; outcome expectancies; drug prevention
15.  Genetic and Environmental Influences on the Rate of Progression to Alcohol Dependence in Young Women 
The development of alcohol dependence (AD) involves transitions through multiple stages of drinking behaviors and is shaped by both heritable and environmental influences. We attempted to capture this dynamic process by characterizing genetic and environmental contributions to the rate at which women progressed through 3 significant transitions along the pathway to AD: nonuse to initiation, initiation to onset of first alcohol-related problem, and first problem to onset of AD.
The sample consisted of 3,546 female twins from the Missouri Adolescent Female Twin Study. Participants ranged in age from 18 to 29 years. Retrospective reports of alcohol use histories were collected by telephone diagnostic interview and transition times between drinking milestones were coded ordinally. Standard genetic analyses were conducted in Mx to derive a trivariate model that provided estimates of genetic and environmental influences that were common as well as specific to the 3 transition times.
Heritable influences were found for rate of progression across all 3 transitions, accounting for 30 to 47% of the variance in transition times. Shared environmental contributions were evident only in rate of progression from nonuse to initiation (i.e., age at first drink). Heritable contributions to the rate of movement through successive drinking milestones were attributable to a common factor, whereas environmental influences were transition-specific.
The current study is unique in its use of a genetically informative design to document the rate of movement between drinking milestones in a female sample and to examine genetic contributions to multiple transition times over the course of AD development. Results indicate that an earlier report of heritability for males in rate of progression from regular drinking to AD generalizes to women and to other alcohol stage transitions. Findings also suggest the need to consider stage-specific environmental contributions to alcohol outcomes in developing interventions.
PMCID: PMC3593341  PMID: 18331380
Alcohol Dependence; Genetics; Women; Transition; Course
16.  A Peer-drinking Group Motivational Intervention among Thai Male Undergraduate Students 
Excessive alcohol consumption, particularly among young males, is an important global health problem, in part because of the increased risks of intentional and non-intentional injuries, uses of illicit drug, crime, and psychiatric disorders. There are no data available to evaluate the extent to which interventions are effective in reducing hazardous/harmful alcohol consumption among young males in Thailand. We examined the efficacy of alcohol harm reduction strategies administered as a peer-drinking group motivational intervention (PD-GMI) among Thai male undergraduates.
We used a quasi-experimental study design that included two student groups assessed at baseline and at two time points post-intervention. Participants were students enrolled in two public universities and who reported alcohol consumption during the current academic year. Students in one university were assigned to an assessment-only study group (n=110); and students in the other university were assigned to a 2-hour PD-GMI (n=115). This intervention was designed to (1) increase the awareness of risks associated with hazardous/harmful alcohol consumption; (2) enhance students' motivation to change their drinking behaviors; and (3) encourage harm reduction strategies during episodes of alcohol consumption. Alcohol consumption and adverse consequences were assessed using the Alcohol Use Disorders Identification Test (AUDIT) and the Rutgers Alcohol Problem Index (RAPI).
Students receiving the intervention had significant reductions in mean AUDIT scores; 50.4% at baseline to 1-month and 61.2% at baseline to 3-month post-intervention. Their mean RAPI scores were also reduced; 42.0% at baseline to 1-month and 42.9% at baseline to 3-month post-intervention. Reductions in alcohol consumption and the prevalence of harmful alcohol consumption patterns were statistically significant among students in the intervention group versus those in the control group. The reductions remained after adjustments for baseline differences.
These results suggest the efficacy of the PD-GMI intervention for reducing alcohol consumption and adverse consequences among Thai male students.
PMCID: PMC3683575  PMID: 20347584
alcohol; harm reduction; group motivational intervention; students; Thailand
17.  Peer selection and influence effects on adolescent alcohol use: a stochastic actor-based model 
BMC Pediatrics  2012;12:115.
Early adolescent alcohol use is a major public health challenge. Without clear guidance on the causal pathways between peers and alcohol use, adolescent alcohol interventions may be incomplete. The objective of this study is to disentangle selection and influence effects associated with the dynamic interplay of adolescent friendships and alcohol use.
The study analyzes data from Add Health, a longitudinal survey of seventh through eleventh grade U.S. students enrolled between 1995 and 1996. A stochastic actor-based model is used to model the co-evolution of alcohol use and friendship connections.
Selection effects play a significant role in the creation of peer clusters with similar alcohol use. Friendship nominations between two students who shared the same alcohol use frequency were 3.60 (95% CI: 2.01-9.62) times more likely than between otherwise identical students with differing alcohol use frequency. The model controlled for alternative pathways to friendship nomination including reciprocity, transitivity, and similarities in age, gender, and race/ethnicity. The simulation model did not support a significant friends’ influence effect on alcohol behavior.
The findings suggest that peer selection plays a major role in alcohol use behavior among adolescent friends. Our simulation results would lend themselves to adolescent alcohol abuse interventions that leverage adolescent social network characteristics.
PMCID: PMC3469361  PMID: 22867027
18.  Personal values and involvement in problem behaviors among Bahamian early adolescents: a cross-sectional study 
BMC Public Health  2007;7:135.
Few studies, particularly in developing countries, have explored the relationship between adolescents and parental values with adolescent problem behaviors. The objectives of the study are to (1) describe adolescents' personal values, their problem behaviors, and the relationships thereof according to gender and (2) examine the relationship between parental values, adolescent values, and adolescents' problem behaviors among sixth-grade students and one of their parents.
The data used in these analyses were from the baseline assessment of a school-based HIV risk reduction intervention being conducted and evaluated among sixth grade students and one of their parents across 9 elementary schools in The Bahamas. Personal values were measured by the Portrait Values Questionnaire (PVQ). Seven reported problem behaviors were queried from the students, which included physical fight with a friend, drank alcohol, beer, or wine, smoked a cigarette, pushed or carried any drugs, carried a gun, knife, screwdriver or cutlass to use as a weapon, had sex and used marijuana or other illicit drugs over the past 6 months. Multilevel modeling for binary data was performed to estimate the associations between adolescent and parental values and adolescent problem behaviors.
Among 785 students, 47% of the students reported at least one problem behavior. More boys (54%) reported having one or more problem behaviors than girls (41%, p < 0.01). Boys compared to girls expressed a higher level of self-enhancement (means score: 36.5 vs. 35.1; p = 0.03), while girls expressed a higher level of self-transcendence (42.3 vs. 40.7; p = 0.03). The results of multilevel modeling indicates that boys with a higher level of self-enhancement and girls with a higher level of openness to change and a lower level of conservation were more likely to report engagement in problem behaviors. Only two parental values (self-transcendence and conservation) were low or modestly correlated with youth' values (openness to change and self-enhancement). Parental-reported values documented limited association on adolescents' reported values and behaviors.
In designing interventions for reducing adolescents' problem behaviors, it may be important to understand the values associated with specific problem behaviors. Further exploration regarding lack of association between adolescent and parental values and problem behaviors is needed.
PMCID: PMC1924852  PMID: 17605792
19.  The Belief that Alcohol Use is Inconsistent with Personal Autonomy: A Promotive Factor for Younger Adolescents 
This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40 schools were analyzed using a structural equation model. Autonomy was negatively correlated with intention to use alcohol and subsequent alcohol use at a later wave, and intention to use fully mediated the effect of autonomy on subsequent alcohol use. These results are consistent with the proposition that when personal autonomy is perceived as inconsistent with alcohol use among younger adolescents, students indicate a lower intention to use alcohol and use less alcohol during the following school year.
PMCID: PMC3601668  PMID: 23519434
adolescent protective factors; alcohol use; autonomy; subjective norms; theory of reasoned action
20.  Correlates of Early Alcohol and Drug Use in Hispanic Adolescents: Examining the Role of ADHD with Comorbid Conduct Disorder, Family, School, and Peers 
This study examined correlates of early adolescent alcohol and drug use in a community sample of 217 eighth-grade adolescents with behavior problems and from Hispanic/ Latino immigrant families. Structural equation modeling was used to examine relationships of multiple contexts (e.g., family, school, and peers) to alcohol and drug use. Results suggest that conduct disorder in youth with high levels of hyperactivity symptoms, poor school functioning, and peer alcohol and drug use was directly related to early adolescent alcohol and drug use. Attention deficit/hyperactivity disorder with comorbid conduct disorder and family functioning was indirectly related to early alcohol and drug use through poor school functioning and through peer alcohol and drug use. Results are discussed in terms of possible targets for interventions to prevent alcohol and drug use in Hispanic adolescents.
PMCID: PMC2916647  PMID: 18991132
21.  Childhood and adolescent predictors of heavy drinking and alcohol use disorders in early adulthood: a longitudinal developmental analysis 
Addiction (Abingdon, England)  2008;103(Suppl 1):23.
To identify childhood and adolescent factors differentiating heavy alcohol users in early adulthood from more moderate users or abstainers.
Low-income participants followed from birth to age 28 years.
A total of 178 adults (95 males) who were first-born children of low-income mothers recruited in Minneapolis, Minnesota, during their third trimester of pregnancy.
Maternal hostility (24/42 months), externalizing and internalizing behavior problems (9 years), peer acceptance and academic achievement (12 years), maternal alcohol use and participants’ drinking behavior (16 years), quantity of alcohol use per occasion (19, 23 and 26 years), alcohol use disorders (28 years).
For men: (i) higher amounts of alcohol consumption at age 16 increased the odds of being a heavy drinker compared to an abstainer (age 19) and a moderate drinker (ages 23 and 26); (ii) lower achievement scores at age 12 and having a mother who drank more when the participant was age 16 increased the odds of being a heavy drinker compared to moderate drinker (age 26). Higher levels of externalizing behavior problems at age 9 and drinking more when the participants were age 16 increased the odds that men would have a current alcohol use disorder at age 28. For women: (i) drinking more at age 16 increased the odds of being a heavy drinker compared to being either an abstainer or a moderate drinker (age 26); (ii) having higher levels of achievement at age 12 increased the odds of being a heavy drinker compared to an abstainer at age 23. Adolescent alcohol use mediated the relation between externalizing behavior at age 9 and alcohol use at age 26 for women.
Problem drinking may be the result of a long-term developmental process wherein childhood externalizing behavior problems sets a pathway leading to heavy drinking during and after adolescence.
PMCID: PMC2822999  PMID: 18426538
Adolescence; alcohol; childhood; problem behavior
22.  Understanding AIDS-Risk Behavior Among Adolescents in Psychiatric Care: Links to Psychopathology and Peer Relationships 
Severely mentally ill youths are at elevated risk for human immunodeficiency virus infection, but little is known about acquired immunodeficiency syndrome (AIDS) risk behavior in adolescents who seek outpatient mental health services or about the links between psychiatric problems and particular high-risk behaviors. This pilot study used structural equation modeling to conduct a path analysis to explore the direct and indirect effects of adolescent psychopathology on risky sex, drug/alcohol use, and needle use.
Ethnically diverse youths (N = 86) and their caregivers who sought outpatient psychiatric services in Chicago completed questionnaires of adolescent psychopathology. Youths reported their relationship attitudes, peer influence, sexual behavior, and drug/alcohol use.
Different AIDS-risk behaviors were associated with distinct forms of adolescent psychopathology (e.g., delinquency was linked to drug/alcohol use, whereas aggression was related to risky sexual behavior), and peer influence mediated these linkages. Some patterns were similar for caregiver- and adolescent-reported problems (e.g., peer influence mediated the relation between delinquency and drug/alcohol use), but others were different (e.g., caregiver-reported delinquency was associated with risky sex, whereas adolescent-reported delinquency was not).
Findings underscore the complexity of factors (types of informants and dimensions of psychopathology) that underlie AIDS risk in troubled youths, and they offer specific directions for designing and implementing uniquely tailored AIDS prevention programs, for example, by targeting delinquent behavior and including high-risk peers and important family members in interventions.
PMCID: PMC1201503  PMID: 11392341
acquired immunodeficiency syndrome; AIDS risk; psychopathology; adolescents; peer influence
23.  Do Research Assessments Make College Students More Reactive to Alcohol Events? 
Psychology of Addictive Behaviors  2011;26(2):338-344.
This study examines possible synergistic effects of alcohol-related events and post-event assessments on changes in college student readiness to change alcohol use, frequency of alcohol use, and negative consequences. Students were participants in a longitudinal study of drinking behavior. A portion of those reporting negative alcohol events/consequences (e.g., injury, vomiting, memory loss) during the parent study were randomly selected to participate in the present study (n = 492) and randomized to a post-event assessment (n = 296) or a no-assessment control (n = 196). Participants in the post-event assessment group were interviewed soon after their event, and participants in both conditions were interviewed three months after their event. Linear regression models showed higher 3-month readiness to change alcohol use in participants who received a post-event assessment than those who did not. There were reductions in drinking days, heavy drinking days, and further consequences post-event, but no differences by assessment group. However, female participants showed greater reductions in drinking days and heavy drinking days if they were assigned to assessment compared to control. There also was greater post-event reduction in drinking days among assessment group participants with high pre-college alcohol severity compared to low pre-college alcohol severity. Conversely, participants who reported high aversiveness of their event and were in the control group showed greater reduction in heavy drinking days than those assigned to the assessment group. Findings suggest that college student heavy drinking is reactive to alcohol events, whereas reactivity to post-event assessments may depend on gender, alcohol severity, and event aversiveness. This work highlights the importance of considering possible interactions among extra-therapeutic factors in clinical outcome research.
PMCID: PMC3257404  PMID: 21928871
Alcohol Abuse; Alcohol Consequences; Assessment Reactivity; College Student Drinking; Readiness to Change; Research Reactivity
24.  The relationship between baseline drinking status, peer motivational interviewing microskills and drinking outcomes in a brief alcohol intervention for matriculating college students: A replication 
Behavior therapy  2012;44(1):137-151.
The purpose of this study was to replicate and extend previous findings (Tollison, Lee, Neighbors, Neil, Olson, & Larimer, 2008) on the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. This study used a larger sample size, multiple follow-up time-points, and latent variable analyses allowing for more complex models to be tested in a sample with different characteristics than Tollison et al. (2008). Matriculating students who participated in high school sports (N = 327) took part in a Brief Alcohol Screening and Intervention for College Students (BASICS) led by peer facilitators trained in Motivational Interviewing. Participants were assessed pre- and immediately post-intervention on contemplation to change, as well as pre-, 5 months and 10 months post-intervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (MITI, Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence. Contrary to our previous study, results indicated that a higher number of open questions was positively related to increases in drinking, especially for heavier drinkers. Congruent with the previous study, more simple reflections was positively related to increases in drinking. Finally, this study revealed that heavier baseline drinking was associated with more simple reflections. There were no significant results found for changes in contemplation. Results corroborate previous findings that the excessive use of simple reflections may be indicative of counter therapeutic outcomes while raising questions about the relationship between the frequency of open questions and therapeutic outcomes.
PMCID: PMC3676275  PMID: 23312433
Motivational interviewing; adherence; brief intervention; alcohol; college students; counselor behavior
25.  Perception of tobacco, cannabis, and alcohol use of others is associated with one’s own use 
Interventions have been developed to reduce overestimations of substance use among others, especially for alcohol and among students. Nevertheless, there is a lack of knowledge on misperceptions of use for substances other than alcohol. We studied the prevalence of misperceptions of use for tobacco, cannabis, and alcohol and whether the perception of tobacco, cannabis, and alcohol use by others is associated with one’s own use.
Participants (n = 5216) in a cohort study from a census of 20-year-old men (N = 11,819) estimated the prevalence of tobacco and cannabis use among peers of the same age and sex and the percentage of their peers drinking more alcohol than they did. Using the census data, we determined whether participants overestimated, accurately estimated, or underestimated substance use by others. Regression models were used to compare substance use by those who overestimated or underestimated peer substance with those who accurately estimated peer use. Other variables included in the analyses were the presence of close friends with alcohol or other drug problems and family history of substance use.
Tobacco use by others was overestimated by 46.1% and accurately estimated by 37.3% of participants. Cannabis use by others was overestimated by 21.8% and accurately estimated by 31.6% of participants. Alcohol use by others was overestimated by more than half (53.4%) of participants and accurately estimated by 31.0%. In multivariable models, compared with participants who accurately estimated tobacco use by others, those who overestimated it reported smoking more cigarettes per week (incidence rate ratio [IRR] [95% CI], 1.17 [range, 1.05, 1.32]). There was no difference in the number of cigarettes smoked per week between those underestimating and those accurately estimating tobacco use by others (IRR [95% CI], 0.99 [range, 0.84, 1.17]). Compared with participants accurately estimating cannabis use by others, those who overestimated it reported more days of cannabis use per month (IRR [95% CI], 1.43 [range, 1.21, 1.70]), whereas those who underestimated it reported fewer days of cannabis use per month (IRR [95% CI], 0.62 [range, 0.23, 0.75]). Compared with participants accurately estimating alcohol use by others, those who overestimated it reported consuming more drinks per week (IRR [95% CI], 1.57 [range, 1.43, 1.72]), whereas those who underestimated it reported consuming fewer drinks per week (IRR [95% CI], 0.41 [range, 0.34, 0.50]).
Perceptions of substance use by others are associated with one’s own use. In particular, overestimating use by others is frequent among young men and is associated with one’s own greater consumption. This association is independent of the substance use environment, indicating that, even in the case of proximity to a heavy-usage group, perception of use by others may influence one’s own use. If preventive interventions are to be based on normative feedback, and their aim is to reduce overestimations of use by others, then the prevalence of overestimation indicates that they may be of benefit to roughly half the population; or, in the case of cannabis, to as few as 20%. Such interventions should take into account differing strengths of association across substances.
PMCID: PMC3853223  PMID: 24499600
Overestimation; Substance use; Perception; Alcohol; Tobacco; Cannabis

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