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ABSTRACT: Previous research has found a longitudinal relationship between sleep problems and suicidal behavior while controlling for depression and other important covariates in a high risk sample of adolescents and controls. In this paper, we replicated this longitudinal relationship in a national sample and examined whether the relationship was partially mediated by depression, alcohol-related problems and other drug use.
Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH).
In bivariate analyses, sleep problems (i.e., having trouble falling asleep or staying asleep) at Wave 1 were associated with suicidal thoughts and suicide attempts at Waves 1, 2, and 3 (W1, 2 and 3). In multivariate analyses, controlling for depression, alcohol problems, illicit drug use, and important covariates such as gender, age, and chronic health problems, sleep problems at a previous wave predicted suicidal thoughts and suicide attempts at a subsequent wave. In mediation analyses, W2 depression significantly mediated the effect of W1 sleep problems on W3 suicide thoughts. Moreover, W2 suicidal thoughts also significantly mediated the effect of W1 sleep problems on W3 suicidal attempts.
Sleep problems appear to be a robust predictor of subsequent suicidal thoughts and attempts in adolescence and young adulthood. Having trouble falling sleeping or staying asleep had both direct and indirect effects (via depression and suicidal thoughts) on suicidal behavior. Future research could determine if early intervention with sleep disturbances reduces the risk for suicidality in adolescents and young adults.
Journal of psychiatric research 04/2012; 46(7):953-9. · 3.72 Impact Factor
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Maria M Wong
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ABSTRACT: This commentary discussed the study conducted by Pieters et al. (2010 AlcoholClin Exp Res in press) on the relationships among puberty dependent, sleep regulation, and alcohol use in adolescents. The goal of this commentary is to underscore the significance of the study and discuss some of the unaddressed questions in the area.
The significance of the study and unaddressed questions are discussed.
Pieters et al. (2010 Alcohol Clin Exp Res in press) provided valuable data to understanding the relationships among puberty, sleep problems, and alcohol use. Questions regarding the relationship between puberty and sleep problems, the possible reciprocal relationships among circadian phase preference, sleep problems and alcohol use, mediators and moderators of such relationships, as well as potential gender differences on these relationships were discussed.
To understand the relationships among pubertal development, sleep problems, and alcohol use, researchers need to be aware of the physiological changes that take place in puberty, as well as the psychosocial factors that are associated with such changes. Important mediators and moderators of the relationships among these constructs also need to be identified. Longitudinal design may be useful in this regard.
Alcoholism Clinical and Experimental Research 12/2010; 34(12):2019-21. · 3.34 Impact Factor
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ABSTRACT: Previous research has found an association between sleep problems and suicidal behavior. However, it is still unclear whether the association can be largely explained by depression. In this study, we prospectively examined relationships between sleep problems when participants were 12-14 years old and subsequent suicidal thoughts and self-harm behaviors--including suicide attempts--at ages 15-17 while controlling for depressive symptoms at baseline.
Study participants were 280 boys and 112 girls from a community sample of high-risk alcoholic families and controls in an ongoing longitudinal study.
Controlling for gender, parental alcoholism and parental suicidal thoughts, and prior suicidal thoughts or self-harm behaviors when participants were 12-14 years old, having trouble sleeping at 12-14 significantly predicted suicidal thoughts and self-harm behaviors at ages 15-17. Depressive symptoms, nightmares, aggressive behavior, and substance-related problems at ages 12-14 were not significant predictors when other variables were in the model.
Having trouble sleeping was a strong predictor of subsequent suicidal thoughts and self-harm behaviors in adolescence. Sleep problems may be an early and important marker for suicidal behavior in adolescence. Parents and primary care physicians are encouraged to be vigilant and screen for sleep problems in young adolescents. Future research should determine if early intervention with sleep disturbances reduces the risk for suicidality in adolescents.
Journal of psychiatric research 10/2010; 45(4):505-11. · 3.72 Impact Factor
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ABSTRACT: To our knowledge, no prospective studies examine the relationships among childhood sleep problems, adolescent executive functioning, and substance outcomes (i.e., substance use and substance-related problems). In this study, we examined whether childhood sleep problems predicted adolescent sleep problems and response inhibition. We also tested whether adolescent sleep problems and poor response inhibition mediated the relationship between childhood sleep problems and substance (alcohol and drug) outcomes in young adulthood.
Study participants were 292 boys and 94 girls (M = 4.85, SD = 1.47) from a community sample of high-risk families and controls.
When compared to their counterparts, those with trouble sleeping in childhood were twice as likely to have the same problem in adolescence. Childhood overtiredness predicted poor response inhibition in adolescence. Persistent trouble sleeping from childhood to adolescence and response inhibition in adolescence mediated the relationship between childhood sleep problems and drug outcomes in young adulthood, whereas overtiredness in childhood directly predicted alcohol use outcomes and alcohol-related problems in young adulthood.
This is the first study showing a long-term relationship between childhood sleep measures and subsequent alcohol and drug outcomes. The developmental and clinical implications of these findings were discussed. Prevention and intervention programs may want to consider the role of sleep problems and response inhibition on substance use and abuse.
Alcoholism Clinical and Experimental Research 04/2010; 34(6):1033-44. · 3.34 Impact Factor
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Sleep Medicine - SLEEP MED. 01/2010; 11(1):110-111.
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ABSTRACT: Very few prospective studies examine the relationship between childhood sleep problems and subsequent substance use. In this study, we examined how sleep problems at ages 3-8 predicted onset of alcohol, cigarette, and marijuana use in adolescence. We also investigated the relationships between childhood sleep problems and adolescent internalizing and externalizing problems.
Study participants were 292 boys and 94 girls from a community sample of high risk families and controls in an ongoing longitudinal study.
Controlling for parental alcoholism, sleep problems at ages 3-8 predicted onset of alcohol, cigarette, and marijuana use among boys and onset of alcohol use among girls. Childhood sleep problems were related to maternal ratings of internalizing and externalizing problems during adolescence for both boys and girls. Adjusting for these problems did not weaken the effects of sleep problems on onset of substance use.
This is to our knowledge the first study that prospectively examines gender differences in the relationship between sleep problems and early onset of substance use. Childhood sleep problems predicted early onset of substance use for boys but not girls. If childhood sleep problems indeed increase the probability of substance use onset, greater attention by parents to sleep problems in children and adolescents would potentially have ameliorative long-term effects. Parents are encouraged to explore different ways to help their children sleep better, including obtaining information and suggestions from their primary care physicians.
Sleep Medicine 02/2009; 10(7):787-96. · 3.40 Impact Factor
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ABSTRACT: This study first examined the respective relations of resiliency and
reactive control with executive functioning. It then examined the
relationship of these different domains to the development of academic and
social outcomes, and to the emergence of internalizing and externalizing
problem behavior in adolescence. Resiliency and reactive control were
assessed from preschool to adolescence in a high-risk sample of boys and
girls (n = 498) and then linked to component operations of
neuropsychological executive functioning (i.e., response inhibition,
interference control, fluency, working memory/set-shifting, planning,
and alertness), assessed in early and late adolescence. Consistent, linear
relations were found between resiliency and executive functions (average
r = .17). A curvilinear relationship was observed between
reactive control and resiliency, such that resiliency was weaker when
reactive control was either very high or very low. In multivariate,
multilevel models, executive functions contributed to academic competence,
whereas resiliency and interference control jointly predicted social
competence. Low resiliency, low reactive control, and poor response
inhibition uniquely and additively predicted internalizing problem
behavior, whereas low reactive control and poor response inhibition
uniquely predicted externalizing problem behavior. Results are discussed
in relation to recent trait models of regulation and the scaffolded
development of competence and problems in childhood and adolescence. a
Development and Psychopathology 03/2007; 19(02):541 - 563. · 4.40 Impact Factor
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ABSTRACT: In a sample of 202 adult women and their families, the authors examined the effects of their male partners' alcohol problems and antisociality, the women's alcohol problems and antisociality, family conflict, and offspring behavioral problems on the women's depressive symptoms over a 3-year period. The women's antisociality and alcohol problems were more strongly related to family conflict, offspring behavioral problems, and the women's depressive symptoms than were the men's antisociality and alcohol problems. The women's antisociality and family conflict most strongly predicted increases in the women's depressive symptoms over time. In addition, family conflict mediated the effects of maternal antisociality on the women's depressive symptoms.
Journal of Abnormal Psychology 09/2006; 115(3):601-9. · 4.86 Impact Factor
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ABSTRACT: Impaired problem solving, visual-spatial processing, memory, and cognitive proficiency are consequences of severe alcoholism. Smoking is much more prevalent among alcoholics than the general population, yet the possible neurocognitive effects of cigarette smoking in alcoholism have not been studied, despite evidence that long-term smoking is associated with neurocognitive deficits.
Determine whether smoking contributes to neurocognitive deficits associated with alcoholism.
Neurocognitive function was examined in a community-recruited (n=172) sample of men. Alcohol problems/alcoholism were measured by the lifetime alcohol problems score (LAPS), DSM-IV diagnosis, and monthly drinking rate. Smoking was measured in pack-years. Neurocognitive function was measured with IQ (short version of WAIS-R), and cognitive proficiency (fast, accurate performance).
Both alcoholism and smoking were negatively correlated with neurocognitive function. When alcoholism and smoking were included in regression models, smoking remained a significant predictor for both measures, but alcoholism remained significant only for IQ.
Both smoking and alcoholism were related to neurocognitive function. Smoking may explain some of the relationship between alcoholism and neurocognitive function, perhaps especially for measures that focus on proficiency. Future studies are necessary to more fully understand the effects of smoking on neurocognitive function in alcoholism.
Drug and Alcohol Dependence 05/2006; 82(2):119-26. · 3.38 Impact Factor
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ABSTRACT: To evaluate the predictive power of executive functions, in particular, response inhibition, in relation to alcohol-related problems and illicit drug use in adolescence.
A total of 498 children from 275 families from a longitudinal high-risk study completed executive function measures in early and late adolescence and lifetime drinking and drug-related ratings at multiple time points including late adolescence (ages 15-17). Multi-informant measures of attention-deficit/hyperactivity disorder and conduct disorder were obtained in early childhood (ages 3-5), middle childhood, and adolescence.
In multilevel models, poor response inhibition predicted aggregate alcohol-related problems, the number of illicit drugs used, and comorbid alcohol and drug use (but not the number of drug-related problems), independently of IQ, parental alcoholism and antisocial personality disorder, child attention-deficit/hyperactivity disorder and conduct symptoms, or age. Multivariate models explained 8% to 20% of residual variance in outcome scores. The incremental predictive power of response inhibition was modest, explaining about 1% of the variance in most outcomes, but more than 9% of the residual variance in problem outcomes within the highest risk families. Other measured executive functions did not independently predict substance use onset.
Models of alcoholism and other drug risks that invoke executive functions may benefit from specifying response inhibition as an incremental component.
Journal of the American Academy of Child & Adolescent Psychiatry 05/2006; 45(4):468-75. · 6.44 Impact Factor
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Robert A Zucker, Maria M Wong,
Duncan B Clark,
Kenneth E Leonard,
John E Schulenberg,
Jack R Cornelius,
Hiram E Fitzgerald,
Gregory G Homish,
Alicia Merline,
Joel T Nigg,
Patrick M O'Malley,
Leon I Puttler
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ABSTRACT: This paper summarizes the proceedings of a symposium presented at the 2005 Research Society on Alcoholism meeting in Santa Barbara, California, that spans the interval from toddlerhood to early middle adulthood and addresses questions about how far ahead developmentally we can anticipate alcohol problems and related substance use disorder and how such work informs our understanding of the causes and course of alcohol problems and alcohol use disorder. The context of these questions both historically and developmentally is set by Robert Zucker in an introductory section. Next, Maria Wong and colleagues describe the developmental trajectories of behavioral and affective control from preschool to early adolescence in a high risk for alcoholism longitudinal study and demonstrate their ability to predict alcohol and drug outcomes in adolescence. Duncan Clark and Jack Cornelius follow with a report on the predictive utility of parental disruptive behavior disorders in predicting onset of alcohol problems in their adolescent offspring in late adolescence. Next, Kenneth Leonard and Gregory Homish report on adult development study findings relating baseline individual, spouse, and peer network drinking indicators at marriage onset that distinguish different patterns of stability and change in alcohol problems over the first 2 years of marriage. In the final paper, John Schulenberg and colleagues, utilizing national panel data from the Monitoring the Future Study, which cover the 18- to 35-year age span, show how trajectories of alcohol use in early adulthood predict differential alcohol abuse and dependence outcomes at age 35. Finally, Robert Zucker examines the degree to which the core symposium questions are answered and comments on next step research and clinical practice changes that are called for by these findings.
Alcoholism Clinical and Experimental Research 03/2006; 30(2):243-52. · 3.34 Impact Factor
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ABSTRACT: The Symbol Digit Modalities Test is a substitution task that is the inverse of the Digit Symbol Test. The familiar task of filling numbers in boxes, and the availability of an oral administration, make this a popular screening instrument for brain impairment. Normative data were previously reported for a variety of clinical groups, but complete information on non-clinical samples across age, education, gender, and socioeconomic status is limited. The present study examines the performance of a community-dwelling control sample across age, education, gender, and income groupings. In a multivariate model, these four variables did not impact test performance. These results support the utilization of the SDMT as a robust screening test for adult neuropsychological impairment.
Archives of Clinical Neuropsychology 02/2006; 21(1):23-8. · 2.18 Impact Factor
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ABSTRACT: In the current study, the authors tested the hypothesis that children of alcoholic parents (COAs) show deficits in social competence that begin in early childhood and escalate through middle adolescence. Teachers, parents, and children reported on the social competence of COAs and matched controls in a community sample assessed from ages 6 to 15. Hierarchical linear growth models revealed different patterns of change in social competence across development as a function of the reporter of various indicators of competence. Moreover, female COAs showed deficits in social competence in early childhood that receded in adolescence and that varied across subtypes of parent alcoholism. Implications of these findings for understanding the development of social competence in children, and at-risk children in particular, are discussed.
Developmental Psychology 10/2005; 41(5):747-59. · 3.21 Impact Factor
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ABSTRACT: Numerous studies have focused on the predictors of recovery in persons with alcohol use disorder (AUD). Most have been retrospective and have measured only predictors of short-term recovery after the completion of treatment. This prospective study evaluates the role of psychological and social factors in a community sample of both alcoholics and their partners in predicting recovery over a 9-year interval.
Alcoholic diagnostic status and life functioning of 134 community-recruited, initially coupled men meeting criteria for a 3-year Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, AUD diagnosis at baseline were assessed over the 9-year period. Their partners also were assessed. Prediction involved comparing those who still had an AUD diagnosis at 9-year follow-up against those who no longer met AUD criteria.
Predictors of recovery included number of experiences with treatment, education, number of years of intervening recovery over the follow-up period, partner baseline AUD status and partner's social support network. Alcoholics' initial severity of drinking did not predict long-term outcome. Furthermore, recovered men's partners decreased their AUD in the interim, whereas nonremitters' partners increased their AUD. The findings highlight the transitions in and out of AUD, with 62% of the men having stable drinking patterns of either remission or unremitting AUD diagnosis over the entire follow-up period.
This study demonstrated the importance of interpersonal factors in maintaining AUD or promoting recovery. Consideration of partner characteristics and the marital context as factors in the recovery process is essential. Future research should examine the predictors of recovery in women, in adolescents and in racial groups other than white.
Journal of studies on alcohol 04/2005; 66(2):220-8.
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Recent developments in alcoholism: an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism 02/2005; 17:299-320.
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ABSTRACT: Inattention/hyperactivity and aggressive behavior problems were measured in 335 children from school entry throughout adolescence, at 3-year intervals. Children were participants in a high-risk prospective study of substance use disorders and comorbid problems. A parallel process latent growth model found aggressive behavior decreasing throughout childhood and adolescence, whereas inattentive/hyperactive behavior levels were constant. Growth mixture modeling, in which developmental trajectories are statistically classified, found two classes for inattention/hyperactivity and two for aggressive behavior, resulting in a total of four trajectory classes. Different influences of the family environment predicted development of the two types of behavior problems when the other behavior problem was held constant. Lower emotional support and lower intellectual stimulation by the parents in early childhood predicted membership in the high problem class of inattention/hyperactivity when the trajectory of aggression was held constant. Conversely, conflict and lack of cohesiveness in the family environment predicted membership in a worse developmental trajectory of aggressive behavior when the inattention/hyperactivity trajectories were held constant. The implications of these findings for the development of inattention/hyperactivity and for the development of risk for the emergence of substance use disorders are discussed.
Development and Psychopathology 02/2005; 17(1):99-125. · 4.40 Impact Factor
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ABSTRACT: One component of individual risk for alcoholism may involve cognitive vulnerabilities prodromal to alcoholism onset. This prospective study of 198 boys followed between 3 and 14 years of age evaluated neurocognitive functioning across three groups who varied in familial risk for future alcoholism. Measures of intelligence, reward-response, and a battery of neuropsychological executive and cognitive inhibitory measures were used. Executive functioning weaknesses were greater in families with alcoholism but no antisocial comorbidity. IQ and reward-response weaknesses were associated with familial antisocial alcoholism. Executive function effects were clearest for response inhibition, response speed, and symbol-digit modalities. Results suggest that executive deficits are not part of the highest risk, antisocial pathway to alcoholism but that some executive function weaknesses may contribute to a secondary risk pathway.
Journal of Abnormal Psychology 06/2004; 113(2):302-14. · 4.86 Impact Factor
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ABSTRACT: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood.
This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families.
Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use.
This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed.
Alcoholism Clinical and Experimental Research 05/2004; 28(4):578-87. · 3.34 Impact Factor
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ABSTRACT: Despite the current societal concern with underage drinking, little attention has been paid to alcohol use within the preadolescent population. This article presents the proceedings of a symposium held at the 2003 Research Society on Alcoholism meeting in Fort Lauderdale, Florida, that was organized and chaired by John E. Donovan. The intent of the symposium was to kick start research on alcohol use among elementary school children by reviewing what is known regarding drinking in childhood. Presentations included (1) The Epidemiology of Children's Alcohol Use, by John E. Donovan; (2) The Validity of Children's Self-Reports of Alcohol Use, by Sharon L. Leech; (3) Predicting Onset of Drinking From Behavior at Three Years of Age: Influence of Early Child Expectancies and Parental Alcohol Involvement Upon Early First Use, by Robert A. Zucker; and (4) Parent, Peer, and Child Risk Factors for Alcohol Use in Two Cohorts of Elementary School Children, by Carol J. Loveland-Cherry. Presentations indicated the need for better nationwide surveillance of children's experience with alcohol; suggested that children's reports of their use of alcohol tend to be reliable and valid; supported children's alcohol use schemas and parental drinking and alcoholism at child age three as independent predictors of early onset drinking; and showed that onset of drinking before fourth or fifth grade, peer pressure, and parental norms and monitoring predict elementary student alcohol use and misuse.
Alcoholism Clinical and Experimental Research 03/2004; 28(2):341-9. · 3.34 Impact Factor
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04/2003; , ISBN: 9780471264385
