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The association between child alcohol sipping and alcohol expectancies in the ABCD study
Abstract
Background
Underage drinking is a serious societal concern, yet relatively little is known about child sipping of alcohol and its relation to beliefs about alcohol. The current study aimed to (1) examine the contexts in which the first sip of alcohol occurs (e.g., type of alcohol, who provided sip, sip offered or taken without permission); (2) examine the association between sipping and alcohol expectancies; and (3) explore how different contexts of sipping are related to alcohol expectancies. We expected to find that children who had sipped alcohol would have increased positive expectancies and reduced negative expectancies compared to children who had never sipped alcohol.
Methods
Data were derived from the 2.0 release of the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal study of children in the United States. We utilized data from 4,842 children ages 9 to 11; 52% were male, 60% were White, 19% were Hispanic/Latinx, and 9% were Black/African American.
Results
We found that 22% of the sample had sipped alcohol. Children reported sipping beer most frequently, and the drink most often belonged to the child’s father. We found that children who had sipped had higher positive alcohol expectancies than children who had not while accounting for variables related to alcohol expectancies. Child sipping was not significantly associated with negative expectancies and the context of the first sip of alcohol was not significantly associated with positive and negative expectancies.
Conclusions
Providing sips of alcohol to children is associated with them having more favorable expectations about drinking.
... Prevalence rates ranged from 17.2 to 57.9% for males, and from 16.0 to 61.9% for females ( Figure 2). Overall, the prevalence of parental supply was higher for female than male respondents in 15 out of 23 studies (65.2%) (Clark et al., 2013;Asante et al., 2014;Strandberg et al., 2014;Substance Abuse and Mental Health Services Administration, 2015, Substance2016, Substance2017, 2018, 2019White and Williams, 2016;Health and Social Care Information Centre, 2017;Lam et al., 2017a, b;Guerin and White, 2020;Murphy et al., 2021). For studies reporting prevalence rates by gender for all minors, four out of eight studies (50.0%) found no significant differences in prevalence rates between male and female respondents (Danielsson et al., 2011;Health and Social Care Information Centre, 2011, two studies (25.0%) found slightly higher prevalence rates in females than males (Strandberg et al., 2014;Health and Social Care Information Centre, 2017) and one study found slightly higher prevalence rates in males than females (Murphy et al., 2021). ...
... Overall, the prevalence of parental supply was higher for female than male respondents in 15 out of 23 studies (65.2%) (Clark et al., 2013;Asante et al., 2014;Strandberg et al., 2014;Substance Abuse and Mental Health Services Administration, 2015, Substance2016, Substance2017, 2018, 2019White and Williams, 2016;Health and Social Care Information Centre, 2017;Lam et al., 2017a, b;Guerin and White, 2020;Murphy et al., 2021). For studies reporting prevalence rates by gender for all minors, four out of eight studies (50.0%) found no significant differences in prevalence rates between male and female respondents (Danielsson et al., 2011;Health and Social Care Information Centre, 2011, two studies (25.0%) found slightly higher prevalence rates in females than males (Strandberg et al., 2014;Health and Social Care Information Centre, 2017) and one study found slightly higher prevalence rates in males than females (Murphy et al., 2021). Another study (Najman et al., 2021) reported parental supply separated by age and the individual parent who supplied alcohol (i.e. ...
... The total prevalence of parental supply of alcohol among all minors ranged from 17.0 to 22.0% in England (Health and Social Care Information Centre, 2011, 2017, 2019, 31.1 (Stafström, 2014) to 41.7% (Berge et al., 2016) in Sweden, 9.3 Boland et al., 2020) to 45.2% in Australia and was reported as 22.1% in the USA (Murphy et al., 2021). Among only minors who reported drinking alcohol, prevalence rates ranged from 10.8 (King et al., 2016;Vidourek et al., 2018) to 22.4% (Jackson et al., 2016) in the USA, 20.9 (Lam et al., 2017a, b) to 43.0% (Guerin and White, 2020) in Australia and were reported as 18.2% in Canada (Wilson et al., 2018), 34.0% in Argentina (Pilatti et al., 2013), 41.5% in Thailand (Prasartpornsirichoke et al., 2022) and 60.1% in New Zealand (Clark et al., 2013;King et al., 2016;Vidourek et al., 2018) (Table 1). ...
Parental supply of alcohol to minors (i.e. those under the legal drinking age) is often perceived by parents as protective against harms from drinking, despite evidence linking it with adverse alcohol-related outcomes. This systematic review describes the prevalence of parental supply of alcohol, as reported in the international literature. The review was registered with PROSPERO (CRD42020218754). We searched seven online databases (Medline, Embase, PsycINFO, CINAHL, Scopus, Web of Science and Public Health Database) and grey literature from January 2011 to December 2022 and assessed the risk of bias with the JBI Critical Appraisal Checklist. Among 58 articles included in narrative synthesis from 29 unique datasets, there was substantial variation in the definition and measurement of parental supply of alcohol. Overall prevalence rates ranged from 7.0 to 60.0% for minor-report samples, and from 24.0 to 8.0% for parent-report samples. Data indicate that parental supply prevalence is generally proportionately higher for older minors or later-stage students, for girls, and has increased over time among minors who report drinking. Literature on the prevalence of parental supply of alcohol is robust in quantity but inconsistent in quality and reported prevalence. Greater consistency in defining and measuring parental supply is needed to better inform health promotion initiatives aimed at increasing parents' awareness.
... In the subsample of youth who had not initiated alcohol use (i.e., not even had a sip of alcohol; N = 8,319), we examined whether polygenic liability scores, sociodemographic factors, parent history of alcohol use, adverse childhood experiences, and peer use and attitudes toward alcohol were associated with positive and negative AEs. These variables were chosen based on prior associations in the literature (e.g., (Samek et al. 2013;Brown et al. 1999;Chen et al. 2021;Martino et al. 2006;Murphy et al. 2021)) or hypothesized importance for shaping AEs prior to alcohol use. The examination of the extent to which polygenic liability to problematic alcohol use, as well as risk-taking (related to anticipated positive reinforcement from alcohol) and depression (related to anticipated negative effects of alcohol), were associated with AEs was novel to the study; we hoped this would advance our understanding of whether AEs are merely a product of familial and peer-related environmental factors or whether genetic propensities also shape their development. ...
... These data were collected at the 1-year follow-up, when the participants were 10-12 years old. Consistent with past work (Murphy et al. 2021;Lisdahl et al. 2018), we created a positive AE sum score by summing responses to questions 1, 2, 4, and 6, and created a negative AE sum score by summing responses to questions 3, 5, and 7 (questions available in Supplemental Table 1, correlations available in Supplemental Fig. 1). As the AE data were collected at the 1-year follow-up, all other assessments described below were also taken from this timepoint, with the exception of demographic measures and parental history of alcohol problems which were only collected at baseline. ...
... We collapsed some of the response categories to create 7 categories in total: White, Black, Asian, American Indian and Alaska Native (AIAN), Native Hawaiian and Pacific Islander (NHPI), "Other" (note: this was a caregiver-endorsed category), and Multiracial (for children whose caregivers indicated more than one racial category). Child's ethnicity was also collected at baseline in the same survey with the question, "Do you consider the child Hispanic/Latino/Latina?" We recoded responses as "yes" = 1 and "no" = 0. Following the example of a prior study (Murphy et al. 2021), parents' marital status was recoded into two categories: married and not married. Family income was coded as a categorical variable with 3 categories: less than $35,000, $35,000 to $99,999, and $100,000 and above. ...
Alcohol expectancies (AEs) are associated with likelihood of alcohol initiation and subsequent alcohol use disorders. It is unclear whether genetic predisposition to alcohol use and/or related traits contributes to shaping how one expects to feel when drinking alcohol. We used the Adolescent Brain Cognitive Development study to examine associations between genetic propensities (i.e., polygenic risk for problematic alcohol use, depression, risk-taking), sociodemographic factors (i.e., parent income), and the immediate social environment (i.e., peer use and disapproval toward alcohol) and positive and negative AEs in alcohol-naïve children (max analytic N = 5,352). Mixed-effect regression models showed that age, parental education, importance of the child’s religious beliefs, adverse childhood experiences, and peer disapproval of alcohol use were associated with positive and/or negative AEs, to varying degrees. Overall, our results suggest several familial and psychosocial predictors of AEs but little evidence of contributions from polygenic liability to problematic alcohol use or related phenotypes.
... We collapsed some of the response categories to create 7 categories in total: White, Black, Asian, American Indian and Alaska Native (AIAN), Native Hawaiian and Paci c Islander (NHPI), "Other" (note: this was a caregiver-endorsed category), and Multiracial (for children whose caregivers indicated more than one racial category). Child's ethnicity was also collected at baseline in the same survey with the question, "Do you consider the child Hispanic/Latino/Latina?" We recoded responses as "yes" = 1 and "no" = 0. Following the example of a prior study 30 , parents' marital status was recoded into two categories: married and not married. Family income was coded as a categorical variable with 3 categories: less than $35,000, $35,000 to $99,999, and $100,000 and above. ...
... We analyzed positive and negative expectancies separately due to their relatively small correlation (Spearman's = -0.10), their separate treatment in prior literature (e.g., 20,30 ), and their potentially distinct pattern of associations with future alcohol use and alcohol use disorders [8][9][10] . We analyzed the ABCD data using a series of six models: ...
... In a sample of predominantly alcohol-naïve youth, positive and negative AEs were associated with older age, higher parental education, more adverse childhood experiences, and greater peer disapproval of alcohol use, while greater importance of religious beliefs was only associated with fewer positive AEs. These ndings were broadly consistent with a prior study by Murphy et al. 30 that was conducted in the ABCD sample, but some distinctions also emerged, discussed in more detail below. Notably, after accounting for these psychosocial and demographic factors, polygenic liability to risk-taking -the only PRS associated with AEs -was no longer signi cantly associated with negative AEs. ...
Alcohol expectancies (AEs) are associated with likelihood of alcohol initiation and subsequent alcohol use disorders. It is unclear whether genetic predisposition to alcohol use and/or related traits contributes to shaping how one expects to feel when drinking alcohol. We used the Adolescent Brain Cognitive Development study to examine associations between genetic (i.e., polygenic risk for problematic alcohol use, depression, risk-taking), familial (i.e., parent self-reported alcohol problems), and psychosocial (i.e., adverse childhood experiences, peer use and disapproval toward alcohol) factors and positive and negative AEs in alcohol-naïve children (max analytic N = 6,935). Mixed-effect regression models showed that parental education, importance of the child’s religious beliefs, adverse childhood experiences, peer disapproval of alcohol use, and polygenic liability for risk-taking were associated with positive and/or negative AEs, to varying degrees. Overall, our results suggest several familial and psychosocial predictors of AEs but little evidence of contributions from polygenic liability to problematic alcohol use or related phenotypes.
... The peer-level factor of relational victimization and the individual-level factor (i.e., negative life events), followed by other peer, school, and community-level factors, were associated with negative AE. Robust literature links AE to subsequent early drinking initiation (Smit et al., 2018). Indeed, previous studies using the ABCD Study sample have found associations between positive AE and alcohol sipping among 9-to 11-year-old children (Murphy et al., 2021). While existing multilevel prevention interventions are shown to be effective in targeting substance use behaviors including smoking and illicit drug use among youth, evidence remains limited regarding their efficacy in reducing underage drinking. ...
... Specifically, older age was associated with greater positive and negative AE. This is consistent with previous studies, which suggest that AE increase with age as a result of greater exposure to alcohol (Murphy et al., 2021). Notably, alcohol use reduction interventions based on AE have demonstrated limited efficacy among adolescents that have already initiated alcohol use (Smit et al., 2018). ...
Objective: Alcohol expectancies (AE) during early adolescence predict early alcohol use initiation and problem drinking both cross-sectionally and prospectively well into adulthood. Yet, our understanding of the sociocultural factors associated with AE during this development period remains limited. This study examines associations between AE and sociocultural factors across various domains (i.e., individual, family, peer, school, community, and culture) in a demographically diverse sample of 10- to 14-year-old youth in the Adolescent Brain Cognitive Development Study (ABCD Study). Method: This cross-sectional study used 2-year follow-up data from the ABCD Release 3.0 for N = 5,322 early adolescents (Mage = 12 years [SD = 0.6]; 47% male). Approximately 60% identified as non-Hispanic/Latinx White, 17% as Hispanic/Latinx, 11% as non-Hispanic/Latinx Black, 2% as non-Hispanic/Latinx Asian, and 11% as mixed/other race–ethnicity. Separate models for positive and negative AE outcomes were conducted using linear mixed-effect models while controlling for demographic covariates. Results: Positive AE were most strongly associated with familism, followed by other peer, school, community, and cultural level factors. Negative AE were most strongly associated with the peer-level factor of relational victimization and the individual-level factor of negative life events, followed by other peer, school, and community-level factors. Conclusion: The present findings reveal the potential constellation of sociocultural factors that may serve as targets for modifying AE during the middle school years. Study results also underscore the need for future research that integrates cultural factors into our understanding of alcohol use risk and resilience during early adolescence.
... To ensure the accuracy and reliability of self-reported data, participants were assured of the confidentiality of their responses. Standardized questionnaires, such as the iSay Sipping Inventory [23] and the web-based Timeline Follow-Back [24], were used. These measures were administered using standardized protocols across all study sites. ...
Background
The initiation of substance use during adolescence is a significant public health concern with long-term implications. Structural and environmental factors, such as community-level crime statistics related to drug offenses, are often assumed to influence the likelihood of substance use among youth. However, the relationship between these environmental crime indicators and early substance use initiation in adolescents is not well understood.
Objective
This study aims to examine the association between environmental drug-related crime statistics—derived from Uniform Crime Reports, including drug abuse violations, drug sales, marijuana sales, drug possession, and driving under the influence (DUI)—and the use of tobacco, marijuana, and alcohol among adolescents aged 9-16 in the United States.
Methods
Data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of adolescents from ages 9-10 to 16, were analyzed. 11,878 participants entered our analysis. The primary environmental measures included total drug abuse violations, drug sale offenses, marijuana sale offenses, drug possession offenses, and DUI reports. Substance use outcomes of interest were the frequency and prevalence of tobacco, marijuana, and alcohol use across the observed age range.
Results
Contrary to expectations, higher levels of drug-related crime in a community were not associated with increased use of tobacco, marijuana, or alcohol among adolescents. In fact, the study found a significant inverse relationship between the total number of drug-related crimes and tobacco use, suggesting lower tobacco use in areas with higher reported drug abuse violations, drug sales, marijuana sales, drug possession, and DUI incidents. No significant associations were observed between these crime indicators and the use of marijuana or alcohol.
Conclusions
These findings challenge the prevailing assumption that higher environmental drug-related crime statistics necessarily predict greater substance use among adolescents. The observed inverse relationship between drug-related crime and tobacco use warrants further investigation to understand the underlying mechanisms and to inform targeted intervention strategies. Future research should explore the complex interplay between structural environmental factors and youth substance use to better inform public health policies.
... This study did not include data on parent, guardian, family member, and/ or adolescent alcohol use. We plan to include these data in future studies to assess the influence of alcohol use on alcohol expectancy, to build on previous research (65). Also, although the ABCD cohort is vast and representative of diverse regions and backgrounds, it may not be representative of the entire adolescent population due to selection and self-selection biases. ...
Introduction
Alcohol expectancies predict subsequent alcohol use and related problems among adolescents, although predictors of alcohol expectancies remain unclear. This study examined the longitudinal association between family conflict, a sociocultural factor strongly implicated in adolescent alcohol use, and positive and negative alcohol expectancies of adolescents of diverse racial/ethnic backgrounds.
Methods
Data were from the Adolescent Brain Cognitive Development Study 4.0 release, a multisite longitudinal study (N = 6,231, baseline age 9–10). Linear mixed-effects regression, with interactions between race/ethnicity and family conflict, tested the association between family conflict and alcohol expectancies, for each racial/ethnicity (e.g., Black vs. non-Black; White vs. non-White).
Results
Interactions of family conflict with race/ethnicity in predicting negative and positive alcohol expectancies were statistically significant for models testing Black and White adolescents, but not for Asian, Hispanic, and Other. Family conflict at baseline predicted lower negative alcohol expectancy for Black adolescents (B = −.166, p = 0.033) and positive alcohol expectancy for White adolescents (B = 0.71, p = 0.023) at the year 3 follow-up. All models controlled for sex, age, family socioeconomic status, alcohol expectancies at year 1, and family conflict at year 3.
Conclusion
The results indicate that family conflict is a potential risk factor for problematic alcohol expectancies for Black and White adolescents. Although we did not directly compare Black and White adolescents, our findings indicate that family conflict may operate differently for Black and White adolescents. Prevention and intervention efforts targeting family conflict may be relevant for different aspects of alcohol expectancies in Black and White families.
... Underage drinking results in over 4000 deaths in the United States each year (Murphy et al., 2021). Initiation of alcohol use often begins with sipping, defined as taking a sip of alcohol without consuming a full standard drink (Donovan, 2007). ...
... This behaviour will be beneficial to include in screening as an additional category for children who have only sipped alcohol but have not consumed a full drink, as the findings show that it is different from teetotallers. (Murphy, Dufour and Gray, 2021) First use of alcohol at the age of 11-14 significantly increases the risk of progression to the development of alcohol-related disorders and is therefore a reasonable target for intervention strategies that seek to delay the first use of alcohol as a means to avert problems later in life (DeWit, 2000;Staton et al., 2020). ...
Background: The WHO European Region has the highest alcohol consumption of all six WHO regions. The research presented here is conducted in the Czech Republic, which has the highest average per capita alcohol consumption in Europe. The problem of alcoholism among children and adults is still not sufficiently perceived by Czech society as a risk and threat to the population's future health. Objective: The research aimed to confirm a relationship between the onset of alcohol consumption at a young age and the amount/frequency of current alcohol consumption. Method: Data analysis was conducted on a representative sample of children aged 6-17 (n= 2948; man:1492; 50,61 %; woman: 1456; 49,39%). Only 36.87% of children in our sample do not drink alcohol at all. 6.28% of children tasted alcohol for the first time before the age of 6. 19.30% tasted alcohol between the ages of 6 and 10, and 38.16% between the ages of 11 and 14. Results: The research confirms the association between early initiation of alcohol consumption and increased risk of binge drinking at older ages. Children who drink alcohol daily start very early. Children who consume alcohol only infrequently start drinking after age 15. Conclusion: The text intends to draw attention to the fact that despite existing prevention programs and interventions, alcohol consumption among children and adolescents is still a severe and contemporary problem related to the high tolerance of society towards alcohol consumption. The degree of denormalization of underage drinking in the Czech Republic is still low. However, even if we accept the thesis of gradual demoralization of drinking, which is based on the assumption of declining alcohol consumption, it appears that early initiation of drinking is thus becoming an increasingly important indicator of wider risk behavior and needs increased attention.
... A typical example is the existence of parents who continue to offer alcohol to their children, as in some countries it is socially accepted, ignoring that age of onset is a predictor of present and future harm, including the development of dependence (Hingson et al., 2006) and even increase the overall mortality, as a large North American study (Hu et al., 2017) identified. If alcohol was not so culturally accepted (as inherently "recreational"), parents would not consider tolerating the use of their children so early, despite the evidence that parental introduction into sipping alcohol increases the harms and quantities of alcohol consumed in adolescence (Colder et al., 2018;Murphy et al., 2021;Clare et al., 2020). ...
This debate paper discusses six reasons why the term "recreational substance use" should be avoided. (1) Social norms and beliefs are drivers of behavior; therefore, the normalized use of the term conveys injunctive norms of a fully socially acceptable substance. Injunctive norms are the most important drivers of initiation into substance use. (2) The illusion of being in control, suggesting that if consumed for leisure and recreation it can easily be controlled; (3) Idealized social representations that fuel an idealized image of an alternative glamourous or mindful consumption culture; (4) Downplaying potential harms; (5) The implicit promise of everyday pleasure, the ever-growing potency of cannabis products does not fit the narrative of its use for recreation; (6) Industry as a trojan horse branding discourse of the concept of medical cannabis to normalize the image of non-medical use: to complement "therapeutic" with "recreational". "Recreational use" is a subjective ill-defined term. This debate paper aims to find a better terminological solution, honestly denominating with a neutral, unbiased, and objective connotation what is now called "recreational use". Thus, we propose using the term "non-therapeutic" use.
... Some parents may view drinking with supervision as a harm reduction strategy that promotes responsible drinking or reduces interest in alcohol (Friese et al., 2012;Jackson et al., 2012), some view drinking on special occasions (e.g., family gatherings or religious ceremonies) is less risky due to the presence of other family members (Friese et al., 2012;Watts et al., 2020), and some believe that alcohol use by adolescents is inevitable and drinking under parental supervision is preferable compared to riskier contexts, such as with peers (Wadolowski et al., 2016;Ward & Snow, 2011). Despite these perceived protective effects, evidence suggests drinking (even just sipping and tasting) with parental permission poses risk for increased drinking later in adolescence Donovan & Molina, 2011;Jackson et al., 1997Jackson et al., , 1999Komro et al., 2007;Sharmin et al., 2017), positive alcohol expectancies (Murphy et al., 2021), and negative alcohol-related consequences (Kaynak et al., 2014;McMorris et al., 2011). Drinking alcohol with parent permission may have a unique effect on the effectiveness of ARC compared to drinking without permission. ...
The frequency of parental alcohol risk communication (ARC) is considered an integral component of socializing youth about alcohol, but the literature offers mixed findings on whether such communication is protective. Early adolescents’ prior drinking experiences may moderate the effectiveness of ARC, but evidence for such an interaction is inconsistent. One limitation of this work considering prior drinking experience is that it has not distinguished drinking with versus without parental permission. Parents are one of the earliest sources of information about alcohol use and many parents view allowing adolescents to drink alcohol with permission as a harm reduction strategy, despite some work suggesting the opposite effect. Using a random effects multilevel regression, we tested the unique moderating effects of drinking with and without parental permission on the prospective association between alcohol risk communication and later drinking without parental permission. Adolescent and parent dyads completed 3 annual assessments (first assessment mean age = 12.6, 52% girls, 76% White/non-Hispanic). Results supported a three-way interaction. There was a modest protective effect of parental ARC on later adolescent drinking, but only for adolescents who had prior experience drinking both with and without parental permission. For all other combinations of prior drinking experience, parental communication was not prospectively related to later drinking. These results help clarify the mixed literature on alcohol communication and suggests that ARC may help reduce some of the risk associated with allowing youth to drink alcohol but only for youth who also have experience with alcohol outside of parental supervision.
Background:
Social media can influence alcohol initiation behaviors such as sipping, which can lead to future adverse alcohol-related outcomes. Few studies have examined the role of problematic social media use, characterized by addiction, mood modification, tolerance, withdrawal, conflict, and relapse, especially in early adolescence.
Objective:
To examine the prospective association between social media use and sipping alcohol in a nationwide sample of early adolescents, and the extent to which problematic social media use mediates the association.
Methods:
We analyzed prospective data from the Adolescent Brain Cognitive Development Study (N = 7514; ages 9-10 years at baseline; 2016-2018) to estimate associations between social media time (Year 1) and alcohol sipping (Year 3) using modified Poisson regression, adjusting for confounders and testing problematic social media use (Year 2) as a mediator.
Results:
Social media time (Year 1) was prospectively associated with 1.31 (95% confidence interval 1.20-1.43) times higher risk of new-onset sipping (Year 3). The association between social media time and new-onset alcohol sipping was partially mediated by problematic social media use at Year 2 (25.0% reduction in the association between the former two factors after adding problematic social media use, p = 0.002).
Conclusions:
Time spent on social media was associated with a higher risk of alcohol sipping in a diverse national sample of early adolescents, and the association was partially mediated by problematic social media use. Media literacy education and family media use plans could advise early adolescents about exposure to alcohol content on social media and warning signs for problematic use.
Alcohol use emerges during early adolescence and is strongly associated with individual and peer risky, delinquent, and rule breaking behaviors. Genetic predisposition for risky behavior contributes to individual rule breaking in adolescence and can also evoke peer rule breaking or lead youth to select into delinquent peer groups via gene-environment correlations (rGE), collectively increasing risk for alcohol use. Little research has examined whether genetic predisposition for risky behavior contributes to individual and peer rule breaking behavior in developmental pathways to alcohol use in early adolescence or in large diverse racial/ethnic populations. To address this, polygenic scores for risky behavior were considered predictors of individual rule breaking, peer rule breaking, and alcohol sips using data from the Adolescent Brain Cognitive Development (ABCD) study at age 11-12 and 12-13 in a cross-time cross-lagged model. This was examined separately in European American (EA; n = 5113; 47% female), African American (AA; n = 1159; 50% female), and Hispanic/Latinx (Latinx; n = 1624; 48% female) subgroups accounting for sociodemographic covariates and genetic ancestry principal components. Polygenic scores were positively associated with all constructs in EAs, with individual rule breaking at age 11-12 in AAs and Latinx, and with alcohol sips at age 11-12 in Latinx. Individual and peer rule breaking were associated with one another across time only in the EA subgroup. In all subgroups, peer rule breaking at 12-13 was associated with alcohol sips at 12-13. Results indicate that alcohol sips in early adolescence are associated with individual and peer rule breaking with rGE implicated in EAs.
This review compares the main brain abnormalities in schizophrenia (SZ), bipolar disorder (BD), major depressive disorder (MDD), and 22q11.2 Deletion Syndrome (22q11DS) determined by ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) consortium investigations. We obtained ranked effect sizes for subcortical volumes, regional cortical thickness, cortical surface area, and diffusion tensor imaging abnormalities, comparing each of these disorders relative to healthy controls. In addition, the studies report on significant associations between brain imaging metrics and disorder‐related factors such as symptom severity and treatments. Visual comparison of effect size profiles shows that effect sizes are generally in the same direction and scale in severity with the disorders (in the order SZ>BD>MDD). The effect sizes for 22q11DS, a rare genetic syndrome that increases the risk for psychiatric disorders, appear to be much larger than for either of the complex psychiatric disorders. This is consistent with the idea of generally larger effects on the brain of rare compared to common genetic variants. Cortical thickness and surface area effect sizes for 22q11DS with psychosis compared to 22q11DS without psychosis are more similar to those of SZ and BD than those of MDD; a pattern not observed for subcortical brain structures and fractional anisotropy effect sizes. The observed similarities in effect size profiles for cortical measures across the psychiatric disorders mimic those observed for shared genetic variance between these disorders reported based on family and genetic studies and are consistent with shared genetic risk for SZ and BD and structural brain phenotypes. This article is protected by copyright. All rights reserved.
An accumulating literature has shown the influence of childhood experiences associated with alcohol use on later drinking practices. Recent studies have suggested that alcohol-related expectancy may serve as an intervening variable to connect these early experiences with the later, proximal decision to drink when opportunities for actual alcohol consumption arise. Those studies, however, have collected expectancy and drinking data concurrently, whereas the present study for the first time reports on the power of expectancies measured in early adolescents (seventh and eighth grades) to predict self-reported drinking onset and drinking behavior measured a full year later. Results show that five of seven expectancy scores readily discriminated between nonproblem drinkers and those subsequently beginning problem drinking and accounted for a large portion of the variance in a continuous quantity/frequency index and a problem drinking index. The strength of these time-lagged relations strengthens the case for inferring that expectancies have causal power on drinking behavior and suggests prevention strategies.
Background:
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question screen is a valid adolescent alcohol screening tool. No studies have examined if this tool predicts future alcohol problems. We conducted a study at 16 pediatric emergency departments to determine the tool's predictive validity for alcohol misuse and alcohol use disorders (AUDs).
Methods:
Participants (N = 4834) completed a baseline assessment battery. A subsample of participants completed the battery at 1, 2, and 3 years follow up.
Results:
Of the 2209 participants assigned to follow-up, 1611 (73%) completed a 1-year follow-up, 1591 (72%) completed a 2-year follow-up, and 1377 (62%) completed a 3-year follow-up. The differences in AUDs between baseline NIAAA screen nondrinkers and lower-risk drinkers were statistically significant at 1 year (P = .0002), 2 years (P <.0001), and 3 years (P = .0005), as were the differences between moderate- and highest-risk drinkers at 1 and 2 years (P < .0001 and P = .0088, respectively) but not at 3 years (P = .0758). The best combined score for sensitivity (86.2% at 1 year, 75.6% at 2 years, and 60.0% at 3 years) and specificity (78.1% at 1 year, 79.2% at 2 years, and 80.0% at 3 years) was achieved by using "lower risk" and higher as a cutoff for the prediction of a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis.
Conclusions:
The NIAAA 2-question screen can accurately characterize adolescent risk for future AUDs. Future studies are needed to determine optimaluse of the screen.
The ABCD study is a new and ongoing project of very substantial size and scale involving 21 data acquisition sites. It aims to recruit 11,500 children and follow them for ten years with extensive assessments at multiple timepoints. To deliver on its potential to adequately describe adolescent development, it is essential that it adopt recruitment procedures that are efficient and effective and will yield a sample that reflects the nation's diversity in an epidemiologically informed manner. Here, we describe the sampling plans and recruitment procedures of this study. Participants are largely recruited through the school systems with school selection informed by gender, race and ethnicity, socioeconomic status, and urbanicity. Procedures for school selection designed to mitigate selection biases, dynamic monitoring of the accumulating sample to correct deviations from recruitment targets, and a description of the recruitment procedures designed to foster a collaborative attitude between the researchers, the schools and the local communities, are provided.
One of the objectives of the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org/) is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States.
Understanding the nature of, and transitions in, young children's alcohol-related knowledge and attitudes is important to determining the age at which we should start educating children about alcohol and informing our understanding of the focus of such education. This paper aimed to explore current literature on the alcohol-related knowledge, beliefs, attitudes and expectancies of children aged 12years and under. Electronic databases were searched for papers published from January 2000-August 2016. Further papers were identified by a manual review of reference lists, and contacting corresponding authors of included papers. Papers that reported on children's knowledge or beliefs about alcohol, attitudes towards alcohol and/or expectancies regarding alcohol consumption were included. Seventeen cross-sectional, experimental or observational studies and seven longitudinal studies met the inclusion criteria. Data on key measures was tabulated. From a very young age children are aware of and able to identify alcohol, and have some knowledge of its effects; their attitudes become more positive with increasing age and these shifts appear to precede drinking initiation by some years. The small number of available studies, with different measures of knowledge, attitudes and expectancies, made assessment of bias unfeasible. Only three studies were published in the last five years. Children's knowledge of, and attitudes towards, alcohol form before they initiate alcohol use, and are likely acquired through observation. Alcohol-related education should commence before children begin drinking, and should encourage the delay of alcohol initiation, address social norms, and reduce positive expectancies.
Purpose of review:
This review investigates effects of alcohol advertising on adolescent drinking. Prior reviews focused on behavioral outcomes and long-term effects. In contrast, the present review focuses on subgroups with greater exposure to alcohol advertising, research methods to study alcohol advertising, potential mechanisms underlying relationships between adolescent exposure to alcohol advertising and increased drinking and points to prevention/intervention strategies that may reduce effects of alcohol advertising.
Recent findings:
Alcohol advertising influences current and future drinking. Further, evidence suggests adolescents may be targeted specifically. Alcohol advertisements may influence behavior by shifting alcohol expectancies, norms regarding alcohol use, and positive attitudes. Media literacy programs may be an effective intervention strategy.
Summary:
Adolescents are exposed to large quantities of alcohol advertisements, which violates guidelines set by the alcohol industry. However, media literacy programs may be a promising strategy for adolescents to increase critical thinking and create more realistic expectations regarding alcohol.
Alcohol use disorder (AUD) and alcohol misuse are common among adolescents and young adults and are associated with significant personal and societal problems. Similarly, major depressive disorder (MDD) and depressive symptoms are prevalent in this population and when they co-occur with alcohol misuse leads to even more severe consequences. Numerous studies have investigated the association between depressive symptoms, AUD, and various drinking behaviors presenting an unclear picture. In this review, we summarize studies among adolescents and young adults that have examined these relationships. From this review, it emerges that several factors affect results, including study design (cross-sectional vs longitudinal), participants’ age (adolescents vs young adults), severity of problems considered (AUD vs heavy drinking; MDD vs depressive symptoms), and gender. Adolescents with AUD are at higher risk for MDD in particular at a younger age. During adolescence, several drinking behaviors, including weekly alcohol use and heavy drinking, increase the risk for depressive symptoms and MDD, while during young adulthood primarily AUD, but not other drinking behaviors, is associated with increased risk for MDD. Gender may have an effect on the association between depression and drinking behaviors but its role is still unclear. Some evidence suggests that the association between AUD and MDD is bidirectional such that mood problems contribute to the onset of alcohol problems and vice versa. More longitudinal studies are needed to examine these associations in young adults and to clarify the effect of gender on these associations. To date, findings suggest the critical need to reduce any alcohol use at a young age and to treat both depressive symptoms and AUD to prevent the occurrence of comorbid disorders.
The analysis of experimental data with mixed-effects models requires
decisions about the specification of the appropriate random-effects structure.
Recently, Barr et al. (2013) recommended fitting 'maximal' models with all
possible random effect components included. Estimation of maximal models,
however, may not converge. We show that failure to converge typically is not
due to a suboptimal estimation algorithm, but is a consequence of attempting to
fit a model that is too complex to be properly supported by the data,
irrespective of whether estimation is based on maximum likelihood or on
Bayesian hierarchical modeling with uninformative or weakly informative priors.
Importantly, even under convergence, overparameterization may lead to
uninterpretable models. We provide diagnostic tools for detecting
overparameterization and guiding model simplification. Finally, we clarify that
the simulations on which Barr et al. base their recommendations are atypical
for real data. A detailed example is provided of how subject-related
attentional fluctuation across trials may further qualify statistical
inferences about fixed effects, and of how such nonlinear effects can be
accommodated within the mixed-effects modeling framework.
Background:
Sipping or tasting alcohol is one of the earliest alcohol-use behaviors in which young children engage, yet there is relatively little research on this behavior. Previous cross-sectional analyses determined that child sipping or tasting is associated with the child's attitude toward sipping and with a family environment supportive of alcohol use, but not with variables reflecting psychosocial proneness for problem behavior as formulated in Problem Behavior Theory (Jessor and Jessor, Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth, 1977, Academic Press, New York). This study extended these analyses longitudinally to identify antecedent predictors of the childhood initiation of sipping or tasting alcohol in a multiwave study.
Methods:
A sample of 452 children (238 girls) aged 8 or 10 and their families was drawn from Allegheny County, PA, using targeted-age directory sampling and random digit dialing procedures. Children were interviewed using computer-assisted interviews. Antecedent variables collected at baseline (Wave 1) were examined as predictors of the initiation of sipping/tasting alcohol in childhood (before age 12) among Wave 1 abstainers (n = 286).
Results:
Ninety-four children initiated sipping/tasting alcohol in a nonreligious context between baseline and turning age 12. Initiation of sipping/tasting did not generally relate to baseline variables reflecting psychosocial proneness for problem behavior. Instead, as found in the previous cross-sectional analyses, the variables most predictive of initiating sipping/tasting were perceived parents' approval for child sipping, parents' reported approval for child sipping, parents' current drinking status, and children's attitudes toward sipping/tasting alcohol.
Conclusions:
These longitudinal analyses replicate the earlier cross-sectional results. Young children's sipping/tasting of alcohol reflects parental modeling of drinking and parental approval of child sipping and does not represent a precocious manifestation of a psychosocial proneness to engage in problem behavior.
Maximum likelihood or restricted maximum likelihood (REML) estimates of the
parameters in linear mixed-effects models can be determined using the lmer
function in the lme4 package for R. As for most model-fitting functions in R,
the model is described in an lmer call by a formula, in this case including
both fixed- and random-effects terms. The formula and data together determine a
numerical representation of the model from which the profiled deviance or the
profiled REML criterion can be evaluated as a function of some of the model
parameters. The appropriate criterion is optimized, using one of the
constrained optimization functions in R, to provide the parameter estimates. We
describe the structure of the model, the steps in evaluating the profiled
deviance or REML criterion, and the structure of classes or types that
represents such a model. Sufficient detail is included to allow specialization
of these structures by users who wish to write functions to fit specialized
linear mixed models, such as models incorporating pedigrees or smoothing
splines, that are not easily expressible in the formula language used by lmer.
This longitudinal study provided a comprehensive examination of age-related changes in alcohol outcome expectancies, subjective evaluation of alcohol outcomes, and automatic alcohol associations in early adolescence. A community sample (52% female, 75% White/non-Hispanic) was assessed annually for 3 years (mean age at the first assessment = 11.6 years). Results from growth modeling suggested that perceived likelihood of positive outcomes increased and that subjective evaluations of these outcomes were more positive with age. Perceived likelihood of negative outcomes declined with age. Automatic alcohol associations were assessed with an Implicit Association Task (IAT), and were predominantly negative, but these negative associations weakened with age. High initial levels of perceived likelihood of positive outcomes at age 11 were associated with escalation of drinking. Perceived likelihood of negative outcomes was associated with low risk for drinking at age 11, but not with changes in drinking. Increases in positive evaluations of positive outcomes were associated with increases in alcohol use. Overall, findings suggest that at age 11, youth maintain largely negative attitudes and perceptions about alcohol, but with the transition into adolescence, there is a shift toward a more neutral or ambivalent view of alcohol. Some features of this shift are associated with escalation of drinking. Our findings point to the importance of delineating multiple aspects of alcohol information processing for extending cognitive models of alcohol use to the early stages of drinking. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
This article reports on a longitudinal test of a developmental model of early drinking that specifies transactions among personality, learning, and behavior in the risk process. The model was tested on 1,906 children making the transition from elementary school to middle school across 3 time points: the spring of 5th grade, the fall of 6th grade, and the spring of 6th grade. In a transaction that has been referred to as acquired preparedness, individual differences in the trait positive urgency at the end of 5th grade were associated with increases in expectancies for social facilitation from alcohol at the start of 6th grade, which then predicted drinker status at the end of 6th grade. In addition, the alcohol expectancy and drinker status predicted each other reciprocally across time. Multiple factors appear to transact to predict early drinking behavior. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
To assess the validity of the research into alcohol-related outcome expectancies a systematic review of 80 articles published between 1970 and 2013 was conducted. Participant gender, age, and contextual influences are highlighted as possible causes of the observed variations in research findings. There is a need for fuller consideration of the influences of demographics and environmental and social contexts on research findings. It is recommended that alcohol intake measures should be standardized to a greater degree in future research. Contextual influences on expectancies also require extensive future investigation to increase the validity of research and improve alcohol-related interventions.
Alcohol expectancy (AEs) research has enhanced our understanding of how anticipated alcohol effects confer risk for heavy drinking and alcohol-related problems. However, extant AE measures have limitations within 1 or more of the following areas: assessing a comprehensive range of effects, specifying the hypothetical number of drinks consumed, assessing AEs by limb of the blood alcohol curve (BAC), and/or not having undergone psychometric evaluation. Building upon the strengths of existing measures, we employed conceptual and statistical advances in measurement development to create the novel, psychometrically sound Anticipated Effects of Alcohol Scale (AEAS). Unique to this study, pilot data ensured that the AEAS comprised a comprehensive sampling of effects that varied in valence (positive/negative) and arousal (low/high) and were identified as plausible outcomes of drinking. The AEAS specified the number of drinks individuals imagined consuming (adjusted for sex) and the hypothetical drinking episode length (2 hr). AEs were also assessed separately by BAC limb. For validation purposes, the AEAS was included in several survey studies of young adults (ages 18-30). The validity argument for the proposed interpretation of AEAS test scores was based upon the following: (a) exploratory and confirmatory factor analyses (N = 546) identified a 22-item, 4-factor internal structure, categorizing alcohol effects into quadrants (high/low arousal crossed with positive/negative valence); (b) scalar measurement invariance was established for BAC limb, sex, and binge drinking status; (c) convergence/divergence was observed with alternative AEs measures and mood; and (d) test-criterion relationships were observed with several alcohol-related outcomes. The reliability argument was based on test-retest and internal consistency coefficients. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
This study examined potential explanatory mechanisms linking childhood alcohol use onset and chronicity of adult alcohol dependence by testing the following three competing hypotheses: (1) a marker hypothesis, where early onset of alcohol use may be simply a marker for other factors that have been linked to both age at initiation and adult alcohol problems; (2) a compromised development hypothesis, where early alcohol initiation may interfere with adolescent development, which can lead to later alcohol problems; and (3) an increased substance use hypothesis, where early onset of alcohol use may lead to increased substance use in adolescence and, in turn, chronic alcohol dependence.
Data came from a longitudinal community sample of 808 participants recruited at age 10 in 1985. Participants were followed through age 33 in 2008 with 92% retention.
Childhood onset of alcohol use (before age 11), when compared with initiation during adolescence, predicted an increased chronicity of adult alcohol dependence, even after accounting for the hypothesized confounds from the marker hypothesis. In addition, adolescent compromised functioning did not mediate this relationship between early alcohol use and chronicity of adult dependence (Hypothesis 2), nor did adolescent substance use (Hypothesis 3). However, compromised functioning and substance use in adolescence predicted increased chronicity of alcohol dependence in young adulthood.
Prevention efforts as early as the elementary grades should focus on delaying the onset of alcohol use and reducing substance use in adolescence as well as improving school functioning, reducing adolescent problem behaviors, and targeting adolescent peer networks.
Multivariate Imputation by Chained Equations (MICE) is the name of software for imputing incomplete multivariate data by Fully Conditional Speci cation (FCS). MICE V1.0 appeared in the year 2000 as an S-PLUS library, and in 2001 as an R package. MICE V1.0 introduced predictor selection, passive imputation and automatic pooling. This article presents MICE V2.0, which extends the functionality of MICE V1.0 in several ways. In MICE V2.0, the analysis of imputed data is made completely general, whereas the range of models under which pooling works is substantially extended. MICE V2.0 adds new functionality for imputing multilevel data, automatic predictor selection, data handling, post-processing imputed values, specialized pooling and model selection. Imputation of categorical data is improved in order to bypass problems caused by perfect prediction. Special attention to transformations, sum scores, indices and interactions using passive imputation, and to the proper setup of the predictor matrix. MICE V2.0 is freely available from CRAN as an R package mice. This article provides a hands-on, stepwise approach to using mice for solving incomplete data problems in real data.
The purpose of this study was to evaluate a brief version of the Alcohol Expectancy Questionnaire-Adolescent (AEQ-A; Brown, Christiansen, & Goldman, 1987). The original AEQ-A was reduced to seven items (called the AEQ-AB). Principal Components Analysis (PCA) was performed and two factors emerged (General Positive Effects and Potential Negative Effects) accounting for 46% of the variance. Internal consistencies are comparable to those of the original AEQ-A (0.50). Scales correlate with criterion variables such as average drinks per week and average number of drinks per heavy drinking day (p < 0.05). It is concluded that this questionnaire may be useful to clinicians providing brief assessment and intervention. Cross-validation in other samples and other settings is recommended.
Alcohol expectancies are important predictors of alcohol involvement in both adolescents and adults, yet little research has examined the social origins and transmission of these beliefs. This paper examined alcohol outcome expectancies collected in a cohort-sequential longitudinal study of 452 families with children followed over seven waves. Children completed interviews every 6 months, and parents completed interviews annually. Eighteen of 27 alcohol expectancies were highly consensual, being endorsed by significantly more than 67% of the mothers and fathers. These consensual expectancies were also highly stable over a 3-year period. Over the same period, children increased their adoption of both the positive and negative consensual alcohol expectancies. Unconditional latent growth modeling showed that piece-wise growth models with a transition at age 12 fit the data best. Both the positive and negative consensual expectancies were adopted at a faster rate between ages 8.5 and 11.5 than between ages 12 and 13.5. For negative expectancies, there was no further growth between ages 12 and 13.5. Taken together, these findings support the conceptualization of alcohol outcome expectancies as socially shared and transmitted beliefs.
To determine the accuracy of the CRAFFT substance abuse screening test.
Criterion standard validation study comparing the score on the 6-item CRAFFT test with screening categories determined by a concurrently administered substance-use problem scale and a structured psychiatric diagnostic interview. Screening categories were "any problem" (ie, problem use, abuse, or dependence), "any disorder" (ie, abuse or dependence), and "dependence."
A large, hospital-based adolescent clinic.
Patients aged 14 to 18 years arriving for routine health care.
The CRAFFT receiver operating characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value.
Of the 538 participants, 68.4% were female, and 75.8% were from racial and ethnic minority groups. Diagnostic classifications for substance use during the past 12 months were no use (49.6%), occasional use (23.6%), problem use (10.6%), abuse (9.5%), and dependence (6.7%). Classifications were strongly correlated with the CRAFFT score (Spearman rho, 0.72; P<.001). A CRAFFT score of 2 or higher was optimal for identifying any problem (sensitivity, 0.76; specificity, 0.94; positive predictive value, 0.83; and negative predictive value, 0.91), any disorder (sensitivity, 0.80; specificity, 0.86; positive predictive value, 0.53; and negative predictive value, 0.96) and dependence (sensitivity, 0.92; specificity, 0.80; positive predictive value, 0.25; and negative predictive value 0.99). Approximately one fourth of participants had a CRAFFT score of 2 or higher. Validity was not significantly affected by age, sex, or race.
The CRAFFT test is a valid means of screening adolescents for substance-related problems and disorders, which may be common in some general clinic populations.
Prior research has shown that sipping of alcohol begins to emerge during childhood and is potentially etiologically significant for later substance use problems. Using a large, community sample of 9- and 10-year-olds ( N = 11,872; 53% female), we examined individual differences in precocious alcohol use in the form of alcohol sipping. We focused explicitly on features that are robust and well-demonstrated correlates of, and antecedents to, alcohol excess and related problems later in the lifespan, including youth- and parent-reported externalizing traits (i.e., impulsivity, behavioral inhibition and activation) and psychopathology. Seventeen percent of the sample reported sipping alcohol outside of a religiously sanctioned activity by age 9 or 10. Several aspects of psychopathology and personality emerged as small but reliable correlates of sipping. Nonreligious sipping was related to youth-reported impulsigenic traits, aspects of behavioral activation, prodromal psychotic-like symptoms, and mood disorder diagnoses, as well as parent-reported externalizing disorder diagnoses. Religious sipping was unexpectedly associated with certain aspects of impulsivity. Together, our findings point to the potential importance of impulsivity and other transdiagnostic indicators of psychopathology (e.g., emotion dysregulation, novelty seeking) in the earliest forms of drinking behavior.
Alcohol use continues to be problematic for youth and young adults in the United States. Understanding of neurobiology and neuroplasticity continues to highlight the potential adverse impact of underage drinking on the developing brain. This policy statement provides the position of the American Academy of Pediatrics on the issue of alcohol and is supported by an accompanying technical report.
Aims
The main aim of this study was to assess the relationship between parental attitudes towards children's alcohol use and their child's alcohol use. Secondary aims included assessing the relationship between attitudes reported by parents and those perceived by children, and between perceived parental attitudes and children's alcohol use.
Methods
Meta‐analysis of studies reporting on the associations between parental attitudes towards children's alcohol use and children's self‐reported alcohol use. Published, peer‐reviewed cross‐sectional and longitudinal studies were identified from the following databases up to April 2018: Medline, PsycINFO, EMBASE, Scopus and Web of Science. Quality assessment was performed by using guidelines developed by Hayden, Cote & Bombardier. Pooled effect sizes were calculated by using random‐effects meta‐analyses, if there were at least two studies that could be included per analysis. Of 7471 articles screened, 29 were included comprising data from 16 477 children and 15 229 parents.
Results
Less restrictive parental attitudes towards children's alcohol use were related to higher rates of alcohol use initiation [odds ratio (OR) = 1.45, 95% confidence interval (CI) = 1.17–1.80], alcohol use frequency (OR = 1.52, 95% CI = 1.24–1.86) and drunkenness (OR = 1.58, 95% CI = 1.35–1.85) among children. Less perceived restrictive parental attitudes were related to higher alcohol use frequency (OR = 1.76, 95% CI = 1.29–2.40). Perceived parental attitudes were not clearly related to alcohol use initiation. Parent‐reported attitudes and perceived parental attitudes were weakly positively correlated (r = 0.27, P = ≤ 0.001). The strength of the relationship between parental attitudes and children's alcohol use frequency attenuated with children's age. Study design, sample size, study location and levels of alcohol use frequency did not have a detectable effect on the relationship.
Conclusions
Less restrictive parental attitudes towards children's alcohol use are associated with increases in children's alcohol use onset, alcohol use frequency and drunkenness. Children's perception of less restrictive parental attitudes is associated with children's alcohol use.
The common approach to the multiplicity problem calls for controlling the familywise error rate (FWER). This approach, though, has faults, and we point out a few. A different approach to problems of multiple significance testing is presented. It calls for controlling the expected proportion of falsely rejected hypotheses — the false discovery rate. This error rate is equivalent to the FWER when all hypotheses are true but is smaller otherwise. Therefore, in problems where the control of the false discovery rate rather than that of the FWER is desired, there is potential for a gain in power. A simple sequential Bonferronitype procedure is proved to control the false discovery rate for independent test statistics, and a simulation study shows that the gain in power is substantial. The use of the new procedure and the appropriateness of the criterion are illustrated with examples.
Purpose:
Developmental changes in alcohol expectancies (AE) have been proposed to lead to alcohol use initiation and later alcohol use in adolescence. This systematic review aims to provide longitudinal evidence of the development of AE and the relation of AE to alcohol outcomes from childhood to late adolescence (4-18 years old).
Methods:
A computer-assisted search of relevant articles identified 1602 studies, of which 43 studies (conducted between 1996 and 2016) were selected.
Results:
First, negative AE decline and positive AE increase in early adolescence. Moreover, alcohol use (initiation) seems to strongly influence changes in AE. Second, AE predict alcohol use initiation and drinking patterns over time. Third, longitudinal predictors of AE could be divided into individual predictors (i.e., alcohol-related cognitions, psychopathology, and genetics) and environmental predictors (i.e., family, peer, and media influences). Lastly, the results indicated that AE function as mediators of the relations between the various individual and environmental predictors and adolescent's alcohol use.
Conclusions:
Alcohol expectancies form an important framework through which drinking behavior can be explained over time. Due to the diverse findings on the predictors of AE, future longitudinal studies should further clarify the factors that are essential in the development of AE and adolescent's later alcohol use.
The Adolescent Brain and Cognitive Development (ABCD) Study incorporates a comprehensive range of measures assessing predictors and outcomes related to both mental and physical health across childhood and adolescence. The workgroup developed a battery that would assess a comprehensive range of domains that address study aims while minimizing participant and family burden. We review the major considerations that went into deciding what constructs to cover in the demographics, physical health and mental health domains, as well as the process of selecting measures, piloting and refining the originally proposed battery. We present a description of the baseline battery, as well as the six-month interim assessments and the one-year follow-up assessments. This battery includes assessments from the perspectives of both the parent and the target youth, as well as teacher reports. This battery will provide a foundational baseline assessment of the youth's current function so as to permit characterization of stability and change in key domains over time. The findings from this battery will also be utilized to identify both resilience markers that predict healthy development and risk factors for later adverse outcomes in physical health, mental health, and substance use and abuse.
Background and aims:
Adolescent alcohol misuse is a growing global health concern. Substantial research suggests that parents have an important role in reducing young people's risk for early initiation of alcohol and alcohol-related harms. To facilitate research translation, we conducted a systematic review and meta-analyses of longitudinal studies examining the range of modifiable parenting factors that are associated with adolescent alcohol initiation and levels of later use/misuse.
Methods:
A systematic literature search was conducted in PubMed, PsycINFO and Embase. Studies were included if they (i) used a longitudinal design; (ii) were published in English; (iii) measured any modifiable parenting factors in adolescence as predictors; (iv) assessed any alcohol-related outcome variables in adolescence and/or alcohol-related problems in adulthood; and (v) had a follow-up interval of at least 1 year. Parental behaviours were categorized into 12 parenting factors. Stouffer's P analyses were used to determine whether the associations between variables were reliable; when there were sufficient studies available, meta-analyses were also conducted to estimate mean effect sizes.
Results:
Based on 131 studies, three risk factors (parental provision of alcohol, favourable parental attitudes towards alcohol use and parental drinking) and four protective factors (parental monitoring, parent-child relationship quality, parental support and parental involvement) were identified as longitudinal predictors of both alcohol initiation and levels of later alcohol use/misuse, based on their significant results in both Stouffer's P analyses and meta-analyses. The mean effect sizes were mainly small (rs = -0.224 to 0.263).
Conclusions:
Risk of adolescent alcohol misuse is positively associated with parental provision of alcohol, favourable parental attitudes towards alcohol use and parental drinking. It is negatively associated with parental monitoring, parent-child relationship quality, parental support and parental involvement.
Introduction:
Alcohol expectancies are important determinants and predictors of adolescent alcohol use. Research with African Americans has shown that the endorsement of positive alcohol expectancies differs from that of Whites during childhood and predicts different alcohol outcomes during young adulthood. However, limited research has explored racial differences in the relationship between expectancy endorsement and alcohol use in school-aged adolescents. The current study examines the effect of White or African American race on the relationship between positive alcohol expectancies and alcohol use.
Methods:
Participants were 104 adolescents ages 12-18 who identified as either non-Hispanic White or non-Hispanic African American. Participants completed self-report measures of alcohol consumption and positive social alcohol expectancies.
Results:
Preliminary analyses revealed no racial differences in alcohol expectancies or consumption. However, race moderated the relationship between alcohol expectancies and alcohol use such that more positive expectancies predicted alcohol use among White youth, but not African American youth.
Conclusions:
These results suggest that alcohol expectancies, which were thought to be important mediators of the relationship between social and personality factors and adolescent alcohol use may not be as impactful for African Americans. Future research should focus on identifying factors posing unique risk for alcohol consumption in this population.
The effect of a number of factors, such as the choice of analytical method, the handling method for missing data, sample size, and proportion of missing data, were examined to evaluate the effect of missing data treatment on accuracy of estimation. A methodological approach involving simulated data was adopted. One outcome of the statistical analyses undertaken in this study is the formulation of easy-to-implement guidelines for educational researchers that allows one to choose one of the following factors when all others are given: sample size, proportion of missing data in the sample, method of analysis, and missing data handling method.
Objective:
During adolescence, neurobiological maturation occurs concurrently with social and interpersonal changes, including the initiation of alcohol and other substance use. The National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) is designed to disentangle the complex relationships between onset, escalation, and desistance of alcohol use and changes in neurocognitive functioning and neuromaturation.
Method:
A sample of 831 youth, ages 12-21 years, was recruited at five sites across the United States, oversampling those at risk for alcohol use problems. Most (83%) had limited or no history of alcohol or other drug use, and a smaller portion (17%) exceeded drinking thresholds. A comprehensive assessment of biological development, family background, psychiatric symptomatology, and neuropsychological functioning-in addition to anatomical, diffusion, and functional brain magnetic resonance imaging-was completed at baseline.
Results:
The NCANDA sample of youth is nationally representative of sex and racial/ethnic groups. More than 50% have at least one risk characteristic for subsequent heavy drinking (e.g., family history, internalizing or externalizing symptoms). As expected, those who exceeded drinking thresholds (n = 139) differ from those who did not (n = 692) on identified factors associated with early alcohol use and problems.
Conclusions:
NCANDA successfully recruited a large sample of adolescents and comprehensively assessed psychosocial functioning across multiple domains. Based on the sample's risk profile, NCANDA is well positioned to capture the transition into drinking and alcohol problems in a large portion of the cohort, as well as to help disentangle the associations between alcohol use, neurobiological maturation, and neurocognitive development and functioning.
Although there is a clear association between early use of alcohol and short- and long-term adverse outcomes, it is unclear whether consumption of minor amounts of alcohol (less than a full drink) at a young age is prognostic of risk behaviors in later adolescence.
Data were taken from 561 students enrolled in an ongoing prospective web-based study on alcohol initiation and progression (55% female; 25% White non-Hispanic). Based on a combination of monthly and semiannual surveys, we coded whether participants sipped alcohol before sixth grade and examined associations between early sipping and alcohol consumption by fall of ninth grade, as well as other indices of problem behavior. Participants also reported on the context of the first sipping event.
The prevalence of sipping alcohol by fall of sixth grade was 29.5%. Most participants indicated that their first sip took place at their own home, and the primary source of alcohol was an adult, usually a parent. Youth who sipped alcohol by sixth grade had significantly greater odds of consuming a full drink, getting drunk, and drinking heavily by ninth grade than nonsippers. These associations held even when we controlled for temperamental, behavioral, and environmental factors that contribute to proneness for problem behavior, which suggests that sipping is not simply a marker of underlying risk.
Our findings that early sipping is associated with elevated odds of risky behaviors at high school entry dispute the idea of sipping as a protective factor. Offering even just a sip of alcohol may undermine messages about the unacceptability of alcohol consumption for youth. (J. Stud. Alcohol Drugs, 76, 212-221, 2015).
Aims: Childhood expectancies about alcohol are present long before drinking begins. We examined the relationship between alcohol expectancies in childhood and onset of drinking, binge drinking, and drunkenness in adolescence and the influence of drinking onset on development of alcohol expectancies.
Design: A prospective, longitudinal study of children assessed for alcohol expectancies and drinking at 4 time points between ages 6 and 17.
Setting: Community study of families at high risk for alcoholism conducted in a 4-county area in the Midwest.
Participants: The study involved 614 children; 460 were children of alcoholics and 70% were male.
Measurements: Expectancies about effects of alcohol were measured using the Beverage Opinion Questionnaire and child???s drinking was measured using the Drinking and Drug History - Youth Form.
Findings: Partial factor invariance was found for expectancy factors from age 6 to age 17. Survival analysis showed that social/relaxation expectancies in childhood predicted time to onset of binge drinking and first time drunk (Wald chi-square, 1 d.f. = 3.8, p < .05 and 5.1, p < .05, respectively). The reciprocal effect was also present; when adolescents began drinking, there was an increase in social/relaxation expectancy and a concomitant increase in slope of the expectancy change lasting throughout adolescence.
Conclusions: A reciprocal relationship exists between childhood alcohol expectancies and involvement with alcohol. Higher expectancies for positive effects predict earlier onset of problem drinking. Onset of use, in turn, predicts an increase in rate of development of positive expectancies.
We describe the attitudes and first use of alcohol by children, grades 3-6, who participated in the Bogalusa Heart Study, 1993-94. Questionnaire data reflected that more than one-third of the children had experimented with alcohol at the time of the study. The dominant environmental factor in experimentation was family modeling, and the dominant personal factor was curiosity, regardless of race, gender, or grade. Most children believed that alcohol use can lead to accidents, that drinking has negative social consequences, and that alcohol use hurts only if done to excess. Indications are that young children generally have negative attitudes regarding alcohol use, and that public and family alcohol education efforts need to be more specific about deleterious effects of even low levels of alcohol use in the young.
The National Institute on Alcohol Abuse and Alcoholism developed an alcohol screening instrument for youth based on epidemiologic data. This study examines the concurrent validity of this instrument, expanded to include tobacco and drugs, among pediatric patients, as well as the acceptability of its self-administration on an iPad.
Five hundred and twenty-five patients (54.5% female; 92.8% African American) aged 12 to 17 completed the Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD) via interviewer-administration or self-administration using an iPad. Diagnostic and Statistical Manual, Fifth Edition substance use disorders (SUDs) were identified using a modified Composite International Diagnostic Interview-2 Substance Abuse Module. Receiver operating characteristic curves, sensitivities, and specificities were obtained to determine optimal cut points on the BSTAD in relation to SUDs.
One hundred fifty-nine (30.3%) adolescents reported past-year use of ≥1 substances on the BSTAD: 113 (21.5%) used alcohol, 84 (16.0%) used marijuana, and 50 (9.5%) used tobacco. Optimal cut points for past-year frequency of use items on the BSTAD to identify SUDs were ≥6 days of tobacco use (sensitivity = 0.95; specificity = 0.97); ≥2 days of alcohol use (sensitivity = 0.96; specificity = 0.85); and ≥2 days of marijuana use (sensitivity = 0.80; specificity = 0.93). iPad self-administration was preferred over interviewer administration (z = 5.8; P < .001).
The BSTAD is a promising screening tool for identifying problematic tobacco, alcohol, and marijuana use in pediatric settings. Even low frequency of substance use among adolescents may indicate need for intervention.
This study used latent growth curve modeling to examine adolescent alcohol expectancies as potential mediators of the effects of parent alcoholism on escalation in adolescent heavy drinking. Data were drawn from a 3-year longitudinal study of a community sample of children of alcoholics (COAs) and demographically matched controls. Parent alcoholism had a direct effect on adolescent heavy drinking. Compared to non-COAs, COAs started out at higher initial levels of heavy drinking and increased their heavy drinking at a steeper rate over the three waves of measurement. However, expectancies concerning negative alcohol effects (negative expectancies) and expectancies concerning positive alcohol effects (positive expectancies) were unrelated to growth in adolescents' heavy drinking. Thus, alcohol expectancies did not mediate parent alcoholism effects on trajectories of adolescent drinking. There was some cross-sectional evidence that adolescents' positive expectancies mediated the effects of parent alcoholism on initial levels of adolescent heavy drinking. Children of alcoholic fathers reported higher levels of positive expectancies than did non-COAs, and positive expectancies predicted high initial levels of heavy drinking. Although weak adolescent negative expectancies were associated with high initial levels of alcohol use, they were unrelated to parent alcoholism. Implications of these findings for COA risk and escalation of heavy drinking in the adolescent years are discussed.
Sipping alcohol during childhood may be a marker of differentiation as regards children's future risk of underage drinking; yet very little is known about alcohol use when it occurs among elementary school-aged children. The purpose of the present study is to examine alcohol sipping behavior in a sample of third-grade school children to learn whether sipping is associated with attributes that could increase children's likelihood of further underage drinking. We collected telephone interview data from 1,050 mothers and their third grade children (mean age 9.2 years; 48.2 % male) residing in the Southeastern United States. The majority of mothers were White non-Hispanic (69.02 %) or Black non-Hispanic (21.3 %); most (85 %) lived in households shared with fathers or other adult caretakers. We hypothesized that children who sip alcohol would score lower than abstinent peers on indicators of competence and score higher on indicators of exposure to alcohol-specific socialization by parents and peers. A multivariate model controlling for frequency of parent alcohol use and demographic covariates showed that children who had sipped alcohol were significantly less likely than abstinent peers to affirm indicators of competence and significantly more likely to affirm indicators of exposure to alcohol specific socialization by parents and by same age peers. These preliminary findings suggest that developmental attributes associated with risk of underage drinking begin to differentiate at least as young as middle childhood. Research is needed to test prospectively for continuity between alcohol risk attributes present in middle childhood and future alcohol use.
Objectives To investigate prosipping beliefs about alcohol among parents and the relations among these beliefs, parents' alcohol-specific attitudes and practices, and children's reports of initiation of alcohol use.
Design Telephone interview study of parent-child dyads. Data for the present study are from the baseline interviews of a 4-year intervention trial.
Setting Southeastern United States.
Participants One thousand fifty pairs of mothers or mother surrogates and their third-grade children who were recruited for the 4-year intervention trial.
Main Outcome Measures Key measures from parents included prosipping beliefs (ie, beliefs that sipping alcohol has protective consequences for children), attitudes about children's sipping, and parenting practices that affect children's opportunity to try alcohol. The key measure from children was experience sipping beer, wine, or other types of alcohol.
Results The belief among mothers that allowing children to sip alcohol can have protective consequences for children, including making children less likely to drink as adolescents and making them better at resisting peer influence to drink, ranged from approximately 15% to almost 40%. Alcohol use was reported by 32.8% of children. A strong, significant association was found between parental prosipping beliefs and children's reported alcohol use.
Conclusions The notion that early exposure to alcohol can be beneficial has a strong foothold among some parents of elementary school–aged children. More research is needed to understand how parents acquire prosipping beliefs and to test messages that effectively modify such beliefs and associated prosipping attitudes and practices among parents.
We examined relations between neighborhood context, home and family management practices, deviant peer affiliations, beliefs favorable to use, and alcohol use among urban African American and Hispanic adolescents.
The sample comprised 4,027 African American and Hispanic adolescents who were 50% boys and 75% low income. Participants completed surveys in 2002-2005 and 2008-2009. Structural equation modeling assessed direct and indirect relations between neighborhood context in 6th grade, home and family management practices in 7th grade, deviant peer affiliations and beliefs favorable to use in 8th grade, and alcohol use in 12th grade.
There was significant variation in structural models across race/ethnicity but not gender. Differences included the influence of neighborhood and school strength and, where similarities existed, differences in effect magnitude. Similarities included significant correlations among measurement components; the indirect influence of alcohol advertisement exposure, gender, area deprivation, and home alcohol access on alcohol use; direct influence of deviant peer affiliations and beliefs favorable to use on alcohol use; and indirect effects highlighting the importance of preventing home alcohol access, deviant peer affiliations, and beliefs favorable to use and promoting protective family management practices.
Neighborhood and school strength may be particularly important in preventing alcohol use among African Americans, whereas preventing early onset of alcohol use among Hispanics remains important. Preventive efforts may wish to focus on neighborhood deprivation, exposure to alcohol advertisements, and home risks and protective factors because they have direct and indirect effects on intrapersonal factors and alcohol use.
There is relatively little research on the childhood antecedent predictors of early-onset alcohol use. This study examined an array of psychosocial variables assessed at age 10 and reflecting Problem Behavior Theory as potential antecedent risk factors for the initiation of alcohol use at age 14 or younger.
A sample of 452 children (238 girls) ages 8 or 10 and their families was drawn from Allegheny County, PA, using targeted-age directory sampling and random-digit dialing procedures. Children and parents were interviewed using computer-assisted interviews. Logistic regression analyses were used to examine the age-10 univariate and multivariate predictors of the initiation of alcohol use by age 14 or younger.
Twenty-five percent of the sample reported having more than a sip or a taste of alcohol in their life by age 14. Sex, race, and age cohort did not relate to early drinking status. Children with two parents were less likely to initiate drinking early. Early initiation of drinking related significantly to an array of antecedent risk factors (personality, social environment, and behavioral) assessed at age 10 that reflect psychosocial proneness for problem behavior. In the multivariate model, the variables most predictive of early-onset drinking were having a single parent, sipping or tasting alcohol by age 10, having parents who also started drinking at an early age, and parental drinking frequency.
Initiation of alcohol use by age 14 reflects childhood psychosocial proneness to engage in problem behavior as measured by Problem Behavior Theory and having a family environment conducive to alcohol use.
To highlight standard PhenX (consensus measures for Phenotypes and eXposures) measures for nutrition, dietary supplements, and cardiovascular disease research and to demonstrate how these and other PhenX measures can be used to further interdisciplinary genetics research.
PhenX addresses the need for standard measures in large-scale genomic research studies by providing investigators with high-priority, well established, low-burden measurement protocols in a web-based toolkit (https://www.phenxtoolkit.org). Cardiovascular and Nutrition and Dietary Supplements are just 2 of 21 research domains and accompanying measures included in the PhenX Toolkit.
Genome-wide association studies (GWAS) provide promise for the identification of genomic markers associated with different disease phenotypes, but require replication to validate results. Cross-study comparisons typically increase statistical power and are required to understand the roles of comorbid conditions and environmental factors in the progression of disease. However, the lack of comparable phenotypic, environmental, and risk factor data forces investigators to infer and to compare metadata rather than directly combining data from different studies. PhenX measures provide a common currency for collecting data, thereby greatly facilitating cross-study analysis and increasing statistical power for identification of associations between genotypes, phenotypes, and exposures.
To explore whether early age of drinking onset is prospectively associated with respondents unintentionally injuring themselves and others when respondents were under the influence of alcohol, controlling for current alcohol dependence/abuse, frequency of consuming 5 drinks per occasion, and other demographic characteristics.
From 2001 to 2002, in-person interviews were conducted with a national multistage probability sample of 43,093 adults aged 18 years older. From 2004 to 2005, of 39,959 eligible respondents, 34,653 were reinterviewed. The cumulative 2-survey response rate was 70.2%. Respondents were asked the age at which they first started drinking (not counting tastes or sips), diagnostic questions for alcohol dependence and abuse, questions about behaviors that increase risk of injury, and whether respondents, when under the influence of alcohol, injured themselves or someone else as a driver in a motor vehicle crash or in some other way.
Logistic regression analyses revealed that the younger respondents were when they started drinking, the greater the likelihood that, between the 2 surveys, they experienced alcohol dependence/abuse, drank 5 drinks per occasion at least weekly drove under the influence of alcohol, and placed themselves in situation after drinking where they could be hurt. After controlling for those injury risk and sociodemographic characteristics, respondents who began drinking at earlier ages remained more likely between the 2 surveys to have, under the influence of alcohol, unintentionally injured themselves and someone else. More than one third of those injuries occurred when respondents 25 years of age were under the influence, although only 7% of respondents were 25 years of age. Persons other than respondents experienced 20% of those unintentional injuries, more than one third of them in traffic.
Delaying drinking onset may help reduce unintentional alcohol-related injuries that drinkers may inflict on themselves and others.
Existing studies of the association between age at first drink (AFD) and the risk of alcohol use disorders (AUD) suffer from inconsistent levels of control and designs that may inflate associations by failure to control for duration of exposure to risk.
This study examined associations between AFD (ages <15 and 15-17 vs. 18+ years) and first incidence of DSM-IV alcohol dependence, abuse, and specific AUD criteria over a 3-year follow-up in a longitudinal study of U.S. drinkers 18 years of age and older at baseline (n = 22,316), controlling for duration of exposure, family history, and a wide range of baseline and childhood risk factors.
After adjusting for all risk factors, the incidence of dependence was increased for AFD <15 years (OR = 1.38) and for women only with AFD at ages 15 to 17 (OR = 1.54). The incidence of abuse was increased at AFD <15 and 15 to 17 years (OR = 1.52 and 1.30, respectively). Most dependence criteria showed significant associations with AFD, but hazardous drinking and continued drinking despite interpersonal problems were the only abuse criteria to do so. All associations were nonsignificant after controlling for volume of consumption, except that AFD at all ages <18 combined was associated with a reduced likelihood of impaired control, and AFD at ages 15 to 17 was associated with lower odds of drinking more/longer than intended among heavy-volume drinkers. In a population of low-risk drinkers that excluded those with positive family histories, personality disorders, and childhood risk factors, there were strong associations between early AFD (<18) and the incidence of dependence (OR = 3.79) and continued drinking despite physical/psychological problems (OR = 2.71), but no association with incidence of abuse.
There is a robust association between AFD and the risk of AUD that appears to reflect willful rather than uncontrolled heavy drinking, consistent with misuse governed by poor decision-making and/or reward-processing skills associated with impaired executive cognitive function (ECF). Additional research is needed to determine causality in the role of impaired ECF, including longitudinal studies with samples of low-risk adolescents.
Alcohol-related expectancies can influence the behavioral effects of alcohol and decisions regarding alcohol use. A standard measure of expectancies is needed for research and clinical work in the alcohol arena; the development and current status of the Alcohol Expectancy Questionnaire (AEQ) is summarized. The adolescent and adult forms of this instrument are designed to measure the degree to which individuals expect alcohol to produce a variety of general and specific effects. Research with the AEQ indicates a consistent relationship between alcohol expectancies and alcohol consumption, alcohol abuse and behavior while drinking. Data bearing on the psychometric properties and clinical and research utility of the AEQ are discussed.
Data from 27,616 current and former drinkers interviewed in the 1992 National Longitudinal Alcohol Epidemiologic Survey were used to examine the relationship between age at first use of alcohol and the prevalence of lifetime alcohol abuse and alcohol dependence, among all U.S. adults 18 years of age and over and within subgroups defined by sex and race. The rates of lifetime dependence declined from more than 40% among individuals who started drinking at ages 14 or younger to roughly 10% among those who started drinking at ages 20 and older. The rates of lifetime abuse declined from just over 11% among those who initiated use of alcohol at ages 16 or younger to approximately 4% among those whose onset of use was at ages 20 or older. After using multivariate logistic regression models to adjust for potential confounders, the odds of dependence decreased by 14% with each increasing year of age at onset of use, and the odds of abuse decreased by 8%. These findings are discussed with respect to their implications for prevention policies and the need to integrate epidemiological and intervention research.
The potential importance of alcohol outcome expectancies in the initiation and maintenance of drinking has been supported by studies showing that these expectancies are present before drinking begins, and that they predict drinking both cross-sectionally and longitudinally. Although initiation of drinking behavior may be influenced by expectancy, subsequent drinking experience may modify expectations. We used structural modeling techniques to investigate the relative influence of expectancy and drinking in a three-wave longitudinal study of Norwegian adolescents.
Survey incorporating self-administered questionnaires.
Twenty-two schools in Hordaland County on the west coast of Norway.
Nine hundred and twenty-four seventh-grade students; 45.7% female.
Alcohol use (frequency, quantity, drunkenness); the Norwegian version of the Alcohol Expectancy Questionnaire for adolescents.
Among students who were already drinkers upon entry into the study, expectations of positive social effects of alcohol predicted drinking longitudinally. Among those who began drinking during the study, these social expectancies predicted drinking initiation, but drinking also influenced subsequent expectancy in the early stages of drinking.
These results support a reciprocal relationship of drinking to positive expectancy, highlighting the importance both of expectancies on influencing drinking, and of early drinking experiences on the development of positive expectancies.
This study aimed to describe the natural course of DSM-III-R alcohol disorders as a function of age at first alcohol use and to investigate the influence of early use as a risk factor for progression to the development of alcohol disorders, exclusive of the effect of confounding influences.
Data were obtained from a community sample (N=5,856) of lifetime drinkers participating in the 1990-1991 Mental Health Supplement of the Ontario Health Survey.
Survival analyses revealed a rapid progression to alcohol-related harm among those who reported having their first drink at ages 11-14. After 10 years, 13.5% of the subjects who began to drink at ages 11 and 12 met the criteria for a diagnosis of alcohol abuse, and 15.9% had a diagnosis of dependence. Rates for subjects who began to drink at ages 13 and 14 were 13.7% and 9.0%, respectively. In contrast, rates for those who started drinking at ages 19 and older were 2.0% and 1.0%. Unexpectedly, a delay in progression to harm was observed for the youngest drinkers (ages 10 and under). Hazard regression analyses revealed a nonlinear effect of age at first alcohol use, marked by an elevated risk of developing disorders among subjects first using alcohol at ages 11-14.
First use of alcohol at ages 11-14 greatly heightens the risk of progression to the development of alcohol disorders and therefore is a reasonable target for intervention strategies that seek to delay first use as a means of averting problems later in life.
Because expectancies about the effects of alcohol change as drinking experience is accumulated, it is likely that the relationship of expectancy to drinking will differ with age. In this study, we examine the prediction of drinking behavior from positive and negative outcome expectancy at different ages.
Data were collected as part of the National Alcohol Survey, using a multi-stage area probability sample of the household population of the 48 contiguous United States.
US residents aged 12 and older (n = 2875).
Survey questions included drinking habits (frequency, quantity, frequency of drunkenness, maximum quantity) and beliefs about the effects of alcohol (alcohol expectancies).
Structural equation models tested the relationship of positive and negative expectancy to drinking behavior in six age groups. Outcome expectancy accounted for a larger portion of the variance in drinking among younger respondents than among older respondents. However, suppression effects were common. When suppression effects were considered, positive expectancy predicted drinking better than negative expectancy only among respondents under 35, while negative expectancy was a better predictor of drinking status in most respondents over 35 years. Among drinkers, positive expectancy predominated over negative expectancy when suppression effects were considered.
These results suggest that negative expectancy predicts abstention, while positive expectancy predicts level of drinking among drinkers. In expectancy research, differences between drinkers and abstainers, age of participants and the presence of suppression effects should be taken into account.
To identify precursors of adolescent alcohol initiation and binge drinking.
Prospective cohort study.
Self-report questionnaires.
A total of 5511 Growing Up Today Study participants aged 11 to 18 years in 1998. Main Exposures Individual, family, and social factors.
First whole drink of alcohol and binge drinking.
Between 1998 and 1999, 611 girls (19%) and 384 boys (17%) initiated alcohol use. Older age, later maturational stage, smoking, adults drinking in the home, underage sibling drinking, peer drinking, possession of or willingness to use alcohol promotional items, and positive attitudes toward alcohol were associated with an increased likelihood of alcohol initiation. Girls who ate family dinner at home every day were less likely to initiate alcohol use than girls who ate family dinner only on some days or never (odds ratio, 0.66; 95% confidence interval, 0.50-0.87). Girls with higher social self-esteem and boys with higher athletic self-esteem were more likely to initiate alcohol use than those with lower self-esteem. Among teens who initiated alcohol use, 149 girls (24%) and 112 boys (29%) further engaged in binge drinking. Among girls, positive attitudes toward alcohol, underage sibling drinking, and possession of or willingness to use alcohol promotional items were associated with binge drinking; among boys, positive attitudes toward alcohol and older age were associated with binge drinking.
Eating family dinner at home every day may delay alcohol uptake among some adolescents. Alcohol promotional items appear to encourage underage alcohol initiation and binge drinking; this may warrant marketing restrictions on the alcohol industry.