Article

The association between child alcohol sipping and alcohol expectancies in the ABCD study

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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.

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... 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. ...
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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.
Article
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.
Article
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.
Article
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.
Article
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).
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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).
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.
Article
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.