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Sensation Seeking and Adolescent Drinking: Do Protective Behavioral Strategies Lower Risk?
Abstract
Using a cross‐sectional design, we examined protective behavioral strategies (PBS) as a moderator of the relationship between sensation seeking and hazardous drinking and alcohol‐related consequences among high school seniors (N = 212). Hierarchical regression analyses indicated sensation seeking was a significant predictor of binge drinking (β = 0.65, p < 0.001), prepartying (β = 0.71, p < 0.001), gaming (β = 0.75, p < 0.001), and alcohol‐related consequences (β = 0.69, p < 0.001). Further, PBS moderated these relationships such that among high sensation seeking adolescents, PBS use was associated with better outcomes, including lower levels of binge drinking (β = −0.37, p < 0.01), prepartying (β = −0.44, p < 0.01), gaming (β = −0.31, p < 0.05), and alcohol‐related consequences (β = −0.53, p < 0.001). We discuss counseling implications, including assessment and harm reduction strategies focusing on PBS to reduce hazardous drinking among high sensation seeking adolescents.
Sensation seeking is a significant predictor of alcohol‐related consequences among high school students. High school seniors report the highest prevalence rates of alcohol use and binge drinking among students in high school. Among high sensation‐seeking students, higher rates of Protective Behavioral Strategies (PBS) use are associated with fewer alcohol‐related consequences. To date, however, there is no research investigating which specific PBS are related to lower levels of alcohol‐related consequences in this high‐risk group of students. The current study examined the frequency of use and effectiveness of 20 PBS measured by the PBS Scale‐20 among high sensation‐seeking high school seniors ( N = 77). “Go‐zone” methodology was used to classify PBS items into one of four zones (i.e., used frequently, high effectiveness; used infrequently, high effectiveness; used frequently, low effectiveness; used infrequently; low effectiveness). Four PBS were identified as “go‐zone” strategies (e.g., used frequently; high effectiveness) and five strategies were identified as used infrequently but highly effective. Findings from the current study extend the literature on PBS use as a buffer against alcohol‐related consequences among high sensation‐seeking high school students. Implications for school mental health professionals are discussed.
Trial Registration: ClinicalTrials.gov identifier: NCT03613818
Epigenetics is the study of modifications to gene expression without an alteration to the DNA sequence. Currently there is limited translation of epigenetics to the counseling profession. The purpose of this article is to inform counseling practitioners and counselor educators about the potential role epigenetics plays in mental health. Current mental health epigenetic research supports that adverse psychosocial experiences are associated with mental health disorders such as schizophrenia, anxiety, depression, and addiction. There are also positive epigenetic associations with counseling interventions, including cognitive behavioral therapy, mindfulness, diet, and exercise. These mental health epigenetic findings have implications for the counseling profession such as engaging in early life span health prevention and wellness, attending to micro and macro environmental influences during assessment and treatment, collaborating with other health professionals in epigenetic research, and incorporating epigenetic findings into counselor education curricula that meet the standards of the Council for Accreditation of Counseling and Related Educational Programs (CACREP).
Heterogeneity in development of imbalance between impulse control and sensation seeking has not been studied until now. The present study scrutinized this heterogeneity and the link between imbalance and adolescent risk. Seven-wave data of 7,558 youth (50.71% males; age range from 12/13 until 24/25) were used. Three developmental trajectories were identified. The first trajectory, “sensation seeking to balanced sensation seeking”, included participants with a higher level of sensation seeking than impulse control across all ages. The second trajectory, “moderate dominant control”, included participants showing moderate and increasing impulse control relative to sensation seeking across all ages. The third trajectory, “strong late dominant control”, included participants showing the highest level of impulse control which was about as strong as sensation seeking from early to middle adolescence and became substantially stronger from late adolescence to early adulthood. Although the systematic increase of impulse control in all subgroups is in line with both models, neither of these combined trajectories of control and sensation seeking was predicted by the Dual Systems Model or the Maturational Imbalance Model. Consistent with both models the “sensation seeking to balanced sensation seeking” trajectory showed the highest level of substance use. It can be concluded that, even though both theories adequately predict the link between imbalance and risk, neither the Dual Systems Model nor the Maturational Imbalance Model correctly predict the heterogeneity in development of imbalance between impulse control and sensation seeking.
Purpose of Review
Sport-related concussion (SRC) is a significant public health problem. Understanding the behavioral and personal factors that influence risk and incidence of SRC is critically important for appropriate care and management. Sensation-seeking and impulsivity have been posited to be two such factors that may be significantly associated with SRC. We performed a focused review of recent evidence of the relationships between sensation-seeking and impulsivity in athletes with SRC.
Recent Findings
While the research is relatively limited, extant findings demonstrate a significant relationship between sensation-seeking and contact sport participation and risk of prior and future SRC. Impulsivity appears to be common among athletes competing in high contact sports and may contribute to neural and functional brain changes following SRC; however, causal relationships between impulsivity, contact sport participation, and SRC have not been demonstrated.
Summary
Both sensation-seeking and impulsivity are significantly associated with SRC in collegiate athletes. Interventions designed to ameliorate high levels of these constructs may prove to be beneficial avenues to reducing SRC risk and improving patient care and outcomes.
Risk-taking propensity and sensation seeking are developmentally meaningful traits for emerging adults, individuals ages 18 to 25 years. Adverse childhood experiences (ACEs) of childhood abuse and neglect, exposure to domestic violence, residing with a substance abusing or mentally ill caregiver, and growing up with an incarcerated family member negatively impact the well-being of emerging adults. However, the specific association between ACEs and risk-taking propensity and sensation seeking has not been previously examined in this age group. This study aims to determine whether ACEs are individually or cumulatively related to risk-taking propensity (assessed by the Domain-Specific Risk-Taking Scale) and sensation seeking (assessed by the Behavior Inhibition System/Behavior Approach System Scales) in a diverse sample of undergraduates, n = 436; Mage = 19.73 years (SD = 1.83 years); 67% female; 22% Hispanic. Multivariate ordinary least squares regressions were run to examine the association between ACEs and risk-taking propensity and sensation seeking. Individually, emotional abuse predicted greater inhibition (B = .28, p < .001), growing up with a mentally ill family member (B = –.12, p < .05) and emotional neglect (B = –.13, p < .05) predicted reduced motivation to pursue rewarding cues, and emotional neglect (B = –.12, p < .05) and witnessing domestic violence (B = –.10, p < .05) predicted less reward responsiveness. No cumulative effects were found. ACEs related to environmental instability may have a unique impact on sensation seeking domains in emerging adults. Clarifying the role of sensation seeking in emerging adults can contribute to better understanding of risk and resilience factors in this vulnerable population.
The Neurobiology of Adolescent Drinking in Adulthood (NADIA) Consortium has focused on the impact of adolescent binge drinking on brain development, particularly on effects that persist into adulthood. Adolescent binge drinking is common, and while many factors contribute to human brain development and alcohol use during adolescence, animal models are critical for understanding the specific consequences of alcohol exposure during this developmental period and the underlying mechanisms. Using adolescent intermittent ethanol (AIE) exposure models, NADIA investigators identified long‐lasting AIE‐induced changes in adult behavior that are consistent with observations in humans, such as increased alcohol drinking, increased anxiety (particularly social anxiety), increased impulsivity, reduced behavioral flexibility, impaired memory, disrupted sleep, and altered responses to alcohol. These behavioral changes are associated with multiple molecular, cellular, and physiological alterations in the brain that persist long after AIE exposure. At the molecular level, AIE results in long‐lasting changes in neuroimmune/trophic factor balance and epigenetic‐microRNA (miRNA) signaling across glia and neurons. At the cellular level, AIE history is associated in adulthood with reduced expression of cholinergic, serotonergic and dopaminergic neuron markers, attenuated cortical thickness, decreased neurogenesis, and altered dendritic spine and glial morphology. This constellation of molecular and cellular adaptations to AIE likely contributes to observed alterations in neurophysiology, measured by synaptic physiology, EEG patterns, and functional connectivity. Many of these AIE‐induced brain changes replicate findings seen in post‐mortem brains of humans with alcohol use disorder. NADIA researchers are now elucidating mechanisms of these adaptations. Emerging data demonstrate that exercise, anti‐inflammatory drugs, anti‐cholinesterases, histone deacetylase inhibitors, and other pharmacological compounds are able to prevent (administered during AIE) and/or reverse (given after AIE) AIE‐induced pathology in adulthood. These studies support hypotheses that adolescent binge drinking increases risk of adult hazardous drinking and influences brain development, and may provide insight into novel therapeutic targets for AIE‐induced neuropathology and alcohol use disorders. This article is protected by copyright. All rights reserved.
Background
Research has consistently shown that early onset of drinking (EOD) is associated with alcohol-related problems in adulthood. However, recent reviews have identified several limitations in the early onset literature, including the use of retrospective reports, insufficient control for potential confounders, ambiguous definitions of the concept, and an assumption that early onset is independent of cultural norms and national alcohol policies. This study addresses these limitations by examining whether EOD, independent of early onset of excessive drinking (EOE), prospectively predicts hazardous drinking in late adolescence/young adulthood in Norway and Australia, two countries with different drinking cultures.
Methods
Data were drawn from two population-based longitudinal studies; the Norwegian Tracking Opportunities and Problems Study (n = 329) and the Australian International Youth Development Study (n = 786). Data were collected prospectively from mid adolescence (14–16 years) to late adolescence/young adulthood (18–25 years) and a modified Poisson regression approach was used to estimate prevalence ratios. Adolescent self-reports included measures of EOD and EOE. Young adults completed the Alcohol Use Disorders Identification Test (AUDIT). The results were adjusted for adolescent factors; age, gender, impulsivity, hyperactivity, conduct problems, smoking, early sexual intercourse and friends’ substance use, and family factors; alcohol and drug use in the family, maternal education, family management and monitoring.
Results
Hazardous drinking was identified in 46.8 and 38.9% of young adults in Norway and Australia, respectively. Both EOD and EOE in adolescence were significantly related to an increased risk of alcohol-related problems in late adolescence/young adulthood in both studies, even when adjusting for possible confounders.
Conclusion
Our findings indicate that adolescent drinking behaviour is an indicator of alcohol-related problems in late adolescence/young adulthood, even when controlling for a variety of covariates. This finding is in contrast to previous research on older adults, where no association between adolescent drinking and later alcohol-related problems were found when controlling for covariates. The divergence in findings may suggest that the impact of EOD/EOE is limited to the late adolescent and young adult period. Preventing drinking in early adolescence may thus have some impact on the drinking patterns in late adolescence/young adulthood.
A substantial body of research confirms that trauma exposure predicts adolescent involvement in the justice system, although the mechanisms accounting for this association are not well understood. The most recent revision of the Diagnostic and Statistical Manual (DSM‐5; American Psychiatric Association, 2013, Washington, DC) diagnosis of posttraumatic stress disorder introduced a new symptom, that of
“self‐destructive or risky behavior,” which may have particular relevance to understanding posttraumatic reactions in the adolescent period and the processes by which trauma becomes associated with offending. The present article reviews evidence supporting the link between trauma exposure and self‐harming or recklessness and outlines
theories that propose biological and psychological functions of these behaviors, which can be understood as representing the proposed construct of posttraumatic risk‐seeking. Implications for future research and interventions with traumatized youth are discussed.
A substantial body of research confirms that trauma exposure predicts adolescent involvement in the justice system, although the mechanisms accounting for this association are not well-understood. The most recent revision of the Diagnostic and Statistical Manual (DSM-5; American Psychiatric Association, 2013) diagnosis of posttraumatic stress disorder introduced a new symptom, that of “self-destructive or risky behavior,” which may have particular relevance to understanding posttraumatic reactions in the adolescent period and the processes by which trauma becomes associated with offending. The present paper reviews evidence supporting the link between trauma exposure and self-harming or recklessness and outlines theories that propose biological and psychological functions of these behaviors, which can be understood as representing the proposed construct of posttraumatic risk-seeking. Implications for future research and interventions with traumatized youth are discussed.
Developmental imbalance models attribute the rise in risk-taking during adolescence to a universal imbalance between rising reward sensitivity and lagging cognitive control. This study tested predictions of an alternate Lifespan Wisdom Model that distinguishes between exploratory/adaptive (e.g., sensation seeking) and maladaptive (e.g., acting-without-thinking, delay discounting) risk-taking propensities and attributes the latter to a sub-set of youth with weak cognitive control. Latent trajectory modeling of six waves of data from 387 adolescents (52% females; spanning average ages of 11–18 years) revealed distinct sub-groups with heterogeneous trajectory patterns for acting-without-thinking and delay-discounting. Only those trajectory groups with weak cognitive control, characterized as “high-increasing” acting-without thinking and “high-stable” delay discounting were predictive of a maladaptive risk-taking outcome, namely substance use disorder. Sensation seeking demonstrated a universal peak, but high levels of sensation seeking were not associated with weakness in cognitive control and were unrelated to substance use disorder, controlling for impulsivity. The findings suggest that maladaptive risk-taking characterized by weak cognitive control over reward-driven impulses is a phenomenon limited to only a sub-set of youth.
Studies have shown links between educational outcomes such as letter grades, test scores, or other measures of academic achievement, and health-related behaviors (1-4). However, as reported in a 2013 systematic review, many of these studies have used samples that are not nationally representative, and quite a few studies are now at least 2 decades old (1). To update the relevant data, CDC analyzed results from the 2015 national Youth Risk Behavior Survey (YRBS), a biennial, cross-sectional, school-based survey measuring health-related behaviors among U.S. students in grades 9-12. Analyses assessed relationships between academic achievement (i.e., self-reported letter grades in school) and 30 health-related behaviors (categorized as dietary behaviors, physical activity, sedentary behaviors, substance use, sexual risk behaviors, violence-related behaviors, and suicide-related behaviors) that contribute to leading causes of morbidity and mortality among adolescents in the United States (5). Logistic regression models controlling for sex, race/ethnicity, and grade in school found that students who earned mostly A's, mostly B's, or mostly C's had statistically significantly higher prevalence estimates for most protective health-related behaviors and significantly lower prevalence estimates for most health-related risk behaviors than did students with mostly D's/F's. These findings highlight the link between health-related behaviors and education outcomes, suggesting that education and public health professionals can find their respective education and health improvement goals to be mutually beneficial. Education and public health professionals might benefit from collaborating to achieve both improved education and health outcomes for youths.
Recent neuroscience models of adolescent brain development attribute the morbidity and mortality of this period to structural and functional imbalances between more fully developed limbic regions that subserve reward and emotion as opposed to those that enable cognitive control. We challenge this interpretation of adolescent development by distinguishing risk-taking that peaks during adolescence (sensation seeking and impulsive action) from risk taking that declines monotonically from childhood to adulthood (impulsive choice and other decisions under known risk). Sensation seeking is primarily motivated by exploration of the environment under ambiguous risk contexts, while impulsive action, which is likely to be maladaptive, is more characteristic of a subset of youth with weak control over limbic motivation. Risk taking that declines monotonically from childhood to adulthood occurs primarily under conditions of known risks and reflects increases in executive function as well as aversion to risk based on increases in gist-based reasoning. We propose an alternative Life-span Wisdom Model that highlights the importance of experience gained through exploration during adolescence. We propose, therefore, that brain models that recognize the adaptive roles that cognition and experience play during adolescence provide a more complete and helpful picture of this period of development.
Background:
We tested the effect of initiating marijuana and alcohol use at varying frequencies on academic indices.
Methods:
In a sample of 26,475 grade 9-12 students with at least 2 years of linked longitudinal data from year 1 (Y1: 2012-2013), year 2 (Y2: 2013-2014), and year 3 (Y3: 2014-2015) of the COMPASS study, separate multinomial generalized estimating equations models tested the likelihood of responses to measures of academic goals, engagement, preparedness, and performance when shifting from never using alcohol or marijuana at baseline to using them at varying frequencies at follow -up.
Results:
Students who began using alcohol or marijuana were less likely to attend class regularly, complete their homework, achieve high marks, and value good grades, relative to their abstaining peers. Changing from abstaining to rare/sporadic-to-weekly drinking or rare/sporadic marijuana use predicted aspirations to continue to all levels of higher education, and initiating weekly marijuana use increased the likelihood of college ambitions, while more regular marijuana use reduced the likelihood of wanting to pursue graduate/professional degrees, over high school.
Conclusions:
The importance of delaying or preventing substance use is evident in associations with student performance and engagement. The influence on academic goals varied by substance and frequency of initiated use.
Adolescent substance use carries a considerable public health burden, and early initiation into use is especially problematic. Research has shown that trait sensation seeking increases risk for substance use initiation, but less is known about contextual factors that can potentially unmask this risk. This study utilized a diverse longitudinal subsample of youth (N = 454) from a larger study of familial alcoholism (53.1% female, 61% non-Hispanic Caucasian, 27.8% Hispanic, 11.2% other ethnicity). Study questions examined sensation seeking in early adolescence (mean age = 12.16) and its relations with later substance use initiation (mean age = 15.69), and tested whether neighborhood disadvantage moderated sensation seeking’s effects on initiation of alcohol, tobacco, and marijuana use. Neighborhood disadvantage significantly moderated the relation between sensation seeking and all three forms of substance use. For the most part, sensation seeking effects were weakened as neighborhood disadvantage increased, with the most advantaged neighborhoods exhibiting the strongest link between sensation seeking and substance use initiation. These results highlight the importance of focusing on relatively advantaged areas as potentially risky environments for the sensation seeking pathway to substance use.
Background: Previous work examining college drinking tendencies has identified a disproportionately small (20%), but uniquely high-risk group of students who experience nearly 50% of the reported alcohol-related consequences (i.e., the multiple repeated consequences, or MRC, group). With the goal of reducing drinking-related consequences later in college, the current study sought to identify potential MRC group members in their first semester by examining: 1) early-risk subgroups based on analysis of early-risk screening constructs (e.g., age of drinking onset, middle school alcohol exposure, high school drinking and consequences); and 2) their association with MRC criteria early in the first semester of college. Methods: A random sample of 2021 first year college student drinkers (56% female) completed a web-based drinking survey in their first semester on campus. Results: Latent class analysis (LCA) revealed four early-risk subgroups: 1) an Early Onset Risk group who endorsed early age of drinking onset and engaged in heavy middle and high school drinking (10%); 2) a Late Onset Risk group who engaged in weekend drinking and drunkenness and experienced six or more unique consequences as seniors in high school (32%); 3) an Early Onset Limited Risk group who only endorsed early age of onset and middle school drinking (3%); and 4) a Minimal Risk group who did not engage in any early risk behaviors (55%). Members of both the Early and Late Onset Risk groups had significantly higher odds of MRC membership in their first semester of college (9.85 and 6.79 greater, respectively). Conclusions: Results suggest age of onset, middle and high school drinking and drunkenness, and frequency of unique consequences could be particularly useful in brief screening tools. Further, findings support early screening and prevention efforts for MRC membership prior to college matriculation.
Keywords: early screening; high-risk college drinking; MRC group; alcohol-related consequences
Excessive drinking in college leads to serious harms, but students who use protective behavioral strategies (PBS) avoid negative consequences by drinking in a safer manner. This study aimed to increase the content validity of the Serious Harm Reduction (SHR) subscale of the most widely used measure of PBS, the Protective Behavioral Strategies Scale (PBSS: Martens et al., 2005). An initial item pool was developed from literature on college student drinking, existing lists of drinking control strategies, and an online pilot survey of college students (N = 1,832). Items were also evaluated by focus groups of experts and members of the target population. Next, 1,376 students (57.9% women; Mage = 18.5 years; 86.3% White) completed questionnaires online. A subset (n = 170; 12.4%) completed a second survey 4–6 weeks later to examine test–retest reliability and criterion-related validity. The remaining students (n = 1,206) were divided into equal development and validation samples. Analyses included exploratory and confirmatory factor analysis of the development sample, factor structure replication, and gender invariance testing in the validity sample. Results of this process produced the PBSS-20, with an expanded SHR scale of eight items. The revised SHR scale demonstrated improved internal consistency and was associated with a broader range of alcohol-related negative consequences at follow-up. Given its focus on reducing serious harms, the SHR scale is arguably the most clinically relevant PBSS factor, and those who use this measure will benefit from the expanded breadth of SHR content and improved psychometric properties of the PBSS-20.
Drinking games are a high-risk social drinking activity consisting of rules and guidelines that determine when and how much to drink (Polizzotto et al., 2007). Borsari's (2004) seminal review paper on drinking games in the college environment succinctly captured the published literature as of February 2004. However, research on college drinking games has grown exponentially during the last decade, necessitating an updated review of the literature. This review provides an in-depth summary and synthesis of current drinking games research (e.g., characteristics of drinking games, and behavioral, demographic, social, and psychological influences on participation) and suggests several promising areas for future drinking games research. This review is intended to foster a better understanding of drinking game behaviors among college students and improve efforts to reduce the negative impact of this practice on college campuses. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
The aim of the study was to summarize results of recent epidemiological research on adolescent alcohol use and its consequences, to outline the risk factors for drinking in adolescents and to consider effective treatment and preventative interventions.
A literature review of relevant studies on adolescent alcohol use.
Alcohol use and other risk-taking behaviours such as smoking, substance use and risky sexual behaviour emerge in adolescence and tend to cluster together. Heavy alcohol consumption in late adolescence appears to persist into adulthood and is associated with alcohol problems, including dependence, premature death and diminished work capacity. Early identification of adolescent risk factors may be helpful in preventing and/or attenuating risk.
There is a need for high-quality long-term prospective cohort studies to investigate the long-term consequences of adolescent drinking and further work is needed to identify the most effective intervention strategies.
The aim of the study was to explore the evidence base on alcohol screening and brief intervention for adolescents to determine age appropriate screening tools, effective brief interventions and appropriate locations to undertake these activities.
A review of existing reviews (2003-2013) and a systematic review of recent research not included in earlier reviews.
The CRAFFT and AUDIT tools are recommended for identification of 'at risk' adolescents. Motivational interventions delivered over one or more sessions and based in health care or educational settings are effective at reducing levels of consumption and alcohol-related harm.
Further research to develop age appropriate screening tools needs to be undertaken. Screening and brief intervention activity should be undertaken in settings where young people are likely to present; further assessment at such venues as paediatric emergency departments, sexual health clinics and youth offending teams should be evaluated. The use of electronic (web/smart-phone based) screening and intervention shows promise and should also be the focus of future research.
Recent research indicates that protective behavioral strategies (PBS)—previously established as effective self-regulating tools for reducing alcohol risk among college students—may be especially useful for students with poor mental health, who are shown to be at heightened risk for alcohol-related harm. The current study examined the moderating influence of mental health (depression and anxiety severity), gender, and race (White, Asian) in the relationship between PBS use and alcohol-related negative consequences. Participants were 1,782 undergraduate students from two West Coast universities who reported past-month incidence of heavy episodic drinking (HED). Students reported on their drinking, experience of alcohol-related consequences, use of PBS, and depression and anxiety symptomatology. Overall, results demonstrated that among participants experiencing depression or anxiety, greater PBS utilization was associated with significantly lower levels of alcohol-related consequences, even after controlling for drinking and other predictors. However, findings also revealed important distinctions in the potential effectiveness of PBS by depression/anxiety severity and racial–gender subgroup, such that Asian men with poor mental health appeared to garner unique and substantial benefit (i.e., lesser consequences) from increased PBS use. Further, PBS were found to offer substantial protective benefit for White females, irrespective of mental health. This study points to the potential for targeted PBS-specific skills training and interventions to minimize alcohol-related risks faced by the growing subpopulation of college students experiencing psychological distress, and further highlights important race and gender differentials.
Throughout the world, drug and alcohol use has a clear adolescent onset (Degenhardt et al., 2008). Alcohol continues to be the most popular drug among teens and emerging adults, with almost a third of 12th graders and 40% of college students reporting recent binge drinking (Johnston et al., 2009, 2010), and marijuana (MJ) is the second most popular drug in teens (Johnston et al., 2010). The initiation of drug use is consistent with an overall increase in risk-taking behaviors during adolescence that coincides with significant neurodevelopmental changes in both gray and white matter (Giedd et al., 1996a; Paus et al., 1999; Sowell et al., 1999, 2002, 2004; Gogtay et al., 2004; Barnea-Goraly et al., 2005; Lenroot and Giedd, 2006). Animal studies have suggested that compared to adults, adolescents may be particularly vulnerable to the neurotoxic effects of drugs, especially alcohol and MJ (see Schneider and Koch, 2003; Barron et al., 2005; Monti et al., 2005; Cha et al., 2006; Rubino et al., 2009; Spear, 2010). In this review, we will provide a detailed overview of studies that examined the impact of early adolescent onset of alcohol and MJ use on neurocognition (e.g., Ehrenreich et al., 1999; Wilson et al., 2000; Tapert et al., 2002a; Hartley et al., 2004; Fried et al., 2005; Townshend and Duka, 2005; Medina et al., 2007a; McQueeny et al., 2009; Gruber et al., 2011, 2012; Hanson et al., 2011; Lisdahl and Price, 2012), with a special emphasis on recent prospective longitudinal studies (e.g., White et al., 2011; Hicks et al., 2012; Meier et al., 2012). Finally, we will explore potential clinical and public health implications of these findings.
https://deepblue.lib.umich.edu/bitstream/2027.42/139712/1/mtf-overview2016.pdf
https://deepblue.lib.umich.edu/bitstream/2027.42/150621/1/Overview 2018 FINAL print 2-25.pdf
During adolescence, sensation seeking is linked to several adverse outcomes including substance use, risk taking, and psychopathology. Recent empirical interest in the construct of boredom has revealed that some similar associations may exist for boredom during adolescence. Both boredom and sensation seeking peak during adolescence, and yet, research on boredom and its interaction with sensation seeking are limited. In a multi-cohort, US nationally representative sample of 8th and 10th grade students from the monitoring the future study, latent-moderated structural equation modeling was used to estimate the association of boredom, sensation seeking, and their interaction, to substance use, externalizing behavior, and depressive affect. Moderation by gender was also tested. Boredom and sensation seeking were both significantly associated with most dependent variables. Significant interaction effects were found wherein individuals high on both boredom and sensation seeking reported the highest levels of depressive affect and externalizing behavior. There were no significant interaction effects for substance use indices. Gender moderation was found for depressive affect. The results of this study demonstrate the generalizability of boredom associations and the significance of boredom by sensation-seeking interactions across multiple mental health domains during adolescence. Prevention efforts that attend to both boredom and sensation seeking may be particularly effective for promoting mental health and preventing externalizing behavior.
Depression and suicide are major public health concerns, and the number of youths impacted by these phenomena continues to grow. With the detrimental impact depression can have on children and adolescents, it is imperative that researchers explore risks for depression and suicidality to develop prevention programs and inform clinical practice. One such risk factor identified in the literature is being victimized by an interpersonal trauma. Past researchers also report a relationship between depression/suicidality and substance use. The purpose of this study was to examine if there was a significant interaction effect between substance use and experiencing an interpersonal trauma when predicting depression/suicidality in high school students (n = 3,128). A hierarchical logistic regression revealed a statistically significant model, χ² (9) = 446.41, p <.001, accounting for 17.7% of variance in depression/suicidality. Specifically, the effect of interpersonal violence on depression/suicidality was significantly stronger for adolescents who used substances than those who did not. The findings suggest that substance use does act as a moderator between trauma and depression/suicidality, and substance use more dramatically increases depression/suicidality for students who experience an interpersonal trauma.
As an individual becomes addicted to a drug of abuse, nerve cells within the brain's reward circuitry adapt at the epigenetic level during the course of repeated drug exposure. These drug-induced epigenetic adaptations mediate enduring changes in brain function which contribute to life-long, drug-related behavioral abnormalities that define addiction. Targeting these epigenetic alterations will enhance our understanding of the biological basis of addiction and might even yield more effective anti-addiction therapies. However, the complexity of the neuroepigenetic landscape makes it difficult to determine which drug-induced epigenetic changes causally contribute to the pathogenic mechanisms of drug addiction. In this review, we highlight the evidence that epigenetic modifications, specifically histone modifications, within key brain reward regions are correlated with addiction. We then discuss the emerging field of locus-specific neuroepigenetic editing, which is a promising method for determining the causal epigenetic molecular mechanisms that drive an addicted state. Such approaches will substantially increase the field's ability to establish the precise epigenetic mechanisms underlying drug addiction, and could lead to novel treatments for addictive disorders.
Sensation seeking has been identified as a significant risk factor for adolescent alcohol use. Little is known, however, about the process by which sensation seeking impacts heavy alcohol use. The current study used structural equation modeling (SEM) to examine the relationships among sensation seeking, age of drinking initiation, and heavy alcohol use in a sample of high school seniors (N = 221). Results support age of drinking initiation as a mediator of the relationship between sensation seeking and heavy alcohol use. Implications include providing personality-targeted prevention to adolescents who display sensation-seeking traits to delay drinking initiation among these students.
The authors examined the efficacy of a brief, web‐based personalized feedback intervention on reducing alcohol‐related consequences among high school seniors (N = 105) using a group‐randomized controlled design. Results of repeated measures mixed‐models analyses indicated significant intervention effects over time for alcohol‐related consequences at 30‐day and 6‐month follow‐up assessments. Drinking risk status moderated intervention effects such that results were only significant for high‐risk drinkers (i.e., students reporting initiation of heavy episodic drinking at baseline).
Per occasion, alcohol consumption is higher in adolescents than in adults in both humans and laboratory animals, with changes in the adolescent brain probably contributing to this elevated drinking. This Review examines the contributors to and consequences of the use of alcohol in adolescents. Human adolescents with a history of alcohol use differ neurally and cognitively from other adolescents; some of these differences predate the commencement of alcohol consumption and serve as potential risk factors for later alcohol use, whereas others emerge from its use. The consequences of alcohol use in human adolescents include alterations in attention, verbal learning, visuospatial processing and memory, along with altered development of grey and white matter volumes and disrupted white matter integrity. The functional consequences of adolescent alcohol use emerging from studies of rodent models of adolescence include decreased cognitive flexibility, behavioural inefficiencies and elevations in anxiety, disinhibition, impulsivity and risk-taking. Rodent studies have also showed that adolescent alcohol use can impair neurogenesis, induce neuroinflammation and epigenetic alterations, and lead to the persistence of adolescent-like neurobehavioural phenotypes into adulthood. Although only a limited number of studies have examined comparable measures in humans and laboratory animals, the available data provide evidence for notable across-species similarities in the neural consequences of adolescent alcohol exposure, providing support for further translational efforts in this context.
Background
Early alcohol initiation is common and has been associated with the development of alcohol problems. Yet, past research on the association of age of initiation with later problem drinking has produced inconsistent findings. Using prospective data from the Australian Parental Supply of Alcohol Longitudinal Study cohort, this study examined age of alcohol initiation, and of first drunkenness, and associations with subsequent drinking in adolescence.
Methods
A total of 1,673 parent–child dyads recruited through Australian secondary schools completed annual surveys for 5 years (grades 7 to 11). Limiting the sample to those adolescents who had initiated alcohol use by age 17 (n = 839), multinomial logistic regression models were used to examine associations between (i) age of initiation to alcohol use (consuming at least 1 full serve) and (ii) age of first drunkenness, and 2 outcomes: (i) binge drinking (consuming >4 standard drinks on a single occasion), and (ii) the total number of alcoholic drinks consumed in the past year, adjusted for a range of potential child, parent, family, and peer covariates.
Results
Fifty percent of adolescents reported alcohol use and 36% reported bingeing at wave 5 (mean age 16.9 years), and the mean age of initiation to alcohol use for drinkers was 15.1 years. Age of initiation was significantly associated with binge drinking and total quantity of alcohol consumed in unadjusted and adjusted models. Age of first drunkenness was associated with total quantity of alcohol consumed in unadjusted models but not adjusted models and was not associated with subsequent bingeing.
Conclusions
Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol‐related harms that may accompany this use.
The prevalence of substance use disorders is highest during adolescence; however, many adolescents experience a natural resolution of their substance use by early adulthood, without any formal intervention. Something appears to be unique and adaptive about the adolescent brain. In this Review, we examine the roles of the social environment and neurocognitive development in adolescents' natural resilience to substance use disorders. At present, little is known about the neurocognitive mechanisms that underlie this adaptive phenomenon, since neurodevelopmental studies have mainly focused on the risk side of the substance use equation: escalation of substance use. To provide a framework for future studies, we put forth a social plasticity model that includes developmentally limited enhanced social attunement (ie, the need to harmonise with the social environment), affective processing, and brain plasticity, which underlie adolescents' capacity to learn from and adapt to their constantly evolving social environments.
Objective:
The purpose of this randomized controlled study was to examine the efficacy of a brief, web-based personalized feedback intervention (the eCHECKUP TO GO) on alcohol use and alcohol-related consequences among high school seniors.
Method:
Participants (n = 221) were high school seniors randomized by class period to either a brief, web-based personalized feedback intervention (the eCHECKUP TO GO) or an assessment-only control group. Participants completed online surveys at baseline and at a 6-week follow-up.
Results:
Students participating in the eCHECKUP TO GO intervention reported a significant reduction in weekly drinking quantity, peak drinking quantity, and frequency of drinking to intoxication relative to those in the control group. Intervention effects were moderated by high-risk status (one or more episodes of heavy episodic drinking in the past 2 weeks reported at baseline) such that intervention effects were significant for high-risk students only. Results for alcohol-related consequences were not significant.
Conclusions:
Providing a brief, web-based personalized feedback intervention in the school setting is a promising approach for reducing problem alcohol use among high school seniors who report recent heavy episodic drinking.
This study examined the relationships among substance use, bullying victimization, and school climate among middle and high school students. In high school students, bullying victimization predicted substance use, and victims with positive perceptions of school climate reported less illicit drug use.
Background
Researchers have theorized that adolescents high in sensation seeking are particularly sensitive to positive reinforcement and the rewarding outcomes of alcohol use, and thus that the personality vulnerability is a direct causal risk factor for alcohol use. In contrast, the routine activity perspective theorizes that part of the effect of sensation seeking on alcohol use goes through the propensity that sensation seekers have towards unstructured socializing with peers. The study tests a model with indirect and direct paths from sensation seeking and participation in unstructured peer socialization to adolescent alcohol use.
Methods
Cross-sectional data were collected from 360 students in a state-secular Jewish high school (10th to 12th grade) in the center region of Israel. The sample was equally divided between boys (51.9%) and girls (48.1%), respondents’ age ranged from 15 to 17 years (mean = 16.02 ± 0.85). Structural equation modeling was used to test the direct and indirect paths.
Results
While sensation seeking had a significant direct path to adolescent alcohol use, part of the association was mediated by unstructured socializing with peers. The mediated paths were similar for boys and girls alike.
Conclusions
Sensation seeking is primarily biologically determined and prevention efforts are unlikely to modify this personality vulnerability. The results of this study suggest that a promising prevention avenue is to modify extracurricular participation patterns of vulnerable adolescents.
This study examined gender differences in the relationship between bullying victimization and substance use among high school students (N = 580). Students who reported bullying victimization reported higher levels of alcohol and illicit drug use but not marijuana use. Further, the relationship between bully victimization and illicit drug use was moderated by gender such that males who reported bully victimization reported the highest levels of illicit drug use.
Adolescents are notorious for engaging in reward-seeking behaviors, a tendency attributed to heightened activity in the brain’s reward systems during adolescence. It has been suggested that reward sensitivity in adolescence might be adaptive, but evidence of an adaptive role has been scarce. Using a probabilistic reinforcement learning task combined with reinforcement learning models and fMRI, we found that adolescents showed better reinforcement learning and a stronger link between reinforcement learning and episodic memory for rewarding outcomes. This behavioral benefit was related to heightened prediction error-related BOLD activity in the hippocampus and to stronger functional connectivity between the hippocampus and the striatum at the time of reinforcement. These findings reveal an important role for the hippocampus in reinforcement learning in adolescence and suggest that reward sensitivity in adolescence is related to adaptive differences in how adolescents learn from experience.
This study examined protective behavioral strategies (PBS) as a moderator of the relationship between impulsive sensation seeking and binge drinking and alcohol-related consequences in a sample of high school seniors (N = 346).Hierarchical regression analyses indicated that impulsive sensation seeking was a significant predictor of binge drinking and alcohol-related consequences and that PBS moderated these relationships.Specifically, manner of drinking moderated the relationships such that among students with high impulsive sensation seeking, those using strategies related to how they drink (e.g. avoiding rapid and excessive drinking) reported lower levels of binge drinking and alcohol-related consequences than those using fewer of these strategies.Clinical implications are discussed including using personality-targeted interventions that equip high impulsive sensation seeking adolescents with specific strategies to reduce binge drinking and alcohol-related consequences.
Early initiation of alcohol use is associated with high-risk drinking and an increased risk of adult alcohol dependence. The current study tested age of drinking initiation as a moderator of the efficacy of a brief, Web-based intervention on frequency of drinking and alcohol-related consequences among ninth-grade students (N = 513). At a three-month follow-up, students in the intervention group reported a reduction in drinking frequency and alcohol-related consequences relative to those in the control group. In addition, age of drinking initiation was a significant moderator of intervention efficacy. Intervention effects were greatest among two groups of students—those who reported abstinence at baseline and those who initiated drinking at age 11 or younger. Results support a brief, Web-based intervention as a promising strategy for reducing frequency of drinking and the associated consequences as a prevention strategy for students who report no drinking history and as an intervention strategy for early initiators who are at the highest risk for developing alcohol-related problems.
Objective:
Adolescence is a period of neuromaturation concomitant with increased substance involvement. Most substance use studies of adolescents have focused on categorical classifications (e.g., dependent vs. nondependent), but little is known about the influence of specific substance use behaviors on cognitive functioning in youth.
Method:
This study prospectively evaluated the quantitative effects of different substance use behaviors on neuropsychological functioning. A cognitive test battery was administered at baseline (ages 12-14 years), before substance use initiation, and at follow-up (M = 4.0 years, SD = 2.0) to evaluate changes in verbal memory, visuospatial ability, psychomotor speed, processing speed, and working memory. Robust regressions examined substance use behaviors as predictors of neuropsychological functioning (N = 234).
Results:
Several substance use behaviors predicted follow-up neuropsychological functioning above and beyond effects of baseline performance on the same measure (ps < .05). Specifically, more alcohol use days predicted worse verbal memory (β = -.15) and visuospatial ability (β = -.19). More postdrinking effects (β = -.15) and greater drug use (β = -.11) predicted worse psychomotor speed. Processing speed was not predicted by substance involvement (ps > .05). Unexpectedly, more alcohol use predicted better working memory performance (β = .12).
Conclusions:
The frequency and intensity of adolescent alcohol use may be more intricately linked to neuropsychological outcomes than previously considered. The low prevalence of substance use disorder in the sample suggests that subdiagnostic users may still experience adverse effects to verbal memory, visuospatial functioning, and psychomotor speed after initiating intense or frequent alcohol use.
Daily data collected over 14 consecutive days were used to examine whether extreme drinking was more likely on days college students reported prepartying (i.e., drinking before going out) or playing drinking games in a multi-ethnic sample of college seniors (analysis subsample: N=399; 57% women; M age=21.48years, SD=.40).
Multilevel modeling with drinking occasions at Level 1 (1265 drinking days) nested within persons at Level 2 (399 drinkers) was used to predict four extreme drinking behavior outcomes at the daily level: consuming at least 8/10 (women/men) drinks, reaching an estimated blood alcohol concentration (eBAC) of .16% or greater, drinking enough to stumble, and drinking enough to pass out.
Prepartying only (29% of drinking days) was more common than playing drinking games only (10%) or engaging in both behaviors on the same day (13%). Odds of extreme drinking were greater among students who frequently engaged in prepartying (ORs: 1.86-2.58) and drinking games (ORs: 1.95-4.16), except prepartying frequency did not predict drinking enough to pass out. On days students prepartied (ORs: 1.58-2.02) and on days they played drinking games (ORs: 1.68-1.78), odds of extreme drinking were elevated, except drinking games did not predict eBAC of .16% or greater.
Extreme drinking is attributable to both person-level characteristics (e.g., preparty frequency) and specific drinking behaviors on a given day. Prepartying and drinking games confer elevated risk of extreme drinking and are important targets in alcohol interventions for college seniors.
Copyright © 2014 Elsevier Ltd. All rights reserved.
AimsFailure to complete high school predicts substantial economic and social disadvantage in adult life. The aim of this study was to determine the longitudinal association of mid-adolescent polydrug use and high school non-completion, relative to other drug use profiles.DesignA longitudinal analysis of the relationship between polydrug use in three cohorts at grade 9 (age 14–15 years) and school non-completion (reported post-high school).SettingA State-representative sample of students across Victoria, Australia.ParticipantsA total of 2287 secondary school students from 152 high schools. The retention rate was 85%.MeasurementsThe primary outcome was non-completion of grade 12 (assessed at age 19–23 years). At grade 9, predictors included 30-day use of eight drugs, school commitment, academic failure and peer drug use. Other controls included socio-economic status, family relationship quality, depressive symptoms, gender, age and cohort.FindingsThree distinct classes of drug use were identified—no drug use (31.7%), mainly alcohol use (61.8%) and polydrug use (6.5%). Polydrug users were characterized by high rates of alcohol, tobacco and cannabis use. In the full model, mainly alcohol users and polydrug users were less likely to complete school than non-drug users [odds ratio (OR) = 1.54, 95% confidence interval (CI) = 1.17–2.03) and OR = 2.51, 95% CI = 1.45–4.33), respectively, P < 0.001]. These effects were independent of school commitment, academic failure, peer drug use and other controls.Conclusions
Mid-adolescent polydrug use in Australia predicts subsequent school non-completion after accounting for a range of potential confounding factors. Adolescents who mainly consume alcohol are also at elevated risk of school non-completion.
This study examined the association between sensation seeking, impulsivity, and drunk driving. Results showed significant differences in sensation seeking and impulsivity among 160 individuals convicted of impaired or intoxicated driving and individuals who had never been arrested for driving while under the influence/driving while intoxicated offenses.
High school students consistently report the use of substances such as alcohol, cigarettes, and marijuana. One of the people they would talk to about a substance use problem is their school counselor. A survey study was conducted with a national sample of 289 high school counselors. Results indicated that participants were clearly able to identify their practice limitations and future training needs in this area. Implications for training and recommendations for future research are discussed. © 2009 by the American Counseling Association. All rights reserved.
G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
Public schools are not traditional locations where screening, brief motivational counseling intervention and referral to treatment (SBIRT) are provided. This translational research study aimed to test the feasibility of conducting SBIRT in two urban New York schools and to examine its economic sustainability. In Spring 2012, 248 students were screened during non-academic classes: 42% of them (n=105) reported substance use (versus 28% reported in school-wide, paper anonymous survey). All but one of the positively screened students voluntarily accepted one or more brief intervention sessions and two students were referred to treatment. This school-based SBIRT model did not interfere with academic activities, was feasible to implement, and was attractive to students, teachers and administration. The data offer clear indication that further effectiveness testing is warranted and potentially valuable, however the sustainability of this model was not supported due to our lack of obtaining insurance information, authorization and reimbursement.
Drawing on the self-system model, this study conceptualized school engagement as a multidimensional construct, including behavioral, emotional, and cognitive engagement, and examined whether changes in the three types of school engagement related to changes in problem behaviors from 7th through 11th grades (approximately ages 12-17). In addition, a transactional model of reciprocal relations between school engagement and problem behaviors was tested to predict school dropout. Data were collected on 1,272 youth from an ethnically and economically diverse county (58% African American, 36% European American; 51% females). Results indicated that adolescents who had declines in behavioral and emotional engagement with school tended to have increased delinquency and substance use over time. There were bidirectional associations between behavioral and emotional engagement in school and youth problem behaviors over time. Finally, lower behavioral and emotional engagement and greater problem behaviors predicted greater likelihood of dropping out of school.
