Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: Predictors and substance abuse outcomes.

This study describes binge drinking trajectories from adolescence to emerging adulthood in 238 children of alcoholics and 208 controls. Mixture modeling identified three trajectory groups: early-heavy (early onset, high frequency), late moderate (later onset, moderate frequency), and infrequent (early onset, low frequency). Nonbingers were defined a priori. The early-heavy group was characterized by parental alcoholism and antisociality, peer drinking, drug use, and (for boys) high levels of externalizing behavior, but low depression. The infrequent group was elevated in parent alcoholism and (for girls) adolescent depression, whereas the nonbinger and late-moderate groups showed the most favorable adolescent psychosocial variables. All 3 drinking trajectory groups raised risk for later substance abuse or dependence compared with the nonbingers, with the early-heavy group at highest risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls.

This prospective study tested whether early menarche partially accounts for the increases in depression, eating pathology, substance abuse, and comorbid psychopathology that occur among adolescent girls, with structured interview data from a community sample (N?=?496). Early menarche (prior to 11.6 years) was associated with elevated depression, substance abuse, and "any" disorder but did not confer increased risk for anorexia nervosa, bulimia nervosa, or binge eating disorder. Although there was significant comorbidity across all three classes of pathology, early menarche was associated only with comorbid depression and substance abuse. Results provide partial support for the assertion that early menarche is a general risk factor for psychopathology among adolescent girls but suggest that this risk may not apply to certain disorders and that the effects are modest in size. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation of parent alcoholism to adolescent substance use: A longitudinal follow-up study.

The current study tested parent alcoholism effects on growth curves of adolescent substance use and examined whether parent and peer influences, temperamental emotionality and sociability, and stress and negative affect could explain parent alcoholism effects. Longitudinal latent growth curve modeling showed that adolescents with alcoholic fathers, boys, and adolescents with drug-using peers had steeper growth in substance use over time than did adolescents without alcoholic fathers, girls, and adolescents without drug-using peers. Data were consistent with father's monitoring and stress as possible mediators of paternal alcoholism effects. However, the direct effects of paternal alcoholism on substance use growth remained significant even after including the hypothesized mediators in the model. This suggests that other (unmeasured) mediators are necessary to fully explain paternal alcoholism risk for adolescents' escalating substance use over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical implications of "subthreshold" depressive symptoms.

There is active debate regarding whether diagnosable depression exists on a continuum with subthreshold depressive symptoms or represents a categorically distinct phenomenon. To address this question, multiple indexes of dysfunction (psychosocial difficulties, mental health treatment history, and future incidence of major depression and substance abuse/dependence) were examined as a function of the extent of depressive symptoms in 3 large community samples (adolescent, adult, and older adult; N?=?3,003). Increasing levels of depressive symptoms were associated with increasing levels of psychosocial dysfunction and incidence of major depression and substance use disorders. These findings suggest that (a) the clinical significance of depressive symptoms does not depend on crossing the major depressive diagnostic threshold and (b) depression may best be conceptualized as a continuum. Limitations of the present study are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between adolescent substance use and young adult internalizing symptoms: Findings from a high-risk longitudinal sample.

The present study examined the role of adolescent substance use and its antecedent behavioral and familial risk factors in the prediction of young adult internalizing symptoms 10 years later, using a community sample of children of alcoholics (n = 194) and demographically matched controls (n = 209). Using growth curve modeling, the authors found that initial levels of adolescent alcohol and drug use (μage = 13) and growth in drug use during adolescence predicted higher levels of internalizing symptoms in young adulthood, even after including in the models shared risk factors for both internalizing symptoms and adolescent substance use. These effects remained significant after including concurrent substance use in adulthood, suggesting that adolescent substance use exerts a long-term impact on young adult internalizing symptoms over and above the effects of persistent substance use over time. The present investigation further revealed that initial levels of alcohol and drug use in adolescence mediate the relation between parental alcoholism and young adult internalizing symptoms. Findings provide evidence for the long-term effects of adolescent substance use on young adult functioning and can help inform both etiological and prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The roles of familial alcoholism and adolescent family harmony in young adults' substance dependence disorders: Mediated and moderated relations.

This study examined the prospective relations among family history density of alcoholism (FHD), adolescent family harmony, and young adults' alcohol and drug dependence. Family harmony was rated by mothers and fathers in adolescence, and young adults' substance dependence diagnoses were obtained through structured interviews. Higher FHD predicted lower adolescent family harmony, which in turn increased young adults' odds of being diagnosed with drug dependence (with and without alcohol dependence) compared to no diagnoses or to alcohol dependence only. Family harmony also interacted with FHD such that the protective effect of family harmony on young adults' drug dependence with or without alcohol dependence decreased as FHD rose, and was nonsignificant at high levels of FHD. The findings suggest the importance of distinguishing among alcohol and drug dependence disorders and examining their differential etiological pathways, and also suggest that the protective effects of harmonious family environments on substance dependence may be limited at high levels of FHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An isocratic high performance liquid chromatography (HPLC) assay for moxifloxacin, a new 8-methoxyquinolone

OBJECTIVE: Studies have shown memory deficits among combat veterans with posttraumatic stress disorder (PTSD); however, high rates of comorbid conditions, including alcoholism, make it difficult to definitively associate these findings with the PTSD diagnosis. In this study the authors examined memory functioning among rape survivors without alcoholism or substance abuse but with PTSD. METHOD: Rape victims with (N = 15) and without (N = 16) PTSD were compared to age- and education-matched nontraumatized comparison subjects (N = 16) on measures of learning and memory. RESULTS: The subjects with PTSD performed significantly worse than the other groups on delayed free recall. The deficits were ameliorated by cueing and recognition testing. CONCLUSIONS: Recall deficits in noncombat PTSD patients strengthen the theory that memory deficits are associated with the PTSD diagnosis. The deficits were mild and were not attributable to comorbid depression, anxiety, or substance abuse.     

Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity.

A literature review on community studies of adolescent substance use, abuse, or dependence (SU/A/D) and psychiatric comorbidity yielded 22 articles from 15 studies with information on rates, specificity, timing, and differential patterns of comorbidity by gender, race/ethnicity, and other factors. Results revealed that 60% of youths with SU/A/D had a comorbid diagnosis, and conduct disorder (CD) and oppositional defiant disorder (not attention-deficit/hyperactivity disorder) were most commonly associated with SU/A/D, followed by depression. Child psychopathology (particularly CD) was associated with early onset of substance use and abuse in later adolescence. The authors suggest that available data relevant to SU/A/D and psychiatric comorbidity can be used to better address such questions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of familial risk, personality, and expectancies on alcohol use and abuse.

This study tested a structural model of the association between familial risk, personality risk, alcohol expectancies, and alcohol abuse in a sample of 224 young adult offspring of alcoholics and 209 offspring of nonalcoholics. The results provided support for 2 personality-risk pathways, a social deviance proneness and an excitement/pleasure seeking path, that accounted for a significant portion of the association between a familial alcoholism and alcohol abuse. The path from familial alcoholism to social deviance proneness lead directly to alcohol problems. The path from familial alcoholism to excitement/ pleasure seeking was associated with increased drinking, which, in turn, was associated with alcohol problems. Positive alcohol expectancies accounted for part of the association between excitement seeking and alcohol use. The results suggest 2 different biopsychosocial mechanisms that elevate risk for abuse in the offspring of alcoholics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent psychopathology, parenting, and child internalizing problems in substance-abusing families.

A structural model accounting for child internalizing problems in substance-abusing families was tested. Parents receiving substance abuse treatment (N = 242) completed forms about children between the ages of 6 and 18 who resided in their home. The effects of parent gender, child gender, and child age were controlled. Negative parenting was examined as a mediator between parent internalizing and externalizing problems and child anxiety and affective problems using path analysis. Negative parenting mediated relations only between parent internalizing problems and child affective problems. High-positive involvement moderated relations between parent externalizing problems and child internalizing problems. Relations between parent externalizing problems and child anxiety and affective problems were significant only among families in which high-positive involvement was present. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis.

We tested special and general explanations of male adolescent sexual offending by conducting a meta-analysis of 59 independent studies comparing male adolescent sex offenders (n = 3,855) with male adolescent non-sex offenders (n = 13,393) on theoretically derived variables reflecting general delinquency risk factors (antisocial tendencies), childhood abuse, exposure to violence, family problems, interpersonal problems, sexuality, psychopathology, and cognitive abilities. The results did not support the notion that adolescent sexual offending can be parsimoniously explained as a simple manifestation of general antisocial tendencies. Adolescent sex offenders had much less extensive criminal histories, fewer antisocial peers, and fewer substance use problems compared with non-sex offenders. Special explanations suggesting a role for sexual abuse history, exposure to sexual violence, other abuse or neglect, social isolation, early exposure to sex or pornography, atypical sexual interests, anxiety, and low self-esteem received support. Explanations focusing on attitudes and beliefs about women or sexual offending, family communication problems or poor parent–child attachment, exposure to nonsexual violence, social incompetence, conventional sexual experience, and low intelligence were not supported. Ranked by effect size, the largest group difference was obtained for atypical sexual interests, followed by sexual abuse history, and, in turn, criminal history, antisocial associations, and substance abuse. We discuss the implications of the findings for theory development, as well as for the assessment, treatment, and prevention of adolescent sexual offending. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent and Parent Alliance and Treatment Outcome in Multidimensional Family Therapy.

In this study, the authors examined the relation between adolescent and parent therapeutic alliances and treatment outcome among 65 substance-abusing adolescents receiving multidimensional family therapy. Observer ratings of parent alliance predicted premature termination from treatment. Observer ratings, but not self-report, of adolescent alliance predicted adolescents' substance abuse and dependency symptoms at posttreatment, as well as days of cannabis use at 3-month follow-up. The association between adolescent alliance and substance abuse and dependency symptoms at posttreatment was moderated by the strength of the parent alliance. Results reveal the unique and interactive effects of the 2 alliances on treatment outcome and emphasize the need for a systemic and well-articulated approach to developing and maintaining the multiple alliances inherent to family therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent–adolescent conflict in the context of parental support: Families with alcoholic and nonalcoholic fathers.

The authors tested the hypothesis that parental support provides a social context that moderates the effects of parent–adolescent conflict on adolescent problem behavior. They also examined the possible potentiating effects of a family risk factor, paternal alcoholism, on parent–adolescent conflict. Cross-sectional and prospective analyses of 269 adolescents and their parents showed that parent–adolescent conflict was more highly related to adolescent problem behavior when parental support was low than when support was high. Parent–adolescent conflict was related to problem behavior for adolescent children of alcoholics, but not for children of nonalcoholic parents. These findings support the contention that the effects of parent–adolescent conflict need to be understood within the context of other interpersonal and family background characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inattention as a key predictor of tobacco use in adolescence.

The authors examined the prediction from inattention to tobacco use among 2 cohorts (ages 7 and 13) of a community sample followed to young adulthood. Changes in self-reported tobacco use were tested with marginal transitional regression models, using parent and teacher ratings of inattention, hyperactivity-impulsivity, and other psychopathology, along with other factors, as predictors. Inattention, but not hyperactivity-impulsivity, significantly predicted adolescent tobacco use and young adult daily tobacco use. Peer substance use, parental substance use, and conduct disorder also predicted increases in tobacco use. African American ethnicity was strongly protective against later tobacco use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overt behavior problems and serotonergic function in middle childhood among male and female offspring of alcoholic fathers

A large body of literature indicates that the serotonergic system is involved in behavioral regulation, as evidenced by the inverse relationship between impulsive aggression and serotonergic function found in adult alcoholics and nonalcoholics. However, studies of this relationship among child and adolescent offspring of alcoholics (COAs) have not previously been done. This study examines the potentially parallel relationship between behavioral dysregulation and low serotonergic function in young COAs. The relationship is of potential interest as a phenotypic marker of biological vulnerability to aggressiveness, which itself has been hypothesized to be a risk factor for later antisocial alcoholism. The present work is part of an ongoing prospective study of the development of risk for alcohol abuse/dependence and other problematic outcomes in a sample of families subtyped by the fathers' alcoholism classification. We examined the relationship between overt behavior problems in middle childhood (mean age = 10.5 +/- 1.7 years) and whole blood serotonin (5-HT) in a subsample of the offspring (N = 32 boys and 12 girls). Using a Child Behavior Checklist (CBCL) index of behavioral undercontrol, we obtained results indicating that high total behavior problem (TBP) children had lower levels of whole blood 5-HT than did low-TBP children (p < 0.01). These results support the hypothesis that there is an inverse relationship between whole blood serotonin levels and behavior problems in young male and female COAs. A father's alcoholism status was not significantly related to his child's 5-HT level, i.e., the child's phenotypic expression of behavioral dysregulation was more reliably connected to serotonergic function than was paternal alcoholism.     

Clarifying the effects of parental substance abuse, child sexual abuse, and parental caregiving on adult adjustment.

Parental alcoholism, childhood sexual abuse, and other forms of child maltreatment are generally viewed as contributing to adult adjustment problems. The long-term effects of these various factors, however, are actually not well understood. The present study found that the largest amount of variance in 255 college students' psychological distress was explained by parental emotional abuse and neglect, with child sexual abuse, parental substance abuse, and other factors explaining additional but smaller amounts of variance in distress. This suggests that comprehensive conceptualizations of family influences on development will result in a more complete understanding of long-term adjustment outcomes than merely focusing on particular childhood risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Co-morbidity and familial aggregation of alcoholism and anxiety disorders

BACKGROUND: This study examined the patterns of familial aggregation and co-morbidity of alcoholism and anxiety disorders in the relatives of 165 probands selected for alcoholism and/or anxiety disorders compared to those of 61 unaffected controls. METHODS: Probands were either selected from treatment settings or at random from the community. DSM-III-R diagnoses were obtained for all probands and their 1053 first-degree relatives, based on direct interview or family history information. RESULTS: The findings indicate that: (1) alcoholism was associated with anxiety disorders in the relatives, particularly among females; (2) both alcoholism and anxiety disorders were highly familial; (3) the familial aggregation of alcoholism was attributable to alcohol dependence rather than to alcohol abuse, particularly among male relatives; and (4) the the pattern of co-aggregation of alcohol dependence and anxiety disorders in families differed according to the subtype of anxiety disorder; there was evidence of a partly shared diathesis underlying panic and alcoholism, whereas social phobia and alcoholism tended to aggregate independently. CONCLUSIONS: The finding that the onset of social phobia tended to precede that of alcoholism, when taken together with the independence of familial aggregation of social phobia and alcoholism support a self-medication hypothesis as the explanation for the co-occurrence of social phobia and alcoholism. In contrast, the lack of a systematic pattern in the order of onset of panic and alcoholism among subjects with both disorders as well as evidence for shared underlying familial risk factors suggests that co-morbidity between panic disorder and alcoholism is not a consequence of self-medication of panic symptoms. The results of this study emphasize the importance of examining co-morbid disorders and subtypes thereof in identifying sources of heterogeneity in the pathogenesis of alcoholism.     

Cognitive and family therapies for adolescent depression: Treatment specificity, mediation, and moderation.

The specificity of cognitive and family therapies, and potential treatment mediators and moderators, was examined in a randomized clinical trial for adolescent depression. After acute treatment, cognitive-behavioral therapy (CBT) exerted specific effects on cognitive distortions relative to either systemic-behavioral family therapy (SBFT) or nondirective supportive therapy (NST). At 2-year follow-up, SBFT was found to impact family conflict and parent–child relationship problems more than CBT; NST and CBT tended to show a greater reduction in anxiety symptoms than SBFT. Nonspecific therapist variables qualified few outcome analyses. No measures of cognitive distortion or family dysfunction mediated or moderated treatment outcome. As in adult studies, relatively few areas of treatment specificity or mediation were identified. The implications of these findings for clinical treatment and research in adolescent depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the well-being of nonclinical college students: Is knowledge of the presence of parental alcoholism useful?

Previous research has studied the assumed effects of parental alcoholism on children in rather narrow ways, which has resulted in misleading assumptions about the psychological well-being of adult children of alcoholics (ACAs). This study takes a broader perspective and confirms and extends prior research by examining the relationship of parental alcoholism and family functioning to problem-solving appraisal, perceived social support, interpersonal cognitive schema, and substance use. The 40 ACA participants were similar to the 40 non-ACAs on all measures except substance abuse: ACAs were at greater risk for moderate and high substance use. Participants from dysfunctional family systems reported more negative problem-solving appraisal and interpersonal cognitive schemata as compared with participants from functional family systems. Psychological adjustment appears multidetermined and not a simple consequence of parental alcoholism. Implications for future research are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between childhood disruptive behavior disorders and substance use and dependence symptoms in young adulthood: Individuals with symptoms of attention-deficit/hyperactivity disorder are uniquely at risk.

Most prior literature examining the relations among attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and substance use and abuse suggests that CD fully accounts for the ADHD-substance abuse relation. This study sought to test an alternate theory that individuals with symptoms of both ADHD and CD are at a special risk for substance abuse. Relations between childhood ADHD and CD symptoms, and young adult tobacco, alcohol, marijuana, and hard drug use and dependence symptoms, were examined in a sample of 481 young adults. ADHD and CD symptoms interacted to predict marijuana dependence symptoms and hard drug use and dependence symptoms, such that individuals with high levels of both ADHD and CD had the highest levels of these outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)