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Young adult maturing out of alcohol involvement: : moderated effects among marriage, developmental changes in personality, and late adolescent alcohol involvement

Description

Research has shown that a developmental process of maturing out of alcohol involvement occurs during young adulthood, and that this process is related to both young adult role transitions (e.g., marriage) and personality developmental (e.g., decreased disinhibition and neuroticism). The current study extended past research by testing whether protective marriage…

Research has shown that a developmental process of maturing out of alcohol involvement occurs during young adulthood, and that this process is related to both young adult role transitions (e.g., marriage) and personality developmental (e.g., decreased disinhibition and neuroticism). The current study extended past research by testing whether protective marriage and personality effects on maturing out were stronger among more severe late adolescent drinkers, and whether protective marriage effects were stronger among those who experienced more personality development. Parental alcoholism and gender were tested as moderators of marriage, personality, and late adolescent drinking effects on maturing out; and as distal predictors mediated by these effects. Participants were a subsample (N = 844; 51% children of alcoholics; 53% male, 71% non-Hispanic Caucasian, 27% Hispanic; Chassin, Barrera, Bech, & Kossak-Fuller, 1992) from a larger longitudinal study of familial alcoholism. Hypotheses were tested with latent growth models characterizing alcohol consumption and drinking consequence trajectories from late adolescence to adulthood (age 17-40). Past findings were replicated by showing protective effects of becoming married, sensation-seeking reductions, and neuroticism reductions on the drinking trajectories. Moderation tests showed that protective marriage effects on the drinking trajectories were stronger among those with higher pre-marriage drinking in late adolescence (i.e., higher growth intercepts). This might reflect role socialization mechanisms such that more severe drinking produces more conflict with the demands of new roles (i.e., role incompatibility), thus requiring greater drinking reductions to resolve this conflict. In contrast, little evidence was found for moderation of personality effects by late adolescent drinking or for moderation of marriage effects by personality. Parental alcoholism findings suggested complex moderated mediation pathways. Parental alcoholism predicted less drinking reduction through decreasing the likelihood of marriage (mediation) and muting marriage's effect on the drinking trajectories (moderation), but parental alcoholism also predicted more drinking reduction through increasing initial drinking in late adolescence (mediation). The current study provides new insights into naturally occurring processes of recovery during young adulthood and suggests that developmentally-tailored interventions for young adults could harness these natural recovery processes (e.g., by integrating role incompatibility themes and addressing factors that block role effects among those with familial alcoholism).

ContributorsLee, Matthew R. (Author) / Chassin, Laurie (Thesis advisor) / Corbin, William R. (Committee member) / Mackinnon, David P (Committee member) / Presson, Clark C. (Committee member) / Arizona State University (Publisher)

Created2013

Different dimensions of anxiety differentially predict binge drinking among juvenile offenders

Description

Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for…

Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for these mixed findings is that separate dimensions of anxiety may differentially confer risk for alcohol use. The present study tested two dimensions of anxiety - worry and physiological anxiety -- as predictors of binge drinking in a longitudinal study of juvenile delinquents. Overall, results indicate that worry and physiological anxiety showed differential relations with drinking behavior. In general, worry was protective against alcohol use, whereas physiological anxiety conferred risk for binge drinking, but both effects were conditional on levels of offending. Implications for future research examining the role of anxiety in predicting drinking behavior among youth are discussed.

ContributorsNichter, Brandon (Author) / Chassin, Laurie (Thesis advisor) / Barrera, Manuel (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)

Created2014

Indirect and Moderated Effects of Parent-Child Communication on Drinking Values and Alcohol Use in the Transition to College.

Description

The transition from high school to college is marked by many changes, one of the most significant being the increased accessibility of alcohol, putting college students at high risk for alcohol-related consequences. It is imperative to identify factors that can protect young adults against these risks during this critical period.…

The transition from high school to college is marked by many changes, one of the most significant being the increased accessibility of alcohol, putting college students at high risk for alcohol-related consequences. It is imperative to identify factors that can protect young adults against these risks during this critical period. Although peers become increasingly influential in college, extant literature has shown that parents still have an impact on their children's behavior during this time. While parents spend less time with their children after college matriculation, they may indirectly protect against risky drinking behaviors by instilling certain values into their children before they make this transition. Using data from a large sample of students during their senior year of high school and their freshman year of college, the current study sought to examine interactive effects of parental communication and parental knowledge and caring on drinking behavior, and the extent to which internalization of personal drinking values mediate these effects. The primary study hypotheses were tested using path analysis conducted in Mplus 7.0. Full information maximum likelihood (FIML) estimation was utilized to estimate missing data and bootstrapping was used to address non-normality in the data. Results showed that, for those whose parents were high in knowledge and caring, higher levels of communication were associated with lower risk for alcohol use and problems at wave 3 through less permissive drinking values at wave 1. This finding has important implications for prevention approaches designed to reduce risk for heavy drinking and related problems during the transition to college.

ContributorsHartman, Jessica Danielle (Author) / Corbin, William (Thesis director) / Knight, George (Committee member) / Chassin, Laurie (Committee member) / Barrett, The Honors College (Contributor) / Department of Psychology (Contributor)

Created2015-05

Investigating adverse effects of adolescent group interventions

Description

This study examined an adverse effect of an adolescent group intervention. Group interventions represent one of the most economical, convenient, and common solution to adolescent behavior problems, although prior findings from program evaluation studies have suggested that these groups can unexpectedly increase the externalizing behaviors that they were designed to…

This study examined an adverse effect of an adolescent group intervention. Group interventions represent one of the most economical, convenient, and common solution to adolescent behavior problems, although prior findings from program evaluation studies have suggested that these groups can unexpectedly increase the externalizing behaviors that they were designed to reduce or prevent. The current study used data from a longitudinal, randomized controlled trial of the Bridges to High School / Puentes a La Secundaria Program, a multicomponent prevention program designed to reduce risk during the middle school transition, which has demonstrated positive effects across an array of outcomes. Data were collected at the beginning of 7th grade, with follow-up data collected at the end of the 7th, 8th, 9th, and 12th grade from a sample of Mexican American adolescents and their mothers. Analyses evaluated long-term effects on externalizing outcomes, trajectories of externalizing behaviors across adolescence, and potential mediators of observed effects. Results showed that the adverse effect that was originally observed based on adolescent self-report of externalizing symptoms at 1-year posttest among youth with high pretest externalizing symptoms was not maintained over time and was not reflected in changes in adolescents' trajectories of externalizing behaviors. Moreover, neither of the peer mediators that theory suggests would explain adverse effects were found to mediate the relationship between intervention status and externalizing symptoms at 1-year posttest. Finally, only beneficial effects were found on externalizing symptoms based on mother report. Together, these findings suggest that the Bridges intervention did not adversely affect adolescent problem behaviors and that future studies should use caution when interpreting unexpected adverse effects.

ContributorsWong, Jessie Jong-Chee (Author) / Gonzales, Nancy A. (Thesis advisor) / West, Stephen G. (Thesis advisor) / Chassin, Laurie (Committee member) / Dishion, Thomas (Committee member) / Arizona State University (Publisher)

Created2015

The comprehensive adolescent drinking history form: a novel measure of adolescent alcohol exposure

Description

Adolescent and young adult alcohol use is a major public health concern given that it is the most widely used substance by teenagers. This is particularly concerning given the important biological and environmental changes that occur during this developmental period. Therefore, it is not surprising that alcohol use in adolescence…

Adolescent and young adult alcohol use is a major public health concern given that it is the most widely used substance by teenagers. This is particularly concerning given the important biological and environmental changes that occur during this developmental period. Therefore, it is not surprising that alcohol use in adolescence is associated with a variety of negative outcomes including alcohol-related consequences, poor academic performance, aggression, and difficulty transitioning to adulthood. Because of this, it is imperative to better understand alcohol use during this time. While there are numerous measures that aim to capture adolescent alcohol use, there is not currently a measure that gathers comprehensive information on alcohol use across adolescence and into early adulthood. Therefore, we developed the Comprehensive Adolescent Drinking History Form (CADHF). The CADHF gathers detailed drinking information for each year since the onset of first regular use, including quantity and frequency of both regular use and periods of heaviest drinking. Additionally, the CADHF collects information on the participants' aggregate drinking experiences between their age of onset and age of first regular use. Using a sample of young adults who completed an alcohol challenge study, we sought to examine (1) whether route of administration of the measure impacts results, (2) which CADHF are most useful, and (3) whether the CADHF shows concurrent, convergent, and incremental validity. Results showed that, the CADHF can be administered online or over the phone and all eight indices provide valuable information depending on the research question. Additionally, strong significant correlations between the CADHF with the Timeline Follow Back (TLFB) and the Young Adult Alcohol Consequences Questionnaire (YAACQ) suggest convergent and concurrent validity. Finally, the CADHF predicted concurrent and future alcohol-related problems over and above the gold standards of alcohol consumption measures; age of onset, age of first intoxication, and the TLFB. This is the first study to retrospectively assess participant's comprehensive alcohol consumption and fills a major gap in the literature. The CADHF has the potential to inform the timing of prevention and intervention efforts and provides unique information from the current gold standards of alcohol consumption measures.

ContributorsHartman, Jessica (Author) / Corbin, William (Thesis advisor) / Chassin, Laurie (Committee member) / Doane, Leah (Committee member) / Arizona State University (Publisher)

Created2017

Investigating the Combined Effects of Alcohol Expectancies and Subjective Response on Future Drinking: An Interaction Approach

Description

Past research suggests that both Alcohol Expectancies and Subjective Response are strong predictors of drinking. However, most studies do not account for the shared variance or relations between the two. Social cognitive and expectancy theories suggest that cognitions may distort reality, creating a discrepancy between expected and subjective effects. Only…

Past research suggests that both Alcohol Expectancies and Subjective Response are strong predictors of drinking. However, most studies do not account for the shared variance or relations between the two. Social cognitive and expectancy theories suggest that cognitions may distort reality, creating a discrepancy between expected and subjective effects. Only one study has tested the effects of such discrepancies (Morean et al., 2015), but that study was cross-sectional, making it impossible to determine the direction of effects. As such, the present study sought to test prospective associations between expectancy-subjective response interactions and future drinking behavior. Participants (N=448) were randomly assigned to receive alcohol (target blood alcohol alcohol =.08 g%) or placebo, with 270 in the alcohol condition. Alcohol expectancies and subjective response were assessed across the full range of affective space of valence by arousal. Hierarchical regression tested whether expectancies, subjective response, and their interaction predicted follow-up drinking in 258 participants who reached a blood alcohol curve of >.06 (to differentiate blood alcohol curve limbs). Covariates included gender, age, drinking context, and baseline drinking. High arousal subjective response was tested on the ascending limb and low arousal subjective response on the descending limb. High arousal positive expectancies and subjective response interacted to predict future drinking, such that mean and low levels of high arousal positive subjective response were associated with more drinking when expectancies were higher. High arousal negative expectancies and subjective response also interacted to predict future drinking, such that high levels of high arousal negative subjective response marginally predicted more drinking when expectancies were lower. There were no interactions between low arousal positive or low arousal negative expectancies and subjective response. Results suggest that those who expected high arousal positive subjective response but did not receive many of these effects drank more, and those who did not expect to feel high arousal negative subjective response but did in fact feel these effects also drank more. The results suggest that challenging inaccurate positive expectancies and increasing awareness of true negative subjective response may be efficacious ways to reduce drinking.

ContributorsWaddell, Jack Thomas (Author) / Corbin, William R. (Thesis advisor) / Chassin, Laurie (Thesis advisor) / Anderson, Samantha F. (Committee member) / Arizona State University (Publisher)

Created2020

Substance Use Among Mexican Adolescents Moderators of Intervention Efficacy and Risk Profile

Description

Adolescent substance use is a complex and significant public health concern that has received considerable attention among researchers and practitioners (Gray & Squeglia, 2018). The purpose of this dissertation was to examine factors associated with substance use intervention effects and to develop subgroups of risk factors for Mexican adolescents. This…

Adolescent substance use is a complex and significant public health concern that has received considerable attention among researchers and practitioners (Gray & Squeglia, 2018). The purpose of this dissertation was to examine factors associated with substance use intervention effects and to develop subgroups of risk factors for Mexican adolescents. This dissertation utilizes secondary data from a randomized controlled trial of the school-based substance use universal prevention program, keepin’ it REAL (kiR). The dissertation included two studies. Study 1: This study tested a model on the efficacy of the school-based substance use universal prevention program, keepin’ it REAL, among a sample of Mexican adolescents (N = 3,742, 11-17 years old). Study 1 analysis included Structural Equation Modeling and results demonstrated that participation in kiR positively predicted alcohol resistance strategies and those alcohol resistance strategies were negatively and significantly associated with alcohol use. Further, depressive symptomology was a moderator of intervention effects as the effects of kiR on resistance strategies increased as the level of depressive symptomology increased. Study 2: this study explored subgroups (classes) of Mexican adolescents (N = 5,520, 11-14 years old) based on their experiences with violence (witnessing, victimization, and perpetration), depressive symptomology, and substance use (alcohol, tobacco, and marijuana). Using Latent Class Analysis (LCA) four empirically, well-differentiated classes emerged representing adolescents various risk typologies (Moderate Risk-Violence at 55% of the sample, Low Risk at 35%, High Risk at ~8%; and Moderate Risk-Substance Use at ~2%) Implications for research and practice are discussed across both studies.

ContributorsArévalo Avalos, Marvyn R (Author) / Spanierman, Lisa (Thesis advisor) / Dillon, Frank (Committee member) / Marsiglia, Flavio (Committee member) / Arizona State University (Publisher)

Created2021

Screening, Brief Intervention and Referral to Treatment (SBIRT): Implementation in the Adolescent Inpatient Psychiatric Setting

Description

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT)…

Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT) provides an evidence-based (EB) framework to detect and treat SU. Evidence shows that mental health (MH) providers are not providing EB SU management. Federally grant-funded SBIRT demonstrated evidence of decreased SU and prevention of full disorders. Implementation outcomes in smaller-scale projects have included increased clinician knowledge, documentation and interdisciplinary teamwork.

Objective: To improve quality of care (QOC) for adolescents who use substances in the inpatient psychiatric setting by implementing EB SBIRT practices.

Methods: Research questions focused on whether the number of SBIRT notes documented (N=170 charts) increased and whether training of the interdisciplinary team (N=26 clinicians) increased SBIRT knowledge. Individualized interventions used existing processes, training and a new SBIRT Note template. An SBIRT knowledge survey was adapted from a similar study. A pre-and post-chart audit was conducted to show increase in SBIRT documentation. The rationale for the latter was not only for compliance, but also so that all team members can know the status of SBIRT services. Thus, increased interdisciplinary teamwork was an intentional, though indirect, outcome.

Results: A paired-samples t-test indicated clinician SBIRT knowledge significantly increased, with a large effect size. The results suggest that a short, 45-60-minute tailored education module can significantly increase clinician SBIRT knowledge. Auditing screening & BI notes both before and after the study period yielded important patient SU information and which types of SBIRT documentation increased post-implementation. The CRAFFT scores of the patients were quite high from a SU perspective, averaging over 3/6 both pre- and post-implementation, revealing over an 80% chance that the adolescent patient had a SU disorder. Most patients were positive for at least one substance (pre- = 47.1%; post- = 65.2%), with cannabis and alcohol being the most commonly used substances. Completed CRAFFT screenings increased from 62.5% to 72.7% of audited patients. Post-implementation, there were two types of BI notes: the preexisting Progress Note BI (PN BI) and the new Auto-Text BI (AT BI), part of the new SBIRT Note template introduced during implementation. The PN BIs not completed despite a positive screen increased from 79.6% to 83.7%. PN BIs increased 1%. The option for AT BI notes ameliorated this effect. Total BI notes completed for a patient positive for a substance increased from 20.4% to 32.6%, with 67.4% not receiving a documented BI. Total BIs completed for all patients was 21.2% post-implementation.

Conclusion: This project is scalable throughout the U.S. in MH settings and will provide crucial knowledge about positive and negative drivers in small-scale SBIRT implementations. The role of registered nurses (RNs), social workers and psychiatrists in providing SBIRT services as an interdisciplinary team will be enhanced. Likely conclusions are that short trainings can significantly increase clinician knowledge about SBIRT and compliance with standards. Consistent with prior evidence, significant management involvement, SBIRT champions, thought leaders and other consistent emphasis is necessary to continue improving SBIRT practice in the target setting.

Keywords: adolescents, teenagers, youth, alcohol, behavioral health, cannabis, crisis, documentation, drug use, epidemic, high-risk use, illicit drugs, implementation, mental health, opiates, opioid, pilot study, psychiatric inpatient hospital, quality improvement, SBIRT, Screening, Brief Intervention and Referral to Treatment, substance use, unhealthy alcohol use, use disorders

ContributorsMaixner, Roberta (Author) / Guthery, Ann (Thesis advisor) / Mensik, Jennifer (Thesis advisor) / Uriri-Glover, Johannah (Thesis advisor)

Created2019-05-02

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