This cross-sectional study examined group differences in substance use, substance-related problems, and psychological symptoms among college students based on their prescription stimulant use, with a focus on medical and nonmedical misuse. Participants were 1,856 undergraduate students with a mean age of 19.1 (SD = 4.45); 52.5% were male, and 47.6% were female. In this sample, 11.4% reported past-year stimulant misuse, with 26% engaging in medical misuse and 74% in nonmedical misuse. Aim 1 analyses revealed that nonmedical stimulant misusers reported higher impulsivity, alcohol use, cannabis use, and alcohol-related consequences compared to appropriate users and alcohol/cannabis-only users, though often not significantly different from polysubstance misusers. Medical stimulant misusers reported higher cannabis use but not alcohol-related outcomes. Aim 2 analyses reinforced these findings, showing that nonmedical stimulant misuse was associated with greater alcohol and cannabis use, while medical misuse was associated specifically with cannabis use, after controlling for covariates. Findings support the notion that nonmedical misuse is a distinct contributor to increased substance use, while medical misuse is linked more specifically to cannabis use. Differences in impulsivity and substance use patterns suggest that targeted interventions for both misuse types could address their unique psychological and behavioral profiles. Limitations include reliance on self-report data and the cross-sectional design, restricting causal interpretations. Future research should examine longitudinal patterns and motivations for stimulant misuse to better inform prevention strategies.

This cross-sectional study examined group differences in substance use, substance-related problems, and psychological symptoms among college students based on their prescription stimulant use, with a focus on medical and nonmedical misuse. Participants were 1,856 undergraduate students with a mean age of 19.1 (SD = 4.45); 52.5% were male, and 47.6% were female. In this sample, 11.4% reported past-year stimulant misuse, with 26% engaging in medical misuse and 74% in nonmedical misuse. Aim 1 analyses revealed that nonmedical stimulant misusers reported higher impulsivity, alcohol use, cannabis use, and alcohol-related consequences compared to appropriate users and alcohol/cannabis-only users, though often not significantly different from polysubstance misusers. Medical stimulant misusers reported higher cannabis use but not alcohol-related outcomes. Aim 2 analyses reinforced these findings, showing that nonmedical stimulant misuse was associated with greater alcohol and cannabis use, while medical misuse was associated specifically with cannabis use, after controlling for covariates. Findings support the notion that nonmedical misuse is a distinct contributor to increased substance use, while medical misuse is linked more specifically to cannabis use. Differences in impulsivity and substance use patterns suggest that targeted interventions for both misuse types could address their unique psychological and behavioral profiles. Limitations include reliance on self-report data and the cross-sectional design, restricting causal interpretations. Future research should examine longitudinal patterns and motivations for stimulant misuse to better inform prevention strategies.

Organized youth activities are environments typically oriented towards the promotion of skills rather than the prevention of mental health difficulties. The current study explored whether such youth activities might be leveraged as an ecological context for prevention efforts. Using data from the Seattle Social Development Project (SSDP), this study first examined the relation between early adolescent participation in organized activities and early adult internalizing symptoms. Then, merging the approaches of positive youth development and prevention science, the study assessed a potential mediating mechanism (social competence) that is known to be promotive of positive development, frequently targeted in youth activities, and preventive regarding prospective mental health symptoms. Last, the study examined a potential multiple-mediator pathway to explain intervention effects for Raising Healthy Children (RHC), a multi-component preventive intervention, which is tested in a quasi-experiment nested within the broader SSDP study design. While the direct associations between youths’ involvement and later internalizing symptoms were small and not statistically significant, they were in the hypothesized direction (i.e., more involvement predicting lower internalizing symptoms). Examining potential mediation through joint significance testing and bootstrapped asymmetric confidence intervals on indirect effect estimates, there were indicators that social competence mediated the involvement-to-internalizing relation; higher involvement predicted higher levels of social competence, which in turn predicted lower levels of symptoms. Regarding the RHC quasi-experiment, sensitivity analyses showed that youth who had more exposure to the intervention throughout grade school were more involved during early adolescence (i.e., on average, they participated in more organizations, clubs, activities, groups) than those in the control group or who had only late exposure to the intervention. Again, more involvement predicted greater social competence, and greater social competence predicted lower levels of internalizing symptoms. These findings constitute preliminary support for leveraging organized youth activities as a context for prevention by increasing their focus on cultivating skills and developmental competencies, such as social competence, that can help to reduce the youth mental health burden.

Subjective response to a drug is an important variable in understanding addiction, yet it has received very little attention in cannabis use. Given that mental health concerns are a commonly cited reason for cannabis use, perhaps people experiencing affective disturbances such as anxiety and depression may experience more rewarding subjective responses. Additionally, due to the growing influx of THC in cannabis products, which was found to produce positive and negative subjective responses, this study investigated the moderating role of THC potency between anxiety, depression, and subjective response. We used ecological momentary assessment data from 105 regular cannabis-using participants. We used hierarchical multiple regression to examine baseline anxiety and depression scores and THC levels as predictors of subjective response (generally positive, low arousal negative, and high arousal negative) to cannabis flower (main effect), as well as interactions between baseline anxiety and depression and THC concentration (interactions). We found that at higher THC concentrations, higher levels of anxiety and depression were associated with an increase in positive subjective response. Likewise, higher levels of depression were associated with more high arousal negative effects. Future research should investigate THC levels across different cannabis products and include broader measures to capture THC levels in the body.

Objective: This study examined time trends in associations of cannabis- and alcohol-related hospital visits with psychosis-related hospital visits in Arizona from 2016 to 2022. Methods: Data were emergency department and inpatient hospital visits from all hospitals licensed and regulated by the Arizona Department of Health Services from January 2016 to December 2022 (n=21,921,214 visits). For each visit, data included patient demographics and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes in up to 25 diagnostic fields. Exposures were cannabis and alcohol-related diagnoses (use, abuse, dependence), and the outcome was psychosis diagnoses. Results: In any given year from 2016 to 2022, emergency department and inpatient hospital visits involving a cannabis-related diagnosis were 6-7 times more likely also to receive a psychosis diagnosis when compared with visits that did not include a cannabis-related diagnosis. By comparison, emergency department and inpatient hospital visits involving an alcohol-related diagnosis were only three times more likely also to receive a psychosis diagnosis.

Depression and anxiety are among the most prevalent psychiatric disorders for adults and adolescents and can be intergenerationally transmitted from parents to their children. Moreover, depressive and anxiety disorders often develop during adolescence. Additionally, family environment and the parent-child relationship are significant predictors of mental health among adolescents. Yet, few studies have considered how adolescent depression and anxiety problems may influence the family environment and mental health of parents. Moreover, even fewer studies have examined how depressive and anxious intergenerational pathways may vary by racial/ethnic status. As such, bidirectional effects of parent and adolescent depressive and anxiety problems were investigated using data from the Adolescent Brain and Cognitive Development (ABCD) study at Time 1 (T1)(Mage = 9.92, n=11,861), Time 2 (T2), and Time 3 (T3). Each follow-up was approximately one-year apart. Multiple path analysis models were used to examined bidirectional associations between parent and adolescent A) depressive problems B) anxiety problems and C) depressive and anxiety problems from T1 to T3 and how family conflict and adolescent-reported parental acceptance at T2 mediated these associations. Measurement invariance testing and multigroup analyses were conducted across non-Hispanic White, Hispanic, and non-Hispanic Black participants to examine if depressive and anxious pathways or measurement differed by racial-ethnic status. Findings revealed that both adolescent and parent depression problems at T1 predicted increases in depression at T3. Greater adolescent or parent anxiety problems at T1 predicted increases in adolescent and parent anxiety problems at T3. Greater family conflict and lower perceived parental acceptance at T2 predicted increases in adolescent depressive problems but did not predict adolescent anxiety problems over time. Parental depressive and anxiety problems at T1 did not predict adolescent-reported parental acceptance at T2 but did predict greater family conflict. Measurement noninvariance was found for family conflict and adolescent depressive problems. Multigroup analyses revealed that the association between both depressive and anxiety problems from T1 to T3 was weaker among Black adolescents compared to White and Hispanic adolescents. In summary, this research contributes valuable insights into the measurement of and relationship between parent and adolescent mental health, family dynamics, and adolescent perceived parental acceptance.

Background: Premature infants may be at risk for lower effortful control, and subsequent lower academic achievement, peer competence, and emotional and physical wellness throughout the lifespan. However, because prematurity is related to obstetrical and neonatal complications, it is unclear what may drive the effect. Effortful control also has a strong heritable component; therefore, environmental factors during pregnancy and the neonatal period may interact with genetic factors to predict effortful control development. In this study, I aimed to dissect the influences of genetics, prematurity, and neonatal and obstetrical complications on the development of effortful control from 12 months to 10 years using a twin cohort. Methods: This study used data from the Arizona Twin Project, an ongoing longitudinal study of approximately 350 pairs of twins. Twins were primarily Hispanic/Latinx (23.8%-27.1%) and non-Hispanic/Latinx White (53.2%-57.8%), and families ranged in socioeconomic status with around one-third falling below or near the poverty line. Of the twins, 62.6% were born prematurely. Effortful control was assessed via parent report at six waves. Results: There was not a significant relationship between gestational age and effortful control regardless of whether obstetrical and neonatal complications were controlled for. Biometric twin modeling revealed that the attentional focusing subdomain of effortful control was highly heritable. Gestational age did not moderate genetic and environmental estimates. Conclusions: The findings help inform the risk assessment of prematurity and provide evidence for differing etiology of each subdomain of effortful control and the strong role of genetics in effortful control development.

This dissertation combines three first-author manuscripts that focused broadly on the study of adolescent sleep within a family context (Sasser et al., 2021; Sasser & Oshri, 2023; Sasser et al., 2023). First, Chapter 1 introduces the theoretical background and empirical research that grounded the research questions and hypotheses explored across the studies. The first study (Chapter 2) examined the influence of family connection on actigraphy-measured sleep among Latinx late adolescents and explored family dynamics and cultural values as potential moderators. The second study (Chapter 3) investigated daily and average concordance between parent and youth actigraphy-measured sleep and how this varied as a function of family context (e.g., parenting, family functioning). The third study (Chapter 4) examined concordance in actigraphy sleep among parent-youth and sibling dyads and explored how relations differed across zygosity type and sleeping arrangements. The dissertation concludes with an immersive discussion (Chapter 5) that summarizes the key differences, similarities, and takeaways across studies and highlights future directions and implications for developmental science, public policy, and clinical interventions. Collectively, this dissertation contributes to the understanding of youth and adolescent sleep within a family context by identifying proximal (e.g., daily interactions with parents/siblings) and broader family-level factors (e.g., dynamics, culture) that may help promote more healthful sleep among both adolescents and their family members.

Hispanic/Latinx college students are at a greater risk for developing problematic alcohol use and negative mental health outcomes such as depression and anxiety because they experience contextual stressors (i.e., financial stress, academic stress, peer pressure) and cultural stressors (i.e., bicultural stress, acculturative stress, discrimination). Bicultural stress may be a risk factor for depressive, anxiety, and alcohol use disorder (AUD) symptoms. The cultural value of familism may play a protective role in Hispanic/Latinx college students. The purpose of this study was to investigate the effects of bicultural stress on depressive, anxiety, and AUD symptoms in first-year Hispanic/Latinx college students, and the role familism plays on moderating the relationship between bicultural stress and the outcomes. The sample was taken from the Pathways to College Health Study (N = 264; Female = 74.9%), which was survey administered via Qualtrics to first-year, Hispanic/Latinx college students at Arizona State University. The survey captured the participants’ levels of bicultural stress, familism, depressive, anxiety, and AUD symptoms. IBM SPSS Statistics was used for data analyses where three hierarchical regression models were run investigating the main effects and interaction effect of bicultural stress and familism. Results showed that higher levels of bicultural stress were associated with higher levels of mental health but were not associated with higher levels of AUD symptoms. Additionally, familism was not significantly associated with mental health or AUD symptoms suggesting familism may not play a substantial role in Hispanic/Latinx college students. There was no interaction found between familism and bicultural stress on the outcomes. These findings may aide in informing Hispanic/Latinx college students, universities, and clinicians on the impact bicultural stress may have on mental health outcomes.

Latinxs are one of the largest ethnic-racial minoritized groups in the U.S., with children and youth serving as the driving force of the population’s growth. Latinx children and youth living in the U.S. navigate their development within sociocultural contexts that present unique stressors (e.g., discrimination) and assets (e.g., biculturalism) that shape their development. Thus, when studying Latinx youth and families, it is critical to consider important individual, developmental, and contextual factors that enhance Latinx youth development. This includes studying culture-specific family processes (e.g., familism) as well as more universal general parent-child processes that are developmentally salient (e.g., parent-child conflict regarding everyday issues). Therefore, my two-study dissertation focuses on the integration of cultural and developmentally relevant factors in studying parent-child relationships among Latinx families. In Study 1, I use longitudinal data from 246 Mexican-origin families to examine developmental trajectories of parent-child conflict regarding everyday issues across 12 to 22 years of age. In charting parent-youth conflict trajectories, I examine how youth and parent familism values may serve as important cultural factors that are associated with variation in parent-youth conflict. In Study 2, I use a person-centered approach to examine constellations of parental warmth, parent-child conflict, and parental ethnic socialization among Latinx families with children in middle childhood and explore how different patterns of parent-child relationships emerge and how these patterns relate to child adjustment (i.e., academic competence, peer competence, and depressive symptoms). Guided by a family systems theory, both studies consider important nuance in parent-child dyads by examining gender dynamics in mother-child and father-child relationships. Together, the studies make an important contribution to the understanding of culturally and developmentally salient processes of parent-child relationships in Latinx families and provide research and practice implications for enhancing the lives of Latinx youth and families.