Examining the relationship of dieting behavior and substance use among female adolescents

Indiana University-Purdue University Indianapolis (IUPUI)The problem behavior theory suggests that the engagement in one problematic behavior increases the likelihood of engagement in another problematic behavior. Previous research has found among youth an increasing probability of co-occurring dieting and substance use behavior, particularly among girls. However, to date findings are inconclusive on the temporal ordering of these behaviors. Further, limited research has been conducted to explore whether the temporal ordering of the two behaviors exist similarly between White and Black youth. The present study will use a cross-lagged panel design across one year to examine the temporal ordering between dieting behavior and substance use among a sample of 2,016 adolescent females (grade mean=7; 77.2% White; 22.8% Black). We hypothesized that a bidirectional relationship would be observed between the two behaviors. However, given no published studies on this relationship by race, no a priori hypotheses were made for this second aim. Result showed that within the full sample dieting behavior significantly predicted substance use one year later, but the inverse relationship was not found. Additionally, this effect was replicated in the White sample but null effects in both directions was found among Black youth. These findings provide support for a temporal relationship between dieting behavior and substance use, such that the former predicts risk for the latter. Moreover, although there is evidence of race differences in the risk pathway, further research is needed to confirm this effect. Future studies are also needed to determine whether this observed temporal relationship is present among adolescent females of other racial/ethnic groups, as well as if the relationship varies as a function of other demographic variables, such as age (e.g., early, mid, or late-adolescence)

Trauma and racial discrimination: examining their association with marijuana behaviors among black young adults

Indiana University-Purdue University Indianapolis (IUPUI)Marijuana use has been shown to increase and peak during young adulthood (i.e., ages 18-35). However, it appears that Black individuals do not decline in use at rates similar to other race groups. Marijuana use among Black adults has been linked to more problems such as increased arrests, greater mental health disorder diagnoses, and substance dependence. The biopsychosocial model of racism and race-based theoretical framework aims to understand how factors such as racial discrimination as a traumatic event could be associated with marijuana behaviors, particularly among Black adults. The present study aims to examine the association between racial discrimination and marijuana use and problem use above and beyond trauma exposure. Further, I aimed to explore whether gender or vocation (college, community, and military) moderated the relationships. 391 Black adults (57.5% female; mean age 24.9) completed measures on marijuana use and problems, trauma exposure, and racial discrimination distress. Hierarchical linear regression and Hayes PROCESS macro were used to evaluate the study aims. Racial discrimination distress was associated with marijuana use above and beyond trauma exposure (R2=.016, p=.004). However, racial discrimination distress did not add significant variance within the model for problem marijuana use (R2=.001, p=.419). Additionally, moderation by gender and vocation were not supported in either model. Taken together, the present results support that examining psychological and health outcomes among Black young adults should include an evaluation of racial discrimination distress. Further, future studies should continue to evaluate sociodemographic factors in larger more representative community-based studies to better understand potential variation in risk among Black young adults

Trends in typologies of concurrent alcohol, marijuana, and cigarette use among US adolescents: An ecological examination by sex and race/ethnicity

Substance use during adolescence is a public health concern due to associated physical and behavioral health consequences. Such consequences are amplified among concurrent substance users. Although sex and racial/ethnic differences in single-substance use have been observed, the current literature is inconclusive as to whether differences exist in the prevalence of concurrent use. The current study used data from the 2011–2014 National Survey on Drug Use and Health to examine typologies (single and concurrent patterns) of alcohol, marijuana, and cigarette use among current adolescent users age 12–18 by sex and race/ethnicity. Participants were 14,667 White, Hispanic, African American, Asian, and Native American adolescents. The most common typology was alcohol only, followed by concurrent use of alcohol and marijuana. Weighted prevalence estimates indicated that adolescent females were more likely to be current users of alcohol only, whereas male adolescents were more likely to belong to all other typologies. Compared to Whites, racial/ethnic minorities had larger proportions of marijuana only users and were generally less likely than or equally likely to be concurrent users. One exception was for African American adolescents, who were more likely to be alcohol and marijuana users than their White counterparts. Results suggest that concurrent substance use is common among U.S. adolescents, making up over 40% of past-month use, but typologies of use vary by sex and race/ethnicity. Preventive interventions should consider all typologies of use rather than only single substance exposures and address patterns of use that are most pertinent to adolescents based on sex and race/ethnicity

Peer victimization and substance use: Understanding the indirect effect of depressive symptomatology across gender

OBJECTIVE: Peer victimization in school is common, with emerging literature suggesting that it may also increase risk for substance abuse. Yet, little is known about the underlying mechanisms within this risk pathway. The objective of this study is to use a prospective 3-wave design to examine the mediating role of depressive symptomatology on the relationship between peer victimization and substance use, as well as examine if the pathway varies based on gender. METHOD: 801 youth between 6th and 12th grade completed surveys across three years, which included measures on school peer victimization, depression symptomatology and substance use. Models tested the mediational pathway between victimization, depressive symptoms, and substance use. Models were stratified by gender. RESULTS: Controlling for grade and the effect of each variable across waves, a significant indirect effect of peer victimization on substance use through depressive symptoms was found for females, with a non-significant indirect effect for males. CONCLUSION: Results suggest that female youth who are victimized by peers engage in substance use behaviors, at least in part, due to increases in depressive symptoms. Given its effect on depression, female victims may therefore benefit from coping skills training that targets emotion regulation and distress tolerance skills in order to combat increased risk for substance use behaviors as a coping response to their victimization. Further research is warranted to better understand the risk pathway for male youth who also experience peer victimization

Peer Victimization, Mood Symptoms, and Alcohol Use: Examining Effects Among Diverse High School Youth

Peer victimization is associated with alcohol use among adolescents. However, few studies have examined the mediating role of depression and anxiety, or differences by race. The current study examined the prospective relationship of peer victimization, depressive and anxiety symptoms, and alcohol use across two timeframes: 9th to 11th grade and 10th to 12th grade among African American and White youth. 2,202 high school youth (57.6% female) who identified as either African American (n=342, 15.2%) or White (n=1860, 82.6%) provided data on study variables. Path analysis among the overall sample indicated that anxiety symptoms was a significant mediator for both timeframes, with depressive symptoms mediating the pathway during the 10th to 12th grade timeframe. The findings were most consistent among White youth, with no significant indirect effects observed for African American youth. Thus, addressing depressive and anxiety symptoms may be effective targets to decrease alcohol use risk as a result of peer victimization among White youth. However, further research is needed to better understand risk models for peer victimization exposure on substance use outcomes among racial/ethnic minority youth

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society