Emotional distress may increase risk for self-medication and lower risk for mood-related drinking consequences in adolescents

The current study examines indicators of emotional distress and coping that may define sub-populations of adolescents at risk for two potential affect-related mechanisms underlying substance misuse: self-medication and mood-related drinking consequences. Although theory and empirical evidence point to the salience of affect-related drinking to current and future psychopathology, we have little knowledge of whether or for whom such mood-related processes exist in adolescents because few studies have used methods that optimally match the phenomenon to the level of analysis. Consequently, the current study uses multi-level modeling in which daily reports of negative mood and alcohol use are nested within individuals to examine whether adolescents with more emotional distress and poorer coping skills are more likely to evidence self-medication and moodrelated drinking consequences. Seventy-five adolescents participated in a multi-method, multi-reporter study in which they completed a 21-day experience sampling protocol assessing thrice daily measures of mood and daily measures of alcohol use. Results indicate that adolescents reporting greater anger are more likely to evidence self-medication. Conversely, adolescents displaying lower emotional distress and more active coping are more likely to evidence mood-related drinking consequences. Implications for identifying vulnerable sub-populations of adolescents at risk for these mechanisms of problematic alcohol use are discussed.peer-reviewe

Intergenerational continuity in high-conflict family environments

Abstract In the current study, we examined continuity in conflict across generations and explored potential mediators and moderators that could explain this continuity. We followed 246 targets from adolescence to adulthood and examined family conflict as reported by multiple reporters in targets' family of origin and current families. Results showed that conflict in the current family was strongly correlated with that of the family of origin in women but not in men. Continuity in family conflict across generations was mediated by patterns of elevated adolescent externalizing behavior in members of the second generation (G2). In addition, analyses revealed an interaction between both G2 partners' externalizing behavior such that if one partner in the G2 family demonstrated high levels of externalizing behavior, elevated levels of family conflict resulted. Potential explanations and implications of these findings are considered

Predictors of drinking immediacy following daily sadness: An application of survival analysis to experience sampling data

Previous studies of daily assessments show modest mood–drinking covariation as a function of gender and coping motives; however previous analyses also assume a fixed interval across all individuals in the onset of drinking following negative mood. The current study used survival analysis and experience sampling methods to test whether gender and coping motives predicted shorter sadness-to-drinking intervals among those with greater alcohol-related drinking consequences. A sample of 85 college students (46% male; 78% Caucasian) completed daily assessments over 28 days. Survival analyses showed that women drank more on days following elevated sadness when they reported being motivated to drink to cope and having experienced alcohol-related consequences. For men, the two groups showing greater drinking risk following days of elevated sadness did not report alcohol-related consequences, with those reporting the presence of coping motives showing the greatest risk. Implications of these findings for self-medication mechanisms are discussed

Modeling Trajectories of Adolescent-Perceived Family Conflict: Effects of Marital Dissatisfaction and Parental Alcoholism

We evaluated the effects of marital dissatisfaction on adolescent-perceived conflict in 435 families with and without a parental history of alcoholism. On average, family conflict decreased linearly as adolescents aged. Families with an alcoholic parent demonstrated higher adolescent-reported family conflict and this effect was partially mediated by higher mother- and father-reported marital dissatisfaction. Families with higher marital dissatisfaction had greater conflict when adolescents were young (based on fathers' marital dissatisfaction) and as they aged (based on mother's marital dissatisfaction). Years in which mothers reported higher marital dissatisfaction than usual coincided with years in which adolescents reported greater family conflict. Results indicate that marital dissatisfaction has both within and between-family effects on adolescent perceptions of conflict

Stress and coping among children of alcoholic parents through the young adult transition

The transition to young adulthood is both a time when risky health behaviors such as substance misuse peak and a time of opportunity for growth and development through the acquisition of adult roles. In this transition, coping styles include responses to the stressors and opportunities associated with the emergence of adulthood. The extent to which such coping styles are skillfully employed in part determines adjustment into adulthood. The current study used a high-risk, longitudinal design to examine the development of coping styles over adolescence, continuity in these coping styles from adolescence to adulthood, the impact of coping on adult stress and substance misuse, the ability of coping to buffer effects of stress on substance use, and differences in coping between at-risk youth (i.e., children of alcoholics [COAs]) and their peers. A sample of 340 adolescents completed four assessments over ages 11–23. We used latent trajectory models to examine interindividual and intraindividual change in coping over time. Evidence for both change and continuity in the development of coping from adolescence to adulthood was found, although adolescent coping had limited impact on stress and substance use in adulthood. Support was also found for complex stress-buffering and stress-exacerbating effects of coping on the relations between major life events and adult drug use and between stress associated with the new roles of adulthood and heavy alcohol use. Implications of these findings for development and adjustment in the transition to adulthood are discussed

A systematic review of the unique prospective association of negative affect symptoms and adolescent substance use controlling for externalizing symptoms.

This systematic review examines whether negative affect symptoms (i.e., anxiety, depression, and internalizing symptoms more broadly) predict subsequent adolescent substance use after controlling for co-occurring externalizing symptoms. Following PRISMA procedures, we identified 61 studies that tested the association of interest. Findings varied depending on the type of negative affect symptom and to some extent on the substance use outcome. The most consistent associations were evident for depressive symptoms, particularly as predictors of substance use composite scores. No clear association between anxiety and substance use or between internalizing symptoms and substance use was evident, and indeed these associations were as often negative as positive. Mixed findings regarding the depression-substance use association, however, also call for greater attention to potential moderating factors that may help define who, when, and in what context depression serves as an important risk factor for later substance use above and beyond risk associated with externalizing symptoms

Drinking to Dampen Affect Variability: Findings From a College Student Sample

We hypothesized that individuals who are unable to effectively regulate emotional reactivity, which we operationalized as variability in self-reported affect throughout the day, would use alcohol more frequently and would report higher levels of drinking to cope. Further, we hypothesized that affect variation would be a stronger predictor of alcohol use or drinking to cope than level of negative affect

Telescoped trajectories from alcohol initiation to disorder in children of alcoholic parents.

The current study tested whether and why COAs show telescoped (adolescent) drinking initiation-to-disorder trajectories as compared to non-COAs. Using longitudinal data from a community-based sample, survival analyses confirmed that COAs progress more quickly from initial adolescent alcohol use to the onset of disorder than do matched controls. Similar risks for telescoping were evident in COAs whose parents were actively symptomatic versus those whose parents were previously diagnosed. Stronger telescoping effects were observed for COAs whose parents showed comorbidity for either depression or antisocial personality disorder. Both greater externalizing symptoms and more frequent, heavier drinking patterns at initiation failed to explain COAs’ risk for telescoping, although externalizing symptoms were a unique predictor of telescoping. This risk for telescoping was also evident for drug disorders. These findings characterize a risky course of drinking in COAs and raise important questions concerning the underlying mechanisms and consequences of telescoping in COAs