The Relationship Between Adolescent Marijuana Use and Impulsivity: A Meta-Analytic Review

poster abstractObjective: Sensation seeking, a component of impulsivity, has been studied extensively as a personality predictor of marijuana-related behaviors. Other traits of impulsivity have been examined sporadically; however, to date, no review has synthesized the research of this multidimensional trait. The present study reviewed existent literature to examine (1) how separable impulsive personality traits relate to marijuana use and to marijuana use consequences and (2) how these relationships might differ across gender and race. Method: 46 total studies (51 independent samples) were analyzed using a random effects model to examine the relationship between individual impulsive personality traits and marijuana use and consequences. Results: Impulsivity had a small but significant association with marijuana-related behaviors (r= 0.22, p<0.01). Relationships were more robust for marijuana use consequences than marijuana use (Qbetween= 9.60, p<0.01). Importantly, facets of impulsivity such as lack of planning, negative urgency, and positive urgency, had similar relationships with marijuana use (rlpl= 0.13, p<0.01; rnur= 0.23, p<0.01; rpur= 0.19, p<0.01) and marijuana use consequences (rlpl= 0.47, p<0.01; rnur= 0.26, p= 0.22; rpur= 0.37, p<0.01) as sensation seeking (rss= 0.22, p<0.01 and rss= 0.39, p<0.01, respectively). While non-significant, there was a large effect for gender (β= -0.26, p=0.12) and a medium effect for race (β= 0.38, p=0.40) in moderating the relationship between impulsivity and marijuana consequences, such that samples with more Whites and more males had trends towards more robust effect sizes. Discussion: Impulsivity has a robust association with marijuana-related consequences than with marijuana use. Multiple facets of impulsivity were related to marijuana use and its consequences. Research and intervention should consider targeting multiple impulsivity traits to reduce the harmful consequences associated with adolescent marijuana use. Such initiatives should also consider gender and race differences in the impulsivity-marijuana use relationship

Combined expectancies of alcohol and e-cigarette use relate to higher alcohol use

Electronic cigarettes (e-cigs) were created to approximate the look, feel, and experience of using a cigarette. Since cigarette and alcohol use co-occur, we hypothesized that e-cig and alcohol use also co-occur, likely due to shared positive drug expectations. Using self-report data from two independent samples of community-dwelling alcohol using adults, the present study: (1) modified the Nicotine and Other Substance Interaction Expectancy Questionnaire (NOSIE) to assess expectancies of combined e-cig and alcohol use (i.e. the individuals perceived likelihood of using e-cigs and alcohol together; NOSIE-ER); and (2) examined the relationships among e-cig use, expectancies, and alcohol use across e-cig use status. In the first sample (N=692, mean age=32.6, SD=9.74, 50.7% female, 82.2% Caucasian), exploratory factor analysis suggested the presence of two factors: (1) alcohol use leads to e-cig use (Scale 1; α=0.85); and (2) e-cig use leads to alcohol use (Scale 2; α=0.91). In the second sample (N=714, mean age=34.1, SD=10.89, 47.8% female, 75.6% Caucasian), confirmatory factor analysis supported this factor structure (χ(2)=47.00, p<0.01, df=19; RMSEA=0.08, 90% CI=0.05-0.11; TLI=0.99; CFI=0.99). Compared to non e-cig users, e-cig users had significantly higher problematic alcohol use in both samples (b's=0.09 to 0.14, p's<.05). Expectancies of combined e-cig and alcohol use were significantly related to problematic alcohol use (b's=-0.92 to 0.26, p's<.05). In sum, e-cig use is related to alcohol use and expectancies of combined e-cig and alcohol use; consequently, reshaping of beliefs about needs or desires to co-use could be a prime point of intervention

UPPS-P Model Impulsivity and Marijuana Use Behaviors in Adolescents: A Meta-Analysis

Background Impulsivity is often included as a risk factor in models of adolescent marijuana use behaviors; however, the magnitude of the association between impulsivity and marijuana use behaviors is variable across studies. The present study reviewed existent literature to 1) quantify the relationship between separable impulsivity-related traits and both marijuana use and negative marijuana consequences and 2) quantify the size of the effect of gender on these relationships. Method Thirty-eight studies (41 independent samples) were meta-analyzed using a random effects model to examine the relationship between impulsivity traits and marijuana use behaviors. Results Marijuana use was significantly related to all impulsivity-related traits except lack of perseverance (r’s ranging from 0.13–0.23, p’s < 0.01). Negative marijuana consequences were only significantly related to sensation seeking, lack of planning, and positive urgency (r’s ranging from 0.37–0.39, p’s < 0.01). Effects were small for marijuana use, but medium for negative marijuana consequences. Gender was not a significant moderator of any relationships. Conclusions Impulsivity-related traits had more robust relationships with negative marijuana consequences than marijuana use, suggesting impulsivity-related traits are important in differentiating adolescents most likely to experience negative consequences from marijuana use. Few relationships examined gender and many of the impulsivity-related traits, other than sensation seeking. Data and trends suggest a more multi-dimensional approach to marijuana use and consequences is warranted

Beliefs About the Direct Comparison of E-Cigarettes and Cigarettes

Background: Recent data suggests that positive beliefs about electronic cigarettes (e-cigs) use can lead to later e-cig use. Considering that many advertisements claim that e-cigs are superior to cigarettes, individuals' likelihood to view e-cigs more favorably than cigarettes can also influence subsequent e-cig use; however, no studies have directly assessed such a comparison. Objectives: The present study created and validated the Comparing E-Cigarettes and Cigarettes questionnaire (CEAC), which asks individuals to directly compare e-cigs and cigarettes on a number of dimensions, in two independent samples. Methods: In sample 1 (451 undergraduates; mean age = 20.35, SD = 5.44, 72.4% female, 73.4% Caucasian) we explored the factor structure of the CEAC and in sample 2 (699 community adults collected via Amazon's Mechanical Turk; mean age = 34.04, SD = 10.9, 47.7% female, 83.3% Caucasian) we replicated the factor structure. Results: Exploratory factor analysis suggested a three-factor structure: General Benefits (α = 0.80), General Effects (α = 0.86), and Health Benefits (α = 0.88), which was replicated via confirmatory factor analysis, χ2 = 4.36; RMSEA = 0.07, 90% CI = 0.06–0.08; TLI = 0.99; CFI = 0.99, and was relatively invariant across product use and gender. Individuals reported viewing e-cigs as safer and more beneficial than cigarettes and these beliefs were higher in e-cig users. Conclusions: Future work should establish how these comparative beliefs are influenced by e-cig use and/or influence subsequent transition to and increases in e-cig use. Although e-cigs are likely less harmful than cigarettes, and thus these comparative beliefs represent that state of nature, e-cigs are not completely without risk

Transitioning from cigarettes to electronic cigarettes increases alcohol consumption

Objective Electronic cigarettes (e-cigs) are a nicotine delivery device that have recently been linked to alcohol use. Many individuals that smoke cigarettes transition to e-cigs as an alternative to cigarette use, despite potential negative health effects of e-cigs. No research to date has examined how former smokers that have transitioned to e-cigs differ from former smokers that do not use e-cigs, particularly in relation to alcohol use. Further, no research has examined how former smokers that use e-cigs regularly or socially may differ in alcohol consumption. Method Using an online community dwelling sample (Former smokers N=198, mean age=34.70, SD=11.45, 56.1% female, 78.3% Caucasian, 37.9% e-cig users), the present study assessed smoking status and alcohol use, with the latter assessed using a Timeline Followback calendar and the Alcohol Use Disorder Identification Test (AUDIT). Results In all former smokers, total drinks (b=4.01, p=0.02) and average drinks per drinking day (b=0.61, p=.01) were both related to e-cig use status, with e-cig users reporting higher alcohol consumption. Among e-cig using former smokers, social users, but not regular users, showed positive relationships with AUDIT scores, b=1.90, p=.02, total drinks, b=9.12, p<.001, average drinks, b=0.98, p=.006, and hazardous drinking status, OR=3.21, p=.01. Conclusions Findings suggest that: (1) former smokers who use e-cigs may have a potential for higher alcohol use; and (2) those who use e-cigs socially may be at heightened risk for hazardous patterns of alcohol consumption. This should be taken into consideration by healthcare providers

A Meta-Analysis of the Relationship between Trait Mindfulness and Substance Use Behaviors

Background The relationship between trait mindfulness and substance use behaviors has been inconsistent across studies. The current study is a meta-analysis aimed at quantifying the magnitude of this relationship, and at determining how this relationship varies in context of (1) mindfulness facets, (2) substance type, (3) sample characteristics, and (4) substance use severity. Methods A literature search was conducted using electronic databases. The literature search yielded 303 articles, but only 39 articles met inclusion criteria to be included in this meta-analysis. The relationship was quantified as a Pearson's r correlation coefficient for all studies. Results Findings indicated a small, negative, and significant relationship between trait mindfulness and substance use behaviors (r = -0.13). This relationship varied across substance type, clinical status of the sample, and substance use severity. Although not significant, relationship sizes showed different patterns across mindfulness facets. Conclusions This meta-analysis quantified the relationship between trait mindfulness and substance use behaviors, which can be used as future effect size estimates. Findings also clarify inconsistency in previous work by indicating that the trait mindfulness-substance use behaviors relationship was more robust: (1) for alcohol use and tobacco use behaviors; (2) for problematic substance use behaviors; and (3) with inpatient clinical samples. Further work should continue to examine if acting with awareness, non-judgment, and non-reactivity mindfulness facets are more robustly associated with substance use behaviors. Failure to consider these factors, or collapsing across these factors, could explain the smaller or inconsistently reported associations across previous studies

Gender Specific Effects of Mood on Alcohol Seeking Behaviors: Preliminary Findings using Intravenous Alcohol Self-Administration

Background Although negative mood has long been implicated in differences in alcohol seeking by men and women, little research has used precise, well-controlled laboratory experiments to examine how negative mood affects alcohol-seeking behaviors. Methods A total of 34 (19 women) community-dwelling, alcohol-using adults aged 21 to 32 (mean age = 24.86, SD = 3.40, 74.3% Caucasian; Alcohol Use Disorders Identification Test [AUDIT] = 10.1, SD = 3.4) completed 2 counterbalanced intravenous alcohol self-administration sessions: one under negative mood and one under neutral mood. Fourteen individuals (9 women; mean age = 25.00, SD = 2.77) participated in an alcohol “liking” experiment (i.e., free access [FA] drinking) and 20 individuals (10 women; mean age = 24.77, SD = 3.73) participated in an alcohol “wanting” experiment, in which gaining access to alcohol required progressively effortful work. There was no significant difference between men and women on the AUDIT, t(32) = −0.38, p = 0.71. Results Priming with negative mood induction caused a significant decrease in self-reported mood (mean change = −1.85, t(32) = −6.81, p < 0.001), as intended. In FA, negative mood was associated with a significantly increased peak breath alcohol concentration (BrAC; F = 9.41, p = 0.01), with a trend toward a greater effect in men than in women (F = 2.67, p = 0.13). Negative mood also had a significant effect on peak BrAC achieved in the progressive work paradigm (F = 5.28, p = 0.04), with a significantly stronger effect in men (F = 5.35, p = 0.03) than women; men also trended toward more consistent work for alcohol across both neutral and negative sessions. Conclusions These preliminary findings demonstrate a gender-specific response on how mood affects alcohol seeking and suggest gender-specific interventions to prevent mood-based alcohol consumption

Neural Correlates of Implicit and Explicit Metaphors: An ERP Study

Due to the often unfamiliar nature of metaphors as well as the greater semantic distance between the two concepts being linked, many have hypothesized that figurative language is processed in the right hemisphere (RH) (Jung-Beeman, 2005; Schmidtet al., 2007). However, there have been many contradictory findings in this regard. One factor not previously considered is the existence of different type of metaphors such as implicit metaphors (IM) and explicit metaphors (EM). Our goal was to examine how EM (The veteran professor was a fossil) differ from IM (The teenagers could not relate to the fossil) in their neural processing. Understanding the implicit meaning of a sentence may draw on additional cognitive resources, thereby affecting the difficulty, and perhaps neural pathways involved in processing these sentences. We also wanted determine if the RH is specialized for metaphor processing. We used event-related potentials (ERP) in conjunction with divided visual field presentation to measure the N400 for each sentence as presented to each hemisphere of the brain. ERPs are derived from electroencephalographic (EEG) recordings from the scalp. The N400 is a peak of negative brain activity occurring approximately 400ms after a word, which indexes the ease of semantic processing. We can measure differences in neural processing by observing differences in N400 amplitude across visual field presentation. We conducted an ANOVA with factors of figurativeness, implicitness, and side of presentation using the N400 amplitude as the dependent measure. When IM were presented to the RH, the N400s measured by the parietal lobe electrodes were about the same as those for EM. The left hemisphere (LH) presentation showed much larger N400s for IM than for EM. This suggests that the LH is less efficient at processing IM in comparison to EM while the RH can do both equally well

Emergency Room Use in the Healthy Beginnings Program

The Ready For School Healthy Beginnings project aims to increase access to healthcare by establishing a medical home for all children ages birth through five in regional opportunity zones. The intervention program at two pilot sites utilizes a case manager (RN) and a community health worker to increase access to medical care for at risk children. Participants in the Healthy Beginnings program numbered 1375 children between the ages of 0-5. Emergency room (ER) visits, urgent care facility visits and hospital inpatient admissions were tracked across the children to determine the patterns of use with respect to time of day and diagnosis. Data were accessed from reports generated by the local hospitals and urgent care sites. Results showed that for program participants who used the emergency room those visits often occurred between the hours of 8 a.m. and 5 p.m. during the hours of operation of the child’s medical home. Additionally, some of the emergency room visits occurred between 5 p.m. and 8 p.m. during extended clinic hours for the patients’ medical home. Of the indicated diagnoses, there was evidence that some of the participants used the ER as a primary healthcare facility. The most common emergency room diagnoses included respiratory and gastrointestinal maladies. The results from baseline data indicate areas of parental education are needed in order to decrease overuse of the emergency room. Parent education should include orientation to clinic hours to limit ER use when the medical home is open, ensuring that parents know when an ER visit is necessary versus going to the medical home in order to limit diagnoses such as “well-child” and “unspecified” and should emphasize the importance of calling the medical home prior to an ER visit in order to determine whether the clinic can serve the patient’s needs

The Effect of an Outdoors Nature-Based Intervention Program on the Development of Early Literacy Skills in Preschool Aged Children

Evidence suggests that children who spend more time outdoors are healthier, happier and smarter (Kellert, 2005; Wells, 2000). The Ready For School initiative in Holland, MI joined with the Outdoor Discovery Center Macatawa Greenway to do a nature-based intervention program with preschools in the area. There were two groups of participants in this study: those in the experimental group in the outdoor intervention program, and those in the control group not given the outdoor intervention. The outdoor intervention program consisted of a nature lesson and exposure to the outdoors. The goal of the Ready For School initiative is “ensuring that every child from birth enters kindergarten prepared to succeed” (RFS, 2008). In addition, they “recognized early childhood education as the single-most important challenge facing our present and future development” (RFS, 2008). We looked to find a potential link between exposure to the outdoors and the development of early literacy skills in children between the ages of three and five. The GRTR! test designed by Lonigan and Whitehurst (2001) and modified by Molfese, Molfese, Modglin, Walker, & Neamon (2004) is a screening tool used to test the early reading skills of preschool aged children. The GRTR! test has three subtypes of questions: print knowledge, emergent writing and phonological awareness. A pretest/ posttest design was used in this study. The results of a Multivariate Analysis of Variance test show that there was a greater improvement of GRTR! scores in the outdoor group than the control group. The improvement from pretest to posttest in the ODC intervention group was 3.98 points on the GRTR! test compared to 2.71 points in the control group. This difference was statistically significant (F(2,103)= 5.620, df= 103, p=0.005, ƞp2=0.098). This shows that spending more time outdoors improves the development of early literacy skills in preschool aged children