Smoking Policies of Outpatient and Residential Substance Use Disorder Treatment Facilities in the United States.

Tobacco use is associated with morbidity and mortality. Many individuals who present to treatment facilities with substance use disorders (SUDs) other than tobacco use disorder also smoke cigarettes or have a concomitant tobacco use disorder. Despite high rates of smoking among those with an SUD, and numerous demonstrated benefits of comprehensive SUD treatment for tobacco use in addition to co-occurring SUDs, not all facilities address the treatment of comorbid tobacco use disorder. In addition, facilities vary widely in terms of tobacco use policies on campus. This study examined SUD facility smoking policies in a national sample of N = 16,623 SUD treatment providers in the United States in 2021. Most facilities with outpatient treatment (52.1%) and facilities with residential treatment (67.8%) had a smoking policy that permitted smoking in designated outdoor area(s). A multinomial logistic regression model found that among facilities with outpatient treatment (n = 13,778), those located in a state with laws requiring tobacco free grounds at SUD facilities, those with tobacco screening/education/counseling services, and those with nicotine pharmacotherapy were less likely to have an unrestrictive tobacco smoking policy. Among facilities with residential treatment (n = 3449), those with tobacco screening/education/counseling services were less likely to have an unrestrictive tobacco smoking policy. There is variability in smoking policies and tobacco use treatment options in SUD treatment facilities across the United States. Since tobacco use is associated with negative biomedical outcomes, more should be done to ensure that SUD treatment also focuses on reducing the harms of tobacco use.

The impact of COVID-19 on the peer relationships of adolescents around the world: A rapid systematic review.

The main objective of this rapid systematic review was to examine how the COVID-19 pandemic impacted peer relationships for adolescents (10-25 years of age) around the globe. We focused on four indices of peer relationships: (1) loneliness, (2) social connectedness, (3) social support, and (4) social media use. In addition, we examined gender and age differences. Four databases (APA PsychInfo, PubMed, Scopus, and Web of Science) were searched for articles published from January 2020 to November 2022. A total of 96 studies (cross-sectional: n = 66, longitudinal: n = 30, quantitative: n = 67, qualitative: n = 12, mixed-methods: n = 17) met our inclusion criteria (empirical observational studies with data on at least one of the indices of interest, cross-sectional data on COVID-19-related experiences or longitudinal data collected during the pandemic, age range of 10-25 years, typically developing adolescents). We extracted data and conducted a narrative synthesis. Findings suggest that COVID-19 disruptions negatively impacted peer relationships for youth. Most studies reported either an increase in loneliness over the course of the pandemic or a positive association between loneliness and COVID-19-related experiences. Similar findings were observed for increased social media use as a means of continued communication and connection. Fewer studies focused on social support but those that did reported a decrease or negative association with COVID-19-related experiences. Lastly, findings suggest a mixed impact on social connectedness, which might be due to the strengthening of closer ties and weakening of more distant relationships. Results for gender differences were mixed, and a systematic comparison of differences across ages was not possible. The heterogeneity in measures of COVID-19-related experiences as well as timing of data collection prevented a more nuanced examination of short and more long-term impacts.

Peer connectedness and substance use in adolescence: A systematic review and meta-analysis.

OBJECTIVE: Adolescents' relationships with their peers play a pivotal role in their substance-use behaviors. As such, decades of research have examined how substance use relates to adolescents' overall levels of closeness to their peers, here termed peer connectedness, with mixed results. This report sought to determine how the operationalizations of peer connectedness and substance use affect the nature of the relationship between them. METHOD: We used a systematic review strategy to find a comprehensive set of studies investigating the relationship between peer connectedness and substance use. Three-level meta-analytic regression was used to empirically test whether the operationalization of these variables moderates effect sizes across studies. RESULTS: We found 147 studies, of which 128 were analyzed using multilevel meta-analytic regression models. Operationalizations of peer connectedness varied widely, encompassing sociometric and self-report measures. Of these measures, sociometric indices specifically pertaining to popularity were most strongly predictive of substance use. Less consistent relationships were observed between substance use and sociometric measures of friendship, as well as with self-report measures. CONCLUSIONS: Being perceived as popular by one's peers is positively related to substance use among adolescents. This relationship is stronger and more consistent than those between substance use and other peer-connectedness variables, underscoring the necessity of operationalizing these constructs specifically and clearly. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Decreases in Employer Referrals to First-Time Substance Use Treatment for Adults From 2004 to 2020.

OBJECTIVE: The aim of the study is to examine trends of employer/employee assistance program referred admissions to outpatient substance use disorder (SUD) treatment in the United States. METHODS: The publicly available Treatment Episode Data Set was used. Full-time employed adults with no history of SUD treatment referred to outpatient treatment by an employer/employee assistance program from 2004 to 2020 were included ( N = 36,142). Joinpoint regression examined admission trends. RESULTS: Employer/employee assistance program referred admissions to outpatient treatment decreased annually by 6.4% from 2004 to 2020 ( P < 0.001). Joinpoint analyses identified 2 linear segments from 2004 to 2008 (increased but not significant) and from 2008 to 2020. From 2008 to 2020, an average annual percent decrease of 8.7% ( P < 0.001) was identified. CONCLUSIONS: Findings from this repeated cross-sectional study suggest a missed opportunity for workplaces to serve as a potential SUD treatment access point.

Problematic Substance Use among Sexual Minority and Heterosexual Young Adults during COVID-19.

Sexual minority young adults (SMYAs), compared to heterosexual young adults (HYAs), are a uniquely high-risk population for problematic substance use, a disparity perhaps exacerbated by the COVID-19 pandemic. This study tested whether SMYAs had more problematic substance use than HYAs during the pandemic due to isolation and loneliness as well as lower family closeness. Participants (N = 141) aged 23-29 completed self-report surveys in 2014-2015 as college students and in the summer of 2021 as young adults (59% White, 26% Black/African American, 9% Asian/Middle Eastern, 6% Hispanic/Latino, and <1% American Indian/Alaska Native). Results of multivariate regression and multiple group path analyses did not support hypothesized effects-SMYAs did not have greater increases in problematic substance use compared to HYAs, isolation and loneliness were not significant mediators, and family closeness was not a significant moderator. However, SMYAs experienced a lack of social safety-increased loneliness and decreased family closeness-compared to HYAs. Further research is needed to investigate both the impact and underlying processes of this decreased social safety on SMYA well-being beyond the pandemic to better inform tailored supports and interventions.

The daily association between affect and alcohol use: A meta-analysis of individual participant data.

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Generation COVID: Young adult substance use.

Opposing theories posited that young adult substance use during the COVID-19 pandemic would decline due to restricted access and social engagement or increase due to efforts to cope with rising distress, loneliness, and isolation. Peer-reviewed global longitudinal studies found (a) overall declines in commonly used substances in 2020 with some rebounding in 2021; (b) individual differences in this pattern, with declines linked to factors limiting access and increases to pre-existing risk; and (c) under-developed evidence to evaluate increased coping-related use. Given potential links between surging mental health disorders and substance use, further surveillance and wider dissemination of substance use programming is needed, particularly for vulnerable individuals and settings.

Dyadic parent-college student digital interaction styles.

Parents and their emerging adult children are highly connected via mobile phones in the digital age. This digital connection has potential implications for the development of autonomy and sustained parent-child relatedness across the course of emerging adulthood. The present study uses the qualitatively coded content of nearly 30,000 U.S. parent-college student text messages, exchanged by 238 college students and their mothers and fathers over the course of 2 weeks, to identify distinct dyadic parent-emerging adult digital interaction styles across dimensions of responsiveness and monitoring. Results reveal that digital interaction styles are largely consistent across age, gender, and parent education as well as reflective (i.e., texting patterns of parents and emerging adults mirror one another), with little evidence of overparenting profiles. Results also show that those college students who are reciprocally disengaged in text messaging with their parents perceive their parents as less digitally supportive. However, no styles were associated with perceived parental pressure to digitally engage. Findings suggest that the mobile phone is likely a valuable tool to maintain connection with few risks for undermining the privacy and autonomy of emerging adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An Integrative Data Analysis of Main and Moderated Crossover Effects of Parent-Mediated Interventions on Depression and Anxiety Symptoms in Youth in Foster Care.

Without preventative intervention, youth with a history of foster care (FC) involvement have a high likelihood of developing depression and anxiety (DA) symptoms. The current study used integrative data analysis to harmonize data across four foster and kinship parent-mediated interventions (and seven randomized control trials) designed to reduce youth externalizing and other problem behaviors to determine if, and for how long, these interventions may have crossover effects on youth DA symptoms. Moderation of intervention effects by youth biological sex, developmental period, number of prior placements, and race/ethnicity was also examined. Youth (N = 1891; 59% female; ages 4 to 18 years) behaviors were assessed via the Child Behavior Checklist, Parent Daily Report, and Eyberg Child Behavior Inventory at baseline, the end of the interventions (4-6 months post baseline), and two follow-up assessments (9-12 months and 18-24 months post baseline), yielding 4830 total youth-by-time assessments. The interventions were effective at reducing DA symptoms at the end of the interventions; however, effects were only sustained for one program at the follow-up assessments. No moderation effects were found. The current study indicates that parent-mediated interventions implemented during childhood or adolescence aimed at reducing externalizing and other problem behaviors had crossover effects on youth DA symptoms at the end of the interventions. Such intervention effects were sustained 12 and 24 months later only for the most at-risk youth involved in the most intensive intervention.

Psychosocial functioning associated with prescription stimulant and opioid misuse versus illicit drug use among college students.

Objective: College students' prescription stimulant and opioid misuse (PSM and POM) share psychosocial risks with other substance use. We sought to extend a prior study of these issues. Methods: National College Health Assessment (2015-2016) participants ages 18-24 years (n = 79,336) reporting 12-month PSM (defined as use of a drug not prescribed to them), 30-day other illicit drug use (non-cannabis), both, or neither, were compared on other substance use, psychopathology, academic adjustment, attention deficit hyperactivity disorder, and chronic pain. Models were repeated for POM. Results: Relative to those who only misused the prescription drug, those who used other illicit drugs had lower odds of chronic pain and academic problems, but higher odds on nearly every other outcome especially if they also misused the prescription drug. Conclusions: Findings suggest PSM and POM are on a continuum of risk shared with illicit drug use, but also are linked to outcomes specific to these drugs' perceived medical purposes.

Informing Harmonization Decisions in Integrative Data Analysis: Exploring the Measurement Multiverse.

Combining datasets in an integrative data analysis (IDA) requires researchers to make a number of decisions about how best to harmonize item responses across datasets. This entails two sets of steps: logical harmonization, which involves combining items which appear similar across datasets, and analytic harmonization, which involves using psychometric models to find and account for cross-study differences in measurement. Embedded in logical and analytic harmonization are many decisions, from deciding whether items can be combined prima facie to how best to find covariate effects on specific items. Researchers may not have specific hypotheses about these decisions, and each individual choice may seem arbitrary, but the cumulative effects of these decisions are unknown. In the current study, we conducted an IDA of the relationship between alcohol use and delinquency using three datasets (total N = 2245). For analytic harmonization, we used moderated nonlinear factor analysis (MNLFA) to generate factor scores for delinquency. We conducted both logical and analytic harmonization 72 times, each time making a different set of decisions. We assessed the cumulative influence of these decisions on MNLFA parameter estimates, factor scores, and estimates of the relationship between delinquency and alcohol use. There were differences across paths in MNLFA parameter estimates, but fewer differences in estimates of factor scores and regression parameters linking delinquency to alcohol use. These results suggest that factor scores may be relatively robust to subtly different decisions in data harmonization, and measurement model parameters are less so.

Methodological Strategies for Prospective Harmonization of Studies: Application to 10 Distinct Outcomes Studies of Preventive Interventions Targeting Opioid Misuse.

The Helping to End Addiction Long-Term (HEAL) Prevention Cooperative (HPC) is rapidly developing 10 distinct evidence-based interventions for implementation in a variety of settings to prevent opioid misuse and opioid use disorder. One HPC objective is to compare intervention impacts on opioid misuse initiation, escalation, severity, and disorder and identify whether any HPC interventions are more effective than others for types of individuals. It provides a rare opportunity to prospectively harmonize measures across distinct outcomes studies. This paper describes the needs, opportunities, strategies, and processes that were used to harmonize HPC data. They are illustrated with a strategy to measure opioid use that spans the spectrum of opioid use experiences (termed involvement) and is composed of common "anchor items" ranging from initiation to symptoms of opioid use disorder. The limitations and opportunities anticipated from this approach to data harmonization are reviewed. Lastly, implications for future research cooperatives and the broader HEAL data ecosystem are discussed.

What Parents and Children Say When Talking about Children's Gratitude: A Thematic Analysis.

Parent-child conversations are a widely recognized socializing mechanism, linked to children's developing moral agency, empathy, and emotional competence. Similarly, parent-child conversations about gratitude have been linked to growth in children's gratitude. However, the messages that parents and children exchange in conversations about children's gratitude have yet to be investigated in depth. In the current study, we investigate the types of events that parents discuss with their children during times when they saw displays of children's gratitude and events when the children missed the opportunity to display gratitude, along with the messages that parents and children share during these conversations. The study involved a thematic analysis of the gratitude conversations of 43 parent-child dyads (88% mothers, 77% European American, 51% boys, child Mage=10.62, SD=1.15) living in the United States. Gratitude and missed opportunity events primarily involved situations in which the child had the opportunity to attend an event or to receive a material gift, food, or assistance. Three themes characterized parent and child messages. First, parents suggested that being happy was a sign of being grateful, a way to make others happy, and the goal of benefactors' behavior. Second, parents suggested that children should focus on what they receive rather than on what they did not receive. Finally, children conveyed that they could not always be grateful, but that in several cases they were able to both feel and display their excitement and gratitude. In particular, children reported feeling grateful when they received something they thought was special or enjoyable, unique or unexpected, that they knew would make their parent happy or that they felt lucky to have since others did not have it. Together these findings suggest the importance of future research investigating how children and parents coordinate and prioritize the various elements of gratitude moments in deciding how to be grateful and to socialize children's gratitude.

The Role of Social Position Within Peer Groups in Distress-Motivated Smoking Among Adolescents.

OBJECTIVE: The relationship between smoking and adolescents' peer relationships is complex, with studies showing increased risk of smoking for adolescents of both very high and very low social position. A key question is whether the impact of social position on smoking depends on an adolescent's level of coping motives (i.e., their desire to use smoking to mitigate negative affect). METHOD: We assessed how social position predicts nicotine dependence in a longitudinal sample (N = 3,717; 44.8% male; mean age = 13.41 years) of adolescent lifetime smokers measured between 6th and 12th grades. Using both social network analysis and multilevel modeling, we assessed this question at the between-person and within-person level, hypothesizing that within-person decreases in social position would lead to increased risk of nicotine dependence among those with high levels of coping motives. RESULTS: In contrast to our hypotheses, only interactions with the between-person measures of social position were found, with a slight negative relationship at low levels of coping motives. In addition, the main effect of coping motives was considerably stronger than that of social position at the between-person level, and social position had no significant within-person main effect on nicotine dependence risk. CONCLUSIONS: These results suggest that adolescents with higher overall levels of social position among their peers may have slightly decreased risk for nicotine dependence, but only when coping motives are low. Counter to expectations, higher levels of nicotine dependence risk were not linked to fluctuations in social position.

Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships Among Young Women in Rural South Africa Enrolled in HPTN 068.

BACKGROUND: Adolescent girls and young women (AGYW) remain burdened by the HIV epidemic. Positive caregiver-child relationships are associated with safe sexual behaviors in young people; yet, this literature often highlights the role of parent-child communication and parental monitoring, neglecting the importance of emotional relationships between a caregiver and adolescent. SETTING: We used longitudinal data from HIV Prevention Trial Network 068-conducted among 2533 AGYW (13-20 years) over a period of 5 years in Agincourt, South Africa. METHOD: Kaplan-Meier and Cox models were used to estimate the effect of quality of caregiver-adolescent relationships (caring and closeness) on sexual debut, and log-binomial models with generalized estimating equations were used to examine the relationship between our exposures and transactional sex and age-disparate relationships. RESULTS: Sexual debut was delayed among those who reported high levels of caregiver caring [hazard ratio: 0.80, 95% confidence interval (CI): 0.69 to 0.93] and caregiver closeness (hazard ratio: 0.80, 95% CI: 0.68 to 0.95). AGYW who reported high quality caregiver-adolescent relationships had a lower risk of transactional sex [caring: risk ratio (RR): 0.67, 95% CI: 0.58 to 0.78; closeness: RR: 0.58; 95% CI: 0.50 to 0.67]. Similarly, those with high-quality caregiver-adolescent relationships were less likely to be in an age-disparate relationship (caring: RR: 0.68, 95% CI: 0.58 to 0.79; closeness: RR: 0.77, 95% CI: 0.66 to 0.90). CONCLUSIONS: Findings indicate high-quality caregiver-adolescent relationships are associated with delayed sexual debut, a lower risk of transactional sex, and having an older partner. Family-centered interventions are needed to improve relationships between AGYW and caregivers.

COVID-19 Life Events Spill-Over on Family Functioning and Adolescent Adjustment.

We examined US parent and youth perceptions of how life events, both positive and negative, associated with COVID-19 resulted in changes in family and youth functioning. Families (n = 105, 80% white, 48% male, and 87% mothers) completed surveys during the pandemic (May to July 2020) and 3 years prior (for youth ages M = 10.6, SD = 1.17 and M = 13.6, SD = 1.19). Declines in youth, though not parent, report of open family communication, parental support, and family satisfaction were found. Declines were associated with various domains of pandemic-related stress in parent report, though positive life events served as buffers. Pre-pandemic family functioning also predicted pandemic stress. Spillover effects in turn impacted youth functioning. The current findings shed light on how experiences of the pandemic are linked with family functioning and have implications for how to support families during this time.

Parents' responses to children's ingratitude are associated with children's gratitude and internalizing 3 years later.

The current study is the first to examine how parents respond to children's ingratitude and how such responses impact children's later gratitude and internalizing symptoms. We focused on parental responses in families with children aged 6-9 years when gratitude may be actively forming as part of socioemotional learning and other-oriented behavior. Parent-child dyads (n = 101; 52% female; 81% European American, 9% Asian/Asian American, 5% African American, 4% Latino) completed lab-based assessments at baseline and 3 years later. Results indicate that we can reliably assess and differentiate six parental responses to children's ingratitude (i.e., parental self-blame, distress, punishment, instruction, let-it-be, and give-in) using a novel scenario-based measure. Moreover, parents of older children reported more self-blame, distress, and let-it-be responses than those of younger children. More frequent distress and less frequent punishing and giving-in responses to ingratitude by parents predicted greater parent-reported child gratitude at follow-up whereas more frequent distress and less instruction and giving-in responses predicted greater child-reported gratitude at follow-up. Punishing responses also predicted greater later internalizing symptoms in children, whereas self-blame and distress responses predicted lower subsequent symptoms. Collectively, findings showed that parental responses to children's ingratitude predicted child gratitude and internalizing symptoms 3 years later, even after controlling for other factors comprising the parent ecology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Adolescence Amid a Pandemic: Short- and Long-Term Implications.

Members of the Society for Research on Adolescents COVID-19 Response Team offer this commentary to accompany this special issue of the Journal of Research on Adolescence regarding the impact of the pandemic on adolescents' social, emotional, and academic functioning. In addition to outlining the critical need for scholarly collaboration to address the global impact of this crisis on adolescent development, we argue that a broad investigative lens is needed to guide research and recovery efforts targeting youth development. We then use this broad lens to consider dimensions of the pandemic impact relative to developmental implications within community and policy contexts, educational contexts, social contexts, and family contexts. Finally, we describe guideposts for setting a global, shared research agenda that can hasten research to recovery efforts surrounding the pandemic and youth development.

Coping and Mental Health in Early Adolescence during COVID-19.

The current longitudinal study examines changes in overall mental health symptomatology from before to after the COVID-19 outbreak in youth from the southeastern United States as well as the potential mitigating effects of self-efficacy, optimism, and coping. A sample of 105 parent-child dyads participated in the study (49% boys; 81% European American, 1% Alaska Native/American Indian, 9% Asian/Asian American; 4% Black/African American; 4% Latinx; and 4% other; 87% mothers; 25% high school graduate without college education; 30% degree from 4-year college; 45% graduate or professional school). Parents completed surveys when children were aged 6-9, 8-12, 9-13, and 12-16, with the last assessments occurring between May 13, 2020 and July 1, 2020 during the COVID-19 outbreak. Children also completed online surveys at ages 11-16 assessing self-efficacy, optimism, and coping. Multi-level modeling analyses showed a within-person increase in mental health symptoms from before to after the outbreak after controlling for changes associated with maturation. Symptom increases were mitigated in youth with greater self-efficacy and (to some extent) problem-focused engaged coping, and exacerbated in youth with greater emotion-focused engaged and disengaged coping. Implications of this work include the importance of reinforcing self-efficacy in youth during times of crisis, such as the pandemic, and the potential downsides of emotion-focused coping as an early response to the crisis for youth.

Psychometric Models for Scoring Multiple Reporter Assessments: Applications to Integrative Data Analysis in Prevention Science and Beyond.

Conducting valid and reliable empirical research in the prevention sciences is an inherently difficult and challenging task. Chief among these is the need to obtain numerical scores of underlying theoretical constructs for use in subsequent analysis. This challenge is further exacerbated by the increasingly common need to consider multiple reporter assessments, particularly when using integrative data analysis to fit models to data that have been pooled across two or more independent samples. The current paper uses both simulated and real data to examine the utility of a recently proposed psychometric model for multiple reporter data called the trifactor model (TFM) in settings that might be commonly found in prevention research. Results suggest that numerical scores obtained using the TFM are superior to more traditional methods, particularly when pooling samples that contribute different reporter perspectives.