Age of onset of first alcohol intoxication and subsequent alcohol use among urban American Indian adolescents.

The objective was to assess the effect of early onset intoxication on subsequent alcohol involvement among urban American Indian youth. The data come from the American Indian Research (AIR) project, a panel study of urban Indian youth residing in King County, Washington. Data were collected annually from the adolescent and his/her primary caregiver from the 1988-89 school year to the 1996-97 school year, providing a total of nine waves of data. Early intoxication (by age 14) was related to delinquency, family history of alcohol abuse or dependence, poverty, broken family structure, less family cohesiveness, and more family conflict. The effects of these characteristics were, therefore, partialed out in testing effects of early intoxication on later alcohol involvement. Two-part latent growth models of alcohol use and alcohol problems were specified. Effects of early onset intoxication on these trajectories, as well as lifetime alcohol abuse or dependence by the transition to young adulthood, were examined. Findings indicate that adolescents who experienced their first intoxication early (by age 14), used alcohol more heavily from the ages of 16 to 18, experienced more problems related to the alcohol's use from the ages of 16 to 18, and were more likely to have a diagnosed alcohol disorder by the final wave of data collection. Congruent with similar studies in the general population, early intoxication appears to be associated with a deleterious course of alcohol involvement during adolescence and into the transition to young adulthood among urban American Indian youth. Implications for prevention are discussed.

Perceived parental investment in school as a mediator of the relationship between socio-economic indicators and educational outcomes in rural America.

Each year, 1.3 million students fail to graduate, dropping the United States' high school graduation rate to 69%. One of the most salient predictors of high school dropout is socio-economic status (SES), which makes important an improved understanding of the reasons why SES affects educational outcomes. In this study, multilevel mediation models were utilized to examine parental investment in school as a mediator of the relationship between SES and educational outcomes among an ethnically diverse sample of 64,350 7th to 9th grade students from 199 rural communities and towns in the U.S. (50% male, 63% non-Hispanic White). These relationships were assessed at the individual and school district level. Results indicate that parental investment is an important mediator at both levels. Within school districts, 28% of the effect of SES on the expectation to graduate from high school is mediated by perceived parental investment. Between school districts, 60% of the effect of concentrated disadvantage on the district's high school graduation rate and nearly all (87%) of the effect of concentrated disadvantage on the average expectation to graduate from high school among students in the district is mediated by perceived parental investment. Implications for prevention are discussed.

The Role of Attachment to Family, School, and Peers in Adolescents' Use of Alcohol: A Longitudinal Study of Within-Person and Between-Persons Effects.

A great deal of time and money has been spent to understand why adolescents abuse alcohol. Some of the most fruitful work considers the social context navigated by adolescents, including family, school and peer contexts. However, most of this work focuses on differences between adolescents in these contexts. The present study adds to the literature by considering within-person changes in these contexts and examines the extent to which these changes are related to alcohol use. Significant changes in all three contexts were observed, and these changes were significantly related to alcohol use. The significant influence of intrapersonal variability highlights the importance of attending not only to chronic, between-individual issues facing at-risk youth, but emergent and transient issues that may temporarily heighten alcohol use risk.

Use of ephedra among rural-dwelling U.S. adolescents.

Prior to 2004, ephedra had been readily available to adolescents. Due to reports that use of ephedra produced a number of serious adverse consequences, including death, sales of the compound became illegal in the United States on April 12, 2004. Data are presented from a random sample of 156,050 students in grades 7 through 12 from 185 rural communities across the United States who completed the Community Drug and Alcohol Survey. This study provides a valuable epidemiological benchmark of reported rates of lifetime prevalence of ephedra by adolescents living in rural America before the sale of the drug became illegal (data were collected between 1996 and 2001). While there were small regional, racial, and gender differences, rates of adolescent use were, in general, very low. The highest rates of ephedra use were found among youth using other drugs, particularly stimulants. The study's limitations and implications are discussed.

Alcohol use in early adolescence: the effect of changes in risk taking, perceived harm and friends' alcohol use.

OBJECTIVE: Friends' substance use, sensation seeking and low perceived harm are well-established risk factors for substance use, but they are often treated as stable factors that affect adolescents' likelihood of substance use. This study instead explores the effects of changes in risk factors for individual adolescents. METHOD: Participants in this study were 1,065 male and female students. The students were in sixth or seventh grade at the initial survey and provided survey data on three additional occasions over a period of 2 years. Random-coefficient models were used to assess the intraindividual variability of friends' alcohol use, perceived harm, and risk taking and their effect on alcohol use. RESULTS: As expected, the overall number of alcohol-using friends is correlated with a student's own alcohol use. In addition, there is a dynamic relationship within student; as friends' alcohol use changes over time, it is accompanied by parallel changes in alcohol use by the individual. Two moderating variables of the effect of friends' use of alcohol were validated: perceived harm of alcohol use and risk taking. The effect of increased exposure to alcohol-using friends is more robust during times when an adolescent also has become less likely to perceive the harmful effects of alcohol use or when an adolescent indicates increased interest in risk-taking behavior. CONCLUSIONS: Although friends' use of alcohol is a salient predictor of an adolescent's own use of alcohol, some types of students are more likely than others to be influenced by friends' behavior, In particular, students' perception of harm and predisposition to risk taking are important moderators of the effect of friends' influence.

Cognitive-behavioral treatment of high anger drivers.

Relaxation and cognitive-relaxation interventions were compared to a no treatment control in the treatment of high anger drivers. The cognitive portion of the cognitive-relaxation condition adapted the style of Beck's cognitive therapy, particularly use of Socratic questions and behavioral experiments and tryouts, to driving anger reduction. Both interventions lowered indices of driving anger and hostile and aggressive forms of expressing driving anger and increased adaptive/constructive ways of expressing driving anger. The cognitive-relaxation intervention also lowered the frequency of risky behavior. Both interventions lowered trait anger as well. Limitations and implications for treatment and research were discussed.

The driving anger expression inventory: a measure of how people express their anger on the road.

Four ways people express their anger when driving were identified. Verbal Aggressive Expression (alpha=0.88) assesses verbally aggressive expression of anger (e.g., yelling or cursing at another driver); Personal Physical Aggressive Expression (alpha=0.81), the ways the person uses him/herself to express anger (e.g., trying to get out and tell off or have a physical fight with another driver); Use of the Vehicle to Express Anger (alpha=0.86), the ways the person uses his/her vehicle to express anger (e.g., flashing lights at or cutting another driver off in anger); and Adaptive/Constructive Expression (alpha=0.90), the ways the person copes positively with anger (e.g., focuses on safe driving or tries to relax). Aggressive forms can be summed into Total Aggressive Expression Index (alpha=0.90). Aggressive forms of expression correlated positively with each other (rs=0.39-0.48), but were uncorrelated or correlated negatively with adaptive/constructive expression (rs=-0.02 to -0.22). Aggressive forms of anger expression correlated positively with driving-related anger, aggression, and risky behavior; adaptive/constructive expression tended to correlate negatively with these variables. Differences in the strengths of correlations and regression analyses supported discriminant and incremental validity and suggested forms of anger expression contributed differentially to understanding driving-related behaviors. Theoretical and treatment implications were explored.