Prospective relationships between sleep problems and substance use, internalizing and externalizing problems.

While research has shown that sleep problems and substance use are reciprocally associated in adults, much less is known about this association in early adolescence. The main aim of the current longitudinal study was to explore bidirectional relationships between sleep problems, substance use, internalizing and externalizing problems in young adolescents. A prospective design was used incorporating two waves (approximately 1 year interval). A total of 555 young adolescents (290 females, M age = 13.96) participated in this study. All participants completed self-report measures in classrooms during regular school hours (questionnaires about sleep quality and sleep hygiene were used to measure sleep problems). The results indicated that sleep problems predicted changes in substance use, internalizing and externalizing problems over time, but problem behaviours did not predict changes in sleep problems, adjusted for gender, age and puberty. One exception was that alcohol use negatively predicted changes in sleep problems. This study suggests that sleep problems are important precursors of substance use, internalizing and externalizing problems in adolescence.

Impulsive and reflective processes related to alcohol use in young adolescents.

BACKGROUND: Dual process models suggest that the development of addictive behaviors is the result of interplay between impulsive and reflective processes, modulated by boundary conditions such as individual or situational factors. Empirical support for this model has been repeatedly demonstrated in adult samples [for a meta-analysis, see Ref. (1)]. The purpose of this study was to test these processes as they relate to emerging alcohol use in adolescents. Specifically, the interactive effects of several measures of impulsive and reflective processes and working memory capacity (WMC) are examined as predictors of changes in alcohol use among adolescents. It was expected that measures of reflective processes would better predict changes in alcohol use than measures of impulsive processes. Moreover, it was anticipated that WMC would moderate the relation between alcohol-specific impulsive and reflective processes and changes in adolescent alcohol use. METHODS: The sample consisted of 427 adolescents (47.7% male) between 12 and 16 years of age (M = 13.96, SD = 0.78) who reported drinking alcohol at least once. Four measures of impulsive processes were included. Attentional bias for alcohol was assessed with a Visual Probe Test; approach bias toward alcohol was assessed with a Stimulus Response Compatibility (SRC) Test; and memory associations with alcohol were assessed with an Implicit Association Test (IAT) and a Word Association Test. Two measures of reflective measures were included: positive and negative expectancies. WMC was measured using a Self-Ordered Pointing Task. RESULTS: RESULTS showed that positive expectancies predicted changes in alcohol use, but this effect was qualified by an interaction with IAT scores. Moreover, SRC scores predicted changes in alcohol use only when negative expectancies were low. Attentional bias and word association scores did not predict changes in alcohol use. The relations between alcohol-specific processes or reflective processes and alcohol use were not moderated by WMC. CONCLUSION: Although there is empirical evidence for the validity of the model in predicting heavier alcohol use in adolescents, or alcohol abuse and dependence in adults, these observations do not generalize to a sample of normative, early adolescents. More specifically, results indicated that reflective processes are more important predictors of changes in alcohol use than impulsive process during adolescence.

Mediation and moderation effects of an in-home family intervention: the "in control: no alcohol!" pilot study.

The aim of this study was to examine the effect of a theory-based in-home family intervention (In control: No alcohol!) on adolescent alcohol cognitions via its putative mediators using a randomized controlled design. In the South Holland region of the Netherlands, a total of 213 children (11-12 years) and their mothers were randomly assigned to the prevention program (108 dyads) and the control condition (105 dyads). Mediation effects were analyzed using pretest and two follow-up measurements (5 and 12 months after baseline). A path model was estimated (using Mplus) to examine the effect of the intervention on the putative mediators (frequency- and quality of mother-child communication, rules about alcohol, establishing a nondrinking agreement, and parental monitoring of the child's whereabouts). Outcomes were adolescents' perceived harmfulness of drinking and intention to drink. Multigroup analyses were performed to examine potential differences across gender. The program led to an increase in frequency of alcohol-specific communication, nondrinking agreements, and parental monitoring. Moreover, adolescents in the experimental condition perceived drinking to be more harmful and had less intention to drink compared to adolescents in the control condition. The effect of the program on adolescent alcohol cognitions was significantly mediated through having more frequent conversations about alcohol, yet only among boys. Although results on actual drinking need to be added, findings indicate that this relatively inexpensive, easy-to-administer home intervention is promising.

The mediating role of alcohol-related memory associations on the relation between perceived parental drinking and the onset of adolescents' alcohol use.

AIMS: The aim of the current study was to examine the mediating role of alcohol-related memory associations in the relation between perceived parental drinking and the onset of adolescents' alcohol use. Gender and grade were also included in the analyses. DESIGN: We tested a mediation model within a structural path modelling framework using longitudinal data (two waves). SETTING AND PARTICIPANTS: The sample consisted of 608 Canadian adolescents (42.9% boys), who did not have any alcohol experiences at the first measurement. The adolescents were recruited from all grades 7-9 classes in a large school district in western Canada. MEASUREMENTS: Alcohol-related memory associations were tested with the Word Association Test. We used adolescent self-reports of alcohol use and parental drinking. FINDINGS: Results clearly showed a mediation effect of alcohol-related memory associations [estimate = 0.023, 95% confidence interval (CI): 0.002-0.044). That is, parental drinking as perceived by the adolescent was related positively to alcohol-related memory associations, which in turn predicted adolescents' alcohol use a year later. Gender and grade were related to alcohol-related memory associations. That is, boys and adolescents of higher grades had more memory associations. CONCLUSIONS: Children appear to form memory associations related to alcohol before they ever drink alcohol themselves, and these associations appear to mediate the link between their perceptions of their parents' drinking and their own initial alcohol use.

The moderating effect of alcohol-specific parental rule-setting on the relation between the dopamine D2 receptor gene (DRD2), the µ-opioid receptor gene (OPRM1) and alcohol use in young adolescents.

AIMS: The main aim of the study was to test the moderating effect of two genetic polymorphisms, one in the dopamine D2 receptor gene (DRD2) and one in the mu-opioid receptor gene (OPRM1), on the link between parental rule-setting and adolescent alcohol use. METHODS: A total of 214 adolescents (M(age )=13.7, 44.9% male) provided saliva samples and completed survey items describing alcohol use and parental rule-setting. RESULTS: Findings indicated that alcohol-specific parental rule-setting was more robustly associated with alcohol use for adolescents with the DRD2 A1 risk allele and for those with the OPRM1 G-allele. CONCLUSION: This study replicates the interaction between parental rule-setting and the DRD2 risk allele on adolescent alcohol use and extends the literature by demonstrating the moderating effects of the OPRM1 risk allele on the link between parental rule-setting and adolescent alcohol use.

The influence of paternal and maternal drinking patterns within two-partner families on the initiation and development of adolescent drinking.

As it is still unclear to what extent parental drinking is a predictor of children's alcohol use, we tested the association of specific paternal and maternal drinking patterns with both initiation and development of adolescent alcohol use. Longitudinal data (four annual measurements) of parent-child dyads (N=2319) have been used. Parental drinking patterns have been identified using latent class analysis. The association of parental drinking patterns with the initiation and development of 12-15 year olds' drinking have been examined with latent growth curve modeling. Only two out of six parental drinking patterns were related to adolescent drinking. That is, having a heavy drinking father or two heavy episodic drinking parents particularly predicts early and heavier adolescent drinking. When controlled for parenting behaviors and background variables, such as adolescent gender, age and socioeconomic status (SES), these findings remained significant. Interaction analyses revealed that the influence of parental heavy (episodic) drinking differs across gender and is especially strong among adolescents with lower SES. Thus, parental heavy (episodic) drinking, and not so much the frequency of drinking, predicts the initiation and development of alcohol consumption in their offspring. Parents and professionals must be aware that parental heavy drinking affects their offspring, particularly adolescents with lower SES, resulting in earlier and heavier drinking among this high-risk group.

The moderating role of working memory capacity and alcohol-specific rule-setting on the relation between approach tendencies and alcohol use in young adolescents.

BACKGROUND: Dual process models of alcohol addiction propose that the transition from normative alcohol consumption to heavy drinking is the result of an imbalance in interplay between relatively impulsive or automatic and reflective or controlled processes. The current study examines whether impulsive and reflective processes are also detectable in a sample of adolescents with limited alcohol use. METHODS: Specifically, we tested the interaction between alcohol approach tendencies and 2 types of reflective processes, working memory capacity (WMC) and alcohol-specific rule-setting, on changes in alcohol use of 238 young adolescents (mean age: 13.82 years). Gender differences in these associations were also explored. RESULTS: Results showed that WMC did not moderate the relation between approach tendencies and subsequent alcohol use, whereas rule-setting did, with stronger associations between approach tendencies and alcohol use for male adolescents reporting more permissive parents than male adolescents with parents enforcing stricter rules involving alcohol use. Associations between approach tendencies and subsequent alcohol use did not emerge for female adolescents. CONCLUSIONS: Results indicate that even in a sample of adolescents with limited drinking experience, automatic processes are positively associated with alcohol use for male adolescents that are not motivated by parents to control their drinking.

Parental alcohol-specific rules and alcohol use from early adolescence to young adulthood.

BACKGROUND: Several studies stress the importance of alcohol-specific rules during adolescence to prevent them from drinking early and heavily. However, most studies have short follow-up periods and do not cover the relevant developmental period in which direct parental control diminishes and adolescent alcohol use increases. The current study aimed to provide a developmental perspective on the link between alcohol-specific rules and alcohol use from early adolescence until early adulthood in the Netherlands. METHODS: The sample consisted of 428 Dutch families including fathers, mothers and adolescents from 2 age groups (13 and 15 years old) at Time 1 (T1), who have been surveyed annually for 6 years. To address the effect of alcohol-specific rules on adolescent alcohol use over time, a latent growth curve analytic approach with time-varying covariates was employed. RESULTS: Over time, adolescent alcohol use increased, whereas alcohol-specific rules decreased. Most importantly, however, the lagged paths of alcohol-specific rules consistently predicted subsequent alcohol use across the 6 assessments for both younger and older siblings. Thus, strict alcohol-specific rules at a certain point in time were related to a lower intensity of adolescent alcohol use a year later. CONCLUSIONS: Although parents turn somewhat less strict in alcohol-specific rules over time, and adolescent alcohol use increases over time, the specific rules parents set remain important in restraining the alcohol use of their adolescent offspring. Thus, parents should and can feel confident about their parenting capabilities, and they should maintain being strict to prevent their offspring from drinking.

Alcohol use and friendship dynamics: selection and socialization in early-, middle-, and late-adolescent peer networks.

OBJECTIVE: This study examined developmental trends of peer selection and socialization related to friends' alcohol use in early-, middle-, and late-adolescent peer networks, with the primary goal of identifying when these mechanisms emerge, when these mechanisms exert their strongest effects, and when (or if) they decrease in importance. Gender and reciprocity are also tested as moderators of selection and socialization. METHOD: Cross-sequential study (three age cohorts assessed at three annual measurements) of 950 youth (53% male) initially attending classrooms in Grade 4 (n = 314; M = 10.1 years), Grade 7 (n = 335; M = 13.1 years), and Grade 10 (n = 301; M = 16.2 years). RESULTS: Similarity between friends' drinking behaviors emerged in Grade 6, peaked in Grade 8, and decreased throughout late adolescence. Adolescents in all three age groups selected peers with similar drinking behaviors, with effects being more robust for early-adolescent males and for late-adolescent females. Peers' alcohol use emerged as a significant predictor of middle-adolescent alcohol use and remained a significant predictor of individual drinking behaviors throughout late adolescence. Socialization did not differ as a function of gender or reciprocity. CONCLUSIONS: Alcohol-related peer selection was relatively more important than socialization in early-adolescent friendship networks; both mechanisms contributed to explaining similarity between the drinking behaviors of friends in middle and late adolescence. Effects of peer socialization emerged in middle adolescence and remained throughout late adolescence.

Results of the 'in control: no alcohol!' pilot study.

More than 50% of Dutch 12-year olds already started drinking. Since it is known that delaying the onset of alcohol use results in a lower risk of alcohol-related problems, the recently developed 'In control: No alcohol!' prevention program is targeted at elementary school children and their mothers. In this pilot study, the success of program implementation and impact of the program on quality of alcohol-specific communication, rules and monitoring were evaluated, using a randomized controlled design. A total of 108 children (11-12 years) and their mothers participated in the prevention program, while the control group consisted of 105 dyads. Families participating in the experimental condition showed an increase in frequency of alcohol-specific communication and 75% of the dyads reported that they took part in at least 3 of 5 magazines, suggesting implementation was successful. The program led to an increase in quality of communication but only for those dyads in which mothers' alcohol use was above average. The program led parents to set up a non-drinking contract with their children and to monitor their children more closely. Results are promising but need to be replicated in a larger longitudinal study.

Effectiveness of the home-based alcohol prevention program "In control: no alcohol!": study protocol of a randomized controlled trial.

BACKGROUND: In the Netherlands, children start to drink at an early age; of the Dutch 12-year olds, 40% reports lifetime alcohol use, while 9.7% reports last-month drinking. Starting to drink at an early age puts youth at risk of developing several alcohol-related problems later in life. Recently, a home-based prevention program called "In control: No alcohol!" was developed to delay the age of alcohol onset in children. The main aim of this project is to conduct a Randomized Controlled Trial (RCT) to evaluate the effectiveness of the program. METHODS/DESIGN: The prevention program will be tested with an RCT among mothers and their 6 grade primary school children (11-12 years old), randomly assigned to the prevention or control condition. The program consists of five printed magazines and an activity book designed to improve parental alcohol-specific socialization. Parent-child dyads in the control group receive a factsheet information brochure, which is the standard alcohol brochure of the Trimbos Institute (the Netherlands Institute for Mental Health and Addiction).Outcome measures are initiation of alcohol use (have been drinking at least one glass of alcohol), alcohol-specific parenting, susceptibility to drinking alcohol, alcohol expectancies, self-efficacy, and frequency and intensity of child alcohol use. Questionnaires will be administered online on secured Internet webpages, with personal login codes for both mothers and children. Mothers and children in both the experimental and control condition will be surveyed at baseline and after 6, 12, and 18 months (follow-ups). DISCUSSION: The present study protocol presents the design of an RCT evaluating the effectiveness of the home-based "In control: No alcohol!" program for 6 grade primary school children (11-12 years old). It is hypothesized that children in the prevention condition will be less likely to have their first glass of alcohol, compared to the control condition. When the prevention appears to be effective, it can easily and relatively quickly be implemented as a standard alcohol prevention program on a large scale. TRIAL REGISTRATION: Nederlands Trial Register NTR2564.

The effect of the OPRM1 and DRD4 polymorphisms on the relation between attentional bias and alcohol use in adolescence and young adulthood.

BACKGROUND: The incentive sensitization theory posits that in the transition from sporadic to problematic alcohol use, the incentive value of alcohol increases (wanting) while its hedonic effects (liking) do not change or decreases. The effect of the OPRM1 c.118A>G polymorphism, associated with liking and wanting, and the DRD4-VNTR polymorphism, related to wanting, on the relation between attentional bias and alcohol use was investigated. METHODS: A total of 195 young adolescents (Study 1) and 86 young adult male heavy drinkers (Study 2) completed a visual probe test. Saliva samples were collected to test both polymorphisms. RESULTS: In Study 1, attentional bias was positively associated with adolescent alcohol use only for OPRM1 G-allele carriers. In Study 2, attentional bias was positively associated with problem drinking for carriers of a DRD4 long allele. DISCUSSION: It is tentatively proposed that an attentional bias for alcohol is related most strongly to liking and wanting in early adolescents, while in young adults, an attentional bias may reflect wanting. In addition, individual differences associated with two both genetic markers should be taken into account when examining the relation between attentional bias and alcohol use.

Parental alcohol use, alcohol-related problems, and alcohol-specific attitudes, alcohol-specific communication, and adolescent excessive alcohol use and alcohol-related problems: An indirect path model.

Alcohol-specific parent-child communication has often been studied in relation to regular alcohol use of adolescents. However, it might be as important to focus on adolescent problematic alcohol use. In addition, the way parents communicate with their children about alcohol might depend on their own (problematic) drinking behaviors. Therefore, the current study examined the direct effects of parental alcohol use, alcohol-related problems, and parental alcohol-specific attitudes on adolescent excessive drinking and alcohol-related problems later in life. It also looked at indirect effects via alcohol-specific communication. The sample consisted of 428 Dutch families including fathers, mothers and adolescents from two age groups (13 and 15 years old) at T1, who have been surveyed annually for 5 years. We tested the model with structural equation modeling (SEM). The results showed that parental alcohol-related problems were positively associated with communication about alcohol, which in turn was related with less excessive adolescent drinking and alcohol-related problems. Lenient parental attitudes about alcohol and parental alcohol-related problems were directly related to more excessive drinking and alcohol-related problems in adolescents. In conclusion, alcohol-specific communication intervenes in the relationship between parental alcohol-related problems and adolescent excessive drinking and alcohol-related problems. This indicates that in family alcohol interventions targeted at youth alcohol use, parental alcohol-related problems should be taken into account.

Bidirectional associations between sibling relationships and parental support during adolescence.

Sibling relationships and parental support are important for adolescents' development and well-being, yet both are likely to change during adolescence. Since adolescents participate in both the sibling relationship and the parent-child relationship, we can expect sibling relationships and parental support to be associated with each other. Theoretically, it can be expected that there is either a spillover from one relationship to another (congruence hypothesis) or that one relationship can compensate for the other (compensation hypothesis). However, research examining these associations in adolescence is limited. The present study longitudinally investigated the bidirectional associations between sibling relationships and parental support during adolescence. For five consecutive years, data were collected using self-reports of 428 families, consisting of a father, a mother, and two adolescent siblings. The mean ages of the first-born (52.8% males) and second-born (47.7% males) were 15 and 13 years at T1, respectively. For the second-born siblings, prospective associations were found between sibling relationships and adolescent-reported parental support in early adolescence, with no differences between same-sex and mixed-sex dyads. These associations were not found for first-born siblings or for parents' reports of support. The findings suggest a spillover from the sibling relationship to adolescent-reported parental support only in early adolescence. Findings and implications are discussed in terms of the congruence/spillover and the compensation hypothesis.

The role of parental alcohol-specific communication in early adolescents' alcohol use.

Many alcohol prevention programs advocate conversations about alcohol between parents and children because verbal communication is the most direct way for parents to express their thoughts, rules, and concerns about alcohol to their children, so called alcohol-specific communication. Nevertheless, research on the effects of alcohol-specific communication has produced inconsistent findings. This study examined the bidirectional links between frequency of alcohol-specific communication and early adolescents' alcohol use, and the moderating effects on these links of gender and experience with alcohol. The longitudinal sample consisted of 428 Dutch early adolescents who were followed over 3 years. Results of structural equation models indicated that more frequent alcohol-specific communication at time two predicted more adolescent alcohol use at time three. Follow-up multiple-group analyses clearly show that prospective links between alcohol-specific communication and adolescent alcohol use were limited to adolescent males reporting the highest levels of drinking. For this group of drinking males, alcohol use predicted less parent-child communication, and more frequency of alcohol-specific communication predicted an increase in drinking. Alcohol-specific communication and adolescent alcohol use were not prospectively linked for males reporting lower levels of alcohol use or for adolescent females. These findings highlight the need for future research that examines both quantitative and qualitative aspects of how parents communicate with their adolescent children about alcohol. Advocation of specific parent-child communication skills meant to reduce youth alcohol use may be somewhat premature until additional studies refine our understanding of how specific parenting strategies are linked to different patterns of adolescent alcohol use.

Puberty-dependent sleep regulation and alcohol use in early adolescents.

BACKGROUND: Research has shown a bi-directional relation between alcohol use and sleep regulation in adults. Much less is known about this association in early adolescents, while profound puberty-dependent transitions regarding sleep patterns take place in early adolescence. Moreover, puberty has been associated with an increase in alcohol use of adolescents. METHODS: In this study, we investigated the associations between pubertal development, sleep preference, sleep problems, and alcohol use in 431 early adolescents (mean age: 13.66). Second, it was studied whether the associations changed when controlling for adolescent internalizing and externalizing problems. Furthermore, we included gender as a moderator on all the associations. RESULTS: Results showed that pubertal development was positively associated with sleep problems and more evening-type tendencies (e.g., favoring later bedtimes), which in turn were positively related to alcohol use. Underlying psychopathology, gender and educational level did not change these relationships. CONCLUSIONS: From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.

Do parents and best friends influence the normative increase in adolescents' alcohol use at home and outside the home?

OBJECTIVE: The present study explored the possible impact of parental supervision of adolescents' alcohol use and drinking with parents on concurrent and prospective associations between adolescents' drinking at home and drinking outside the home. The impact of drinking with their best friend, parental drinking behaviors, and sibling influence on adolescent alcohol use were also examined, as well as whether drinking at home and outside the home predicted problem drinking. METHOD: We used three waves of longitudinal full-family data (fathers, mothers, and two adolescent siblings; N = 428). RESULTS: Bi-directional effects between drinking at home and drinking outside the home were found for both adolescents, with drinking in one setting predicting drinking in another setting over time. Both drinking at home and drinking outside the home predicted subsequent problem drinking. These associations did not differ as a function of adolescents drinking with parents or their best friend or of parental supervision of adolescents' alcohol use. Only adolescents' gender seemed to moderate these effects but solely in midadolescence. For 15-year-old boys (but not for girls), at-home drinking predicted outside-the-home drinking 1 year later. CONCLUSIONS: Taken together, adolescents' alcohol use increases over time, regardless of setting or with whom they drink. According to these results, prevention workers should focus on making parents more aware of their role in delaying the age at drinking onset.

Implicit and explicit cognitions related to alcohol use in children.

Research has indicated that implicit and explicit alcohol-related cognitions jointly predict alcohol use in adolescents and adults. Only few studies assessed these cognitions in children. Associations between alcohol cognitions and alcohol use were tested in two studies with 10 year olds (Study 1; N=99) and 11-12 year olds (Study 2; N=35). Furthermore, the role of parental alcohol use was examined. Implicit alcohol cognitions were assessed in an Implicit Association Test (IAT) using pictures of alcohol and soft drinks as target stimuli and happy versus angry faces as attribute stimuli (children's faces in Study 1, adults' faces in Study 2). Explicit expectancies and parental alcohol use were assessed with questionnaires. Children demonstrated a relatively stronger association between alcohol and negative facial expressions, and in Study 2, this association was negatively related to alcohol use. In Study 2, paternal drinking was related to implicit negative associations and explicit arousal associations. These studies show that young children have both implicit and explicit alcohol-related cognitions and both appear to play a role in explaining emerging alcohol use of elementary schoolchildren.

Identification and prediction of drinking trajectories in early and mid-adolescence.

The aim of this study was to identify subgroups of early and mid-adolescents with different drinking trajectories. In addition, we examined whether gender, parental, and peer factors predicted adolescents' membership of these drinking trajectories. We used longitudinal data of 428 families (fathers, mothers, mid-adolescents, and their younger siblings). Latent Class Growth Analyses were performed to identify drinking trajectories. Four drinking trajectories emerged for early adolescents: abstainers, light drinkers, increasers, and heavy drinkers. For mid-adolescents, we identified a fifth group (stable drinkers) in addition to the four trajectories identified for early adolescents. Our results showed that being a boy, having a best friend or father who drinks heavily, and having parents who are permissive toward adolescents' alcohol creates increased risk for both siblings to attend the more heavy drinking trajectories.