Coping Flexibility and Alcohol-Related Outcomes: Examining Coping Motives as Mediators.

Background: Coping has been implicated in the etiology and treatment of problem drinking. Traditional, static measurement of coping styles (e.g., approach, avoidance, social support) may fail to capture how adaptive a given coping style may be. Coping flexibility is an emerging construct, associated with psychological health, and one that may shed light on coping's role in drinking risk. Coping flexibility includes (1) discontinuation of an ineffective coping strategy ("Discontinuation") and (2) production of an alternative strategy ("Implementation"). This study is the first to our knowledge to examine its association to drinking outcomes. Further, because coping deficits are theorized to lead to drinking through coping motives, we also examined mediated pathways from coping flexibility to alcohol outcomes via coping motives. Methods: College students (N = 528) completed an online assessment. Data were analyzed using path analysis. Control variables included sex and coping styles. Results: In path analytic models, Implementation was negatively associated with alcohol use and, indirectly via coping motives, negatively associated with alcohol consequences. The direct effect on alcohol use remained when controlling for coping styles and sex, but the mediational pathway was no longer significant. Conclusions: This study provides some evidence for the protective role of coping flexibility in alcohol use behavior, which may have implications for how best to address coping skills in alcohol interventions. The direct effect of Implementation on drinking suggests that there may be utility in teaching clients a flexible approach to coping in treatment. Replication, particularly with longitudinal designs, is needed.

The Acquired Preparedness Model of Cannabis Use in Emerging Adulthood: Comparing Within-Person and Between-Person Effects.

OBJECTIVE: The acquired preparedness model (APM) posits that high sensitivity to reward biases individuals to learn and maintain positive outcome expectancies, which in turn increase substance use, and that high sensitivity to punishment biases individuals to learn and maintain negative outcome expectancies, decreasing use. Little work has applied the APM to cannabis use, particularly with longitudinal data and methods that separate within- and between-person associations. The current study addressed these gaps. METHOD: The sample comprised 314 emerging adults (age range: 19.13-21.39 years; 52% female; predominantly non-Hispanic White [76%] or African American [15%]) recruited using random-digit dialing. Data were taken from three annual assessments. Latent curve models with structure residuals were used to distinguish between- and within-person associations. We controlled for bidirectional associations and demographic covariates. RESULTS: At the between-person level, high sensitivity to reward was related to high positive expectancies and high cannabis use. High positive expectancies were associated with high cannabis use. High sensitivity to punishment was related to high negative expectancies and low cannabis use. No within-person associations were supported. CONCLUSIONS: These findings suggest a risk profile for emerging adult cannabis use involving high sensitivity to reward and positive expectancies and a protective profile involving high sensitivity to punishment and negative expectancies. However, our findings did not support the notion that the proposed learning processes unfold within individuals across annual assessments. Most notably, the findings emphasize the importance of disaggregating within- and between-person associations using a longitudinal design to better understand pathways to cannabis use in the developmental period of emerging adulthood.

Testing the dual process model of adolescent cannabis use with prospective three-way interactions between self-regulation, negative outcome expectancies, and implicit cannabis attitudes.

OBJECTIVE: Dual-process models of substance use (Wiers et al., 2007) propose that whether automatic processes (i.e., implicit attitudes) influence use depends on self-regulation, such that an individual is more likely to act in accordance with automatically activated implicit attitudes when there is limited capacity for self-regulation (a two-way interaction). In this model, the relevance of self-regulation likely depends on whether an individual recognizes reasons or the need to inhibit substance use. The current study tested a three-way interaction between implicit cannabis attitudes, self-regulation, and negative expectancies to prospectively predict adolescent cannabis use. METHOD: A community sample of late adolescents (N = 246; M age = 19.02) were assessed across two annual time points. Negative binomial regressions predicting adolescent cannabis use were estimated to test the proposed interaction using two indictors of self-regulation (effortful control and working memory) above and beyond prior cannabis use and demographic covariates. RESULTS: There was support for a three-way interaction with effortful control, but not working memory. As hypothesized, implicit cannabis attitudes were positively associated with cannabis use for adolescents with low levels of negative expectancies and low levels of effortful control. CONCLUSION: Findings suggest expecting negative outcomes of cannabis use is germane to dual process interactions between controlled and automatic processes. How to best operationalize self-regulation is an important consideration for future work.

Learning from drinking experiences in college: A test of reciprocal determinism with drinking refusal self-efficacy.

Problematic drinking is common in college, with many students experiencing a range of detrimental alcohol-related consequences. An understanding of the etiological factors involved in the development and maintenance of this behavior is important, as it would inform intervention efforts. Drinking refusal self-efficacy (DRSE) plays a central role in drinking behavior. Social learning theory's principle of reciprocal determinism suggests that cognitions such as DRSE are not only learned over time from drinking experiences but also impact an individual's subsequent drinking behavior. To date, no study has tested reciprocal determinism in relation to DRSE. Accordingly, in the current study, we examined within-person reciprocal associations between DRSE and drinking experiences (alcohol use and related consequences) in college drinkers during the first year of college (n = 728). Data were drawn from a larger study of trauma, posttraumatic stress, and substance use in young adulthood. Data were analyzed using a random intercept cross-lagged panel model to disaggregate between-person and within-person effects. At the between-person level, DRSE was negatively associated with both alcohol use and alcohol-related consequences. Furthermore, DRSE exhibited significant negative prospective within-person associations with alcohol-related consequences but not with alcohol consumption. Both alcohol consumption and alcohol-related consequences exhibited significant negative prospective within-person associations with DRSE. As such, findings support reciprocal determinism between alcohol-related consequences and DRSE. These findings have several clinical implications, as they point to a risky learning process that could be targeted in treatment or in prevention programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Does Cannabis Use Predict More Severe Types of Alcohol Consequences? Longitudinal Associations in a 3-Year Study of College Students.

BACKGROUND: Prior research shows that negative drinking outcomes among young adults may be exacerbated by cannabis use. However, to date, there have been few longitudinal studies of associations between cannabis use and negative alcohol-related consequences. This study examined longitudinal within-person associations between cannabis use and several domains of negative alcohol consequences among young adults and explored the moderating role of sex. METHOD: We analyzed data from N = 997 students assessed 4 times per year over the first 3 years of university. At each time point, participants completed measures of past-month cannabis use frequency, typical weekly number of drinks, and 8 domains of negative alcohol consequences. Longitudinal associations were examined in multilevel models. RESULTS: Within-person changes in frequency of cannabis use were not uniquely associated with changes in total alcohol consequences aggregated across several alcohol consequence domains. However, when examining alcohol consequence domains separately, within-person increases in cannabis use frequency were specifically associated with increases in some (but not all) of the more severe types of alcohol consequences, including risky behaviors, poor self-care, and alcohol dependence symptoms. No support was observed for the moderating role of sex in the longitudinal within-person associations between cannabis use and alcohol consequence domains. CONCLUSIONS: Findings suggest that within-person changes in cannabis use frequency among young adults are associated with corresponding changes in some domains of alcohol consequences (but not others) when examined over the course of several years. Results may inform targeted harm reduction interventions for young adult drinkers who use cannabis, although future research is needed to clarify the mechanisms of the observed associations.

Distress-Related Internalizing Symptoms Interact With Externalizing Symptoms to Predict Alcohol Problems in an Inpatient Adolescent Sample.

BACKGROUND AND OBJECTIVES: Previous research has yielded equivocal findings regarding whether internalizing symptoms are risk factors for adolescent hazardous alcohol use (AU), specifically in the presence of externalizing symptoms. This may be due to the type of internalizing symptoms examined (ie, distress vs fear), and the use of primarily normative rather than clinical samples. Thus, we tested internalizing and externalizing symptom interactions as they relate to adolescent hazardous AU in a high-risk, clinical sample of adolescents. METHODS: Adolescents (N = 101; 66% female; Mage = 15) were recruited from an inpatient psychiatric unit and assessed for current symptoms. Hypotheses were tested by running a series of moderation models regressing hazardous AU on a set of internalizing symptoms (ie, depression, generalized anxiety disorder [GAD], social anxiety, separation anxiety, school avoidance, and panic), each interacting with externalizing symptoms. RESULTS: We observed significant interactions between several internalizing symptoms (depression, GAD, and panic symptoms) and externalizing symptoms predicting hazardous AU. These internalizing symptoms were unrelated to AU at low and average levels of externalizing symptoms, but were positively related to AU at high levels of externalizing symptoms. DISCUSSION AND CONCLUSIONS: In this clinical sample, distress-related internalizing symptomatology was associated with risk for, and not protection against, hazardous AU, but only when accompanied by high externalizing symptoms. SCIENTIFIC SIGNIFICANCE: Findings suggest that whether or not internalizing symptoms operate synergistically with externalizing symptoms to predict hazardous AU depends on the subdomain of internalizing symptoms (distress vs fear) and perhaps the type of sample (ie, clinical vs community). (Am J Addict 2019:00:00-00).

Improving the global identification of bipolar spectrum disorders: Meta-analysis of the diagnostic accuracy of checklists.

Shifting definitions and differences in the conceptualization of bipolar disorders have contributed to long diagnostic delays, poor reliability, and inconsistent findings. Rating scales are independent of clinical judgment and offer a reliable way to assess manic symptoms, making them good tools to improve both clinical and research diagnoses of bipolar disorder. However, there are dozens of candidates, with few obvious distinguishing characteristics, making it difficult to select one. Our goal was to metaanalyze the diagnostic accuracy of rating scales designed to identify [hypo]manic symptoms. Additionally, we explored potential moderator variables including global region, translation into a different language, and sample composition. Nearly 4000 articles were identified with searches in PubMed and PsycINFO, yielding 127 effect sizes from 103 studies that met the following inclusion criteria: (a) statistics reported by which a standardized effect size could be calculated, (b) participants age 18 + years, (c) reference diagnoses made by semistructured/structured diagnostic interview, (d) results published in English. Multivariate mixed regression models accounted for multiple effect sizes nested within sample. One hundred twenty-seven effect sizes across 14 rating scales were evaluated. There was significant heterogeneity across effect sizes; Cochran's Q(126 df) = 1622.08, p < .00005, and substantial variance components both within (σ2 = .057) and between samples (σ2 = .253). Four measures performed similarly well and significantly better than some competitors after controlling for design and reporting features. The best rating scales offer an inexpensive, efficient way to improve research and clinical diagnostic processes across diverse populations, and could also complement formal diagnoses for examining secular and cultural trends. (PsycINFO Database Record

Grateful parents raising grateful children: Niche selection and the socialization of child gratitude.

Given that children's exposure to gratitude-related activities may be one way that parents can socialize gratitude in their children, we examined whether parents' niche selection (i.e., tendency to choose perceived gratitude-inducing activities for their children) mediates the association between parents' reports of their own and their children's gratitude. Parent-child dyads (N =101; children aged 6-9; 52% girls; 80% Caucasian; 85% mothers) participated in a laboratory visit and parents also completed a seven-day online diary regarding children's gratitude. Decomposing specific indirect effects within a structural equation model, we found that parents high in gratitude were more likely to set goals to use niche selection as a gratitude socialization strategy, and thereby more likely to place their children in gratitude-related activities. Placement in these activities, in turn, was associated with more frequent expression of gratitude in children. We describe future directions for research on parents' role in socializing gratitude in their children.