Estimating classification consistency of machine learning models for screening measures.

This article illustrates novel quantitative methods to estimate classification consistency in machine learning models used for screening measures. Screening measures are used in psychology and medicine to classify individuals into diagnostic classifications. In addition to achieving high accuracy, it is ideal for the screening process to have high classification consistency, which means that respondents would be classified into the same group every time if the assessment was repeated. Although machine learning models are increasingly being used to predict a screening classification based on individual item responses, methods to describe the classification consistency of machine learning models have not yet been developed. This article addresses this gap by describing methods to estimate classification inconsistency in machine learning models arising from two different sources: sampling error during model fitting and measurement error in the item responses. These methods use data resampling techniques such as the bootstrap and Monte Carlo sampling. These methods are illustrated using three empirical examples predicting a health condition/diagnosis from item responses. R code is provided to facilitate the implementation of the methods. This article highlights the importance of considering classification consistency alongside accuracy when studying screening measures and provides the tools and guidance necessary for applied researchers to obtain classification consistency indices in their machine learning research on diagnostic assessments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Stimulant Medication on the Relation Between Working Memory and Activity Level in ADHD.

There is a positive association between heightened activity levels and improved working memory performance (WM) in individuals with Attention-Deficit/Hyperactivity Disorder (ADHD). Recent research suggests that stimulant medications may have a simultaneous positive impact on WM and motor skills. Yet, it is unclear the specific connection between movement, WM, and stimulant use. We examined how visuospatial (VS) and phonological (PH) WM performance varied with children's stimulant medication usage and naturally occurring activity level. In a repeated measures design, children with ADHD (n = 43; 7-12 years old) completed WM tasks while wearing actigraphy watches to monitor activity level on and off stimulant medication. Significant large sized main effects were observed for medication condition on PH (p < .05, ηp2 = .14) and VS (p < .001, ηp2 = .30) WM. Activity level also had significant medium sized main effects on PH (p < .01, ηp2 = .09) and VS (p < .005, ηp2 = .10) WM. There was a significant medium sized interaction for VS WM (p < .005, ηp2 = .11), indicating that the effect of medication on performance was greatest in the highest activity level category. The findings suggest that a combination of stimulant medication and an "optimal" level of movement may be most effective for improving VS WM.

What is Parental Monitoring?

Parental monitoring is a construct of longstanding interest in multiple fields-but what is it? This paper makes two contributions to the ongoing debate. First, we review how the published literature has defined and operationalized parental monitoring. We show that the monitoring construct has often been defined in an indirect and nonspecific fashion and measured using instruments that vary widely in conceptual content. The result has been a disjointed empirical literature that cannot accurately be described as the unified study of a single construct nor is achieving a cumulative scientific character. Second, we offer a new formulation of the monitoring construct intended to remedy this situation. We define parental monitoring as the set of all behaviors performed by caregivers with the goal of acquiring information about the youth's activities and life. We introduce a taxonomy identifying 5 distinct types of monitoring behaviors (Types 1-5), with each behavior varying along five dimensions (performer, target, frequency, context, style). We distinguish parental monitoring from 16 other parenting constructs it is often conflated with and position monitoring as one element within the broader parent-youth monitoring process: the continuous, dyadic interplay between caregivers and youth as they navigate caregivers attempts' to monitor youth. By offering an explicit and detailed conceptualization of monitoring, we aim to foster more rigorous and impactful research in this area.

Reconceptualizing the approach to supporting students with attention-deficit/hyperactivity disorder in school settings.

The long-term academic outcomes for many students with attention-deficit/hyperactivity disorder (ADHD) are strikingly poor. It has been decades since students with ADHD were specifically recognized as eligible for special education through the Other Health Impaired category under the Education for all Handicapped Children Act of 1975, and similarly, eligible for academic accommodations through Section 504 of the 1973 Rehabilitation Act. It is time to acknowledge that these school-policies have been insufficient for supporting the academic, social, and behavioral outcomes for students with ADHD. Numerous reasons for the unsuccessful outcomes include a lack of evidence-based interventions embedded into school approaches, minimizing the importance of the general education setting for promoting effective behavioral supports, and an over-reliance on assessment and classification at the expense of intervention. Contemporary behavioral support approaches in schools are situated in multi-tiered systems of support (MTSS); within this article we argue that forward-looking school policies should situate ADHD screening, intervention, and maintenance of interventions within MTSS in general education settings and reserve special education eligibility solely for students who require more intensive intervention. An initial model of intervention is presented for addressing ADHD within schools in a manner that should provide stronger interventions, more quickly, and therefore more effectively.

A Comparison of Remote Versus in-Person Assessments of Substance Use and Related Constructs Among Adolescents.

Objective: Underreporting of adolescent substance use is a known issue, with format of assessment (in-person vs. remote) a potentially important factor. We investigate whether being assessed remotely (via phone or videoconference) versus in-person affects youth report of substance use patterns, attitudes, and access, hypothesizing remote visits would garner higher levels of substance use reporting and more positive substance use attitudes. Methods: We used the Adolescent Brain and Cognitive DevelopmentSM [ABCD] Study data between 2021-2022 during the COVID-19 pandemic. Participants chose whether to complete assessments in-person (n=615; 49% female; meanage=13.9; 57% White) or remotely (n=1,467; 49% female, meanage=13.7; 49% White). Regressions predicted substance use patterns, attitudes, and access, by visit format, controlling for relevant sociodemographic factors. Effect sizes and standardized mean differences are presented. Results: 17% of adolescent participants reported any level of substance use. Youth interviewed remotely reported more negative expectancies of alcohol and cannabis. In addition, those queried remotely were less likely to endorse use), sipping alcohol, eating cannabis), and reported less curiosity or intent to try alcohol, though these differences did not survive an adjustment for multiple testing. Effect sizes ranged from small to medium. Conclusions: Preliminary evidence suggests youth completing remote visits were more likely to disclose negative expectancies toward alcohol and cannabis. Effect sizes were modest, though 37 of 39 variables examined trended toward restricted reporting during remote sessions. Thus, format of substance use assessment should be controlled for, but balanced by other study needs (e.g., increasing accessibility of research to all sociodemographic groups).

Do traumatic events and substance use co-occur during adolescence? Testing three causal etiologic hypotheses.

BACKGROUND: Why do potentially traumatic events (PTEs) and substance use (SU) so commonly co-occur during adolescence? Causal hypotheses developed from the study of posttraumatic stress disorder (PTSD) and substance use disorder (SUD) among adults have not yet been subject to rigorous theoretical analysis or empirical tests among adolescents with the precursors to these disorders: PTEs and SU. Establishing causality demands accounting for various factors (e.g. genetics, parent education, race/ethnicity) that distinguish youth endorsing PTEs and SU from those who do not, a step often overlooked in previous research. METHODS: We leveraged nationwide data from a sociodemographically diverse sample of youth (N = 11,468) in the Adolescent Brain and Cognitive Development Study. PTEs and substance use prevalence were assessed annually. To account for the many pre-existing differences between youth with and without PTE/SU (i.e. confounding bias) and provide rigorous tests of causal hypotheses, we linked within-person changes in PTEs and SU (alcohol, cannabis, nicotine) across repeated measurements and adjusted for time-varying factors (e.g. age, internalizing symptoms, externalizing symptoms, and friends' use of substances). RESULTS: Before adjusting for confounding using within-person modeling, PTEs and SU exhibited significant concurrent associations (ßs = .46-1.26, ps < .05) and PTEs prospectively predicted greater SU (ßs = .55-1.43, ps < .05) but not vice versa. After adjustment for confounding, the PTEs exhibited significant concurrent associations for alcohol (ßs = .14-.23, ps < .05) and nicotine (ßs = .16, ps < .05) but not cannabis (ßs = -.01, ps > .05) and PTEs prospectively predicted greater SU (ßs = .28-.55, ps > .05) but not vice versa. CONCLUSIONS: When tested rigorously in a nationwide sample of adolescents, we find support for a model in which PTEs are followed by SU but not for a model in which SU is followed by PTEs. Explanations for why PTSD and SUD co-occur in adults may need further theoretical analysis and adaptation before extension to adolescents.

How Do Anger and Impulsivity Impact Fast-Food Consumption in Transitional Age Youth?

Introduction: Consumption of fast food has been linked to psychiatric distress, violent behaviors, and impulsivity in adolescents. The relationship between eating fast food, anger, and impulsivity has not been widely investigated. The National Consortium on Alcohol and Neurodevelopment in Adolescence community-based cohort consists of 831 youth, half at elevated risk factors for substance use disorders during adolescence, followed annually. Methods: Impulsivity using Urgency, Premeditation, Perseverance, and Sensation Seeking Impulsive Behavior scale from annual assessments was examined in relation to self-reported fast-food consumption frequency and mobile application questions of anger. This study tested the hypotheses that youth anger may be predicted by fast-food consumption frequency and impulsivity using multiple regression, in addition to whether adolescent fast-food consumption frequency may be predicted by anger and impulsivity. Results: Among youth, higher anger levels and impulsivity predicted greater frequency of fast-food consumption, and greater fast-food consumption frequency and impulsivity predicted higher anger levels. Conclusions: This study's longitudinal findings are consistent with those of other studies that have found fast-food consumption and anger associated with impulsivity and also reveal a bidirectional link between anger and fast-food consumption. These results may point attention to food selection considerations for those at risk of anger and poorer psychiatric outcomes.

William E. Pelham Jr. (1948-2023).

William ("Bill") E. Pelham Jr. was a renowned clinical child psychologist who specialized in the assessment and treatment of children with attention-deficit/hyperactivity disorder (ADHD). Bill was born in 1948 in Atlanta, Georgia, to William E. Pelham Sr. and Kittie Copeland Kay, the eldest of four brothers. Bill is most well-known for the development, study, and advocacy of psychosocial treatments for children with ADHD. While at Florida State University in the 1980s, he developed a comprehensive summer treatment program designed to improve family and classroom functioning, strengthen peer relationships, and boost academic achievement. Bill built the case for the behavioral treatment of ADHD over nearly 50 years of programmatic research. Bill was a leader in the field of clinical child psychology. Bill passed away on October 21, 2023, after a brief illness. He is survived by his wife of 33 years Maureen, son William E. Pelham III, and daughter Caroline. His legacy will live on in their work to support children with ADHD and their families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The role of perceived parent drinking motives on alcohol use among adolescents with and without childhood attention-deficit/hyperactivity disorder.

OBJECTIVE: Parent history of alcohol-related problems and antisocial behaviors contribute to adolescent alcohol use and are associated with offspring attention-deficit/hyperactivity disorder (ADHD). Youth with ADHD may be susceptible to intergenerational transmission of alcohol-related cognitions, which may model drinking motives that enhance risk for adolescent alcohol use. We examined whether childhood ADHD and parent history of alcohol use disorder, with or without antisociality, were associated with adolescents' perceptions of their parents' drinking motives and whether these perceptions predicted their alcohol use behaviors. METHOD: Adolescents (N = 199; 56% with ADHD; Mage = 15.73) completed the Drinking Motives Questionnaire regarding perceptions of their parents' drinking motives. Participants subsequently reported their past-year alcohol use behaviors (Mage = 16.95). Parents reported their history of alcohol-related problems and antisocial symptoms. Covariates included adolescent gender (7% girls), race (9% self-identified Black), and parental education and marital status. RESULTS: Perceived parent drinking motives were highest for social and lowest for conformity motives, consistent with adult self-reports in the literature. Parent alcohol use and antisociality history predicted perceptions of parent drinking motives, and child ADHD only predicted perceptions of parent social drinking motives. Perceived parent drinking motives predicted adolescent alcohol use, but only among youth without ADHD. CONCLUSION: Findings reflect the potential importance of assessing adolescent perceptions of parent drinking motives for adolescents without ADHD and a possible need for supporting parents in communicating about their own alcohol use. Future research should consider alternative strategies (e.g., assessing implicit cognitions) for studying the link between alcohol-related cognitions and behaviors for adolescents with ADHD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How Does Parental Monitoring Reduce Adolescent Substance Use? Preliminary Tests of Two Potential Mechanisms.

OBJECTIVE: The purpose of this study was to test two non-exclusive mechanisms by which parental monitoring might reduce teen substance use. The first mechanism (M1) is that monitoring increases punishment for substance use since parents who monitor more are more likely to find out when substance use occurs. The second mechanism (M2) is that monitoring directly prevents/averts teens from using substances in the first place for fear that parents would find out. METHOD: A total of 4,503 teens ages 11-15 years old in 21 communities across the United States completed a survey reporting on parents' monitoring/knowledge and teens' substance use. RESULTS: We found no support for M1: Parents with greater parental monitoring were not more likely to be aware when the teen had used substances (odds ratios = 0.79-0.93, ps = .34-.85), so they could not have increased the rate of punishment. We found support for M2: When asked directly, teens identified instances in which they planned to or had a chance to use substances but did not because their parents got in the way or would have found out (p < .01). Had all those opportunities for substance use occurred rather than been averted by parents, the prevalence of substance use in the sample would have been 1.4 times higher. CONCLUSIONS: In this community-based sample of teens, we failed to support prior punishment-centric theories of how monitoring might reduce teen substance use. Rather, monitoring may directly discourage teens from using substances regardless of whether it increases parents' awareness of substance use or results in more punishment. Replication in other samples and contexts is needed.

Single and Combined Effects of Multiple Intensities of Behavioral Modification and Methylphenidate for Children with ADHD in the Home Setting.

Behavioral treatment, stimulants, and their combination are the recommended treatments for childhood attention-deficit/hyperactivity disorder (ADHD). The current study utilizes within-subjects manipulations of multiple doses of methylphenidate (placebo, 0.15, 0.30, and 0.60 mg/kg/dose t.i.d.) and intensities of behavioral modification (no, low, and high intensity) in the summer treatment program (STP) and home settings. Outcomes are evaluated in the home setting. Participants were 153 children (ages 5-12) diagnosed with ADHD. In alignment with experimental conditions implemented during the STP day, parents implemented behavioral modification levels in three-week intervals, child medication status varied daily, and the orders were randomized. Parents provided daily reports of child behavior, impairment, and symptoms and self-reported parenting stress and self-efficacy. At the end of the study, parents reported treatment preferences. Stimulant medication led to significant improvements across all outcome variables with higher doses resulting in greater improvement. Behavioral treatment significantly improved child individualized goal attainment, symptoms, and impairment in the home setting and parenting stress and self-efficacy. Effect sizes indicate that behavioral treatment combined with a low-medium dose (0.15 or 0.30 mg/kg/dose) of medication results in equivalent or superior outcomes compared to a higher dose (0.60 mg/kg/dose) of medication alone. This pattern was seen across outcomes. Parents overwhelmingly reported preferring treatment with a behavioral component as a first-choice treatment (99%). Results underscore the need to consider dosing as well as parent preference when utilizing combined treatment approaches. This study provides further evidence that combining behavioral treatment and stimulant medication may reduce the stimulant dose needed for beneficial effects.

Do Language-Related Cognitive Capacities Help Predict Adjustment in Children with Attention-Deficit/Hyperactivity Disorder?

The goal of this paper was to examine the role that language-related cognitive capacities (LRCC) might play in explaining adjustment of 7 to 12 year-old children (Mage = 9.24; SDage = 0.91) with and without ADHD. The sample was comprised of 178 children with ADHD and 86 typically-developing children (77.3% male; 81.4% White; 9.5% Black; 1.9% Hispanic; 0.8% Asian; 5.7% multiracial; 0.8% did not report race/ethnicity). Using simultaneous regression, we examined whether LRCC accounted for unique variance in achievement, attention problems, oppositional problems, conduct problems, and internalizing, over and above what standard covariates and ADHD diagnostic status could explain. Finally, we examined LRCC as a mediator of the relation between ADHD diagnostic status and these adjustment measures. Results indicated that LRCC significantly predicted 6 of 7 and partially mediated 5 of 7 measures, suggesting that language-related constructs warrant greater attention in diagnosis and treatment of ADHD.

Pandemic-Related Changes in the Prevalence of Early Adolescent Alcohol and Drug Use, 2020-2021: Data From a Multisite Cohort Study.

PURPOSE: Evaluate changes in early adolescent substance use from May 2020 to May 2021 during the coronavirus disease 2019 pandemic using data from a prospective nationwide cohort: the Adolescent Brain Cognitive Development Study. METHODS: In 2018-2019, 9,270 youth aged 11.5-13.0 completed a prepandemic assessment of past-month alcohol and drug use, then up to seven during-pandemic assessments between May 2020 and May 2021. We compared the prevalence of substance use among same-age youth across these eight timepoints. RESULTS: Pandemic-related decreases in the past-month prevalence of alcohol use were detectable in May 2020, grew larger over time, and remained substantial in May 2021 (0.3% vs. 3.2% prepandemic, p <.001). Pandemic-related increases in inhalant use (p = .04) and prescription drug misuse (p < .001) were detectable in May 2020, shrunk over time, and were smaller but still detectable in May 2021(0.1%-0.2% vs. 0% pre-pandemic). Pandemic-related increases in nicotine use were detectable between May 2020 and March 2021 and no longer significantly different from prepandemic levels in May 2021 (0.5% vs. 0.2% prepandemic, p = .09). There was significant heterogeneity in pandemic-related change in substance use at some timepoints, with increased rates among youth identified as Black or Hispanic or in lower-income families versus stable or decreased rates among youth identified as White or in higher-income families. DISCUSSION: Among youth ages 11.5-13.0 years old, rates of alcohol use remained dramatically reduced in May 2021 relative to prepandemic and rates of prescription drug misuse and inhalant use remained modestly increased. Differences remained despite the partial restoration of prepandemic life, raising questions about whether youth who spent early adolescence under pandemic conditions may exhibit persistently different patterns of substance use.

Prospective associations between cannabis use and depressive symptoms across adolescence and early adulthood.

Cannabis use and occurrences of depression during adolescence are common. However, the temporal relationship between the two is less understood. Does depression lead to cannabis use, or does cannabis use lead to depression, or is it a combination of both? Furthermore, this directionality is confounded by other substance use, specifically binge drinking, which is common during adolescence. This study aimed to examine the temporal directionality of cannabis use and depression among a prospective, longitudinal, sequential cohort of 15 to 24-year-olds. Data were drawn from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. The final sample included 767 participants. Multilevel regression models were run to assess concurrent (at the same time point) and prospective (1 year later) associations between cannabis use and depression. When measured concurrently, depressive symptoms did not significantly predict past-month cannabis use but did significantly predict more days of use among cannabis users. Prospective associations indicated that depressive symptoms significantly predicted cannabis use 1 year later and cannabis use significantly predicted depressive symptoms 1 year later. We found no evidence that these associations varied by age or binge drinking. Overall, the relationship between cannabis use and depression appears to be complex and not unidirectional.

Effects of the COVID-19 pandemic on screen time and sleep in early adolescents.

OBJECTIVE: During the COVID-19 pandemic, adolescents and families have turned to online activities and social platforms more than ever to maintain well-being, connect remotely with friends and family, and online schooling. However, excessive screen use can have negative effects on health (e.g., sleep). This study examined changes in sleep habits and recreational screen time (social media, video gaming), and their relationship, before and across the first year of the pandemic in adolescents in the Adolescent Brain Cognitive Development (ABCD) Study. METHOD: Mixed-effect models were used to examine associations between self-reported sleep and screen time using longitudinal data of 5,027 adolescents in the ABCD Study, assessed before the pandemic (10-13 years) and across six time points between May 2020 and March 2021 (pandemic). RESULTS: Time in bed varied, being higher during May-August 2020 relative to pre-pandemic, partially related to the school summer break, before declining in October 2020 to levels lower than pre-pandemic. Screen time steeply increased and remained high across all pandemic time points relative to pre-pandemic. Higher social media use and video gaming were associated with shorter time in bed, later bedtimes, and longer sleep onset latency. CONCLUSIONS: Sleep behavior and screen time changed during the pandemic in early adolescents. More screen time was associated with poorer sleep behavior, before and during the pandemic. While recreational screen usage is an integral component of adolescent's activities, especially during the pandemic, excessive use can have negative effects on essential health behaviors, highlighting the need to promote balanced screen usage. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Concordance between substance use self-report and hair analysis in community-based adolescents.

Background: Accurate drug use identification through subjective self-report and toxicological biosample (hair) analysis are necessary to determine substance use sequelae in youth. Yet consistency between self-reported substance use and robust, toxicological analysis in a large sample of youth is understudied.Objectives: We aim to assess concordance between self-reported substance use and hair toxicological analysis in community-based adolescents.Methods: Hair results by LC-MS/MS and GC-MS/MS and self-reported past-year substance use from an Adolescent Brain Cognitive Development (ABCD) Study subsample (N = 1,390; ages 9-13; 48% female) were compared. The participants were selected for hair selection through two methods: high scores on a substance risk algorithm selected 93%; 7% were low-risk, randomly selected participants. Kappa coefficients the examined concordance between self-report and hair results.Results: 10% of youth self-reported any past-year substance use (e.g. alcohol, cannabis, nicotine, and opiates), while a mostly non-overlapping 10% had hair results indicating recent substance use (cannabis, alcohol, non-prescription amphetamines, cocaine, nicotine, opiates, and fentanyl). In randomly selected low-risk cases, 7% were confirmed positive in hair. Combining methods, 19% of the sample self-reported substance use and/or had a positive hair sample. Kappa coefficient of concordance between self-report and hair results was low (kappa = 0.07; p = .007).Conclusions: Hair toxicology identified substance use in high-risk and low-risk ABCD cohort subsamples. Given low concordance between hair results and self-report, reliance on either method alone would incorrectly categorize 9% as non-users. Multiple methods for characterizing substance use history in youth improves accuracy. Larger representative samples are needed to assess the prevalence of substance use in youth.

Family Well-Being During the COVID-19 Pandemic: The Risks of Financial Insecurity and Coping.

During the COVID-19 pandemic, families have experienced unprecedented financial and social disruptions. We studied the impact of preexisting psychosocial factors and pandemic-related financial and social disruptions in relation to family well-being among N = 4091 adolescents and parents during early summer 2020, participating in the Adolescent Brain Cognitive DevelopmentSM Study. Poorer family well-being was linked to prepandemic psychosocial and financial adversity and was associated with pandemic-related material hardship and social disruptions to routines. Parental alcohol use increased risk for worsening of family relationships, while a greater endorsement of coping strategies was mainly associated with overall better family well-being. Financial and mental health support may be critical for family well-being during and after a widespread crisis, such as the COVID-19 pandemic.

How Accurate and Consistent Are Score-Based Assessment Decisions? A Procedure Using the Linear Factor Model.

When scales or tests are used to make decisions about individuals (e.g., to identify which adults should be assessed for psychiatric disorders), it is crucial that these decisions be accurate and consistent. However, it is not obvious how to assess accuracy and consistency when the scale was administered only once to a given sample and the true condition based on the latent variable is unknown. This article describes a method based on the linear factor model for evaluating the accuracy and consistency of scale-based decisions using data from a single administration of the scale. We illustrate the procedure and provide R code that investigators can use to apply the method in their own data. Finally, in a simulation study, we evaluate how the method performs when applied to discrete (vs. continuous) items, a practice that is common in published literature. The results suggest that the method is generally robust when applied to discrete items.

Parental knowledge/monitoring and adolescent substance use: A causal relationship?

OBJECTIVE: Many studies have shown that parental knowledge/monitoring is correlated with adolescent substance use, but the association may be confounded by the many preexisting differences between families with low versus high monitoring. We attempted to produce more rigorous evidence for a causal relation using a longitudinal design that took advantage of within-family fluctuations in knowledge/monitoring during the COVID-19 pandemic. METHOD: Youth (N = 8,780, age range = 10.5-15.6 years) at 21 sites across the United States completed up to seven surveys over 12 months. Youth reported on their parents' knowledge/monitoring of their activities and their substance use in the past month. Regressions were fit to within-family changes in youth-perceived knowledge/monitoring and substance use between survey waves. By analyzing within-family changes over time, we controlled for all stable, a priori differences that exist between families with low versus high levels of youth-perceived knowledge/monitoring. RESULTS: Youth initially denying substance use were significantly more likely to start reporting use when they experienced a decrease in the level of perceived knowledge/monitoring (relative risk [RR] = 1.18, p < .001). Youth initially endorsing substance use were significantly more likely to stop reporting use when they experienced an increase in the level of perceived knowledge/monitoring (RR = 1.06; p < .001). Associations were similar or larger when adjusting for several time-varying potential confounders. CONCLUSION: In a large, sociodemographically diverse sample, within-family changes in youth-perceived parental knowledge/monitoring over time were robustly associated with changes in youths' engagement in substance use. Findings lend support to the hypothesis that parent knowledge/monitoring is causally related to substance involvement in early adolescence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Location matters: Regional variation in association of community burden of COVID-19 with caregiver and youth worry.

Our study characterized associations between three indicators of COVID-19's community-level impact in 20 geographically diverse metropolitan regions and how worried youth and their caregivers in the Adolescent Brain Cognitive Development℠ Study have been about COVID-19. County-level COVID-19 case/death rates and monthly unemployment rates were geocoded to participants' addresses. Caregivers' (vs. youths') COVID-19-related worry was more strongly associated with COVID-19's community impact, independent of sociodemographics and pre-pandemic anxiety levels, with these associations varying by location. Public-health agencies and healthcare providers should avoid adopting uniform "one-size-fits-all" approaches to addressing COVID-19-related emotional distress and must consider specific communities' needs, challenges, and strengths.