Background
Depression, anxiety, and alcohol misuse predict adverse social, academic, and emotional outcomes, and their relations to one another increase during adolescence—particularly in girls. ...However, evidence on the directions of these relations is mixed. Longitudinal models of internalizing problem–alcohol use links may identify promising prevention targets. Accordingly, we examined reciprocal associations between anxiety severity and alcohol use, as well as between depression severity and alcohol use, in adolescent girls.
Methods
Data were drawn from a population‐based longitudinal study of female adolescents. The current sample comprised 2,100 participants (57.1% Black, 42.9% White) assessed annually between ages 13 and 17. Girls self‐reported depression severity, anxiety severity, and frequency of alcohol use (consumption of ≥1 full drink) in the past year. Primary caregivers reported on socioeconomic and neighborhood factors; these were included with race, early puberty, and conduct problems (youth‐report) as covariates. Anxiety and depression severity were included within a single cross‐lagged panel model, along with alcohol use, to isolate their independent and reciprocal links to drinking behavior.
Results
Higher depression severity modestly predicted increased likelihood of subsequent alcohol use from ages 13 to 17. However, inconsistent relations emerged for the reverse pathway: Alcohol use modestly predicted decreased depression severity at ages 14 and 16; associations were nonsignificant in other lagged associations. Anxiety severity and alcohol use were not consistently associated.
Conclusions
Results highlight the key role of depression, relative to anxiety, in predicting later alcohol use. Future studies may examine whether depression prevention programs yield secondary reductions in alcohol use in adolescent girls.
•Everyday and major discrimination experiences predict alcohol use in Black adults.•Both types of racial discrimination also independently predict regular smoking.•Risk for alcohol use conferred by ...everyday experiences varies by education level.•Major experiences predict regular smoking in adults under age 45 but not 45–65.
Background: Racial discrimination has consistently been linked to elevated alcohol use and smoking in Black adults, but the independent contributions of everyday and major experiences of discrimination have rarely been investigated. The present study aimed to identify variation in magnitude of the links between each type of racial discrimination with current frequency of alcohol use and regular smoking by demographic characteristics and family history of problem drinking/regular smoking in Black adults in the U.S. Methods: Data were drawn from 4462 adults (29.40% Afro Caribbean, 70.60% African American; 63.20% female) in a nationally representative sample of Black Americans. Logistic regression analyses were conducted to predict current frequency of alcohol use and regular smoking using the Everyday Discrimination Scale (EDS) and Major Experiences of Discrimination Scale (MEDS), testing for interactions with demographic characteristics and family history. Results: In the alcohol model, an EDS by education level interaction was observed: OR = 1.04 (CI:1.02–1.07) for < high school; OR = 0.95 (CI:0.92–0.98) for ≥ high school. MEDS was independently associated with alcohol use (OR = 1.11, CI:1.04–1.18). In the smoking model, EDS was associated with elevated risk (OR = 1.03, CI:1.01–1.04) and a MEDS by age cohort interaction was observed: OR = 1.24 (CI:1.11–1.38) for <age 45; OR = 1.07 (CI:0.97–1.19) for ages 45–65. Conclusions: Everyday and major experiences of racial discrimination contribute independently to both alcohol use and regular smoking in Black adults, with some variation by education level and age. Differentiating everyday from major experiences of discrimination in studies of mechanisms linking racial discrimination to substance use will enhance their informativeness for intervention development.
To characterize gender differences in the prevalence of mental and physical health conditions and evaluate the moderating effect of assaultive trauma on risk for these conditions in a nationally ...representative sample of male and female U.S. veterans.
Cross-sectional data were analyzed from 3157 U.S. veterans from the National Health and Resilience in Veterans Study. Multivariable logistic regression analyses assessed gender differences in health outcomes and evaluated physical and sexual trauma as possible moderators of these outcomes.
Compared to male veterans, female veterans had higher prevalence estimates of lifetime posttraumatic stress (OR=3.33) and lifetime and current major depressive (ORs=2.10 and 2.76, respectively) disorders, and lifetime histories of arthritis, migraine headaches, and osteoporosis (ORs ranging 2.14–9.74), but lower prevalence estimates of lifetime nicotine dependence (OR=0.46), lifetime and current alcohol use (ORs=0.19 and 0.36, respectively) and lifetime drug use (OR=0.39) disorders, and lifetime histories of diabetes, heart attack, and high blood pressure (ORs ranging 0.05–0.49). The elevation in risk associated with physical and sexual assault was greater for males than females for numerous health conditions (but greater for females for posttraumatic stress disorder).
Results provide a comprehensive assessment and characterization of gender differences in mental and physical health conditions and risk conferred by assaultive trauma for certain conditions in U.S. veterans.
•We found substantial gender differences in the prevalence of many health conditions.•Gender differences found are consistent with findings from the general population.•Associations differed by gender and type of trauma on risk for many conditions•Male veterans with sexual assault histories were at increased risk for current MDD.
The current study examines the association of perceived racial and social class discrimination with cannabis involvement among Black youth and young adults.
This secondary analysis used data from the ...Missouri Family Study (MOFAM), a high-risk longitudinal family study of alcohol use disorder, oversampled for Black families. Offspring (n = 806) and their mothers were interviewed by telephone. Cox proportional hazards regression analyzes were used to examine associations of racial and social class discrimination (experienced by offspring and their mothers) with offspring cannabis involvement. Two stages of cannabis involvement were analyzed: timing of 1) initiation and 2) transition from initiation to first cannabis use disorder (CUD) symptom.
The study found that offspring report of experiencing racial (HR: 1.28, CI: 1.01–1.62) and social class discrimination (HR: 1.45, CI: 1.14–1.84) were associated with cannabis initiation in our fully adjusted model. Mothers’ report of discrimination predicted a lower hazard of cannabis initiation among offspring (HR: 0.79, CI: 0.64–0.98). Offspring social class discrimination (HR: 2.45, CI: 1.71–3.51) predicted an increased hazard of transition from initiation to first CUD symptom, while offspring racial discrimination (HR: 0.57, CI: 0.39–0.85) was associated with lower hazard of transition in our fully adjusted model.
As rates for cannabis use among Black youth are disproportionately rising, there is a critical need to identify pathways to its use among Black youth. These findings suggest racial and social class discrimination may be important targets in efforts to prevent cannabis involvement among Black youth and emerging adults.
•Discrimination was examined in relation to two stages of cannabis use among African Americans.•The association between offspring and maternal discrimination with offspring cannabis initiation was explored.•Offspring endorsement of racial and social class discrimination were associated with cannabis initiation.•Offspring endorsement of social class discrimination was associated with a higher risk of transition from iniiation to first CUD symptom.•Maternal experiences of discrimination was a protective factor for cannabis initiation.
Purpose
This longitudinal study aimed to identify variation by race in the associations between religious involvement and initiation of alcohol, cigarette, and marijuana use, including distinctions ...by substance or type of religious involvement, in Black and White adolescent girls.
Methods
Data were drawn from interviews conducted at ages 11 through 17 with 2172 Pittsburgh Girls Study participants (56.8% Black; 43.2% White). Two indicators of public religious involvement, religious service attendance and participation in other religious activities, and two indicators of private religious involvement, prayer, and importance of religion were queried. A series of Cox proportional hazards regression analyses were conducted to identify independent effects of religious involvement indicators on initiation of each substance.
Results
Prior to adjusting for socioenvironmental and psychosocial factors (e.g., parental monitoring), importance of religion predicted initiation of alcohol use across race and cigarette and marijuana use in White but not Black girls. Participation in other religious activities also predicted marijuana use initiation only in White girls. In adjusted models, importance of religion remained significant for cigarette use initiation in White girls (hazard ratio HR = 0.68, 95% confidence intervals CI: 0.53–0.88) and participation in other religious activities remained significant for marijuana use initiation in White girls (HR = 0.63, CI: 0.47–0.83).
Conclusions
The protective effects of religious involvement against cigarette and marijuana use initiation are more robust for White than Black adolescent girls and overall relatively weak for alcohol use initiation. Furthermore, importance placed on religion may be a better indicator than religious service attendance of risk for adolescent substance use initiation.
Abstract Background A number of demographic factors, psychiatric disorders, and childhood risk factors have been associated with cocaine dependence (CD) and opioid dependence (OD), but little is ...known about their relevance to the rate at which dependence develops. Identification of the subpopulations at elevated risk for rapid development of dependence and the risk factors that accelerate the course of dependence is an important public health goal. Methods Data were derived from cocaine dependent ( n = 6333) and opioid dependent ( n = 3513) participants in a multi-site study of substance dependence. Mean age was approximately 40 and 40% of participants were women; 51.9% of cocaine dependent participants and 29.5% of opioid dependent participants self-identified as Black/African–American. The time from first use to dependence was calculated for each substance and a range of demographic, psychiatric, and childhood risk factors were entered into ordinal logistic regression models to predict the (categorical) transition time to CD and OD. Results In both the cocaine and opioid models, conduct disorder and childhood physical abuse predicted rapid development of dependence and alcohol and nicotine dependence diagnoses were associated with slower progression to CD or OD. Blacks/African Americans were at greater risk than European Americans to progress rapidly to OD. Conclusions Only a subset of factors known to be associated with CD and OD predicted the rate at which dependence developed. Nearly all were common to cocaine and opioids, suggesting that sources of influence on the timing of transitions to dependence are shared across the two substances.
Parental divorce/separation is among the most commonly endorsed adverse childhood events. It has been shown to increase subsequent risk of alcohol dependence and problems across adolescence and early ...adulthood, but its influence on early stages of alcohol involvement has only recently been explored. In the present study, we examined whether time to first full drink was accelerated among youth who experienced parental divorce/separation. To determine specificity of risk, models controlled for perceived stress as well as family history of alcoholism, current parental drinking, and internalizing and externalizing problems. Developmental specificity in terms of timing of both parental divorce and first drink was also examined. Participants were 931 middle-school students (488 girls, 443 boys) who were enrolled in a prospective study on drinking initiation and progression (52% female; 23% non-White, 11% Hispanic). Students indicated whether and at what age they had consumed a full drink of alcohol. Parental divorce/separation was coded from a parent-reported life-events inventory and was grouped based on age experienced (ages 0-5, ages 6-9, age 10+). Cox proportional hazard models showed increased risk for onset of drinking as a function of divorce/separation, even controlling for stress, parental alcohol involvement, and psychopathology. There was no evidence for developmental specificity of the divorce/separation effect based on when it occurred nor in timing of first drink. However, the effect of parental divorce/separation on initiation was magnified at higher levels of parental drinking. Given the rates of parental divorce/separation and its association with increased risk of early drinking, investigation of the mechanisms underlying this link is clearly warranted.
Characterizing variations in the timing of alcohol, cigarette, and cannabis use onset both among and between Black and White youth can inform targeted prevention. The current study aimed to capture ...cross-substance initiation patterns in Black and White girls and characterize these patterns with respect to substance use related socioeconomic, neighborhood, family, community, and individual level factors. Data were drawn from interviews conducted at ages 8 through 17 in an urban sample of girls (n = 2172; 56.86% Black, 43.14% White). Discrete-time multiple event process survival mixture modeling was used to identify patterns (i.e., classes) representing timing of alcohol, cigarette, and cannabis use initiation, separately by race. Class characteristics were compared using multinomial logistic regression. Among both Black and White girls, four classes, including abstainer and cross-substance early onset classes, emerged. Two classes characterized by mid-adolescence onset (Black girls) and variation in onset by substance (White girls) were also observed. Class differences centered around cannabis for Black girls (e.g., preceding or following cigarette use) and alcohol for White girls (e.g., (in)consistency over time in greater likelihood of initiation relative to cigarette and cannabis use). Several factors distinguishing the classes were common across race (e.g., externalizing behaviors, friends' cannabis use); some were specific to Black girls (e.g., intentions to smoke cigarettes) or White girls (e.g., primary caregiver problem drinking). Findings underscore the need to recognize a more complex picture than a high-risk/low-risk dichotomy for substance use initiation and to attend to nuanced differences in markers of risky onset pathways between Black and White girls.
•Alcohol, cigarette, and cannabis use onset were examined in Black and White girls.•Modeling separately by race revealed four classes each for Black and White girls.•Abstainer and cross-substance early onset classes were observed in both groups.•Among Black girls only, two onset patterns involved cannabis before cigarette use.•Friends' cannabis use, externalizing, and depression distinguished classes.
Background: Religious involvement is a well-documented protective factor against alcohol use among Black adults, but the extent to which social connections to the religious community can explain ...those effects remains largely unknown. The current study was designed to capture contributions of religious community support and demands - independent of religious service attendance - to alcohol use among three age cohorts of Black adults. Methods: Data were drawn from 18- to 65-year-old Black participants in the National Survey of American Life (n = 4,462; 29.4% Afro Caribbean, 70.6% African American; 63.20% female). Ordinal logistic regression analyses, conducted separately for each age cohort (18-29, 30-44, and 45-65), were used to model frequency of alcohol use as a function of religious community support and demands in two stages: (1) prior to and (2) after accounting for religious service attendance. Results: Religious community support accounted for differences in alcohol use frequency over and above religious service attendance (in Stage 2 models) for adults aged 30-44 (OR = 0.85, CI: 0.74-0.96) and 45-65 (OR = 0.77, CI: 0.64-0.93) but not 18-29 (OR = 0.85, CI: 0.71-1.03). The association of religious community demands with alcohol use frequency was specific to the age 30-44 cohort in both stage models (Stage 2: OR = 1.33, CI: 1.06-1.68). Conclusions: Study findings suggest that in addition to attending religious services regularly, developing supportive social connections to the religious community may reduce risk for frequent drinking among Black adults, particularly during middle adulthood, when demands from the religious community may increase risk.
•The settings and social contexts of young adult cannabis use are understudied.•We assessed them separately for vaping and smoking over a six-week period.•The most common settings and social contexts ...were the same for vaping as smoking.•They were: home, friend’s home, and car; friends, significant other, and alone.•However, a lower proportion of vaping than smoking occurred at home.
Vaping is an increasingly common mode of cannabis use among young adults. Despite potential to inform targeted prevention, settings and social contexts where young adults vape and/or smoke cannabis have rarely been investigated. We addressed this question in a diverse young adult sample.
Data were collected weekly in a web-based daily diary format for six weeks. The analytic sample consisted of the 108 participants (of the 119 enrolled) who used cannabis during the assessment period (mean age = 22.06; 23.78% college students; 65.74% female; 5.56% Asian, 22.22% Black, 16.67% Latinx, 2.78% Multi-racial or Other and 52.77% White). Cannabis use was queried separately for vaping and smoking; respondents reported all settings (14 options) and social contexts (7 options) where they used.
For both vaping and smoking cannabis, the most common settings were home (vaping: 56.97%, smoking: 68.72% significantly lower for vaping), friend’s home (vaping: 22.49%, smoking: 21.49%), and car (vaping: 18.80%, smoking: 12.99%). The most common social contexts were with friends (vaping: 55.96%, smoking: 50.61%), with significant other (vaping: 25.19%, smoking: 28.53%), and alone (vaping: 25.92%, smoking: 22.62%). Compared to non-students, college students reported vaping on a significantly higher proportion (27.88% vs. 16.50%) of cannabis use days.
Very similar patterns in settings and social contexts were observed for vaping as smoking and in prevalence of vaping and smoking cannabis across demographic groups. The few notable exceptions have implications for vaping related public health measures: targeting reducing vaping outside the home, particularly in cars, and implementing prevention programming on college campuses.
PDF
