Jennifer L. Maggs

A Developmental Perspective on Alcohol and Youths 16 to 20 Years of Age

Late adolescence (ie, 16–20 years of age) is a period characterized by escalation of drinking and alcohol use problems for many and by the onset of an alcohol use disorder for some. This heightened period of vulnerability is a joint consequence of the continuity of risk from earlier developmental stages and the unique neurologic, cognitive, and social changes that occur in late adolescence. We review the normative neurologic, cognitive, and social changes that typically occur in late adolescence, and we discuss the evidence for the impact of these transitions on individual drinking trajectories. We also describe evidence linking alcohol abuse in late adolescence with neurologic damage and social impairments, and we discuss whether these are the bases for the association of adolescent drinking with increased risks of mental health, substance abuse, and social problems in adulthood. Finally, we discuss both the challenges and successes in the treatment and prevention of adolescent drinking problems.

Childhood and adolescent predictors of alcohol use and problems in adolescence and adulthood in the National Child Development Study

AIMS To identify childhood and adolescent predictors of alcohol use and harmful drinking in adolescence and adulthood. DESIGN Longitudinal data from childhood to mid-life from the National Child Development Study (NCDS) were used, including predictors collected at ages 7, 11, 16 years and alcohol outcomes collected at ages 16, 23, 33 and 42 years. SETTING The NCDS is an ongoing longitudinal study of a cohort of 1 weeks births in Britain in 1958. PARTICIPANTS Childhood and adolescent predictors and alcohol use data from at least one adolescent or adult wave were available from 7883 females and 8126 males. MEASUREMENTS Social background, family, academic and behavioural predictors measured at ages 7, 11 and 16 years were entered into hierarchical multiple and logistic regressions to predict quantity of alcohol use at ages 16, 23, and 33 years and harmful drinking [i.e. Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire score] by age 42 years. FINDINGS Previous drinking was controlled in final models to predict change. Drinking was heavier among those with greater childhood and adolescent social advantage (especially females), less harmonious family relationships, more social maladjustment, greater academic performance, less internalizing problems, more truancy and earlier school-leaving plans. CONCLUSIONS Alcohol use and problems in adulthood can be predicted by indicators of social background, adjustment and behaviour in childhood and adolescence. Results demonstrate that the early roots of adolescent and adult alcohol use behaviours begin in childhood.

Substance use changes and social role transitions: Proximal developmental effects on ongoing trajectories from late adolescence through early adulthood

Substance use changes rapidly during late adolescence and early adulthood. This time in the life course is also dense with social role changes, as role changes provide dynamic context for individual developmental change. Using nationally representative, multiwave longitudinal data from age 18 to 28, we examine proximal links between changes in social roles and changes in substance use during the transition to adulthood. We find that changes in family roles, such as marriage, divorce, and parenthood, have clear and consistent associations with changes in substance use. With some notable exceptions, changes in school and work roles have weaker effects on changes in substance use compared to family roles. Changes in socializing (i.e., nights out for fun and recreation) and in religiosity were found to mediate the relationship of social role transitions to substance use. Two time-invariant covariates, socioeconomic background and heavy adolescent substance use, predicted social role status, but did not moderate associations, as within-person links between social roles and substance use were largely equivalent across groups. This paper adds to the cascading effects literature by considering how, within individuals, more proximal variations in school, work, and family roles relate to variations in substance use, and which roles appear to be most influential in precipitating changes in substance use during the transition to adulthood.

Extreme Binge Drinking Among 12th-Grade Students in the United States: Prevalence and Predictors

IMPORTANCE The prevalence of underage alcohol use has been studied extensively, but binge drinking among youth in the United States is not yet well understood. In particular, adolescents may drink much larger amounts than the threshold (5 drinks) often used in definitions of binge drinking. Delineating various levels of binge drinking, including extreme levels, and understanding predictors of such extreme binge drinking among youth will benefit public health efforts. OBJECTIVE To examine the prevalence and predictors of 5+ (≥5 drinks) binge drinking and of 10+ (≥10 drinks) and 15+ (≥15 drinks) extreme binge drinking among 12th graders in the United States. DESIGN, SETTING, AND PARTICIPANTS A nonclinical nationally representative sample of high school seniors in the annual Monitoring the Future study between 2005 and 2011. The sample included 16,332 high school seniors (modal age, 18 years) in the United States. Response rates were 79.1% to 84.7%. MAIN OUTCOMES AND MEASURES Prevalence of consuming 5 or more, 10 or more, and 15 or more drinks in a row in the last 2 weeks. RESULTS Between 2005 and 2011, a total of 20.2% of high school seniors reported 5+ binge drinking, 10.5% reported 10+ extreme binge drinking, and 5.6% reported 15+ extreme binge drinking in the last 2 weeks. Rates of 5+ binge drinking and 10+ extreme binge drinking have declined since 2005, but rates of 15+ extreme binge drinking have not significantly declined. Students with college-educated parents were more likely to consume 5 or more drinks but were less likely to consume 15 or more drinks than students whose parents were not college educated. Students from more rural areas were more likely than students from large metropolitan areas to consume 15 or more drinks. Substance-related attitudes, socializing with substance-using peers, the number of evenings out with friends, and other substance use (cigarettes and marijuana) predicted all 3 levels of binge and extreme binge drinking. CONCLUSIONS AND RELEVANCE Binge drinking at the traditionally defined 5+ drinking level was common among high school seniors representative of all 12th graders in the contiguous United States. A significant segment of students also reported extreme binge drinking at levels 2 and 3 times higher. These data suggest the importance of assessing multiple levels of binge drinking behavior and their predictors among youth to target effective screening and intervention efforts.

Family needs of parents of children and youth with cerebral palsy

BACKGROUND Understanding the needs of families of children and youth with cerebral palsy (CP) is important for family-centred services. The aims of this study were to identify: (1) differences in the number and types of family needs expressed by parents based on the age and gross motor function level of their children with CP; (2) the most frequent family needs; and (3) needs that differ on gross motor function level. METHODS A total of 501 parents (77.6% mothers) of children and youth with CP completed a modified version of a Family Needs Survey and a demographic questionnaire. Childrens gross motor function level was classified using the Gross Motor Function Classification System. RESULTS Total number of family needs differed based on gross motor function level (P < 0.001) but not age. Parents of children/youth who use wheeled mobility expressed the highest number of family needs, while parents of children/youth who walk without restrictions expressed the fewest needs. Family needs for Information (P= 0.001), Support (P= 0.001), Community Services (P < 0.001) and Finances (P < 0.001) differed based on childrens gross motor function level. Over 50% of parents expressed family needs for information on current and future services, planning for the future, help in locating community activities and more personal time. Parents of children and youth who use wheeled mobility were more likely to express the need for help in paying for home modifications, equipment, services and locating sitters, respite care providers and community activities. CONCLUSIONS The gross motor function of children/youth with CP has implications for collaboration with families to identify needs and co-ordinate services. Health professionals have a role to assist families with information needs and locating community services and leisure activities. Family needs for future planning suggest that health professionals should assist families to prepare for key periods in the lives of their children with CP.

Changes in Eating and Physical Activity Behaviors Across Seven Semesters of College Living On or Off Campus Matters

The transition from adolescence to adulthood is an important period for establishing behavioral patterns that affect long-term health and chronic disease risk. Nelson and colleagues speculated that developmental changes and changes in living situation may play an important role in the nutrition and physical activity behaviors of college students. Data from the University Life Study, a longitudinal study of college students that includes web-based surveys administered 14 consecutive days each semester, were used to examine fruit, vegetable, and sugared soda consumption, physical activity, and sedentary activity behaviors across seven semesters. Estimates for each semester were calculated to determine the frequency with which students consumed fruits, vegetables, and sugared soda, engaged in moderate to vigorous physical activity, and engaged in sedentary activities. Four models, estimated with HLM 6.04, were used to predict changes in these behaviors across the seven semesters. Living on or off campus was included to determine if this explained additional variance. Results indicated that few college students consumed fruits and vegetables or exercised at optimal levels during the seven semesters surveyed. Daily fruit and vegetable consumption and daily physical activity declined significantly from the first to the seventh semester. For both of these findings, living off campus exacerbated the problem. Average number of hours of sedentary behaviors declined over time, as did number of days on which at least one sugared soda was consumed. Living location did not explain additional variance in these positive trends. Implications for policy, practice, and future research are discussed.

Initiation and Course of Alcohol Consumption among Adolescents and Young Adults

This chapter takes a normative developmental perspective on the etiology of alcohol use, focusing on the initiation and course of alcohol use (rather than alcohol use disorders) during adolescence and early adulthood. We review evidence regarding the sequelae and meaning of the age of initiation of alcohol use, consider variable- and pattern-centered approaches to modeling trajectories describing the course of alcohol use across adolescence and young adulthood, and offer developmental conceptualizations of risk and protective factors for alcohol use and related problems.

Latent Transition Analysis: Benefits of a Latent Variable Approach to Modeling Transitions in Substance Use:

We apply latent transition analysis (LTA) to characterize transitions over time in substance use behavior profiles among first-year college students. Advantages of modeling substance use behavior as a categorical latent variable are demonstrated. Alcohol use (any drinking and binge drinking), cigarette use, and marijuana use were assessed in a sample (N=718) of college students during the fall and spring semesters. Four profiles of 14-day substance use behavior were identified: (1) Non-Users; (2) Cigarette Smokers; (3) Binge Drinkers; and (4) Bingers with Marijuana Use. The most prevalent behavior profile at both times was the Non-Users (with over half of the students having this profile), followed by Binge Drinkers and Bingers with Marijuana Use. Cigarette Smokers were the least prevalent behavior profile. Gender, race/ethnicity, early onset of alcohol use, grades in high school, membership in the honors program, and friendship goals were all significant predictors of substance use behavior profile.

How and Why the Understanding of Developmental Continuity and Discontinuity is Important

No story is a straight line. The geometry of human life is too imperfect and too complex, too distorted by the laughter of time and the bewildering intricacies of fate to admit the straight line into its system of laws. (Pat Conroy, 1995, p. 104)

The Long Arm of Expectancies: Adolescent Alcohol Expectancies Predict Adult Alcohol Use

AIMS Alcohol expectancies are strong concurrent predictors of alcohol use and problems, but the current study addressed their unique power to predict from adolescence to midlife. METHOD Long-term longitudinal data from the national British Cohort Study 1970 (N = 2146, 59.8% female) were used to predict alcohol use and misuse in the mid-30s by alcohol expectancies reported in adolescence. RESULTS Cohort members with more positive alcohol expectancies at age 16 reported greater alcohol quantity concurrently, increases in alcohol quantity relative to their peers between ages 16 and 35, and a higher likelihood of lifetime and previous year alcohol misuse at age 35, independent of gender, social class in family of origin, age of alcohol use onset, adolescent delinquent behavior and age 16 exam scores. CONCLUSIONS Alcohol expectancies were strong proximal predictors of alcohol use and predicted relative change in alcohol use and misuse across two decades into middle adulthood.