Kristina M. Jackson

A psychosocial model of sun protection and sunbathing in young women: the impact of health beliefs, attitudes, norms, and self-efficacy for sun protection.

A psychosocial model of sun protection and sunbathing as distinct behaviors was developed on 202 young Caucasian women and replicated in an independent sample (n = 207). Proximal outcomes were intention to sun protect and intention to sunbathe; distal outcomes included sun protection and sunbathing behavior measured 5 months later. Objective risk for skin cancer plus 4 classes of psychosocial variables (sun-protective health beliefs, self-efficacy for sun protection, attitudes toward sunbathing, and norms for sunbathing and sun protection) served as predictors. Sun-protective norms and self-efficacy for sun protection predicted only intention to sun protect; sunbathing norms predicted only intention to sunbathe. Susceptibility and advantages of tanning predicted both intention constructs, which, in turn, predicted behavior. These findings distinguish sun protection from sunbathing and provide a basis for intervention design.

The natural history of problem gambling from age 18 to 29.

Aggregate-level prevalences and individual-level developmental trajectories of untreated problem gambling were examined in an 11-year, 4-wave longitudinal study spanning the adolescent through young adult years. The past-year prevalences, 3-4 year incidences, and lifetime prevalences of problem gambling from adolescence through young adulthood were relatively stable at 2%-3%, 1%-2%, and 3%-5%, respectively. Despite the stability of the prevalences at the aggregate level, problem gambling appeared to be more transitory and episodic than enduring and chronic at the individual level. The present study is consistent with the limited evidence available on the natural history of problem gambling in the community in suggesting that natural recovery may be the rule rather than the exception.

Conjoint Developmental Trajectories of Young Adult Substance Use

BACKGROUND Despite the prominence of comorbidity among substances and the recent attention focused on trajectory-based approaches to characterizing developmental change, little research in the substance use field has simultaneously considered both course and comorbidity. METHODS Using nationally representative panel data from the Monitoring the Future Project (MTF; n = 32,087; 56% female; 82% Caucasian), we identified developmental courses of heavy drinking, smoking, and marijuana use using 4 waves of data spanning ages 18 to 26 in a multi-cohort young adult sample. Comorbidity was examined by cross-classifying group membership in substance use trajectories. Finally, the extent to which risk factors (sex, race, alcohol expectancies, delinquency, sensation seeking, depressive affect, religiosity, academic achievement, and parent education) accounted for combinations of comorbidity that occurred at a rate greater than chance was examined. RESULTS For each substance, we identified 4 courses of substance use that were largely consistent with those found in the literature (chronic high use, late-onset use, developmentally limited use, and low-use), with a fifth moderate smoking group. Heavy drinking, smoking, and marijuana use were each highly associated, and distinct patterns of comorbidity were evident, with greatest agreement along the diagonal. All risk factors explained comorbidity to some degree, with delinquency, sensation seeking, alcohol expectancies, and religion in particular predicting combinations of comorbidity that were characterized by early onset and chronic high use. CONCLUSIONS Cross-substance trajectory concordance was high, with parallel changes in substance use over emerging adulthood. This suggests similar developmental timing of use, perhaps due to the experience of developmental transitions that have a common influence on use of different substances. Prediction of combinations of comorbidity characterized by early onset and persistently high use suggests that to some extent, individuals use multiple substances because of a common vulnerability to each, rather than directional relations among substances (e.g., cross-tolerance, cueing).

Web-based alcohol prevention for incoming college students: A randomized controlled trial

College students are an at-risk population based on their heavy alcohol consumption and associated consequences. First-year students are at particular risk due to greater freedom and access to alcohol on campus. Web-based (electronic) interventions (e-interventions) are being rapidly adopted as a universal approach to prevent high-risk drinking, but have not been well evaluated. The objective of this study was to investigate the effectiveness of the two most widely adopted EIs, AlcoholEdu and The Alcohol eCHECKUP TO GO (e-Chug), in reducing both alcohol use and alcohol-related consequences in incoming college students. To do so, we conducted a 3-group randomized trial (N=82) comparing AlcoholEdu and e-Chug to an assessment-only control group. Compared to the assessment-only control group, participants in the AlcoholEdu and e-Chug groups reported lower levels of alcohol use across multiple measures at 1-month follow-up. Participants who received AlcoholEdu showed significantly fewer lower alcohol-related consequences than assessment-only controls, while there was a trend for reduced consequences in participants who received e-Chug versus assessment-only. Findings indicate that e-intervention is a promising prevention approach to address the problem of college student alcohol consumption, especially for campuses that have limited resources.

Borderline personality disorder features predict negative outcomes 2 years later.

In a sample of 351 young adults, the authors assessed whether borderline personality disorder (BPD) features prospectively predicted negative outcomes (poorer academic achievement and social maladjustment) over the subsequent 2 years, over and above gender and both Axis I and Axis II psychopathology. Borderline traits were significantly related to these outcomes, with impulsivity and affective instability the most highly associated. The present findings suggest that the impulsivity and affective instability associated with BPD leads to impairment in relating well with others, in meeting social role obligations, and in academic or occupational achievement. Therefore, these may be especially important features to target in interventions for BPD.

Evaluation of a multicomponent appearance-based sun-protective intervention for young women: Uncovering the mechanisms of program efficacy.

An appearance-based sun-protection intervention program was developed, implemented, and evaluated in a sample of 211 Caucasian women (ages 18-25) randomly assigned to the sun-protection program or to a stress management (control) program. The sun-protection program incorporated a novel construct of image norms of aspirational peers (i.e., female media figures, fashion models) approving paleness. The authors targeted these image norms as well as the advantages of tanning, health beliefs about photoaging and skin cancer, and self-efficacy for sun protection. The intervention produced significant differences across conditions favoring sun protection on all constructs but severity of skin cancer and barriers to sun protection. At follow-up, treatment participants exceeded controls both in intention to sun protect and sun-protective behavior and reported lower intention to sunbathe and fewer hours of sunbathing. A mediational model of intervention outcomes revealed distinct mediators for sun protection versus sunbathing.

Conjoint developmental trajectories of young adult alcohol and tobacco use

Developmental and etiological advances have set the stage for considering trajectories of problem behavior across the life course, but little work thus far addresses co-occurring problem behavior trajectories. Although recent work characterizes drinking and smoking trajectories, none has explored the course of concurrent drinking and smoking. Using panel data from the Monitoring the Future Project (N=32,087), the authors applied growth mixture modeling to 4 waves of heavy drinking and smoking in a young-adult sample. The authors extracted a single latent group membership factor from heavy drinking and smoking. Associations between trajectory classes and risk factors were relatively unique to the substance being predicted. The association of smoking with alcohol expectancies and delinquency appeared to exist by virtue of smokings comorbidity with drinking.

Alcohol use disorders and psychological distress: a prospective state-trait analysis.

The present study examined the association between alcohol use disorders (AUDs) and psychological distress over an 11-year period using a sample of 378 young adults (46% men, 54% women: baseline age = 18.5; 51% with paternal history of alcoholism). The authors examined this relation using a state-trait model, which decomposes variance in a given construct into a general traitlike factor that spans measurement occasion and more situational, occasion-specific variability. Trait AUD and trait distress were correlated (r =.43), suggesting that the tendency to meet criteria for an AUD is associated with the tendency to experience psychological distress. Much of this association was due to 3rd variables (primarily neuroticism but also childhood stressors and behavioral undercontrol), supporting a common 3rd-variable influence model of comorbidity.

Heavy episodic drinking: determining the predictive utility of five or more drinks.

Although the heavy episodic drinking (HED) measure of 5+ drinks (sometimes 4+ for women) is used extensively, there is no empirical basis for the designation of 5 drinks as the threshold (vs. another threshold that may perform equally). The present study sought to determine the threshold for HED that maximally predicts proximal and distal adverse-drinking-related outcomes. Participants included 115 young adults (57% female; 96% Caucasian) who partook in an 8-week Internet survey that assessed daily drinking as well as next-day hangover; 10 months later, adverse outcomes (problem drinking, alcohol-related problems, maximum number of drinks, and drug use) were surveyed. Thresholds were computed, with a range from 1+ drinks to 15+ drinks, and outcomes were predicted from each threshold. Findings for hangover measures showed relatively good convergence across multiple indicators, with greatest prediction occurring at a threshold of 10+ drinks per occasion. Different thresholds were observed for long-term outcomes, with higher thresholds indicative of outcomes with greater severity. Although alternatives to HED, such as subjective effects and blood alcohol concentration, can indicate risky drinking, a threshold measure of HED may have advantages in terms of prevention and of intervention efforts.

Similarities and differences of longitudinal phenotypes across alternate indices of alcohol involvement : A methodologic comparison of trajectory approaches

Extant developmental research distinguishing young adults who moderate versus persist in alcohol consumption has not consistently evaluated the domain of alcohol involvement being modeled, making it difficult to compare findings across studies. In the present study, the authors characterized the developmental course of 5 indices of alcohol involvement using a prospective (6-wave) sample of 377 young adults (Year 1 age = 18.52 years; 55% female; 51% with family history of alcoholism) over 11 years. Growth mixture models were applied to each measure. Despite similarity in trajectory shape, predicted prevalences varied, and the consistency of trajectory classifications across alternate indices revealed low agreement. Correlates of drinking course, however, were somewhat robust across alcohol index. The finding that trajectories are conditional on the specific indices used suggests that it may be hazardous to generalize across alternate indices of alcohol involvement.