Megan E. Patrick

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.

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.

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 Trajectories of Reasons for Alcohol Use Relate to Trajectories of Binge Drinking: National Panel Data Spanning Late Adolescence to Early Adulthood.

Developmental changes in both alcohol use behaviors and self-reported reasons for alcohol use were investigated. Participants were surveyed every 2 years from ages 18 to 30 as part of the Monitoring the Future national study (analytic weighted sample size N = 9,308; 53% women, 40% college attenders). Latent growth models were used to examine correlations between trajectories of binge drinking and trajectories of self-reported reasons for alcohol use across young adulthood. Results revealed developmental changes in reasons for use and correlations between the patterns of within-person change in frequency of binge drinking and within-person change in reasons for use. In particular, an increase in binge drinking between ages 18 and 22 was most positively correlated with slopes of using alcohol to get high and because of boredom. Continued binge drinking between ages 22 and 30 was most strongly correlated with using alcohol to get away from problems. Almost no moderation by gender, race, college attendance, employment, or marital status was found. Binge drinking and reasons for alcohol use traveled together, illustrating the ongoing and dynamic connections between changes in binge drinking and changes in reasons for use across late adolescence and early adulthood.

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.

Does Drinking Lead to Sex? Daily Alcohol-Sex Behaviors and Expectancies among College Students

A within-person multilevel approach was used to model the links between alcohol use and sexual behavior among first-year college students, using up to 14 days of data for each person with occasions (Level 1, N = 2879 days) nested within people (Level 2, N = 218 people; 51.4% male). Between-persons (Level 2) effects were gender, relationship status, person means of alcohol use, and alcohol-sex expectancies for sexual affect and sexual drive. Within-person (Level 1) effects were weekend days, number of drinks consumed, and the interaction between drinks consumed and alcohol-sex expectancies. Independent of average alcohol use, consuming more drinks on a given day was associated with a greater likelihood of oral sex and with experiencing more positive consequences of sex that day. Significant Alcohol Use x Alcohol-Sex Expectancies interactions were found for oral sex and total sex behaviors, indicating that individuals with more positive expectancies were more likely to have sex after drinking. The negative association between drinks and condom use was at a trend level of significance. Results support the potential for promoting sexual health by focusing on cross-behavior expectancies among late adolescents.

Reasons to Have Sex, Personal Goals, and Sexual Behavior During the Transition to College

Emerging adults (M = 18.99 years, SD = .50) completed cross-sectional questionnaires (N = 943) and targeted follow-up telephone surveys (N = 202) across the transition to college. Gender, personal goals (dating, friendship, academic), and past sexual behavior were examined as predictors of reasons to have and not to have sex. Men rated Self-focused reasons to have sex as more important; women rated Partner-focused reasons to have sex and Ethical reasons not to have sex as more important. Importance of Pregnancy/STD reasons not to have sex did not differ by gender. Before college entrance, sexual history and personal goals predicted endorsement of reasons for/against sex. Personal goals predicted first intercourse during freshman year. Limitations of the study include the single university sample and use of closed-ended self-report measures. Personal goals and reasons for/against sex are associated with sexual behavior and should be addressed in programs designed to promote sexual health among emerging adult college students.

What is a representative brain? Neuroscience meets population science

The last decades of neuroscience research have produced immense progress in the methods available to understand brain structure and function. Social, cognitive, clinical, affective, economic, communication, and developmental neurosciences have begun to map the relationships between neuro-psychological processes and behavioral outcomes, yielding a new understanding of human behavior and promising interventions. However, a limitation of this fast moving research is that most findings are based on small samples of convenience. Furthermore, our understanding of individual differences may be distorted by unrepresentative samples, undermining findings regarding brain–behavior mechanisms. These limitations are issues that social demographers, epidemiologists, and other population scientists have tackled, with solutions that can be applied to neuroscience. By contrast, nearly all social science disciplines, including social demography, sociology, political science, economics, communication science, and psychology, make assumptions about processes that involve the brain, but have incorporated neural measures to differing, and often limited, degrees; many still treat the brain as a black box. In this article, we describe and promote a perspective—population neuroscience—that leverages interdisciplinary expertise to (i) emphasize the importance of sampling to more clearly define the relevant populations and sampling strategies needed when using neuroscience methods to address such questions; and (ii) deepen understanding of mechanisms within population science by providing insight regarding underlying neural mechanisms. Doing so will increase our confidence in the generalizability of the findings. We provide examples to illustrate the population neuroscience approach for specific types of research questions and discuss the potential for theoretical and applied advances from this approach across areas.

Trends in use of marijuana and attitudes toward marijuana among youth before and after decriminalization: the case of California 2007-2013

BACKGROUND This analysis examines decriminalization as a risk factor for future increases in youth marijuana acceptance and use. Specifically, we examine marijuana-related behaviors and attitudes of 8th, 10th, and 12th graders in California as compared to other U.S. states during the years before and after California passed legislation in 2010 to decriminalize marijuana. METHODS Data come from Monitoring the Future, an annual, nationally representative survey of 8th, 10th, and 12th grade students. RESULTS In 2012 and afterwards California 12th graders as compared to their peers in other states became (a) 25% more likely to have used marijuana in the past 30 days, (b) 20% less likely to perceive regular marijuana use as a great health risk, (c) 20% less likely to strongly disapprove of regular marijuana use, and (d) about 60% more likely to expect to be using marijuana five years in the future. Analysis of 10th graders raises the possibility that the findings among 12th graders may reflect a cohort effect that was set into place two years earlier. CONCLUSION These results provide empirical evidence to support concerns that decriminalization may be a risk factor for future increases in youth marijuana use and acceptance.

Drinking motives, protective behavioral strategies, and experienced consequences: Identifying students at risk.

The association between drinking motives and protective behavioral strategies was explored, including whether individuals with different drinking motives were more or less likely to utilize protective behavioral strategies and whether the combination of drinking motives and use of protective strategies may help identify individuals at elevated risk for alcohol-related problems. The final sample included 358 college students (59.2% female; M=18.47 years old, SD=.58). Individuals who had greater enhancement and social motives for drinking used protective strategies less frequently, controlling for number of drinks per week; those who had greater conformity motives used protective strategies more frequently. Coping motives were not significantly correlated with the mean of protective factors, but were associated with less frequently using individual strategies. Using protective strategies more frequently was associated with consuming fewer drinks and having lower RAPI scores. Interactions of drinking motives with the number of protective strategies tended to be non-significant; however, significant interactions indicated that greater coping and conformity motives were especially associated with negative outcomes among individuals who used fewer protective strategies.