Rebecca C. Windle

Coping strategies, drinking motives, and stressful life events among middle adolescents: associations with emotional and behavioral problems and with academic functioning.

A sample of 733 middle adolescents was used to study interrelations among coping strategies, drinking motives, stressful life events (major, daily positive, and daily negative), emotional and behavioral problems, and academic functioning. A main-effects (vs. stress-buffering) model was supported. Some predictors (e.g., task-oriented coping, major stressful events) were general in their predictive relations to the outcome variables, whereas others were highly specific (e.g., emotion-focused coping predicting depressed affect). Overall, the predictors accounted for 22-53% of the variance in regression equations. Positive daily events predicted higher levels of alcohol use, alcohol problems, and delinquent activity; as well as higher academic performance and lower levels of depressed affect.

Collecting Longitudinal Data Through Childhood, Adolescence, and Young Adulthood: Methodological Challenges

This article presents the proceedings of a workshop at the 2003 Research Society on Alcoholism meeting in Fort Lauderdale, Florida. The organizers and chairs were Vivian Faden and Nancy Day. The presentations were (1) Lessons Learned From the Lives Across Time Longitudinal Study, by Michael Windle and Rebecca Windle; (2) Methodological Issues in Longitudinal Surveys With Children and Adolescents, by Joel Grube; (3) The Pittsburgh ADHD Longitudinal Study: Methodological and Conceptual Challenges, by Brooke Molina, William Pelham, Elizabeth Gnagy, and Tracey Wilson; and (4) Lessons learned in Conducting Longitudinal Research on Alcohol Involvement: If Only I Had Known Before Hand! by Kristina Jackson and Kenneth Sher.

The continuity of behavioral expression among disinhibited and inhibited childhood subtypes

Abstract This article focuses on issues related to the continuity and specificity/generality of inhibitory and disinhibitory behaviors from childhood to adolescence. Literature pertinent to the stability and predictive validity of inhibitory (internalizing) and disinhibitory (externalizing) behaviors is reviewed, in addition to selected comorbid subtypes, including a “mixed” subtype characterized by high levels of both inhibitory and disinhibitory behaviors. Whereas empirical support for prospective relations typically has been indicated for the continuity and predictive validity of disinhibitory behaviors, this review suggests that a budding literature supports prospective relations for inhibitory behaviors and, to some extent, for the behaviors of a mixed subtype. Data from a relatively large, nonclinical adolescent sample are used to further demonstrate the proposed prospective relations among childhood inhibitory, disinhibitory, and mixed subtypes, and the expression of serious internalizing and externalizing problems in adolescence. Future research directions are proposed that emphasize prospective studies of multiple diagnostic subtypes with both treatment and nontreatment populations.

Testing the specificity between social anxiety disorder and drinking motives.

This study tested the specificity of the relationship between social anxiety disorder (SAD) and coping drinking motives (versus enhancement drinking motives and social drinking motives) within the context of a range of potentially confounding variables measured during adolescence (e.g., quantity and frequency of alcohol use, coping drinking motives) and substantively important variables assessed during young adulthood (e.g., other anxiety disorders and major depressive disorder). A sample of high school sophomores and juniors (n=717) completed measures of substance use and risk factors during adolescence and were then prospectively followed-up in early- and middle-young adulthood, and psychiatric diagnoses and drinking motives (i.e., coping, enhancement, and social) were assessed each time. Findings indicated that SAD was specifically related to coping motives (measured during early-to-middle young adulthood) after controlling for the effects of a range of alcohol and mental health variables. In addition, adolescent variables predicted young adult drinking motives as did major depressive disorder and other anxiety disorders. These findings are discussed within a conceptual framework of the functional role (e.g., self-medication) that drinking motives, and especially coping drinking motives, may play in the etiology of alcohol problems and disorders. Implications for prevention and treatment interventions are discussed.

Recurrent depression, cardiovascular disease, and diabetes among middle-aged and older adult women

BACKGROUND The goal of this study was to investigate the concurrent and prospective relationships between a history of single and recurrent major depression disorder (MDD) and the medical conditions of cardiovascular disease (CVD) and diabetes using a community sample of middle- and older-aged women. METHODS Data from women (n=557 at baseline; mean age=55.7 years) participating in a two-wave longitudinal study (5-year interval) were used to examine associations between single and recurrent MDD, assessed with a structured clinical interview, and three self-report indicators of CVD (heart attack or myocardial infarction, stroke, angina), major CVD risk markers (hypertension, high cholesterol), and diabetes. Analyses were conducted to evaluate hypotheses which proposed that recurrent depression would be significantly associated with the three medical outcomes, but not single episode MDD. RESULTS After controlling for a range of important covariates (e.g., BMI, smoking, alcohol use), cross-sectional analyses indicated that recurrent MDD, but not single episode MDD, significantly predicted CVD risk and diabetes. Prospective analyses indicated that recurrent MDD, but not single episode MDD, increased the risk for CVD and diabetes. LIMITATIONS The sample was a predominantly white, middle-class sample so generalizability of findings may be limited for minorities and men. Reliance on self-report data may have biased the findings. CONCLUSIONS These findings suggest the benefits of measuring single versus recurrent MDD when investigating the risk of depression on chronic diseases. Findings also suggest the importance of identifying individuals suffering from recurrent MDD early in their lifespan with the goal of preventing future depressive episodes.

Predicting young adulthood smoking among adolescent smokers and nonsmokers

OBJECTIVE To examine predictors of smoking in young adulthood among (1) adolescent nonsmokers and (2) adolescent smokers. METHODS Data were analyzed from a longitudinal study of adolescents to young adulthood in 1988-1998. RESULTS Predictors of smoking in young adulthood among adolescent nonsmokers included less education, being unmarried in adulthood, lower family social support, non-smoking parents, and increased alcohol use over time. Predictors of smoking in young adulthood among adolescent smokers included lower family social support, more adolescent friends who used drugs, and slower decreases in depressive symptoms over time. CONCLUSIONS Distinct factors predict smoking initiation versus maintenance among young adults.

A Prospective Study of Mutual Influence for Substance Use Among Young Adult Marital Dyads.

The purpose of this 2-wave longitudinal study was to specify, test, and evaluate an actor–partner interdependence model (APIM) with young adult marital dyads to test husbands’ and wives’ mutual influences on each other’s substance use. Prospective data were collected from young adults and their spouses at baseline and 5 years later. Data from 237 dyads were used to test spouses’ interdependence on alcohol use, alcohol problems, and marijuana use with the APIMs. Marital partners had significant effects on each other’s substance use, though the patterns were different contingent on the outcome referenced. Husbands’ alcohol use significantly predicted wives’ alcohol use and alcohol problems. Wives’ alcohol use and marijuana use significantly predicted husbands’ alcohol use, alcohol problems, and marijuana use. For these young adult dyads, partner influences were indicated for both spouses, but more pervasive influences were indicated from wives-to-husbands than the reverse.

Adolescent precursors of young adult drinking motives

INTRODUCTION Numerous cross-sectional and shorter-term longitudinal studies have supported the role of drinking motives as potent proximal predictors of alcohol phenotypes (e.g., alcohol use, heavy episodic drinking). However, missing from this literature is a focus both on the stability of drinking motives across young adulthood and on adolescent precursors of drinking motives. METHODS We investigated the adequacy of using a latent trait-state model (LTSM) to investigate three-wave data on social, enhancement, and coping motives for drinking with a community sample of young adults (N = 1004) at the mean ages of 23.8 years, 28.9 years, and 33.5 years. We further investigated adolescent (M age = 16.73 years) predictors of young adult drinking motives using data collected on the sample approximately seven years prior to the first young adult data collection. RESULTS Findings indicated that all three drinking motives across young adulthood were modeled adequately via the LTSM, and that drinking motives manifested high stability (i.e., rank order) across individuals. Significant common (e.g., being male, alcohol-using peers, stressful life events, boredom susceptibility) and specific (e.g., depressive symptoms for coping motives; heavy episodic drinking for enhancement motives) adolescent precursors of young adult drinking motives were identified. CONCLUSIONS Common and unique adolescent factors predicted trait-like drinking motives during young adulthood. These findings suggest the utility of intervening during the teen years to prevent or interrupt the development of cognitive motivations that encourage alcohol use for the purpose of affect regulation.

Influence of Alcohol and Illicit Drug Use on Sexual Behavior

The prevalence and co-occurrence of adolescent alcohol and drug use and sexual behaviors are at disturbingly high rates. Higher levels of substance use during adolescence have been associated with an earlier sexual debut, more sexual partners, higher rates of sexually transmitted diseases and HIV, and more unintended pregnancies. Furthermore, higher levels of substance use during adolescence have been associated with more dating violence, sexual coercion, and sexual assault. Whereas most sexual risk reduction intervention programs do not also target substance use reduction, a few small-scale studies with residential treatment samples have demonstrated reductions in multiple sexual risk behaviors among substance-abusing teens. Some school-based drug use prevention programs targeting general social skills competencies have also demonstrated some crossover effects in reducing risky sexual behaviors. Multi-targeted interventions that focus jointly on reducing substance use and sexual behaviors may prove better able to deter adolescent risk behaviors and promote positive health outcomes.

Women and Health-Related Behaviors

Acquired immunodeficiency syndrome (AIDS) continues to be a major public health problem, as AIDS has been diagnosed in over 196,000 Americans,1 with cumulative projections of 390,000–480,000 AIDS cases by the end of 1993.2Furthermore, the spread of AIDS is becoming more pervasive, with about 2000 children under 13 yr of age diagnosed with AIDS,3and with increases in the prevalence of human immunodeficiency virus (HIV) infection and AIDS among heterosexuals and women.4