Renee M. Cloutier

Social anxiety, disengagement coping, and alcohol use behaviors among adolescents

ABSTRACT Background and Objectives: Although research indicates that social anxiety (SA) is associated with problematic drinking, few studies have examined these relations among adolescents, and all alcohol-related assessments have been retrospective. Socially anxious youth may be at risk to drink in an effort to manage negative affectivity, and a proclivity toward disengagement coping (e.g. avoidance of aversive stimuli) may enhance the desire to drink and learning of coping-related use. Design: Adding to research addressing adolescent SA and alcohol use, the current study examined (1) proportional drinking motives (subscale scores divided by the sum of all subscales), (2) current desire to drink in a socially relevant environment (introduction to research laboratory), and (3) the indirect effect of retrospectively reported disengagement in social stress contexts on proportional coping motives and desire to drink. Method: Participants were 70 community-recruited adolescents who reported recent alcohol use. Level of SA, disengagement coping, drinking motives, and desire to drink following laboratory introduction were assessed. Results: Proclivity toward disengagement in prior socially stressful contexts accounted for significant variance in the positive relations between SA and both proportional coping motives and current desire to drink. Conclusions: These data complement existing work. Continued efforts in building developmentally sensitive models of alcohol use are needed.

Drinking Game Participation Among High School and Incoming College Students: A Narrative Review

AbstractThe transition from high school to college has been characterized as a potentially vulnerable period because of decreased parental supervision and increased autonomy. This transition can increase risk for participation in high-risk behaviors such as drinking games (DGs), which are a social drinking activity that encourages intoxication and are associated with negative alcohol-related consequences. To date, there has not been a narrative review of DG research that examines this activity among high schoolers and incoming college students specifically, and thus, the current review bridges this gap. Findings indicate that DG participation is consistently linked to negative consequences (e.g., passing out, becoming sick) and other high-risk behaviors, such as prepartying (drinking before going to a social event). In addition, DG participation is linked to demographic (e.g., age, gender), psychological (e.g., personality, alcohol cognitions), and contextual/cultural factors (e.g., the college drinking culture). These findings have implications for current prevention and intervention efforts and suggest promising directions for future research.

An Examination of Social Anxiety in Marijuana and Cigarette Use Motives Among Adolescents

ABSTRACT Marijuana and nicotine are two of the most widely used substances among adolescents in the United States. Symptoms of social anxiety (SA) typically emerge during early adolescence, and elevated levels are associated with increased substance-related problems despite inconsistent links to frequency of use. Substance use motives, and in particular coping motives, have been found to play an important role in understanding the heightened risk for use problems among those with elevated SA. Importantly, work to date has been conducted almost exclusively with adult samples; thus the current study examined whether similar patterns would emerge among adolescents. The current project included 56 community-recruited adolescents (ages 12–17 years; 41% girls) with a positive history of lifetime marijuana and cigarette use. Consistent with the adult literature, SA was not positively associated with frequency of use across either substance. Further, SA was positively associated with conformity use motives and unrelated to social or enhancement motives for both substances. Unexpectedly, SA was unrelated to coping use motives for either marijuana or cigarettes. These preliminary data highlight the need for future research designed to forward developmentally sensitive models of substance use behaviors and etiology.

Development and initial psychometric validation of the Brief-Caffeine Expectancy Questionnaire (B-CaffEQ).

Caffeine is the most widely available and consumed psychoactive substance in the United States. Extant work indicates that across substances, use expectancies play a marked role in the development and maintenance of consumption patterns. Despite a burgeoning line of etiological and intervention-oriented research focused on expectancies (e.g., alcohol), there is a limited literature regarding caffeine use effect expectancies, specifically. To facilitate this work, the Caffeine Expectancy Questionnaire (CaffEQ) was developed and psychometrically validated; however, the length of the CaffEQ (i.e., 47 items) may hinder widespread adoption of this tool. As such, the current study provides an initial psychometric validation of a brief, 20-item version—the Brief-Caffeine Expectancy Questionnaire (B-CaffEQ)—in a multiethnic sample of undergraduate students (N = 975). Results showed that the B-CaffEQ replicated the 7-factor structure of the original CaffEQ using both constrained (confirmatory factor analysis) and less constrained (exploratory structural equation modeling) structural models and evidenced good internal consistency across subscales. The B-CaffEQ also demonstrated concurrent validity with caffeine use frequency indices, replicated and extended convergent validity between caffeine expectancy subscales and related behavioral and psychological constructs, and demonstrated discriminant validity with other related, but notably distinct, stimulant use metrics (e.g., cocaine, Ritalin). Lastly, the B-CaffEQ appears to provide an invariant measure of expectancies across types of caffeine users. These findings indicate that the B-CaffEQ is a reliable assessment of caffeine use effect expectancies, with acceptable-to-good psychometric properties—comparable in length to other substance use expectancies measures—that may be more readily incorporated into research and clinical settings.

An experimental test of the impact of adolescent anxiety on parental sick role reinforcement behavior

A large body of work links parental sick role reinforcement behavior to adolescent panic vulnerability. To date, however, little work has examined the role of the adolescent in this process. The current study addressed this gap in the literature, using a novel method to experimentally test the impact of adolescent anxiety during a straw-breathing task on parental propensity to engage in sick role reinforcement behavior. An unselected sample of 51 early adolescents (26 female, 10-14 years) and their parents participated in the study. Adolescents were trained to mimic a straw-breathing task, and adolescent reactions to the task were scripted. Parents were randomly assigned to watch their adolescent react either a) anxiously or b) non-anxiously to the straw-breathing task. Parents who viewed their adolescent react anxiously ended the task earlier, reported that they would reinforce more sick role behavior, and reported more negatively valenced reactions during the task than parents who viewed their adolescent react non-anxiously to the task. No group differences emerged in terms of parental self-reported or physiological arousal during the task. Results suggest that adolescent anxiety increases parental sick role reinforcement behavior. Findings are discussed in terms of future directions for reducing parenting behaviors thought to increase vulnerability for panic among adolescents.

The Links Between Social Anxiety Disorder, Insomnia Symptoms, and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States

Social anxiety disorder (SAD) is associated with increased risk of developing an alcohol use disorder (AUD). Most of the current literature has focused on the role of acute stress responding in this relation; however, both SAD and AUDs also are linked to insomnia symptoms (i.e., difficulty falling or staying asleep). As adolescence is a sensitive period for the onset of these disorders, the present study examined if insomnia symptoms might partially account for the SAD-AUD link in a large sample of adolescents. Data from the National Comorbidity Survey-Adolescent Supplement were examined. Participants (N = 10,140) completed interviews to assess past 12-month SAD and AUD diagnostic status as well as insomnia symptoms. Analyses tested whether insomnia symptoms accounted for a significant proportion of the SAD-AUD relation. Results indicated that insomnia symptoms were positively related to both SAD and AUD status, and the relation between SAD and AUD status was significantly reduced when insomnia symptoms were included in the model. Findings remained significant after controlling for the effects of age, gender, posttraumatic stress disorder, major depressive disorder, and other drug dependence status. Experimental examination and intensive longitudinal assessment of these relationships are needed before strong conclusions can be inferred about causality and temporal relationships. The current findings do indicate insomnia may be an important indirect and stigma-free treatment target to address in prevention and treatment efforts for SAD, AUDs, and their co-occurrence.

Posttraumatic stress severity is associated with coping motives for alcohol use among in-patient and community recruited adolescents

ABSTRACT Background and Objectives: A growing body of work suggests individuals with more severe post-traumatic stress symptoms (PTSS) are at higher risk for developing problematic alcohol use outcomes. Extending work from the adult literature, the present study was the first to examine the extent to which PTSS is related to drinking motives for alcohol use in both clinical and non-clinical samples of adolescents. Design: Hierarchical regression analyses were used to predict coping motives for alcohol use from PTSS, above and beyond demographic variables, alcohol use frequency, and other alcohol use motives. Methods: Trauma-exposed adolescents before entering treatment (Sample 1 n = 41) and recruited from the local community (Sample 2 n = 55) self-reported on PTSS and alcohol use motives. Results: PTSS positively predicted coping motives for alcohol use after controlling for age, gender, and alcohol use frequency. Conclusions: The current study highlights the need to consider both PTSS severity, as well as underlying cognitive mechanisms (e.g., motives), to better understand the etiology of problematic alcohol use among trauma-exposed youth. Future work focused on clarifying the trajectory of alcohol use motives and problems as a function of PTSS is needed.

Dimensions of parenting among mothers and fathers in relation to social anxiety among female adolescents

Social anxiety is the most common anxiety disorder among youth; theoretical and empirical work suggest specific parenting behaviors may be relevant. However, findings are inconsistent, particularly in terms of maternal as compared to paternal effects. In the current study, we evaluated the indirect effects of perceived psychological control on the relation between anxious rearing behaviors and child social anxiety among 112 community-recruited girls (ages 12-15 years). In addition to self-report, adolescent participants completed a laboratory-based social stress task. In line with hypotheses, results indicated indirect effects of psychological control on the relation between anxious rearing behaviors and child social anxiety in maternal but not paternal models. Findings are discussed in terms of their theoretical and empirical implications for clarifying the role of parental relations in adolescent social anxiety.

A laboratory-based test of the relation between adolescent alcohol use and panic-relevant responding.

A burgeoning literature supports a link between alcohol use and panic-spectrum problems (e.g., panic attacks, disorder) among adolescents, but the direction of influence has yet to be properly examined. From a theoretical perspective, panic-spectrum problems may increase risk for problematic drinking via affect regulation efforts (e.g., self-medication), and problematic consumption also may increase or initiate panic-relevant responding (e.g., learning or kindling models). The objective of the current investigation was to examine the role of prior alcohol use in predicting panic-relevant responding, as well as panic symptom history in predicting the desire to consume alcohol, in the context of either a voluntary hyperventilation or a low-arousal task. Participants were community-recruited adolescents aged 12-17 years (n = 92, Mage = 15.42, SD = 1.51; 39.1% girls). Results indicated that prior alcohol use predicted panic-relevant responding among those undergoing the hyperventilation task (but not the low-arousal task), and that this finding was robust to the inclusion of theoretically relevant covariates (i.e., age, sex, negative affectivity). However, panic symptom history did not predict the desire to consume alcohol as a function of either the hyperventilation or low-arousal condition. This work sheds further light on the nature of the relation between panic-spectrum problems and problematic alcohol use in adolescence. Specifically, the current findings suggest that frequent alcohol use may increase panic vulnerability among adolescents, whereas acute panic symptoms may not elicit the immediate (self-reported) desire to drink.