Tim Janssen

Automatic processes in at-risk adolescents: the role of alcohol-approach tendencies and response inhibition in drinking behavior

AIMS This study examined the association between automatic processes and drinking behavior in relation to individual differences in response inhibition in young adolescents who had just started drinking. It was hypothesized that strong automatic behavioral tendencies toward alcohol-related stimuli (alcohol-approach bias) were associated with higher levels of alcohol use, especially amongst adolescents with relatively weak inhibition skills. DESIGN To test this hypothesis structural equation analyses (standard error of mean) were performed using a zero inflated Poisson (ZIP) model. A well-known problem in studying risk behavior is the low incidence rate resulting in a zero dominated distribution. A ZIP-model accounts for non-normality of the data. SETTING Adolescents were selected from secondary Special Education schools (a risk group for the development of substance use problems). PARTICIPANTS Participants were 374 adolescents (mean age of M = 13.6 years). MEASUREMENTS Adolescents completed the alcohol approach avoidance task (a-AAT), the Stroop colour naming task (Stroop) and a questionnaire that assessed alcohol use. FINDINGS The ZIP-model established stronger alcohol-approach tendencies for adolescent drinkers (P < 0.01) and the interaction revealed a stronger effect of alcohol-approach tendencies on alcohol use in the absence of good inhibition skills (P < 0.05). CONCLUSION Automatically-activated cognitive processes are associated with the drinking behavior of young, at-risk adolescents. It appears that alcohol-approach tendencies are formed shortly after the initiation of drinking and particularly affect the drinking behavior of adolescents with relatively weak inhibition skills. Implications for the prevention of problem drinking in adolescents are discussed.

Same Wording, Distinct Concepts? Testing Differences Between Expectancies and Motives in a Mediation Model of Alcohol Outcomes

Per definition, alcohol expectancies (after alcohol I expect X), and drinking motives (I drink to achieve X) are conceptually distinct constructs. Theorists have argued that motives mediate the association between expectancies and drinking outcomes. Yet, given the use of different instruments, do these constructs remain distinct when assessment items are matched? The present study tested to what extent motives mediated the link between expectancies and alcohol outcomes when identical items were used, first as expectancies and then as motives. A linear structural equation model was estimated based on a national representative sample of 5,779 alcohol-using students in Switzerland (mean age = 15.2 years). The results showed that expectancies explained up to 38% of the variance in motives. Together with motives, they explained up to 48% of the variance in alcohol outcomes (volume, 5+ drinking, and problems). In 10 of 12 outcomes, there was a significant mediated effect that was often higher than the direct expectancy effect. For coping, the expectancy effect was close to zero, indicating the strongest form of mediation. In only one case (conformity and 5+ drinking), there was a direct expectancy effect but no mediation. To conclude, the study demonstrates that motives are distinct from expectancies even when identical items are used. Motives are more proximally related to different alcohol outcomes, often mediating the effects of expectancies. Consequently, the effectiveness of interventions, particularly those aimed at coping drinkers, should be improved through a shift in focus from expectancies to drinking motives.

Automatic processes and the drinking behavior in early adolescence: a prospective study

BACKGROUND This study examined the bi-directional prospective link between automatic alcohol-approach tendencies and alcohol use in a group of young adolescents (mean age = 13.6 years). The adolescents in the present study were assumed to be at-risk of early alcohol use and later problem drinking. It was hypothesized that alcohol use and automatic approach tendencies would reinforce one another particularly in the absence of well-developed inhibition skills. METHODS A total of 347 adolescents (N = 279 at follow-up) from special secondary education, a risk group for the development of substance use problems, participated in the study. Automatic approach tendencies were assessed with the alcohol-approach avoidance task, inhibition skills were assessed with the Stroop task, and alcohol used was measured using a self-report measure. RESULTS Zero-inflated Poisson analysis revealed a significant effect of automatic approach tendencies predicting alcohol use 6 months later, although only for adolescents with weaker inhibition skills. CONCLUSIONS Automatic approach tendencies predict future drinking behavior of young adolescents with relatively weak inhibition skills. The findings of the present study have important implications for alcohol interventions for adolescents. Results are discussed in terms of risk factors for the development of problematic alcohol use in young adolescents.

Weaknesses in executive functioning predict the initiating of adolescents’ alcohol use

Highlights • Working memory functioning predicts the initiating of (binge) drinking in adolescents.• Response inhibition predicts the initiating of drinking, but not binge drinking in adolescents.• Weakness in executive functioning precedes drinking behavior of adolescents.

Working Memory and Alcohol Use in At-Risk Adolescents : A 2-Year Follow-Up

BACKGROUND Previous research has identified working memory (WM) as a possible risk factor for problem drinking in adolescence. At the same time, results suggest that WM functioning is negatively influenced by the use of alcohol. To get a better understanding of the nature of this relationship, the present study examined the prospective bidirectional association between alcohol use and WM in a sample of young adolescents at risk for problem drinking. METHODS Adolescents were all 8th graders from 17 different Special Education Schools (for youth with externalizing behavior problems). At the beginning of the study, 374 adolescents participated (mean age of 13.6 years). Approximately every 6 months, adolescents completed a questionnaire to establish alcohol use and a Self-Ordered Pointing Task (SOPT) to assess WM. RESULTS Cross-lagged analyses revealed that alcohol use at T1 negatively predicted WM functioning 6 months later (p < 0.001). WM functioning at T2 and at T3 predicted alcohol use 6 months later (p < 0.01). CONCLUSIONS WM functioning has been identified as both risk factor for and as function negatively influenced by alcohol use. Findings indicate that early alcohol use in at-risk adolescents negatively influences the development of subsequent WM functioning, which in turn constitutes as a risk factor for later alcohol use problems. Implications for early interventions are discussed.

Longitudinal relations between cognitive bias and adolescent alcohol use.

INTRODUCTION To prospectively predict the development of adolescent alcohol use with alcohol-related cognitive biases, and to predict the development of alcohol-related cognitive biases with aspects of impulsivity. METHODS Data were used from a two-year, four-wave online sample of 378 Dutch young adolescents (mean age 14.9 years, 64.8% female). With zero-inflated Poisson regression analysis we prospectively predicted weekly alcohol use using baseline cognitive biases. Additionally, multiple regression analyses were used to prospectively predict the emergence of alcohol-specific cognitive biases by baseline impulsivity and alcohol use. RESULTS Zero-inflated Poisson analyses demonstrated that the Visual Probe Task reliably predicted weekly alcohol use at different time points. Baseline alcohol use and baseline impulsivity measures did generally not predict alcohol-specific cognitive biases. CONCLUSIONS The findings of this study indicated that while certain measures of alcohol-related attentional bias predicted later alcohol use in young adolescents, approach biases did not. Baseline measures of impulsivity and alcohol use did not predict later alcohol-related cognitive biases. We discuss implications for cognitive models on the development of cognitive biases and their role in early addictive behaviors.

Interactions between Parental Alcohol-Specific Rules and Risk Personalities in the Prediction of Adolescent Alcohol Use

AIMS To examine the impact of an important context variable (alcohol-specific parental rules) and an important person variable (risky personality traits) and their interaction on prospective adolescent drinking. METHODS Participants were 252 adolescents, 67.9% female, between 13 and 16 years old. Data were collected via online assessments during 2 years with four time points of assessments. We examined membership of alcohol use trajectories as a function of parental alcohol-specific rules, moderated by risk-associated personality traits. RESULTS Permissive parental rules predicted early onset and trajectories of heavy drinking. High scores on Sensation Seeking and Hopelessness also predicted early onset and heavy drinking, but there was no evidence for moderation. CONCLUSION The influence of parental rule setting and risk personality was confirmed, but no evidence was found that the impact of risk personality on adolescent drinking is moderated by parental rules. Implications of these findings, and limitations of the study, are discussed.

Do online assessed self-report and behavioral measures of impulsivity-related constructs predict onset of substance use in adolescents?

Introduction To prospectively predict the onset of use of alcohol, cigarettes and marijuana among Dutch adolescents, using behavioral and self-report measures of impulsivity-related facets. Specifically, we investigated whether behavioral measures of impulsivity predicted the onset of substance use above and beyond self-report measures of impulsivity and sensation seeking in an online sample. Methods Self-report and behavioral data from 284 adolescents (195 girls, mean age = 14.8 years, SD = 1.26) were collected at four time points over a period of two years, using an online survey system. Impulsivity-related facets were assessed at time point 1 with the Delay Discounting Task, the Balloon Analogue Risk Task and the Passive Avoidance Learning Task. We conducted logistic regression analysis to examine whether behavioral and self-report measures uniquely predicted onset of alcohol use, heavy episodic drinking, smoking and marijuana use. Results Onset of cigarette smoking was associated with behavioral assessment of impulsive decision making, but not after controlling for self-reported impulsivity and sensation seeking. Behavioral measures were sometimes associated with, but appeared not to prospectively predict, the onset of substance use in this online sample after controlling for self-report measures. Conclusions Based on the present results, the added value of online behavioral assessment of impulsivity-related factors in the prediction of onset of substance use was not confirmed. We suggest that factors specific to each behavioral task underlie their lack of prediction and suggest that future research addresses limitations of current behavioral tasks to increase their validity in online testing.

Investigating the joint development of approach bias and adolescent alcohol use

BACKGROUND We investigated the joint development between implicit approach bias and early adolescent alcohol use, and examined whether the link between approach bias and alcohol use was moderated by working memory (WM). METHODS The current study used data from a 2-year, 4-wave online sample of 378 Dutch early adolescents (mean age 14.9 years, 64.8% female). First, using latent growth curve modeling, we examined trajectories of approach bias and alcohol use over time. Second, we examined relations between baseline approach bias and WM and the development of alcohol use. Third, we examined the joint development of approach bias and alcohol use. Fourth, we examined whether the nature of this joint development varied for different levels of WM. RESULTS Unconditional growth curve model analyses indicated that the functional forms of alcohol use and cognitive bias were best captured by quadratic and linear trajectories, respectively. We found that cognitive bias decreased over time. We found no significant relations between baseline predictors and observed increases in alcohol use. We found relations between the intercepts, but not to growth factors, in the joint development of alcohol use and approach bias. WM was not found to moderate relations between growth in approach bias and alcohol use in this sample. CONCLUSIONS While we observed evidence of association between approach bias and alcohol use at baseline, there was no evidence of relations between development trajectories of the two. These findings replicate prior research demonstrating a role of implicit approach bias in predicting early adolescent alcohol use but do not demonstrate, in a light drinking early adolescent sample, the importance of interrelations between changes in approach bias and alcohol use over time, or a moderating role of WM. It is important to consider the potential consequences of repeated online approach bias assessment (e.g., changes in stimulus valence) when interpreting these results.

Exposure to Alcohol Content in Movies and Initiation of Early Drinking Milestones

BACKGROUND Exposure to alcohol content in movies has been shown to be associated with adolescent use of alcohol, including earlier onset. This study examined the influence of movie alcohol exposure on subsequent alcohol onset, considering the social context (whether the movie was viewed with a friend or parent). We examined whether medias influence holds across a spectrum of early drinking milestones: sipping (but not consuming a full drink of) alcohol, consuming a full drink of alcohol, and engaging in heavy episodic drinking (HED). METHODS Data were taken from a sample of 882 middle school youth (52% female; 24% non-White) enrolled in an ongoing study on alcohol initiation and progression. Exposure to alcohol content in films was measured using a method that combines content analysis and random assignment of movie titles to youth surveys. The hazard of initiating alcohol use (sip, full drink, HED) as a function of exposure was estimated using survival analysis. Associations were adjusted for demographic, personality, and social influence factors known to be associated with both movie exposure and alcohol use. RESULTS Exposure to alcohol content was common. Hours of exposure prospectively predicted earlier onset of alcohol involvement across all outcomes. Viewing movies with friends appeared to augment the media exposure effect, in contrast to viewing movies with parents, which was not a significant predictor of initiation. CONCLUSIONS Exposure to alcohol in films is involved in the entry into early stages of alcohol involvement. Findings support further investigation into the role of the media in underage drinking, especially in the context of consuming media with friends and peers. Limiting media exposure and/or stronger Federal Trade Commission oversight of movie ratings should be a priority for preventing underage drinking.