A genetically informed study of the processes underlying the association between parental marital instability and offspring adjustment

Parental divorce is associated with problematic offspring adjustment, but the relation may be due to shared genetic or environmental factors. One way to test for these confounds is to study offspring of twins discordant for divorce. The current analyses used this design to separate the mechanisms responsible for the association between parental divorce, experienced either before or after the age of 16, and offspring well-being. The results were consistent with a causal role of divorce in earlier initiation of sexual intercourse and emotional difficulties, in addition to a greater probability of educational problems, depressed mood, and suicidal ideation. In contrast, the increased risk for cohabitation and earlier initiation of drug use was explained by selection factors, including genetic confounds. ((c) 2006 APA, all rights reserved).     

Affect and alcohol use: an ecological momentary assessment study of outpatients with borderline personality disorder

Alcohol use may be viewed as an attempt (albeit maladaptive) to regulate negative emotional states. We examined associations between both negative and positive affects and alcohol use in outpatient women diagnosed with borderline personality disorder (BPD; n=74), a prototype of emotional dysregulation, as well as a psychiatric control group of women with current depressive disorder (major depressive disorder/dysthymic disorder [MDD\DYS]; n=50). Participants completed randomly prompted reports of mood and alcohol use up to six times a day over a 28-day period using electronic diaries. Mean levels of either positive or negative affects did not distinguish between drinkers and nondrinkers in either diagnostic group. However, levels of both negative and positive affects were positively associated with alcohol use at the momentary level in BPD drinkers. More robust findings were obtained with respect to within-person affective variability, which was related to alcohol use in multiple ways. BPD drinkers showed higher within-person variability for most negative affects than BPD nondrinkers; MDD\DYS drinkers in general showed less within-person variability than MDD\DYS nondrinkers for negative affects. Multilevel lagged analyses for BPD drinkers indicated that alcohol use was positively related to variability in all affects, concurrently, but fewer significant effects of affect variability on the next day's drinking or significant effects of alcohol use on the next day's affect variability were observed. Among MDD\DYS drinkers, we observed more significant associations between affect variability on next day's alcohol use and of alcohol use on next day's affect variability. We discuss theoretical and methodological issues relevant to these findings as well as implications for future research.     

Psychological adjustment among adult children of alcoholics: a cross-cultural study.

In this study, we compared Hispanic and Caucasian college students identified as adult children of alcoholics in terms of psychological adjustment using the Diagnostic Inventory of Personality and Symptoms (DIPS; Vincent, 1985). Results of the study suggested that, among college students, Caucasian men seem to be at a greater risk for using alcohol and drugs than Caucasian women or Hispanic men and women.     

Effects of parental alcoholism and life stress on hispanic and non-hispanic caucasian adelescents: A prospective study

Investigated ethnicity and parental alcoholism as factors that might influence the stress vulnerability of adolescents. It extended an initial cross-sectional study of this same sample by adding two annual assessments which allowed for additional cross-sectional analyses and longitudinal tests. Hispanic and Caucasian adolescents (N=306 at Time 1) completed measures of their own life stress, family conflict, and alcohol use. Their parents reported on adolescents' internalizing and externalizing symptoms. Cross-sectional analyses at Time 2, and prospective analyses involving Time 1 and Time 2 measures were, for the most part, consistent with the original study's results. Caucasian adolescents and children of alcoholic parents appeared to be more vulnerable to stress than Hispanic adolescents and children of nonalcoholic parents. Family conflict was a partial explanation for this increased vulnerability. This research was supported by National Institute on Drug Abuse Grant DA05227 to Laurie Chassin (pricipal investigator) and Manuel Barrera, Jr. (coprincipal investigator). Susan Li was supported by an American Psychological Association Minority Fellowship Award. Portions of this research were presented at the conference, “Resiliency in Families: Racial and Ethnic Minority Families in America” that was held at the University of Wisconsin, May 31–June 2, 1994.     

A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety, and depression

This study tested the specificity of parent alcoholism effects on young adult alcohol and drug abuse/dependence, anxiety, and depression, and tested whether adolescent symptomatology and substance use mediated parent alcoholism effects. Participants were from a longitudinal study in which a target child was assessed in adolescence and young adulthood with structured interview measures (N = 454 families at Time 1). Results showed unique effects of parent alcoholism on young adult substance abuse/dependence diagnoses over and above the effects of other parental psychopathology. There was some evidence of parent alcoholism effects on young adult depression and of maternal alcoholism effects on young adult anxiety, although these were not found consistently across subsamples. Mediational models suggested that parent alcoholism effects could be partially (but not totally) explained by adolescent externalizing symptoms.     

'That's OK. He's a guy': a mixed-methods study of gender double-standards for alcohol use

Although drinking and drunkenness have traditionally been considered masculine behaviours, young women's alcohol consumption has increased in recent years. This mixed methods study was conducted to examine the extent to which young people endorse gender double-standards for alcohol use--i.e., less acceptance of drinking and drunkenness in women than men--and how these influence men's and women's alcohol consumption. A sample of 731 English university students completed an online survey of gender role attitudes, beliefs about the gendered nature of alcohol use and recent alcohol consumption. Sixteen participants were then purposively selected for individual interviews: eight women and men with the most egalitarian gender role beliefs, and eight women and men with the least egalitarian beliefs. The two sets of data revealed that although there were few sex differences in actual levels of drinking or drunkenness, gender double-standards for alcohol use persist: beer drinking, binge drinking and public drunkenness tended to be perceived as masculine, and even the most egalitarian respondents were more judgemental of women's drinking. Participants modified their drinking style so as to maintain a desired gender identity. Although gender double-standards could be a focus of interventions to encourage moderate drinking, such approaches could reinforce gender inequalities.     

The effect of parental modeling of anxious behaviors and cognitions in school-aged children: An experimental pilot study

The current study tested: (1) the impact of parental modeling of anxious behaviors and cognitions on child anxiety level, anxious cognitions, desired avoidance, and objective performance using an experimental paradigm; and (2) whether the impact of parental modeling of anxious behaviors and cognitions differed by parent gender. Twenty-five parents (a random selection of 12 male and 13 female parents) participated with one of their children (ages 8-12 years; 56.0% male; 76.0% Caucasian). All children experienced two test conditions: an anxious condition in which their parent was trained to act anxiously before a planned spelling test and a non-anxious condition in which their parent was trained to act in a relaxed and confident manner before a planned spelling test. Results showed that, regardless of parent gender, children endorsed higher anxiety levels, anxious cognitions, and desired avoidance of the spelling test in the anxious relative to the non-anxious condition. Parental modeling of anxiety did not affect child spelling performance. Significant interaction effects indicated that fathers had a stronger impact on child anxiety level and cognitions than did mothers. Results highlight the importance of parental modeling and the potential role of both mothers and fathers in prevention and treatment for child anxiety.     

Hangover frequency and risk for alcohol use disorders: evidence from a longitudinal high-risk study

Data from a prospective high-risk study (N=489; 51% with a family history of alcoholism) were used to test whether family history is associated with greater hangover proneness and whether hangover is a risk factor for alcohol use disorders. Hangover was more frequent in family-history-positive participants during the college years. Persons with an alcohol diagnosis showed excess hangover before earning a diagnosis. Year 1 hangover predicted alcohol use disorders at Years 7 and 11, even when family history, sex, Year 1 diagnoses, and Year 1 drinking were statistically controlled. Several nonhangover drinking symptoms failed to predict later diagnoses. Taken together, the findings suggest a need for further research and theory on the role of hangover in the etiology of drinking problems.     

Children's self-selection into prevention programs: Evaluation of an innovative recruitment strategy for children of alcoholics

Systematically evaluated the efficacy of a self-selection strategy to recruit elementary-aged children into a school-based prevention program for children of alcoholics. Recruitment involved: a film about parental alcoholism, a follow-up meeting, and an invitation to participate in a prevention program. Of the 844 4th-6th graders exposed to recruitment, 67% showed no interest in the program, 26% attended the follow-up meeting, and 11% obtained parental permission. Analyses focused on group differences according to selection classification on measures of symptomatology and resources available to the child. Significant differences were noted on level of concern about parents' drinking, depression, conduct disorder, and self-worth. Children interested in the program tended to score higher on measures of symptomatology. The potential of a self-selection model for identifying children at risk and areas for future research are discussed.     

Development of a portable psychometric testing device for use in the field: an alcohol investigation

Cognitive and psychomotor performance have traditionally been assessed in the laboratory. There is a need for an objective portable assessment tool to assess cognitive and psychomotor performance. This study investigated the viability of a portable psychometric test battery, in a controlled laboratory environment, possibly leading to use in the field. A randomised, double-blind placebo controlled, three-way crossover design was employed. 16 subjects received 50 mg/100 ml and 80 mg/100 ml of alcohol and alcohol placebo. Performance was assessed with a tracking task, and an attention task presented on a small ruggedised handheld computer. The attention task showed no significant training effects; however, an element of the tracking task did. Statistical significance, effect size, and test-retest reliability analyses are presented indicating sensitivity of the portable psychometric test battery to the impairing effects of two separate doses of alcohol. Ability to undertake wide-scale impairment testing in the field with meaningful results in the absence of baseline data collection may have wide reaching implications, particularly in relation to the assessment of drivers impaired by drug use.     

Interactive voice response for relapse prevention following cognitive-behavioral therapy for alcohol use disorders: a pilot study

Relapse after alcoholism treatment is high. Alcohol Therapeutic Interactive Voice Response (ATIVR) is an automated telephone program for posttreatment self-monitoring, skills practice, and feedback. This pilot study examined feasibility of ATIVR. Participants (n = 21; 57% male) had access to ATIVR for 90 days following outpatient group cognitive-behavioral therapy (CBT) to make daily reports of mood, confidence in sobriety, urges to use substances, and actual use. Reports of relapse or risk were followed with additional questions. Participants received personalized therapist feedback based on responses, and could access recorded CBT skill reviews. Pre-post assessments included: alcohol consumption (Timeline Follow-Back), self-efficacy (Situational Confidence Questionnaire), and perceived coping ability (Effectiveness of Coping Behaviors Inventory). Participants called on 59% of scheduled days and continued making calls for an average of 84 days. Following ATIVR, participants gave feedback that ATIVR was easy to use and increased self-awareness. Participants particularly liked the therapist feedback component. Abstinence rate increased significantly during ATIVR (p = .03), and both self-efficacy and coping significantly improved from pre-CBT to post-ATIVR (p < .01). Results indicate ATIVR is feasible and acceptable. Its efficacy should be evaluated in a randomized controlled trial.     

A pilot study of the DBT coach: an interactive mobile phone application for individuals with borderline personality disorder and substance use disorder

Dialectical behavior therapy (DBT) has received strong empirical support and is practiced widely as a treatment for borderline personality disorder (BPD) and BPD with comorbid substance use disorders (BPD-SUD). Therapeutic success in DBT requires that individuals generalize newly acquired skills to their natural environment. However, there have been only a limited number of options available to achieve this end. The primary goal of this research was to develop and test the feasibility of the DBT Coach, a software application for a smartphone, designed specifically to enhance generalization of a specific DBT skill (opposite action) among individuals with BPD-SUD. We conducted a quasiexperimental study in which 22 individuals who were enrolled in DBT treatment programs received a smartphone with the DBT Coach for 10 to 14 days and were instructed to use it as needed. Participants used the DBT Coach an average of nearly 15 times and gave high ratings of helpfulness and usability. Results indicate that both emotion intensity and urges to use substances significantly decreased within each coaching session. Furthermore, over the trial period, participants reported a decrease in depression and general distress. Mobile technology offering in vivo skills coaching may be a useful tool for reducing urges to use substances and engage in other maladaptive behavior by directly teaching and coaching in alternative, adaptive coping behavior.     

Externalizing symptoms among children of alcoholic parents: Entry points for an antisocial pathway to alcoholism

The authors examined heterogeneity in risk for externalizing symptoms in children of alcoholic parents, as it may inform the search for entry points into an antisocial pathway to alcoholism. That is, they tested whether the number of alcoholic parents in a family, the comorbid subtype of parental alcoholism, and the gender of the child predicted trajectories of externalizing symptoms over the early life course, as assessed in high-risk samples of children of alcoholic parents and matched controls. Through integrative analyses of 2 independent, longitudinal studies, they showed that children with either an antisocial alcoholic parent or 2 alcoholic parents were at greatest risk for externalizing symptoms. Moreover, children with a depressed alcoholic parent did not differ from those with an antisocial alcoholic parent in reported symptoms. These findings were generally consistent across mother, father, and adolescent reports of symptoms; child gender and child age (ages 2 through 17); and the 2 independent studies examined. Multialcoholic and comorbid-alcoholic families may thus convey a genetic susceptibility to dysregulation along with environments that both exacerbate this susceptibility and provide few supports to offset it.     

A pilot study exploring the use of a telephone-assisted planning intervention to promote parental support for physical activity among children and youth with disabilities

Parent support is an important contributor to physical activity (PA) among children and youth with disabilities (CYD). Although many parents of CYD are motivated to provide parent PA support, CYD remain insufficiently active. The multi-process action control model has been applied to understand parent PA support and highlights behavioral regulation strategies such as action and coping planning as critical for translating intentions into behavior. Parents may struggle to create and carryout planning without support. There is no known research examining telephone support as a tool to promote planning and subsequent parent PA support behavior.MethodParents (43 mothers and 6 fathers) of CYD (child M_age = 12.53 years ± 5.53; 75% male; 38.6% developmental disability) completed a baseline questionnaire and were subsequently randomized to a telephone-assisted planning experimental group twice over four weeks (n = 23) or a control group who had access to planning tools but no telephone assistance (n = 26).ResultsNo significant main or interaction effects emerged for parent PA support behavior. However, a significant time × condition interaction was found for behavioral regulation strategies (i.e., action and coping planning and self-monitoring; F(1,44) = 5.05, p = 0.03) indicating a significant increase in the use of behavioral regulation strategies for parent PA support from baseline, for parents assigned to the telephone-assisted intervention.ConclusionThese findings suggest potential for planning support as a tool to enhance behavioral regulation strategies related to parent PA support among parents of CYD.     

Social phobia and avoidant personality disorder as related to parental history of social anxiety: a general population study

Using a validated and DSM-IV compatible questionnaire, the present study related family history of excessive social anxiety to social phobia and avoidant personality disorder (APD) in epidemiologically identified probands in the general population. Probands met diagnostic criteria for social phobia with or without APD and APD with or without social phobia. A two- to three-fold increased relative risk of social anxiety was observed for all diagnostic groups. Increasing severity in probands by varying diagnostic criteria did not affect the relative risk. Because familial aggregation of social anxiety was not modulated by Axis I or II diagnosis or diagnostic cut-off levels, data imply that social phobia and APD may represent a dimension of social anxiety rather than separate disorders. Thus, having an affected family member is associated with a two- to three-fold risk increase for both social phobia and APD.