Adolescent suicidal behaviors as a function of depression,hopelessness, alcohol use,and social support: A longitudinal investigation

Surveyed two high school cohorts (ns=698 and 283) to study independent prospective predictors of adolescent suicidal behaviors (thoughts, communicatio to others, attempts). Within each cohort, there were two measurements conducted 6 months apart. Structural equation models were tested, with depressive symptoms, hopelessness, alcohol consumption, social support, and gender serving as predictors. In the larger cohort, depression predicted later levels of all three suicidal behaviors controlling for baseline suicidal behaviors. Also, suicidal thoughts predicted later communications, and suicide attempts predicted future thoughts. In the smaller cohort, alcohol consumption predicted all three suicidal behaviors at the later measurement, whereas depression was predictive only of later thoughts. Major issues regarding prevention, theories of suicide and negative affect, and methodological/analytical approaches were discussed.     

The effects of alcohol consumption and expectancies in an experimental date rape analogue

This study examined the impact of perceived token resistance and the psychological and pharmacological effects of alcohol consumption on men's discrimination of when a female wants her partner to stop his sexual advances. In a 2 (alcohol vs. no alcohol) × 2 (expectancy vs. no expectancy) × 2 (perceived token resistance vs. no resistance) randomized factorial design, male college students were exposed to an audiotape of a date rape. Before listening, participants were told that on the previous date the woman did not resist sexual contact or that she initially objected to the contact but the man was able to obtain the level of intimacy he desired. Relative to participants assigned to the no-alcohol expectancy or no-alcohol consumption group, participants in the alcohol expectancy and alcohol consumption groups took significantly longer to determine that the man should refrain from attempting further sexual contact. The implications of the findings are discussed.This investigation was carried out by the first author under the supervision of the second author in partial fulfillment of the requirements for the degree of Doctor of Philosophy.     

Effect of Favorable Employment Change on Alcohol Abuse: One- and Five-Year Follow-Ups in the National Longitudinal Survey of Youth

Job loss has been linked to adverse outcomes such as alcohol abuse, but improved employment, usually assumed to be beneficial, has seldom been evaluated and may not help with addictive disorders. Using the National Longitudinal Survey of Youth, young adults who were unemployed or underemployed (low income or involuntary part-time) in 1984 were followed up in 1985 and 1989. Controlling for 1984 alcohol abuse, there were no effects of positive employment change on 1985 symptoms, but there were significant restorative effects on 1985 binge drinking among those who were heavy drinkers in 1984. There also appeared to be an indirect link of favorable 1984–1985 employment change to heavy drinking in 1989 via 1989 employment status. Because the effects of underemployment partially resembled those of unemployment, the discussion cautions against the conventional wisdom of promoting any work, including underemployment, as curative for the ills of unemployment.     

An investigation of intra-individual variability in children with fetal alcohol spectrum disorder (FASD)

Intra-individual variability (IIV) is defined as systematic within-person variation in performance either across test sessions (e.g., test/retest performance on the same task) or in one session (e.g., variations in performance on multiple trials of a single task). Higher levels of IIV have been noted as a characteristic of neurodevelopmental disorders such as attention deficit/hyperactivity disorder? (ADHD), but IIV is yet to be investigated in fetal alcohol spectrum disorder (FASD). FASD is a term used to describe a range of conditions resulting from prenatal exposure to alcohol. As part of a comprehensive neuropsychological battery, four study groups (1. fetal alcohol syndrome/partial fetal alcohol syndrome; 2. static encephalopathy/alcohol exposed; 3. neurobehavioral disorder/alcohol exposed as diagnosed using the University of Washington FASD 4-Digit Code; 4. typically-developing (TD) age-matched children with no prenatal alcohol exposure) were administered measures of motor response and inhibitory control, attention, and adaptive behavior. The results indicate increased levels of IIV in those with FASD compared to the TD controls. It was found that IIV uniquely contributes to predicting adaptive behavior above and beyond attention, while attention partially mediates the relationship between IIV and adaptive behavior. This is the first study to the authors’ knowledge to show the presence of increased IIV in children with FASD. It additionally provides evidence that IIV measures some inherent variability in performance independent of poor attention in children with FASD.     

Factors predictive of a fetal alcohol spectrum disorder: Neuropsychological assessment

A variety of neurodevelopmental impairments related to fetal alcohol spectrum disorder (FASD) diagnoses have been consistently documented. However, it is not clear whether such variables are predictive of a diagnosis. The purpose of the present study is to use logistic regressions to identify predictors of FASD in neuropsychological assessment. Charts of 180 children and adolescents with prenatal alcohol exposure (PAE) who underwent psychological and diagnostic assessment for FASD were retrospectively reviewed. A total of 107 received an FASD diagnosis (the PAE-FASD group) and 73 did not (the PAE group). Following preliminary analyses, direct logistic regressions were performed to assess the contribution of different neuropsychological testing measures on the likelihood of a child or adolescent receiving an FASD diagnosis. The results indicate that the classification accuracy of the PAE-FASD and PAE groups is clinically significant across models of intelligence, academic achievement, memory, and executive functioning. Classification rates across the various models range from 67.1% to 75.5%, with models incorporating 10 intelligence subtests or 3 academic subtests emerging as superior to those using broad indices of intelligence and/or individual subtests of memory or executive functioning. A “test battery” model incorporating verbal intelligence, verbal/auditory working memory (digit span), basic reading and spelling skills, math calculations, delayed story recall, and spatial planning and problem-solving yielded a classification rate of 74.7%. These results suggest that neuropsychological testing is a critical component of FASD assessment and help guide decisions to maximize the efficiency and efficacy of the diagnostic process and treatment recommendations.     

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

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.     

Comorbid interpretation and expectancy bias in social anxiety and alcohol use

Background: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship.

Design: Cross-sectional, quantitative surveys.

Methods: Measures of social anxiety and alcohol use disorder symptoms, as well as an interpretation and expectancy bias task assessing biases for social anxiety, drinking, and comorbid social anxiety and drinking.

Results: In Study 1 (N?=?447), individuals high (vs. low) in social anxiety had stronger social threat bias and individuals high (vs. low) in alcohol use disorder symptoms had stronger drinking bias. Those high in both social anxiety and alcohol use disorder symptoms endorsed interpretations and expectancies linking social interaction with alcohol use. Comorbid bias predicted membership into the high social anxiety/drinking group, even after taking into account single-disorder biases. In Study 2 (N?=?325), alcohol use disorder symptoms predicted drinking bias and social anxiety symptoms predicted social anxiety bias. Alcohol use disorder symptoms, social anxiety symptoms, and their interaction predicted comorbid interpretation and expectancy bias.

Conclusion: Results indicate unique cognitive vulnerability markers for persons with comorbid social anxiety and alcohol use disorder symptoms, which may improve detection and treatment of this serious comorbidity.     

A Brief Alcohol Intervention During Inpatient Psychiatric Hospitalization for Suicidal Adolescents

Alcohol use and suicide-related thoughts and behaviors are common in psychiatrically hospitalized adolescents and each problem can exacerbate the other. Despite knowledge about the functional relationship between alcohol use and suicide-related thoughts and behaviors, inpatient psychiatric units only cursorily address alcohol use because suicide risk is considered primary. In this paper we provide theoretical and empirical rationale for the inclusion of brief motivational interventions for alcohol use in inpatient treatment settings for suicidal adolescents. We give a case example of the brief intervention in practice, including when and how to use specific techniques. Following the case example, we discuss the flexibility of this intervention and how it can be adapted for adolescents with varying risk profiles. We conclude with recommendations for future research, including the development and testing of technology-based boosters following hospital discharge.     

Affordances for drinking alcohol: A non‐participant observation study in licensed premises

Alcohol misuse is a pressing area of public health concern. This non‐participant observational study investigated the functional characteristics of on‐licensed premises where alcohol is consumed. Seven different licensed premises from South Central England were visited and observed for similar three hour periods on Saturday evenings. Observations within these ecological niches were grouped using a functional taxonomy of affordances and effectivities related to alcohol drinking. Affordances provide a theoretically grounded and useful concept for evaluating how individuals behave in drinking contexts, while identifying action opportunities for inhibiting and promoting consumption. Identified alcohol‐related affordances were related to: Alcohol access, regulations, furnishing, alternative opportunities for action, décor and lighting, drink and accessory availability, and action opportunities provided by others. This research has implications for understanding alcohol consumption in real‐time, social environments, with direct implications for preventing excessive consumption within community alcohol outlets.