The relationship of early social, mental, and behavioral experiences with adult obesity and Alcohol Use Disorder

Stressful life events early in life, including symptoms of mental disorders or childhood maltreatment, may increase risk for worse mental and physical health outcomes in adulthood. The purpose of this dissertation was to examine the effects of childhood Attention Deficit Hyperactivity Disorder (ADHD) symptoms and maltreatment experience on two adult outcomes: obesity and alcohol use disorder (AUD). Mediational effects of adolescent characteristics were explored. This dissertation used Waves I, III, and IV of the National Longitudinal Study of Adolescent to Adult Health. In Paper 1 (Chapter 3), we investigated the association between multiple types of child maltreatment and adult objective (body mass index; BMI) and subjective (self-rated) obesity, as well as mediating effects by adolescent characteristics including depressive symptoms and BMI. Results showed that after adjusting for sex, race/ethnicity, and maternal education, physical maltreatment was moderately associated with adulthood obesity as measured by BMI and self-reported obesity, while sexual maltreatment was more strongly associated with the objective measure but not the subjective measure. The indirect effects of mediation of adolescent BMI and depressive symptoms were statistically significant. In Paper 2 (Chapter 4), the objective was to examine mediation by adolescent depressive symptoms, alcohol consumption, peer alcohol consumption, and delinquency in the relationship between ADHD symptoms and adult AUD. The indirect effects of mediation of adolescent delinquency, alcohol consumption, and peer alcohol consumption were statistically significant in single and multiple mediator models. In Paper 3 (Chapter 5), the objective was to assess the joint effects of maltreatment/neglect on adult AUD. After adjusting for sex, race/ethnicity, child maltreatment, and parental AUD, ADHD symptoms were significantly associated with increased odds of AUD. There was no strong evidence of multiplicative interaction by maltreatment. This association was stronger for males than females, although the interaction term was not statistically significant. This dissertation adds to the literature by examining relationships between several major public health problems: ADHD symptoms, childhood maltreatment, AUD, depressive symptoms, and obesity. This project has implications for understanding how early life stress increases risk for later physical and mental health problems, and identifying potential intervention targets for adolescents.

The Role of Feminine and Masculine Norms in College Women's Alcohol Use

Current literature suggests not only that men and women can conform to both feminine and masculine norms, but that women who adhere to certain masculine norms may be at greater risk for problematic alcohol use. This study examined conformity to both masculine and feminine norms, and how conformity to distinct norms influenced heavy episodic drinking and alcohol-related problems among a sample of underage college women (N= 645). Results demonstrated that the masculine norms risk-taking and emotional control were associated with increased HED, while the masculine norm power over women was associated with a decrease in HED. Traditional feminine norms, including modesty and sexual fidelity, were associated with a decrease in HED and alcohol-related problems. The feminine norm relational was associated with increased HED, while the norms thinness and appearance were associated with increased alcohol-related problems. The study’s theoretical and clinical implications are discussed.

Assessing teen risk behavior and later drug use

Gemstone Team Risky Business

Gender, Behavioral Assessment of Negative Reinforcement Driven Risk Taking Propensity, and Cigarette Smoking

Cigarette smoking remains the leading preventable cause of death and disability in the United States and most often is initiated during adolescence. An emerging body of research suggests that a negative reinforcement model may explain factors that contribute to tobacco use during adolescence and that negative reinforcement processes may contribute to tobacco use to a greater extent among female adolescents than among male adolescents. However, the extant literature both on the relationship between negative reinforcement processes and adolescent tobacco use as well as on the relationship between gender, negative reinforcement processes, and adolescent tobacco use is limited by the sole reliance on self-report measures of negative reinforcement processes that may contribute to cigarette smoking. The current study aimed to further disentangle the relationships between negative reinforcement based risk taking, gender and tobacco use during older adolescence by utilizing a behavioral analogue measure of negative reinforcement based risk taking, the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS). Specifically, we examined the relationship between pumps on the MRBURNS, an indicator of risk taking, and smoking status as well as the interaction between MRBURNS pumps and gender for predicting smoking status. Participants included 103 older adolescents (n=51 smokers, 50.5% female, Age (M(SD) = 19.41(1.06)) who all attended one experimental session during which they completed the MRBURNS as well as self-report measures of tobacco use, nicotine dependence, alcohol use, depression, and anxiety. We utilized binary logistic regressions to examine the relationship between MRBURNS pumps and smoking status as well as the interactive effect of MRBURNS pumps and gender for predicting smoking status. Controlling for relevant covariates, pumps on the MRBURNS did not significantly predict smoking status and the interaction between pumps on the MRBURNS and gender also did not significantly predict smoking status. These findings highlight the importance of future research examining various task modifications to the MRBURNS as well as the need for replications of this study with larger, more diverse samples.