Does the tendency to act impulsively underlie binge eating and alcohol use problems? An empirical investigation

The co-occurrence of problem drinking and binge eating and purging has been well documented. However, there has been relatively little investigation of etiological models that may influence the development of this  co-occurrence. This study tests the hypotheses that impulsivity is heightened in eating disordered women compared with controls, and that women with comorbid bulimia and alcohol use disorders show higher impulsivity than bulimic-only women. The Impulsivity scale, BIS/BAS scales, State Anxiety Inventory, and a behavioural measure of reward responsiveness (CARROT) were administered to 22 women with bulimia, 23 women with comorbid bulimia and alcohol abuse/dependence, and 21 control women. As hypothesised, eating disordered women scored higher than controls on several self-report measures of impulsivity and sorted cards faster during a financially rewarded trial on the behavioural task. Also, as predicted, comorbid women scored higher than bulimic women on the Impulsivity scale. These findings suggest that individual differences in impulsiveness and a tendency to approach rewarding stimuli may contribute to developing these disorders.

Adolescent alcohol-use trajectories in the transition from high school

A cohort of 3300 students from high schools across Victoria, Australia, were surveyed regarding their patterns of alcohol consumption from mid-1993 to 1995. The first wave of data was collected halfway through the students' final year of school (year 12). Students were then resurveyed 3 months following school completion and on two subsequent occasions, each separated by 6-month intervals. Analysis of the four waves of data indicated that five longitudinal patterns (trajectories) characterized temporal trends in male and female alcohol use through the transition from high school. Stable non-use trajectories were evident for 17% of males and 16% of females. Trajectories of less than weekly use characterized 45% of females and 46% of males, and showed little tendency to escalate toward harmful use. Among those using alcohol on a weekly or more frequent basis in high school, with few exceptions, use continued with at least the same frequency, but the quantity of alcohol consumed tended to escalate over time toward harmful levels. Overall, findings indicate that patterns of alcohol use tend to be stable over time, and more frequent alcohol use during the final year of high school tends to precede potentially harmful alcohol use following high school. Encouraging those high school students who consume alcohol once per week or more often to use alcohol on a less than weekly basis may be a valuable yet neglected harm minimization strategy.

The relationship between social anxiety and alcohol use in remand prisoners

Community studies have found a consistently high co-occurrence, between alcohol use and anxiety disorders, such as social phobia. Despite high prevalence rates of alcohol use and anxiety disorders in remand prisoners, the extent to which they co-occur in this population and the use of alcohol as a strategy to reduce social anxiety, have not been examined. The aim of this study was to assess levels of social phobia and the use of alcohol to reduce anxiety associated with social and performance situations in a remanded prison population. One hundred and one male prisoners (age M = 34.88 years, SD = 11.70) participated in the study. They completed the Social Phobia Inventory (SoPhI) and a questionnaire designed to assess levels of drinking in social and performance situations to reduce anxiety. High levels of social anxiety were found, together with high levels of drinking to reduce anxiety associated with social or performance situations. Drinking was predictive of reduced levels of social anxiety but the effect of social anxiety on drinking was stronger. The implications for treatment and future research are discussed.

Family, school, peer and individual influences on early adolescent alcohol use: first-year impact of the Resilient Families programme

Introduction and Aims:  This study aimed to examine: (a) the influence of family factors relative to school, peer and individual influences on the development of adolescent alcohol use during the first year of secondary school; and (b) the feasibility of preventing adolescent alcohol use by modifying family factors. Design and Methods:  Twenty-four schools in Melbourne, Australia were randomly assigned to either the 'Resilient Families' intervention or a control condition. A baseline cohort of 2315 grade 7 students (mean age 12.3 years) were followed-up one year later (n = 2128 for longitudinal analyses). A sub-set of parents (n = 1166) also returned baseline surveys. Results: The prevalence of lifetime alcohol use in year 7 was 33% and rose to 47% by year 8. Student-reported predictors of year 8 alcohol use included baseline alcohol [Odds Ratio (OR) 3.64] and tobacco use (2.68), and school friend's alcohol (1.41) and tobacco use (1.64). After adjusting for other influences, student-reported family factors were not maintained as significant predictors of year 8 alcohol use. Parent-report predictors of student-reported alcohol use included allowing alcohol use in the home (2.55), parental alcohol use (1.88) and child hyperactivity (1.85). Protective factors included attendance at brief parent education (0.60) and parent involvement in school education (0.65). Discussion and Conclusions: The intervention appeared to benefit education-related outcomes, but no overall effect in reducing student alcohol use was found in year 8. Intervention effects on alcohol misuse may become significant in later secondary school once the entire program has been implemented. Considerable alcohol use was detected in early secondary school,   suggesting that interventions to reduce alcohol use may be usefully implemented prior to this period.

"As long as it doesn't spill over into class": harms arising from students` alcohol use, and the role of policy in reducing them

While there is considerable evidence about the prevalence of student alcohol use, little empirical work has examined the range and level of exposure to alcohol-related risks facing student populations, and the views of key stakeholders about these. This study was conducted at a large multi-campus university in order to gauge the scale and severity of students’ alcohol-related problems, and ways in which these may be mitigated. Student perspectives on campus based policy making with respect to alcohol were also canvassed. This study utilised a range of evaluative instruments, including standardised questionnaire protocols, structured interviews and focus groups. Data gained from students showed a large level of exposure to alcohol-related harm, and staff informants reported student harms such as drink-driving, interpersonal aggression, social nuisance, inadequate security, sexually risky behaviour, and physical malaise. As a group, students seem receptive to campus-based policies that have a harm reduction focus, but are less supportive of institutionalised measures aimed at the student body. Given the divergence of views about the harms arising from student drinking, and a general repudiation of institutional policy measures which may lessen these, the development of harm-reducing policy on alcohol remains challenging.

Alcohol use and negative affect in the offence cycle

Introduction : It is commonly acknowledged that, for many offenders, alcohol use is strongly associated with criminal behaviour. The belief held by many professionals that the two phenomena are associated, probably in a causal way, has led to the inclusion of alcohol use as a ‘criminogenic need’ in many settings where rehabilitation programmes are used to reduce recidivism. However, the mechanisms and pathways involved in the alcohol–crime link remain poorly understood.

Argument and conclusion : This paper reviews the literature relating to alcohol–offending links and draws some inferences about the role of alcohol use as a criminogenic need in offender rehabilitation. It is proposed that the bi-directional relationship between alcohol use and negative affective states is important in understanding the offence cycle, and that deficits in self-regulation not only characterize both alcohol misuse and negative affect but are also implicated in the offending behaviour itself.

Alcohol use and related harms in school students in the USA and Australia

Recognizing there have been few methodologically rigorous cross-national studies of youth alcohol and drug behaviour, state student samples were compared in Australia and the USA. Sampling methods were matched to recruit two independent, state-representative, cross-sectional samples of students in Grades 5, 7 and 9 in Washington State, USA, (n = 2866) and Victoria, Australia (n = 2864) in 2002. Of Washington students in Grade 5 (age 11), 10.3% (95% CI 7.2–14.7) of boys and 5.2% (95% CI 3.4–7.9) of girls reported alcohol use in the past year. Prevalence rates were markedly higher in Victoria (34.2%, 95% CI 28.8–40.1 boys; 21.0%, 95% CI 17.1–25.5 girls). Relative to Washington, the students in Victoria demonstrated a two to three times increased likelihood of reporting substance use (either alcohol, tobacco or illicit drug use), and by Grade 9, experiences of loss-of-control of alcohol use, binge drinking (frequent episodes of five or more alcoholic drinks), and injuries related to alcohol were two to four times higher. The high rates of early age alcohol use in Victoria were associated with frequent, heavy and harmful alcohol use and higher overall exposure to alcohol or other drug use. These findings reveal considerable variation in international rates of both adolescent alcohol misuse and co-occurring drug use and suggest the need for cross-national research to identify policies and practices that contribute to the lower rate of adolescent alcohol and drug use observed in the USA in this study.

Reinforcement sensitivity theory : a paradigm for understanding the motivational processes underlying alcohol use

Provides an examination of the processes which motivate individuals to drink alcohol. It was found that heavier drinkers are highly sensitive to reward yet more likely to experience negative affect, both generally, and in response to alcohol-related cues. Based on these findings a model focusing on the links between personality, mood and craving for alcohol was developed.

The importance of family management, closeness with father and family structure in early adolescent alcohol use

Aims To examine the importance of family management, family structure and father–adolescent relationships on early adolescent alcohol use.

Design Cross-sectional data was collected across 30 randomly selected Australian communities stratified to represent a range of socio-economic and regional variation.

Setting Data were collected during school time from adolescents attending a broad range of schools.

Participants The sample consisted of a combined 8256 students (aged 10–14 years).

Measurements Students completed a web-based survey as part of the Healthy Neighbourhoods project.

Findings Family management—which included practices such as parental monitoring and family rules about alcohol use—had the strongest and most consistent relationship with alcohol use in early adolescence. Adolescents reporting higher family management were less likely to have drunk alcohol in their life-time, less likely to drink alcohol in the preceding 30 days and less likely to have had an alcohol binge. Adolescents reporting emotionally close relationships with their fathers were less likely to have drunk alcohol in their life-time and less likely to have had an alcohol binge in the preceding fortnight.

Conclusions Findings indicate that family management practices may contribute to alcohol abstinence in adolescents. Furthermore, emotionally close father–adolescent relationships may also foster abstinence; however, fathers’ drinking behaviours need to be considered.

Patterns of alcohol use and associated physical and lifestyle characteristics according to new Australian guidelines

Objective: To describe the pattern of alcohol consumption and associated physical and lifestyle characteristics in a population-based sample of Australian men.
Method: A community-based age-stratifi ed random sample of 1420 men (median age 56 years, range 20 – 93) participating in the Geelong Osteoporosis Study, an epidemiological study set in south-eastern Australia. Daily alcohol intake was ascertained from a detailed food frequency questionnaire and categorized according to the Australian National Health and Medical Research Council 2009 guidelines (non-drinkers, greater than zero but ≤ 2 drinks per day, > 2 drinks per day), with a standard drink equivalent to 10 g of ethanol. Anthropometry was measured and lifestyle factors self-reported. Body composition was determined using dual energy absorptiometry. Socio-economic status was categorized according to the Australian Bureau of Statistics data. Results were age standardized to the Australian male population figures.
Results: The median daily ethanol consumption was 12 g (IQR 2 – 29) per day with a range of 0 – 117 g/day. The age-standardized proportion of non-drinkers was 8.7%, 51.5% consumed up to two drinks per day ( ≤ 20 g ethanol/day), and 39.9% exceeded 2 standard drinks per day ( > 20 g ethanol/day). Alcohol consumption was positively associated with cigarette smoking, weight, higher SES and inversely with age and physical activity.
Conclusions: Approximately, 40% of Australian men consume alcohol at levels in excess of current recommendations, which in combination with other risk factors may adversely impact upon health.

Family relationship quality and early alcohol use : evidence for gender-specific risk processes

Objective: Family characteristics (relationship quality, parental behaviors, and attitudes relating to alcohol use) are known to influence alcohol use in the mid-teen years, and there is evidence that family characteristics have different influences on mid-teen girls versus boys. This study examined child gender differences in the association of family relationship quality, parental disapproval of children's alcohol use, and parental alcohol use with early adolescent alcohol use.

Method: Grade 6 and 8 students (modal age 11 and 13, respectively; N = 6,837; 52.6% female) were recruited from 231 schools across three Australian states. Hypotheses were tested using two-level ordinal logistic regression (individuals nested within schools). The main dependent measure was lifetime frequency of early adolescent alcohol consumption. Independent variables included mother's/father's alcohol use, closeness, conflict, and disapproval of adolescent alcohol use. Control variables included sensation seeking, peer alcohol use, and socioeconomic disadvantage.

Results: The key findings were that for the young age group (Grade 6), emotional closeness to the parent of the opposite sex was protective. Family conflict was associated with females' drinking in both age groups but not males' drinking.

Conclusions: There was evidence of gender differences in the epidemiology of family relationship quality and early alcohol use. Social developmental models may need revision to account for these child gender differences. Gender-specific family dynamics may be an important consideration for family-oriented prevention strategy.

Influence of family factors and supervised alcohol use on adolescent alcohol use and harms : similarities between youth in different alcohol policy contexts

Objective: Harm-minimization policies suggest that alcohol use is a part of normal adolescent development and that parents should supervise their children's use to encourage responsible drinking. Zero-tolerance policies suggest that all underage alcohol use should be discouraged. This article compared hypotheses derived from harm-minimization and zero-tolerance policies regarding the influence of family context and supervised drinking on adolescent alcohol use and related harms among adolescents in Washington State, USA, and Victoria, Australia. two states that have respectively adopted zero-tolerance and harm-minimization policies.

Method: Representative samples of seventh-grade students (N = 1,945:989 females) were recruited from schools in each state. Students completed comprehensive questionnaires on alcohol use, related problem behaviors, and risk and protective factors annually from 2002 to 2004 when they were in ninth grade.

Results: Relationships between family context and alcohol use and harmful use were very similar in both states. Adult-supervised settings for alcohol use were associated with higher levels of harmful alcohol consequences. Adult-supervised alcohol use mediated the links between favorable parental attitudes to alcohol use and ninth-grade alcohol use for students in both states.

Conclusions: Despite policy differences in the two states, relationships between family context variables and alcohol use and harmful use are remarkably similar. Adult-supervised settings for alcohol use resulted in higher levels of harmful alcohol consequences, contrary to predictions derived from harm-minimization policy. Findings challenge the harm-minimization position that supervised alcohol use or early-age alcohol use will reduce the development of adolescent alcohol problems.

Gender differences in the impact of families on alcohol use : a lagged longitudinal study of early adolescents

Aims From the pre-teen to the mid-teen years, rates of alcohol use and misuse increase rapidly. Cross-sectional research shows that positive family emotional climate (low conflict, high closeness) is protective, and there is emerging evidence that these protective mechanisms are different for girls versus boys. The aim of this study was to explore gender differences in the longitudinal impact of family emotional climate on adolescent alcohol use and exposure to peer drinking networks.

Design Three-wave two-level (individual, within-individual over time) ordinal logistic regression with alcohol use in the past year as the dependent measure and family variables lagged by 1 year.

Setting Adolescents completed surveys during school hours.

Participants A total of 855 Australian students (modal age 10–11 years at baseline) participating in the International Youth Development Study (Victoria, Australia).

Measurements These included emotional closeness to mother/father, family conflict, parent disapproval of alcohol use and peer alcohol use.

Findings For girls, the effect of emotional closeness to mothers on alcohol use was mediated by exposure to high-risk peer networks. Parent disapproval of alcohol use was protective for both genders, but this effect was larger for boys versus girls, and there was no evidence that peer use mediated this effect. Peer drinking networks showed stronger direct risk effects than family variables.

Conclusions Family factors unidirectionally impact on growth in adolescent alcohol use and effects vary with child gender.