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BACKGROUND AND AIMS: Impulsivity impacts adolescent alcohol use. We aimed to prospectively evaluate the cognitive mechanisms outlined in two-factor models and the protective role of coping skills. METHODS: Two cohorts of adolescents followed for three years were included in the study (younger cohort: N = 908, aged 10–12 years at Time 1; older cohort: N = 943, aged 12–15 years at Time 1). Constructs measured included impulsivity (reward drive, rash impulsiveness), positive social alcohol expectancies (PSAE), drinking-refusal self-efficacy (DRSE), problem-based coping skills, family and community risk factors, and alcohol use including the Alcohol Use Disorders Identification Test (AUDIT). RESULTS: Data were analysed using structural equation modelling controlling for family and community risk factors, testing mediation and moderation. Impulsivity traits predicted cognitive mechanisms and these in turn predicted alcohol use in both cohorts (χ(2) = 1,139.79, df = 249, p < .001, CFI = .92, SRMR = .06, RMSEA = .04). DRSE and PSAE mediated the effects of rash impulsiveness and reward drive, respectively, on alcohol use. Problem-based coping skills moderated several pathways to drinking within each cohort, being protective even when adolescents have low DRSE, and buffering the impact of PSAE on alcohol use. CONCLUSIONS: The current study details the prospective interactive influences of impulsivity and cognitive risk factors on adolescent alcohol use. The findings have direct implications for prevention and treatment programs, providing information about possible high-impact targets for intervention.

To assess gender differences in the relationship between eating and weight loss attitudes (EWAs), and 30-day tobacco and alcohol use among adolescents, while controlling for potential confounds (age, country of birth, psychological distress, pubertal development, peer alcohol and tobacco use, and sexual activity).School students aged between 11 and 17 years (N = 10,273) from high schools in the State of Victoria (Australia) completed surveys in class under conditions of anonymity and confidentiality.The interaction between EWAs and gender was significant for tobacco use but not for alcohol use, indicating that the effect of EWAs on tobacco use, but not alcohol use, vary by gender.Tobacco use was related to EWAs in adolescent females but not males, and this is consistent with the possibility that females use tobacco in an instrumental fashion to control weight. Implications and Contribution: Female adolescents high in eating and weight loss attitudes were more likely to engage in tobacco use. In contrast, eating and weight loss attitudes were not related to male tobacco use. These results point to the potential importance of developing gender-specific approaches towards addressing problematic behaviors in adolescent populations.

Objective: To examine the extent to which family conflict, peer bullying and psychological distress account for eating and weight loss attitudes in adolescent females. This study examined the degree to which psychological distress mediated the association between family conflict and eating and weight loss attitudes, and the association of bullying and eating and weight loss attitudes. Method: Females aged between 11 and 17 years (N = 5125) were recruited from schools in the State of Victoria (Australia). Key measures included psychological distress, family conflict, and bullying victimisation. Results: A structural model showed good fit, and all predictors were significant. Psychological distress mediated the association between eating and weight loss attitudes, and family problems and bullying. Conclusion: Family conflict and peer bullying were associated with eating and weight loss attitudes and this association may occur via psychological distress. Early intervention programs may benefit from a focus on family and peer relationships.

AIMS: This study examined the association between peer drug use and adolescent polysubstance use, and investigated if this association was moderated by parenting and/or school factors. METHODS: The sample consisted of 9966 participants (mean age=14.3; 49.34% males) randomly selected from secondary schools in Victoria, Australia. Three 30-day polysubstance use profiles were derived from latent class analysis - no drug use (47.7%), mainly alcohol use (44.1%) and polysubstance use (8.2%). These profiles were then regressed on peer's drug use, family conflict, parental monitoring, parental disapproval of drug use, school commitment, reward for prosocial involvement in school and academic failure, and the interactions between peer's drug use and each of the parenting and school variables. RESULTS: Relative to non-users, peer's drug use was strongly associated with polysubstance use (OR=30.91, p

Military forces are among vulnerable groups to high-risk behaviors, especially substance use. Accordingly, this study aimed to investigate the role of personality traits and socio-familial factors in the prediction of risk of substance use among soldiers. A total of 309 soldiers doing military service in Tehran, Iran, were selected using convenience sampling, and completed measures included risk of substance use, personality traits, and social and familial risk/protective factors. Current results showed significant relationships between personality traits and socio-familial factors with tendency toward substance use. Moreover, linear regression analyses indicated that personality traits (i.e., conscientiousness and agreeableness), social factors (i.e., friends’ substance use and social disorganization), and familial factors (i.e., parents’ positive attitude toward substance use) were significantly associated with tendency toward smoking, drug use, and alcohol use in soldiers. Multimodal interventions targeting individual, familial, and social vulnerabilities may help reduce adjustment problems among Iranian soldiers.

The extent to which parental traits of autism are related to parenting efficacy has yet to be explored. Parents of children with Autism Spectrum Disorder (ASD) were studied in three groups: (a) families in which both the parent and the child had a DSM-IV-TR ASD diagnosis (n = 109); (b) families in which only the child had a DSM-IV-TR ASD diagnosis (n = 128); and (c) families in which no member had ASD (n = 109). Each subject completed the Autism Spectrum Quotient (AQ) and a measure of parenting efficacy. Fathers with ASD had the lowest parental efficacy, but mothers with ASD had comparable levels of parental efficacy to parents without ASD in the family. Results suggest that screening and intervention to build fathers parental efficacy may be a useful adjunct to therapy.

Adolescent depressed mood is related to the development of subsequent mental health problems, and family problems have been linked to adolescent depression. Longitudinal research on adolescent depressed mood is needed to establish the unique impact of family problems independent of other potential drivers. This study tested the extent to which family conflict exacerbates depressed mood during adolescence, independent of changes in depressed mood over time, academic performance, bullying victimization, negative cognitive style, and gender. Students (13 years old) participated in a three-wave bi-national study (n = 961 from the State of Washington, United States, n = 981 from Victoria, Australia; 98 % retention, 51 % female in each sample). The model was cross-lagged and controlled for the autocorrelation of depressed mood, negative cognitive style, academic failure, and bullying victimization. Family conflict partially predicted changes in depressed mood independent of changes in depressed mood over time and the other controls. There was also evidence that family conflict and adolescent depressed mood are reciprocally related over time. The findings were closely replicated across the two samples. The study identifies potential points of intervention to interrupt the progression of depressed mood in early to middle adolescence.

Introduction Preventing adolescent alcohol use is an international public health priority. To further understand adolescent alcohol use, this study tested a model of adolescent intention to consume alcohol that incorporated multiple social systems influences. Methods Participants included 2529 Australian secondary school students (Mage = 14.20; 53.7% female). Participants completed a survey about risk and protective factors for alcohol use at individual, family, school and community levels. Structural Equation Modeling (path analysis) was used to evaluate an extended Theory of Planned Behavior (TPB) that incorporated social system determinants of intention to consume alcohol. Results The final model explained 60% of the variance in adolescent alcohol use intention. All TPB constructs correlated with intention and experience of lifetime alcohol use. More exposure to information about alcohol use had a weak but significant influence on adolescents’ stronger perceived behavioral control. Having less friends who use alcohol, stricter parental rules for adolescent alcohol use, and unfavorable parent attitudes towards alcohol use, were associated with stronger adolescent anti-alcohol attitudes and subjective norms. Community level pro-abstinence attitudes predicted unfavorable adolescent attitudes to alcohol and intention to consume alcohol. Parental rules showed significantly stronger influences on alcohol use intention amongst younger adolescents. Conclusions Key social systems around adolescents significantly predicted intention to consume alcohol, and the extended TPB model explained the major variance in adolescent alcohol use. The findings emphasize the importance of multi-level approaches to the prevention of alcohol use. Situation-based factors that could trigger impulsive emotional response may be a future intervention focus.

Polydrug use is relatively common among adolescents. Psychological distress is associated with the use of specific drugs, and may be uniquely associated with polydrug use. The purpose of this study was to test the association of psychological distress with polydrug use using a large adolescent sample. The sample consisted of 10,273 students aged 12-17 years from the State of Victoria, Australia. Participants completed frequency measures of tobacco, alcohol, cannabis, inhalant, and other drug use in the past 30 days, and psychological distress. Control variables included age, gender, family socioeconomic status, school suspensions, academic failure, cultural background, and peer drug use. Drug-use classes were derived using latent-class analysis, then the association of psychological distress and controls with drug-use classes was modeled using multinomial ordinal regression. There were 3 distinct classes of drug use: no drug use (47.7%), mainly alcohol use (44.1%), and polydrug use (8.2%). Independent of all controls, psychological distress was higher in polydrug users and alcohol users, relative to nondrug users, and polydrug users reported more psychological distress than alcohol users. Psychological distress was most characteristic of polydrug users, and targeted prevention outcomes may be enhanced by a collateral focus on polydrug use and depression and/or anxiety.

INTRODUCTION AND AIMS: Alcohol misuse and depressed mood are common during early adolescence, and comorbidity of these conditions in adulthood is associated with poorer health and social outcomes, yet little research has examined the co-occurrence of these problems at early adolescence. This study assessed risky and protective characteristics of pre-teens with concurrent depressed mood/early alcohol use in a large school-based sample. DESIGN AND METHODS: School children aged 10-14 years (n = 7289) from late primary and early secondary school classes in government, Catholic and independent sectors participated with parental consent in the cross-sectional Healthy Neighbourhoods Study. Key measures included depressed mood, recent alcohol use, school mobility, family relationship quality, school engagement and coping style. Multinomial logistic regression analyses were used to identify school and family-related factors that distinguished those with co-occurring drinking and depressive symptoms from those with either single condition. Gender and school-level interactions for each factor were evaluated. RESULTS: Co-occurring conditions were reported by 5.7% of students [confidence interval (CI)95 5.19, 6.19]. Recent drinkers were more likely than non-drinkers to have symptoms consistent with depression (odds ratio 1.80; CI95 1.58, 2.03). Low school commitment was associated with co-occurring drinking/depressive symptoms (odds ratio 2.86; CI95 2.25, 3.65 compared with null condition). This association appeared to be weaker in the presence of adaptive stress-coping skills (odds ratio 0.18; CI95 0.14, 0.23). CONCLUSIONS: We have identified factors that distinguish pre-teens with very early co-occurrence of drinking and depressed mood, and protective factors with potential utility for school-based prevention programmes targeting these conditions. [Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev 2015]. Language: en

Objective This study examined the association of risky dieting amongst adolescent girls with depressed mood, family conflict, and parent-child emotional closeness. Method Grade 6 and 8 females (aged 11–14 years, N = 4031) were recruited from 231 schools in 30 communities, across three Australian States (Queensland, Victoria, and Western Australia). Key measures were based on the Adolescent Dieting Scale, Short Mood and Feelings Questionnaire, and widely used short measures of family relationship quality. Controls included age, early pubertal onset, and socioeconomic status. Results Risky dieting was significantly related to family conflict and depressed mood, depressed mood mediated the association of family conflict and risky dieting, and these associations remained significant with controls in the model. Conclusion Family conflict and adolescent depressed mood are associated with risky dieting. Implications Prevention programs may benefit from a broadening of behavioural targets to include depressed mood and family problems.

Aims: Failure to complete high school predicts substantial economic and social disadvantage in adult life. The aim of this study was to determine the longitudinal association of mid‐adolescent polydrug use and high school non‐completion, relative to other drug use profiles. Design: A longitudinal analysis of the relationship between polydrug use in three cohorts at grade 9 (age 14–15 years) and school non‐completion (reported post‐high school). Setting: A State‐representative sample of students across Victoria, Australia. Participants: A total of 2287 secondary school students from 152 high schools. The retention rate was 85%. Measurements: The primary outcome was non‐completion of grade 12 (assessed at age 19–23 years). At grade 9, predictors included 30‐day use of eight drugs, school commitment, academic failure and peer drug use. Other controls included socio‐economic status, family relationship quality, depressive symptoms, gender, age and cohort. Findings: Three distinct classes of drug use were identified—no drug use (31.7%), mainly alcohol use (61.8%) and polydrug use (6.5%). Polydrug users were characterized by high rates of alcohol, tobacco and cannabis use. In the full model, mainly alcohol users and polydrug users were less likely to complete school than non‐drug users [odds ratio (OR) = 1.54, 95% confidence interval (CI) = 1.17–2.03) and OR = 2.51, 95% CI = 1.45–4.33), respectively, P

Aims: This study estimated the extent of familial alcohol supply in 45 low and middle income countries (LMIC), and examined the country-level effects of familial alcohol supply on adolescents’ alcohol use. Method: We used data from 45 LMICs that participated in the Global School-Based Student Health Survey (GSHS) between 2003 and 2013 (n=139,840). The weighted prevalence of familial alcohol supply in each country was estimated. Multilevel binary and ordinal logistic regression analyses were used to examine the country-level effect of familial alcohol supply on early onset of alcohol use (first alcohol before 12), past 30-day alcohol use, lifetime drunkenness and alcohol-related social problems. Results: There were large variations between LMICs in the prevalence of familial alcohol supply and pattern of adolescent alcohol use. The prevalence of familial supply ranged from 0.1% in Tajikistan to 23.8% in St Lucia. It was estimated that a one percentage change in prevalence of familial alcohol supply was associated with 10%, 12% and 12% change in the odds of lifetime drunkenness (OR = 1.10, 95% CI = [1.04, 1.16]), early onset of alcohol use (OR = 1.12, 95% CI = [1.07, 1.08]) and more frequent drinking in the past month (OR = 1.12, 95% CI = [1.04, 1.20]). Conclusion: There were large variations in the prevalence of familial alcohol supply and adolescent alcohol use among LMICs. Adolescents in countries with higher prevalence of familial alcohol supply were more likely to start using alcohol at an earlier age, to have used alcohol in the past 30 days and experience intoxication.

Given the stressful nature of military life, people in the armed forces are vulnerable to substance use. The aim of this study was to explore the relationship between family and peers with drug use among military forces in Iran. Convenience sampling was used to recruit a total of 422 draftees doing military service in army units in Tehran, Iran. Measures of family and peers' risk and protective factors, alcohol use, and other drug use were administered. Findings indicated significant relationships between family (i.e., family models for risk behavior, parent sanctions, and family controls) and peers (i.e., peer modeling for risk behavior, peer controls, support from friends) with drug use. A multiple regression analysis revealed that peer modeling for risk behavior, family models for risk behavior, and parent sanctions were significant predictors of drug use in soldiers. These results were consistent with the influence of family and peer on drug use amongst soldiers. Programs designed to reduce alcohol and other drug use may benefit from tailoring to fit risk and protective files amongst peer and family networks.

PURPOSE To explore the extent to which parent-adolescent emotional closeness, family conflict, and parental permissiveness moderate the association of puberty and alcohol use in adolescents (aged 10-14). METHODS Cross-sectional survey of 7631 adolescents from 231 Australian schools. Measures included pubertal status, recent (30day) alcohol use, parent-adolescent emotional closeness, family conflict, parental permissiveness of alcohol use and peer alcohol use. The analysis was based on a two-level (individuals nested within schools) logistic regression model, with main effects entered first, and interaction terms added second. RESULTS The interaction of family factors and pubertal stage did not improve the fit of the model, so a main effect model of family factors and pubertal stage was adopted. There were significant main effects for pubertal stage with boys in middle puberty at increased odds of alcohol use, and girls in advanced puberty at increased odds of alcohol use. CONCLUSIONS Puberty and family factors were strong predictors of adolescent alcohol use, but family factors did not account for variation in the association of pubertal stage and alcohol use.

Heavy alcohol use increases dramatically at age 14, and there is emerging cross-sectional evidence that when girls experience family conflict at younger ages (11-13 years) the risk of alcohol use and misuse is high. This study evaluated the role of family conflict and subsequent depressed mood in predicting heavy alcohol use among adolescent girls.This was a three-wave longitudinal study with annual assessments (modal ages 12, 13, and 14 years). The participants (N = 886, 57% female) were from 12 metropolitan schools in Victoria, Australia, and participants completed questionnaires during school class time. The key measures were based on the Communities That Care Youth Survey and included family conflict (Wave 1), depressed mood (Wave 2), and heavy alcohol use (Wave 3). Control variables included school commitment, number of peers who consumed alcohol, whether parents were living together, and ethnic background.With all controls in the model, depressed mood at Wave 2 was predicted by family conflict at Wave 1. The interaction of family conflict with gender was significant, with girls showing a stronger association of family conflict and depressed mood. Depressed mood at Wave 2 predicted heavy alcohol use at Wave 3.Girls may be especially vulnerable to family conflict, and subsequent depressed mood increases the risk of heavy alcohol use. The results support the need for gender-sensitive family-oriented prevention programs delivered in late childhood and early adolescence.

Introduction and aims Despite evidence that many Australian adolescents have considerable experience with various drug types, little is known about the extent to which adolescents use multiple substances. The aim of this study was to examine the degree of clustering of drug types within individuals, and the extent to which demographic and psychosocial predictors are related to cluster membership. Design and method A sample of 1402 adolescents aged 12–17 years were extracted from the Australian 2007 National Drug Strategy Household Survey . Extracted data included lifetime use of 10 substances, gender, psychological distress, physical health, perceived peer substance use, socioeconomic disadvantage, and regionality. Latent class analysis was used to determine clusters, and multinomial logistic regression employed to examine predictors of cluster membership. Result There were 3 latent classes. The great majority (79.6%) of adolescents used alcohol only, 18.3% were limited range multidrug users (encompassing alcohol, tobacco, and marijuana), and 2% were extended range multidrug users. Perceived peer drug use and psychological distress predicted limited and extended multiple drug use. Psychological distress was a more significant predictor of extended multidrug use compared to limited multidrug use. Discussion and conclusion In the Australian school-based prevention setting, a very strong focus on alcohol use and the linkages between alcohol, tobacco and marijuana are warranted. Psychological distress may be an important target for screening and early intervention for adolescents who use multiple drugs.

Background : For young couples, a partner's heavy alcohol use may be a point of conflict and relationship distress, particularly when there are disparities in the severity of drinking across partners. Objective : The aim was to examine the longitudinal impact of discrepancies in heavy alcohol use, particularly in couples with parenting responsibilities. Methods : Data were obtained from 554 heterosexual couples (with at least one partner aged between 18 and 30 years of age) over two assessments from a well-established longitudinal study of Australian households. Results : Multilevel analyses (examining time within partners within couples) indicated a high level of couple-level variation in individual reports of relationship satisfaction. Discrepancies in heavy alcohol use were negatively associated with relationship satisfaction over the assessment period and this was significantly moderated by parenthood. More specifically, heavy drinking discrepancies were associated with lower relationship satisfaction amongst parents more than nonparents. Conclusion : Among dissatisfied couples, managing discrepancies in alcohol use and helping heavy drinking partners may be an important intervention focus, particularly when providing professional support for young parents.

OBJECTIVES: The co-occurrence of anger in young people with Asperger's syndrome (AS) has received little attention despite aggression, agitation, and tantrums frequently being identified as issues of concern in this population. The present study investigated the occurrence of anger in young people with AS and explores its relationship with anxiety and depression. METHOD: Sixty-two young people (12-23 years old) diagnosed with AS were assessed using the Beck Anger Inventory for Youth, Spence Children's Anxiety Scale, and Reynolds Adolescent Depression Scale. RESULTS: Among young people with AS who participated in this study, 41% of participants reported clinically significant levels of anger (17%), anxiety (25.8%) and/or depression (11.5%). Anger, anxiety, and depression were positively correlated with each other. Depression, however, was the only significant predictor of anger. CONCLUSION: Anger is commonly experienced by young people with AS and is correlated with anxiety and depression. These findings suggest that the emotional and behavioral presentation of anger could serve as a cue for further assessment, and facilitate earlier identification and intervention for anger, as well as other mental health problems. Language: en

AIM: The aim of this study is to examine the susceptibility of very young adolescents (10-12 years of age) to peer alcohol-related influences, compared to older adolescents (13-14 years of age). METHODS: The analysis sample consisted of 7064 adolescents in grade 6 (modal age 11) or grade 8 (modal age 13) from 231 schools in 30 communities across three Australian States. Key measures were adolescent reports of alcohol use (past 30 days) and the number of peers who consume alcohol without their parent's awareness. Control variables included parent alcohol use, family relationship quality, pubertal advancement, school connectedness, sensation seeking, depression, length of time in high school, as well as age, gender, father/mother education, and language spoken at home. A multi-level model of alcohol use was used to account for school-level clustering on the dependent variable. RESULTS: For both groups, the number of peers who consumed alcohol was associated with alcohol use, but Grade 6 students showed a unique susceptibility to peripheral involvement with peer drinking networks (having one friend who consumed alcohol). CONCLUSION: The results point to the importance of monitoring and responding to comparatively minor shifts in the proportion of peers who use alcohol, particularly among very young adolescents.

— Aims: To test the relative contribution of two key Social Learning Theory constructs, alcohol expectancies (AEs) and drinking refusal self-efficacy (DRSE), in predicting early adolescent drinking behavior and examine the possible mediational role of DRSE over AE. Methods: High school students (N = 192, mean age 14) were administered measures assessing AE (Drinking Expectancy Questionnaire—Adolescent version; DEQ-A), DRSE (Drinking Refusal Self-Efficacy Questionnaire—Revised Adolescent version; DRSEQ-RA) and indices of alcohol consumption and problem drinking. Age, gender, peer drinking, tobacco use and positive and negative behavioral characteristics were included in the statistical models as known predictors of alcohol misuse. Subjects were followed up at 12 months, with 88.5% retention. Results: Initial confirmatory factor analyses verified factor structures of the DEQ-A and DRSEQ-RA. Prospective structural models controlling for Time 1 drinking behavior, age, gender, peer alcohol use, tobacco use and behavior problems identified that DRSE but not AE was associated with problem drinking 12-month post-initial assessment. DRSE mediated AE in predicting problem drinking. Conclusion: Results suggest that DRSE is a more salient cognitive construct than AE in early adolescence alcohol use. In this age group, prevention and treatment strategies that build refusal self-efficacy may be more effective than strategies that challenge AEs.

Adolescent survivors of sexual abuse frequently report severe trauma, depression, anxiety, and low self-esteem. While cognitive-behavioral group interventions show promise, interpreting efficacy is problematic due to commonly high attrition. This article reports promising exploratory study findings relating to a 12-week multimodal abuse-specific group intervention with a nonoffending parent/caregiver component. Participants (aged 11 16 years) consisted of six adolescents with severe abuse histories, and their caregivers. Participants completed pre-, post-, and 1-month follow-up measures. The results were consistent with the possibility that the program produced clinically meaningful reductions in abuse-related psychological sequelae, the program had excellent face validity with participants, and there were no dropouts.

Heavy alcohol use is common in undergraduates and is associated with health-risk behaviors, negative consequences, and increased risk for future alcohol dependence. Alcohol-related memory associations (AMAs) and mood changes are independently related to student drinking, but more research on how these variables interact is needed. Aims: To examine (i) how AMAs predict drinking behavior after accounting for depression, and (ii) how changes in negative and positive mood predict AMAs among low- and high-risk drinkers. Methods: Positive and negative moods were manipulated using a musical mood induction procedure immediately prior to completion of memory association measures. A bootstrapped structural equation model was tested, permitting a sampling distribution free of the requirement of normality. Results: Negative mood changes predicted AMAs in high-risk drinkers but not in low-risk drinkers, and the opposite was found for positive mood changes. Conclusion: The negative mood-AMA association appeared related to risky drinking, and these subtle implicit cognitive processes may warrant a special focus in intervention programs for high-risk drinkers.

Key psychosocial risks associated with adolescent smoking are well established. However, the ways in which the key risks of impulsivity, peer cigarette smoking, and self-reported use of alcohol interact to predict adolescent cigarette smoking is largely unknown. A sample of 210 Australian middle high school students aged 14–16 completed questionnaires. A 3-way interaction of impulsivity, peer cigarette smoking and self-reports of alcohol use significantly predicted smoking, and relegated simpler interactions to nonsignificance. Adolescents with two and three elevated risk factors were 17 and 40 times more likely to be recent smokers, respectively, compared with those who evidenced no elevated risk factors. Common prevention strategies involving alcohol refusal skills training may need refinement to take into account the complexity of risk factor interactions.

Objective: The frequency and emotional response to bullying victimisation are known to be associated with adolescent mental ill health. A potentially important under-investigated factor is the form of bullying. Four common forms of bullying behaviours are name-calling, physical threats or harm, rumour spreading and social exclusion. To more comprehensively understand bullying victimisation in adolescence, we examined the association of all three factors ( frequency, emotional response, form) to psychological distress and emotional wellbeing. Method: A stratified, random sample of adolescents ( n = 10, 273; mean age = 14.33 years, standard deviation = 1.68 years) completed validated measures of bullying victimisation (Gatehouse Bullying Questionnaire), psychological distress (K10) and emotional wellbeing (Mental Health Inventory) in classroom time. Associations between the form of bullying victimisation and mental health outcomes were examined. Results: Adolescents reported a high prevalence of all four forms of bullying: teased or called names (30.6%), rumour spreading (17.9%), social exclusion (14.3%) and physical threats or harm (10.7%). Victimisation was independently associated with significantly higher levels of psychological distress and reduced levels of emotional wellbeing for all forms of bullying. In particular, social exclusion had a strong association with mental ill health. Adolescents who experienced frequent bullying that was upsetting reported higher psychological distress and reduced emotional wellbeing. Conclusion: Different forms of bullying victimisation were independently associated with psychological distress and reduced emotional wellbeing. In particular, frequent and upsetting social exclusion requires a targeted and measured response by school communities and health practitioners.

Tobacco use is prevalent in adolescents, and understanding factors that contribute to its uptake and early development remains a critical public health priority. Implicit drug-related memory associations (DMAs) are predictive of drug use in older samples, but such models have little application to adolescent tobacco use. Moreover, extant research on memory associations yields little information on contextual factors that may be instrumental in the development of DMAs. The present study examined (a) the degree to which tobacco-related memory associations (TMAs) were associated with concurrent tobacco use and (b) the extent to which TMAs mediated the association of peer and self-use. A sample of 210 Australian high school students was recruited. Participants completed TMA tasks and behavioral checklists designed to obscure the tobacco-related focus of the study. Results showed that TMAs were associated with peer use, and TMAs predicted self-use. We found no evidence that TMAs mediated the association of peer and self-use. Future research might examine the emotive valence of implicit nodes and drinking behavior. The results have implications for testing the efficacy of consciousness-raising interventions for adolescents at risk of tobacco experimentation or regular use.

This study evaluated (i) frequencies of aggression in maritally distressed problem drinking (DP) women relative to controls, (ii) aggression, marital satisfaction, and partner drinking in predicting female drinking, and (iii) discrepant within-couple drinking in predicting marital distress. The sample included 27 DP women, 24 maritally distressed nonproblem drinking women (DNP women), and 24 women with neither problem (NDNP women). DP women reported frequencies of physical aggression similar to DNP women, but less male verbal aggression than DNP women. Predictors of female drinking were marital satisfaction and male drinking, but aggression did not predict female drinking. Female marital satisfaction was predicted by interspousal discrepancies in drinking after accounting for verbal aggression.

The first part of this research assessed the longitudinal relationships between alcohol-related associative strength and alcohol use measured at two time-points, 6 months apart. Cross-lagged results support the utility of alcohol-related associative strength to predict drinking behaviours prospectively and vice versa. These results remained after competing explanations of previous use, autocorrelations between memory measures, sensation seeking and background variables of age and gender were accounted for. Findings offer further evidence for an implicit cognitions approach to drinking processes. In the second part of our study, cross-sectional analysis investigated potential mediating mechanisms in the relation of associative strength to quantity and frequency dimensions of drinking. Mediational models provide preliminary evidence that implicit memory processes may have differential effects on quantity and frequency dimensions of drinking behaviours. The results point to the possibility that increasing awareness of implicit alcohol-related associations may have utility in interventions for young adults.

Background: In the alcohol literature, most cognition research has focused on alcohol expectancies. Overall scores on alcohol expectancy questionnaires predict longitudinal changes in drinking behavior. However, the association between expectancy subscale scores and drinking behavior is inconsistent and modest. Attitudinal information may vary in accessibility (i.e., the ease or speed with which attitudinal information is evaluated), and more accessible (i.e., faster) attitudinal evaluations may predict heavier alcohol consumption. An alternative hypothesis arising from response competition theory is that heavy drinkers will show slow attitudinal evaluations, given that heavy drinkers frequently show mixed, inconsistent, or opposing alcohol-related beliefs. In this study we examined the degree to which speed of processing of alcohol-related evaluative judgments longitudinally predicted alcohol consumption in university students. Methods: Response latencies for alcohol- and non-alcohol-related attitudinal inquiries and measures of alcohol use were administered at two intervals 4 months apart. Results: The key findings were that response times for tension reduction and cognitive impairment items at time 1 positively predicted alcohol consumption at time 2. These results held after we accounted for autocorrelation in drinking and individual variability in reactivity. Conclusion: For items relating to tension reduction, response times fit a response competition hypothesis better than the attitude accessibility hypothesis.

While a large proportion of Aboriginal Australians do not consume alcohol, those who do frequently show severe alcohol problems, and alcohol problems are associated with family conflict and violence. The aims were to examine the internal coherence and reliability of measures of family and alcohol measures for indigenous Australians in remote communities. This study involved 99 indigenous people from a remote North Queensland community. Questions were drawn from established questionnaires and administered verbally. Principle components factor analysis revealed three coherent and reliable measures of family conflict, independence, and cohesion. Expectancies of affective change had sound internal reliability for drinkers, and covaried with alcohol problems in the expected direction. The Alcohol Use Disorders Identification Test had two distinct factors relating to consumption and problems, but quantity/frequency measures may have limited reliability due to the common practice among drinkers of sharing alcohol. These measures should facilitate the detection and initial assessment of alcohol and family problems, and may be useful for evaluating change in future interventions that target family and alcohol problems.

Based on a cognitive–social learning model of alcohol use, it was hypothesised that women with both alcohol and relationship problems would endorse more positive expectations of the effects of alcohol consumption on their relationship and would report lower relational efficacy than women without relationship or alcohol problems. Measures of relationship-referent alcohol expectancies and relational efficacy were completed by 174 married women with both alcohol and relationship problems (n=20), alcohol problems alone (n=26), relationship problems alone (n=30), or neither problem (n=98). Women without either alcohol or relationship problems strongly rejected expectations of enhanced relationship functioning (e.g., enhanced intimacy, increased emotional expression) following alcohol consumption, whereas women with both alcohol and relationship problems were ambivalent about these positive expectations. Women with both problems also reported lower relational efficacy than the other groups of women. Negative expectations about the effect of alcohol consumption on relationships in women with low relational efficacy may inhibit harmful drinking.

Polysubstance use is common, particularly amongst some age groups and subcultures. It is also associated with elevated risk of psychiatric and physical health problems. We review the recent research findings, comment on changes to polysubstance diagnoses, report on contemporary clinical and epidemiological polysubstance trends, and examine the efficacy of preventive and treatment approaches.Approaches to describing polysubstance use profiles are becoming more sophisticated. Models over the last 18 months that employ latent class analysis typically report a no use or limited-range cluster (alcohol, tobacco and marijuana), a moderate-range cluster (limited range and amphetamine derivatives), and an extended-range cluster (moderate range, and nonmedical use of prescription drugs and other illicit drugs). Prevalence rates vary as a function of the population surveyed. Wide-ranging polysubstance users carry higher risk of comorbid psychopathology, health problems, and deficits in cognitive functioning.Wide-ranging polysubstance use is more prevalent in subcultures such as 'ravers' (dance club attendees) and those already dependent on substances. Health risks are elevated in these groups. Research into the prevention and treatment of polysubstance use is underdeveloped. There may be benefit in targeting specific polysubstance use and risk profiles in prevention and clinical research.

Background A significant minority of Australians engage in concurrent drug use (using more than one drug in a given period). We examined clusters and correlates of concurrent drug use using the latest available nationally representative survey data on Australian young adults. Sample 3836 participants aged 18–29 years (mean age 24 years) from the 2010 National Drug Strategy Household Survey (NDSHS). Method Clusters were distilled using latent class analysis of past year use of alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, ketamine, GHB, inhalants, steroids, barbiturates, meth/amphetamines, heroin, methadone/buprenorphine, other opiates, painkillers and tranquillisers/sleeping pills. Results Concurrent drug use in this sample was best described using a 4-class solution. The majority (87.5%) of young adults predominantly used alcohol only (50.9%) or alcohol and tobacco (36.6%). 10.2% reported using alcohol, tobacco, marijuana, and ecstasy, and 2.3% reported using an extensive range of drugs. Conclusion Most drug use clusters were robust in their profile and stable in their prevalence, indicating little meaningful change at the population level from 2007. The targeting of alcohol and tobacco use remains a priority, but openness to experiencing diverse drug-related effects remains a significant concern for 12.5% of young people in this age group.

Aim. To evaluate the efficacy of a short-term alcohol-focused intervention for maritally distressed women, and to explore changes in relationship functioning. Design. Participants were assigned randomly to an alcohol-focused treatment or to a waiting-list control group. The waiting-list control group began the intervention at 1-month follow-up. Setting. The intervention took place at a research and training centre offering outpatient psychology services to the community. Participants. A sample of 32 women with alcohol and marital problems were recruited through the media. Participants reported protracted alcohol problems, moderate to severe impact of alcohol on social and occupational functioning, and moderate to severe marital distress. Measurements. Measures of average alcohol consumption, marital distress, relational efficacy and depression were administered at pre- and post-therapy, and at 1, 6 and 12-month follow-up. Intervention. The intervention involved six 1-hour sessions, consisting of clinical assessment, motivational interviewing, cognitive-behavioural strategies and relapse prevention. Results. At 1-month follow-up, the intervention was associated with statistically significant improvements in alcohol consumption, marital satisfaction, relational efficacy and depression, and these effects were sustained at 12-month follow-up. Conclusions. At 1-month follow-up the intervention was associated with decreased alcohol consumption and depression, and increased marital satisfaction and relational efficacy, with evidence of maintained effects at 12-month follow-up. However, it is unlikely that reduced problem drinking and improved confidence in resolving problems were the only factors producing low marital quality in these couples. Further research is needed to identify those individuals who might benefit from marital interventions.

This article is a review of the association of individual and marital problems. The focus is on depression, alcohol abuse, anxiety disorders, and the functional psychoses, each of which interact with marital distress in important ways. Although the causal connections between these disorders and marital distress are complex and only particularly understood, the available evidence shows that individuals’ and couples’ problems often exacerbate each other. Consequently, regardless of whether the initial presentation is individual or couple focused, there is routinely a need to assess both individual and relationship functioning. Couples therapy, and in particular behavioral couples therapy (BCT), is an important element of effective treatment of depression, alcohol abuse, anxiety disorders, and the functional psychoses. The integration of couple and individual therapy presents a number of clinical challenges, and in concluding this article the authors provide guidelines for managing these challenges.

The marital satisfaction of sixteen maritally distressed couples who received three sessions of Brief Behavioural Couples Therapy (BBCT), and 24 couples who received 12 to 15 sessions of Traditional Behavioural Couples Therapy (TBCT), were compared before and after treatment in a quasi-experimental design. A 2 way ANOVA of treatment (BBCT versus TBCT) by time (pre- and post-treatment) showed both conditions produced significant increases in marital satisfaction, but there were no significant differences between the effects of the two treatments. The results need replication within a true experimental evaluation, but suggest that brief behavioural couples therapy may be a viable treatment option for some distressed couples.

Couples with alcohol and relationship problems often report poor communication, yet little is known about the communication of maritally distressed couples in which the woman abuses alcohol (MDWA couples). Compared with maritally distressed couples without alcohol problems (MDNA) and couples with neither problem (NDNA), MDWA couples showed a distinctive pattern of negative communication. Similar to MDNA men, MDWA men spoke negatively to their partners but listened positively to their partners much like NDNA men. MDWA women listened negatively, much as MDNA women did, but spoke positively, like NDNA women did. The interactions of MDWA couples can be characterized as a male-demand-female-withdraw pattern, which is a gender reversal of the female-demand-male-withdraw pattern often observed in MDNA couples.

This paper describes and evaluates the adaption of Behavioural Marital Therapy (BMT) to the needs of a couple in a secondary marriage (the husband was in his second marriage and brought three dependent children to this marriage). The couple presented with specific difficulties in negotiating parenting roles within the reconstituted family. BMT focused on promoting adaptive cognitions, affect and communication when discussing this specific issue. Evaluation used a multiple probe design assessing self-monitored stressful interactions about parenting, and daily marital satisfaction. Results showed significant reductions in the intensity and frequency of arguments from pre- to post-therapy, and increases in marital satisfaction. These gains were maintained at follow-up. Discussion focuses on future directions for adapting BMT to problems particular to secondary marriages.

Objective: Alcohol-related implicit (preconscious) cognitive processes are established and unique predictors of alcohol use, but most research in this area has focused on alcohol-related implicit cognition and anxiety. This study extends this work into the area of depressed mood by testing a cognitive model that combines traditional explicit (conscious and considered) beliefs, implicit alcohol-related memory associations (AMAs), and self-reported drinking behavior. Method: Using a sample of 106 university students, depressed mood was manipulated using a musical mood induction procedure immediately prior to completion of implicit then explicit alcohol-related cognition measures. A bootstrapped two-group (weak/strong expectancies of negative affect and tension reduction) structural equation model was used to examine how mood changes and alcohol-related memory associations varied across groups. Results: Expectancies of negative affect moderated the association of depressed mood and AMAs, but there was no such association for tension reduction expectancy. Conclusion: Subtle mood changes may unconsciously trigger alcohol-related memories in vulnerable individuals. Results have implications for addressing subtle fluctuations in depressed mood among young adults at risk of alcohol problems.

Alcohol behavioral couples therapy (ABCT) remains the most systematically evaluated and validated couples-based therapy for the treatment of couples where one partner has alcohol problems, with evidence that it has significant long-term benefits for couples over individual interventions. Couples approaches are difficult to implement, in part because identified drinkers are often resistant to participation. Nevertheless, ABCT, by virtue of its various delivery modes (i.e., the various levels in which each partner may be involved), can be adapted readily to the presenting problems of couples affected by alcohol problems and usually complements standard treatment programs well. ABCT has typically been a highly structured approach that draws on traditional behavioral couple interventions. There is debate about the need for ABCT to update its emphasis on skills-deficit models of communication to better address underlying and intense negative emotions that drive conflict and override potentially preexisting skills. Emotion-focused therapy (EFT) is a couples approach that lends itself well to couples where there has been intense hurt and ongoing anger and has proven itself as efficacious as traditional Behavioral couples therapy. ABCT may fit better with what one knows about happy couple relationships and the realities of couples affected by alcohol if EFT-based, forgiveness-oriented approaches are incorporated.

Tobacco use is prevalent in adolescents and understanding factors that contribute to smoking uptake remains a critical public health priority. While there is now good support for the role of implicit (preconscious) cognitive processing in accounting for changes in drug use, these models have not been applied to tobacco use. Longitudinal analysis of smoking data presents unique problems, because these data are usually highly positively skewed (with excess zeros) and render conventional statistical tools (e.g., OLS regression) largely inappropriate. This study advanced the application of implicit memory theory to adolescent smoking by adopting statistical methods that do not rely on assumptions of normality, and produce robust estimates from data with correlated observations. The study examined the longitudinal association of implicit tobacco-related memory associations (TMAs) and smoking in 114 Australian high school students. Participants completed TMA tasks and behavioural checklists designed to obscure the tobacco-related focus of the study. Results showed that the TMA-smoking association remained significant when accounting for within-subject variability, and TMAs at Time 1 were modestly associated with smoking at Time 2 after accounting for within subject variability. Students with stronger preconscious smoking-related associations appear to be at greater risk of smoking. Strategies that target implicit TMAs may be an effective early intervention or prevention tool. The statistical method will be of use in future research on adolescent smoking, and for research on other behavioural distributions that are highly positively skewed.

Alcohol use usually starts in early adolescence. While the greater proportion of young people develop adaptive patterns of drinking, many drink at harmful levels and may be at risk for future alcohol-related problems. Findings from the empirical literature suggest that universal prevention programs may delay onset of drinking among low-risk baseline abstainers; however, there is little evidence supporting their utility for at-risk adolescents. Further research is needed on how risk and protective factors interact to determine substance use trajectory, and intervention outcomes that take substance use trajectories into account may capture change more effectively than the use of absolute measures of substance use. Indicated prevention programs may benefit from modulations that account for adolescent individuation and identity formation. It is argued that motivational interviewing within a harm reduction framework is well suited to adolescents.

While a large proportion of Aboriginal Australians do not consume alcohol, those who do frequently show severe alcohol problems. In European-derived samples, heavy alcohol use is associated with relationship distress, conflict, and violence. Because Aboriginal groups commonly have very different family structures, values, and obligations to European-derived families, the association of family and alcohol problems in Aboriginal Australians may be different from European-derived families. This self-report study is the first known published empirical study of family and alcohol problems among Aboriginal Australians. It involved 99 people from a remote community in the far North of Australia. The aims were to explore the association of family conflict, family cohesion, family independence, alcohol problems, and alcohol-related expectancies. Compared to those without alcohol problems, people with alcohol problems reported more family conflict and women with alcohol problems reported high family independence. Expectancies of negative affect change mediated the association of alcohol problems and family conflict. Family cohesion was unrelated to alcohol or family problems. Implications for detection of and interventions for alcohol and family problems are discussed.

This chapter presents a review and critique of empirical research on communication skills in marriage or married-like relationships. Such a chapter is warranted on several counts. First, marriage remains a popular social institution with about 80% of the population professing an intention to marry at some point in their lives (McDonald, 1995). Although most couple relationships start out happy, satisfaction erodes for a substantial proportion of marriages. At any given time, 20% of all married couples report marital dissatisfaction (Reynolds, Rizzo, Gallagher, & Speedy, 1979), and in Western countries, between 40% and 55% of marriages end in divorce (De Guilbert-Lantoine & Monnier, 1992; McDonald, 1995). Second, marital communication is a more valued resource for married individuals than communication with others; amongst married people, the spouse is the person most often turned to for support (Beach, Martin, Blum, & Roman, 1993; Cutrona, 1996; Sarason, Sarason, & Pierce, 1994). Third, escalation of conflict into violence is common in married couples; physical aggression occurs in about 30% of married couples in the United States (Straus, Gelles, & Steinmetz, 1980) and newly wed couples in the United Kingdom (Kelly & Fincham, 1999), leads to significant physical injury in about 10% of couples (Straus & Gelles, 1986; Straus et al., 1980), and is the most common interpersonal context in which homicide occurs (National Committee on Violence, 1990). Fourth, marital conflict is associated with child problems, particularly when children are exposed to it, when it is frequent, intense, involves physical aggression, and remains unresolved (Cummings & Davies, 1994; Grych & Fincham, 1990, 1992; Fantuzzo, et al., 1991). Finally, conflictual couple communication is associated with stress-related disease indicators, such as poor immune response (Kiecolt-Glaser, et al., 1987), and sustained elevations in stress-related hormones (Malarkey, Kiecolt-Glaser, Pearl, & Glaser, 1994). The overall aim of this chapter is to identify ways in which we might advance our conceptualization of couple communication skills, and to explore their implications for couple interventions. To this end, the chapter is divided into five sections. In the first section, we define what we mean by couple communication skills and evaluate current behavioral assessment technologies. In the second section, we provide an overview of research on couple communication. In the third section, we explore promising new constructs in couple communication skills and their relation to marital satisfaction. The fourth section examines intra- and extra-personal factors that influence couple communication skills. In the final section, we discuss implications for prevention, enhancement, and therapy.

Aim. To evaluate the effectiveness of three approaches to assisting the female partners of male problem drinkers with the stress imposed by the male's drinking. Design. Participants were assigned randomly via random number tables to one of three treatment conditions: supportive counselling, stress management or alcohol-focused couples therapy. Setting. The intervention took place at the Behaviour Research and Therapy Centre (BRTC), The University of Queensland. This research and training centre offers outpatient psychology services to the community. Participants. Sixty-one married women whose husbands drank heavily. Participants reported protracted alcohol problems, severe impact of alcohol on social functioning and severe marital distress. Measurement. The women's stress, alcohol consumption by the male, and relationship functioning were assessed at pre- and post-treatment and at 6-month follow-up. Interventions. All three treatments involved 15 1-hour sessions with the woman. In the alcohol-focused couple therapy, attempts were made to engage the man in these sessions. Results. Contrary to our predictions, there were few differences between the treatments. All three treatments were associated with reductions in the women's reported stress, with trends for somewhat greater reduction in the women's stress in the stress management and alcohol-focused couples therapy conditions than for supportive counselling. None of the treatments produced clinically significant reductions in men's drinking or relationship distress. Conclusion. The treatments ease stresses and burden but do not improve drinking or relationships. Limited power in the design restricted the capacity to detect differential treatment effects.