Psychology
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/32561
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Item EXAMININATION OF THE LONGITUDINAL ASSOCATION BETWEEN ALCOHOL-INDUCED BLACKOUTS AND AUDIT SCORES AND THE MODERATING EFFECTS OF IMPULSIVITY AMONG ADOLESCENTS AND YOUNG ADULTS(2024-03-21) Cross, Allison; Graupensperger, Scott; Litt, Dana; Hicks, Haleigh; Lewis, MelissaPurpose: Adolescent and young adult alcohol consumption and related consequences present persistent public health concern and research highlights the role that alcohol-induced blackouts (AIB) may have on the development of alcohol use disorders. Moreover, impulsivity, specifically premeditation and urgency, are noted to have significant associations with drinking. However, less is known about these associations over time among adolescents and young adults. Therefore, this study examined longitudinal associations between AIB and hazardous alcohol use risk (AUDIT scores) in adolescents and young adults, while exploring the moderating effects of premeditation and urgency. Methods: Participants were recruited for a longitudinal ecological momentary assessment (EMA) study examining cognitions and alcohol use. Data were collected at baseline and 12-month follow-up from participants who reported past month alcohol use. The analytic sample consisted of 556 participants (58.6% females; 70.8% White Non-Hispanic, ages 15-25 [mean = 21.5, SD = 2.5]). Data were analyzed using generalized linear models (GLM). Results: Results revealed a significant association between baseline AIB and AUDIT scores at 12-month follow-up such that a one-unit increase in AIB scores was associated with a 12% increase in residual change of AUDIT scores (RR = 1.12, p = .001). Premeditation was inversely associated with AUDIT scores, such that on average, a one-unit increase corresponded to an 8% relative reduction in AUDIT scores (RR = 0.92, p = .032). Finally, urgency was not significantly associated with AUDIT scores (RR = 1.07, p = .053). Premeditation, but not urgency, significantly moderated the effect of AIB on change in AUDIT scores such that for those with relatively higher premeditation scores, a one-unit increase in AIB corresponds to a 22% increase in AUDIT scores (RR = 1.13, p= .009). Conclusion: Findings suggest a significant association between AIB and AUDIT scores one year later, controlling for baseline AUDIT scores. Furthermore, the moderating effect of premeditation suggests that those with higher premeditation who are still engaging in AIB may be doing so with intentions to engage in high-risk drinking. Targeting prevention programs, towards adolescents and young adults with a history of AIB, especially those who with elevated premeditation, may be effective in mitigating the risk of alcohol use disorder development.Item "Going on 18" Examining Survey Responses from Adolescent and Young Adult Cancer Patients(2024-03-21) Spradley, Parker; Elledge, DanielPurpose: Cancer survival rates among adolescents and young adults (AYAs) (aged 15-39 years) have improved at a lower rate than pediatric and older adult populations since 1975. This disparity in survival rate improvement is termed the “AYA gap” in cancer care. AYAs have lower enrollment in clinical trials and are diagnosed at later stages of cancer compared to other age groups. Young adults underutilize healthcare compared to older adults, which leads to worse health outcomes. Financial instability and low medical decision-making confidence have been identified as obstacles to healthcare use in young adults and are increasingly recognized as barriers to AYA cancer care. Cancer requires a high frequency of expensive treatments for optimal management, and identifying and addressing the financial and medical decision-making treatment challenges unique to AYAs may improve survival rates. The purpose of this project is to examine AYA cancer patients’ survey responses related to financial status and medical decision-making confidence. Methods: A site-developed “Going on 18” questionnaire was administered to AYA patients at Cook Children’s Hospital in Fort Worth, TX between 6/2021 and 8/2022. The survey asked questions about demographics, socioeconomic factors, education, mental health, relationships, and thoughts about becoming a young adult. Four questions were selected as determinants of financial status. The frequencies of responses to these questions and the relative percentages of each response were calculated for each categorical variable. Two questions were selected as indicators of feelings toward increased medical responsibility. The content of the subjective responses to these questions was analyzed by authors to separate them into positive, negative, and mixed or neutral attitudes. Results: 25 participants completed the survey. AYA cancer patients feel mostly confident and enthusiastic about their increased medical decision-making responsibilities, stable in their financial situation (71%), and believe they understand their insurance benefits (73%). However, AYAs are remaining financially dependent on their parents into early adulthood (70%). Conclusions: Patients identified specific responsibilities associated with turning 18, expressed feelings of freedom, and are willing to learn. Their responses suggest they want to be in charge of their care and would be receptive to an intervention that provides education and encourages them to think critically about their medical responsibilities. Reliance on parents to manage financial matters may limit participants’ knowledge of treatment-related expenses. Although participants reported high levels of financial stability and understanding of benefits, this result may be due to a lack of involvement in insurance matters. Therefore, patients, especially those who will become financially independent upon turning 18, may still benefit from interventions related to financial responsibilities.Item Examination of Pregaming: Associations with Drinking Cognitions, Alcohol Use, and Negative Consequences at the Daily-Level among Adolescents and Young Adults(2024-03-21) Cross, Allison; Zhou, Zhengyang; Fairlie, Anne; Litt, Dana; Lee, Christine; Lewis, MelissaPurpose: While research indicates that adolescents and young adults pregame (i.e., drink before going to an event or gathering), it is unclear how daily-level cognitions relate to pregaming behavior and how pregaming relates to alcohol consumption and consequences. We examined (1) occasion-level associations between drinking cognitions (i.e., willingness, attitudes, injunctive norms) and pregaming among adolescents and young adults, and (2) occasion-level associations between pregaming with quantity of alcohol consumed and negative consequences. We also explored potential moderating effects of age on the above associations as well as the moderating effects of the number of drinks on the association between pregaming and the number of negative consequences on drinking days. Methods: Participants from Texas (age 15-25) were enrolled in a longitudinal ecological momentary assessment (EMA) study employing a 3-week EMA burst format (8 surveys weekly, up to 2 times per day). These bursts were scheduled quarterly over a span of 12 months. Participants who reported any drinking days were included in the present analyses. The final analytic sample included 490 individuals ages 15-25 (53.6% Female, 45.2% White Non-Hispanic, Mean Age = 21.2 SD = 2.7). Data were analyzed with mixed effects multilevel models. Results: Multilevel models revealed that occasion-level drinking cognitions (i.e., occasions with higher willingness to drink and more positive attitudes toward pregaming than one’s usual) were associated with greater likelihood of pregaming (Willingness: odds ratio (OR=1.80) = X, p < 0.0001; attitudes: OR = 1.54, p = 0.0009), whereas injunctive norms were not significantly associated. Compared to drinking days when people did not pregame, pregaming days were associated with consuming more drinks (rate ratio (RR) = 1.79, p < 0.0001). For consequences, the positive association between alcohol use and number of consequences was reduced on pregaming days (p of the interaction term between number of drinks and pregame = 0.04). Age was not a significant moderator in any models tested. Conclusion: This study contributes to the literature by examining occasion-level associations between drinking cognitions with pregaming and the role of pregaming in experiencing negative consequences. These findings can be used to inform individual-level intervention approaches by incorporating risk information about willingness and attitudes and their association with pregaming.