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      The effect of parental drinking on alcohol use in young adults: the mediating role of parental monitoring and peer deviance

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          Abstract

          Background and Aims

          Evidence demonstrating an association between parental alcohol use and offspring alcohol use from robust prospective studies is lacking. We tested the direct and indirect associations between parental and young adult alcohol use via early alcohol initiation, parental monitoring and associating with deviant peers.

          Design

          Prospective birth cohort study. Path analysis was used to assess the possible association between parental alcohol use (assessed at 12 years) and alcohol use in young adults (assessed at 18 years) via potential mediators (assessed at 14 and 15.5 years, respectively).

          Setting

          South West England.

          Participants

          Data were available on 3785 adolescents and their parents from the Avon Longitudinal Study of Parents and Children.

          Measurements

          The continuous Alcohol Use Disorders Identification Test (AUDIT) score was used as the primary outcome measure. Maternal alcohol use was defined as light (< 4 units on any day), moderate (≥ 4 units on 1–3 days) and high‐risk (≥ 4 units on ≥ 4 days in 1 week). Partner alcohol use was also defined as light, moderate and high risk. Socio‐economic variables were included as covariates.

          Findings

          There was strong evidence of a total effect from maternal alcohol use to young adult alcohol use [moderate: b = 1.07, 95% confidence interval (CI) = 0.64, 1.49, P < 0.001; high risk: b = 1.71, 95% CI = 1.07, 2.35, P < 0.001]. The majority of this association was explained through early alcohol initiation (moderate: b = 0.14, 95% CI = 0.04, 0.25, P = 0.01; high risk: b = 0.24, 95% CI = 0.07, 0.40, P < 0.01) and early alcohol initiation/associating with deviant peers (moderate: b = 0.06, 95% CI = 0.02, 0.10, P < 0.01; high risk: b = 0.10, 95% CI = 0.03, 0.16, P < 0.01). There was strong evidence of a remaining direct effect (moderate: b = 0.81, 95% CI = 0.39, 1.22, P < 0.001; high risk: b = 1.28, 95% CI = 0.65, 1.91, P < 0.001). A similar pattern of results was evident for partner alcohol use.

          Conclusions

          Young adults whose parents have moderate or high‐risk alcohol consumption are more likely to consume alcohol than those with parents with lower alcohol consumption. This association appears to be partly accounted for by earlier alcohol use initiation and higher prevalence of association with deviant peers.

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          Most cited references33

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          Mediation Analysis: A Practitioner's Guide

          This article provides an overview of recent developments in mediation analysis, that is, analyses used to assess the relative magnitude of different pathways and mechanisms by which an exposure may affect an outcome. Traditional approaches to mediation in the biomedical and social sciences are described. Attention is given to the confounding assumptions required for a causal interpretation of direct and indirect effect estimates. Methods from the causal inference literature to conduct mediation in the presence of exposure-mediator interactions, binary outcomes, binary mediators, and case-control study designs are presented. Sensitivity analysis techniques for unmeasured confounding and measurement error are introduced. Discussion is given to extensions to time-to-event outcomes and multiple mediators. Further flexible modeling strategies arising from the precise counterfactual definitions of direct and indirect effects are also described. The focus throughout is on methodology that is easily implementable in practice across a broad range of potential applications.
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            Reviewing theories of adolescent substance use: Organizing pieces in the puzzle.

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              Parenting factors associated with reduced adolescent alcohol use: a systematic review of longitudinal studies.

              To identify parenting strategies associated with adolescent alcohol consumption that parents can use to implement new national guidelines regarding alcohol consumption by people under the age of 18. A systematic search of academic literature employing the PRISMA method identified 77 relevant articles. Inclusion criteria for the review were (i) longitudinal cohort studies; (ii) measurement of one or more parenting factors during adolescence or pre-adolescence (between the ages of 8 and 17) as a predictor (iii) outcome measurement of any alcohol use and/or alcohol related problems during adolescence at least one time point after the initial parenting factor was measured, and/or problem drinking in adulthood. Studies were excluded if alcohol use was combined with other substance use or problem behaviour as an outcome variable, or if different parenting factors were combined as a single predictor variable for analysis. Stouffer's method of combining p values was used to determine whether associations between variables were reliable. Twelve parenting variables were investigated in these studies: parental modelling, provision of alcohol, alcohol-specific communication, disapproval of adolescent drinking, general discipline, rules about alcohol, parental monitoring, parent-child relationship quality, family conflict, parental support, parental involvement, and general communication. We found that delayed alcohol initiation was predicted by: parental modelling, limiting availability of alcohol to the child, parental monitoring, parent-child relationship quality, parental involvement and general communication. Reduced levels of later drinking by adolescents were predicted by: parental modelling, limiting availability of alcohol to the child, disapproval of adolescent drinking, general discipline, parental monitoring, parent-child relationship quality, parental support and general communication. A number of parenting strategies were identified that parents can use to reduce their adolescent's alcohol consumption. These could be promoted to parents to help them implement new national guidelines on alcohol use.
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                Author and article information

                Contributors
                liam.mahedy@bristol.ac.uk
                Journal
                Addiction
                Addiction
                10.1111/(ISSN)1360-0443
                ADD
                Addiction (Abingdon, England)
                John Wiley and Sons Inc. (Hoboken )
                0965-2140
                1360-0443
                27 June 2018
                November 2018
                : 113
                : 11 ( doiID: 10.1111/add.v113.11 )
                : 2041-2050
                Affiliations
                [ 1 ] Population Health Sciences, Bristol Medical School University of Bristol United Kingdom
                [ 2 ] Department of Psychiatry and School of Medicine Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Richmond Virginia United States of America
                [ 3 ] School of Dentistry, College of Biomedical and Life Science Cardiff University United Kingdom
                Author notes
                [*] [* ] Correspondence to: Liam Mahedy, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, BS8 2BN, UK. E‐mail: liam.mahedy@ 123456bristol.ac.uk
                Author information
                http://orcid.org/0000-0001-5417-6595
                http://orcid.org/0000-0002-4006-9710
                http://orcid.org/0000-0001-9864-459X
                http://orcid.org/0000-0001-5495-4705
                Article
                ADD14280 ADD-17-0920.R1
                10.1111/add.14280
                6176713
                29806869
                2c562db0-91af-41cd-be4e-723be86df88b
                © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 October 2017
                : 20 December 2017
                : 23 May 2018
                Page count
                Figures: 2, Tables: 2, Pages: 10, Words: 4349
                Funding
                Funded by: British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the Welsh Government and the Wellcome Trust
                Award ID: MR/K0232331/1
                Funded by: Economic and Social Research Council
                Award ID: ES/L015471/1
                Funded by: Medical Research Council and Alcohol Research UK
                Award ID: MR/L022206/1
                Funded by: National Institute for Health Research
                Award ID: PDF‐2013‐06‐026
                Funded by: National Institutes of Health
                Award ID: K01AA021399
                Award ID: R01AA018333
                Funded by: UK Medical Research Council, Wellcome Trust
                Award ID: 092731
                Categories
                Research Report
                Research Reports
                Custom metadata
                2.0
                add14280
                November 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.1 mode:remove_FC converted:07.11.2018

                Clinical Psychology & Psychiatry
                alcohol,alspac,parental monitoring,parental transmission,peer deviance,prospective,teenagers

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