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INTRODUCTION: Peer sexual harassment is associated with adolescent substance use at the global level; however, it is unknown whether substance use occurs proximal in time to the sexual harassment experience. This study used daily reports to examine the proximal relations between sexual harassment victimization and affect and substance use. Based on theories of self-medication, we hypothesized that negative affect and substance use (cigarettes, electronic cigarettes, alcohol, and marijuana) would be higher than typical on days when sexual harassment occurred relative to nonvictimization days. METHOD: A community sample of 13-16-year-old adolescents (N = 204, 55.4% female) from a metropolitan area in the northeastern United States completed 56 days of online reports assessing experiences with peer sexual harassment, substance use (cigarettes, electronic cigarettes, alcohol, and marijuana), and positive and negative affect. RESULTS: Multilevel modeling revealed that experiencing sexual harassment on a given day was associated with higher than typical negative affect on that day, relative to nonvictimization days. The likelihood of cigarette and alcohol use (but not electronic cigarettes, marijuana, or positive affect) was greater on days when sexual harassment occurred. CONCLUSION: Sexual harassment victimization is proximally associated with negative affect and alcohol and cigarette use, suggesting that adolescents may be using substances to cope with sexual harassment victimization. The co-occurrence of sexual harassment with negative affect and substance use points to the need for prevention efforts that conjointly address sexual harassment victimization, coping, and substance use.

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OBJECTIVE: We examined the association between the number of tracheal intubation (TI) attempts and clinical outcomes in extremely preterm infants. METHOD: This is a single-center retrospective cohort study examining infants born at ≤28 weeks gestation intubated within the first four postnatal days. We analyzed infant, provider, and practice characteristics and clinical outcomes by exposure groups (1 vs. 2 vs. ≥3 TI attempts). Primary outcomes were death prior to NICU discharge or severe intraventricular hemorrhage (IVH). RESULT: Ninety-nine infants were included. 46.5% required one TI attempt, 29.3% required two, and 24.2% required three or more. Increasing attempts was significantly associated with death (p = 0.004), adverse tracheal intubation-associated events (TIAEs; p = 0.004), and the training level of the first attempt provider (p = 0.002). No association was found with severe IVH or complications of prematurity. CONCLUSIONS: Increasing attempts was associated with death and adverse TIAEs. Careful selection of providers could decrease adverse TIAEs and improve outcomes.

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The popularity of alcohol mixed with energy drinks (AmED) among young adults has spurred studies that focus on its links to aggression and risk-taking behaviors, including risky sex and sexual victimization. However, no studies to date have looked at the relationship between AmED and causes of interpersonal conflict in bars at the event level. The present study evaluated whether AmED use at the time of the bar conflict was associated with greater odds that a bar conflict would be precipitated by sexually related causes. Online survey data, including a description of a recent bar conflict, were collected from a community sample of 175 young adult (97 female) AmED users age 18 to 30 in western New York state. Qualitative findings included the natural categorization of sexually related causes of conflict, consisting of unwanted sexual advances and jealousy, and the prominence of sexual competition in these conflicts. Proportion of AmED use (out of the total quantity of alcoholic drinks) predicted the odds that the bar conflict would have a sexually related cause, above and beyond control variables. How AmED use might be associated with sexual competition and conflict in the bar is discussed.

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Background: Caffeinated alcoholic beverage (CAB) use is associated with general victimization beyond the use of alcohol alone. Materials and Methods: No prior research has evaluated the association between CAB use and intimate partner violence (IPV) victimization. This study evaluated the CAB-IPV victimization relationship using the responses of 100 (40 female) respondents to an online survey. Results: Results of logistic regression analyses indicated that CAB use was associated with IPV physical and sexual victimization after adjusting for demographics and heavy alcohol use. Exploratory analyses detected little evidence of sex differences in the strength of the relationship between CAB use and IPV victimization. Conclusions: The current results provide initial evidence that CAB use may place males and females at greater risk of IPV victimization.

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Background: Problematic alcohol use is a recognized risk factor for intimate partner violence (IPV) perpetration.Objective: The use of caffeinated alcoholic beverages (CAB) appears to be associated with high-risk drinking behavior but the relationship between CAB use and IPV has yet to be explored.Methods: Sixty male and 40 female married or dating participants responded to an online survey including measures of past-year alcohol use and partner violence.Results: Logistic regression analyses revealed that CAB users were significantly more likely to perpetrate physical assault and partner injury after controlling for age, sex, ethnicity, income, and heavy alcohol use. The relationship between CAB use and perpetration of sexual coercion was better accounted for by heavy alcohol use.Conclusion: Results from the current study suggest that there exists an independent link between CAB use and partner violence perpetration.

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Despite the recent, widespread trend of consuming alcohol mixed with energy drinks (AmEDs) in commercial bar settings, few studies have examined whether this practice exacerbates the risk of experiencing aggression in bars and licensed establishments. Past studies have been limited to between-subjects comparison analyses that are at risk for bias due to selection effects. The present analysis examines whether a sample of individuals who regularly use AmEDs are at elevated risk for experiencing or perpetrating physical aggression in bars when drinking AmEDs versus when they are drinking noncaffeinated alcohol (NCA) use alone. This within-subject analysis controls for any individual differences that may be related to both AmED use and the tendency to engage in aggressive behavior. An online survey was completed by 175 young adults (78 male) who were frequent bar patrons, used AmEDs regularly, and had experienced at least one recent bar conflict incident. Although NCA use was more common than was AmED use, AmED-involved bar aggression was more frequently reported than was aggression that coincided with NCA use only. Additionally, victimization and perpetration of aggression in bar environments were both more common when AmEDs were used than when only NCA was used. Frequency of going to bars was predictive of rates of experiencing bar aggression only when drinking NCA but not when drinking AmEDs. Results suggest that AmED use introduces a unique risk factor into the bar environment that must be considered in future research and in subsequent interventions meant to reduce the incidence of bar aggression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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Adolescent involvement in bullying as a victim or perpetrator has been associated with negative health outcomes, including emotional distress and substance use. Whether negative affect and substance use are acute responses to bullying involvement or whether they develop over time is unknown. Such knowledge is needed to understand the conditions under which bullying contributes to adverse outcomes, as well as to inform the development of appropriate interventions. This study examined the daily-level associations among bullying, negative affect, and substance use (i.e., alcohol, cigarettes, electronic-cigarettes, marijuana) among a community sample of adolescents (N = 204) ages 13 - 16 years (55% female, 81% European American, 13% African-American) who had reported bully victimization or perpetration in the past six months. Participants completed a brief on-line survey every day for 56 consecutive days, reporting on their experiences with bully victimization, bully perpetration, mood, and substance use for that day. Consistent with hypotheses, being bullied on a given day was associated with reporting greater than average levels of sadness (b = 0.279, 95% CI = [0.172, 0.387]), anger (b = 0.354, 95% CI = [0.242, 0.466]), and cigarette use (OR = 1.453, 95% CI = [1.006, 2.099]) on that day; however, it was not associated with alcohol, electronic-cigarette, or marijuana use. Perpetration was not associated with same day negative affect or substance use. Results of the current study suggest that negative affect and cigarette use may be acute responses to bully victimization. Bully perpetration does not appear to be proximally linked to mood or substance use after accounting for victimization.

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The present study examined the national prevalence and distribution of adolescent use of caffeinated energy drinks, assessing variations in sociodemographic characteristics, personality traits, lifestyles, and patterns of alcohol and caffeine use. A cross-sectional survey was conducted in May 2014, using a nationally representative sample of 1,032 U.S. early (aged 13-15; n = 602) and middle adolescents (aged 16-17; n = 430). Nearly two thirds of teens reported ever using energy drinks; 41% had done so recently, that is, in the past 3 months. Middle adolescents reported higher prevalences of both lifetime and recent use of energy drinks than early adolescents. Common situational contexts for use (e.g., compensating for lack of sleep or playing sports) differed by both gender and age cohort. In hierarchical logistic regression analyses, gender and geographic region significantly predicted both lifetime and recent use for early adolescents only, whereas age and race were significant predictors only for middle adolescents. For both age cohorts, odds of both lifetime and recent use increased with sensation-seeking score, lifetime alcohol use, and recent caffeinated soft drink use. Among early adolescents, grade point average predicted lifetime use only, whereas coffee and caffeine pill use predicted recent use only. Among middle adolescents, impulsivity and past sports participation predicted lifetime but not recent use. Our findings show that adolescent energy drink use is widespread and varies as a function of demographic, psychosocial, lifestyle, and substance use characteristics. Future research is needed to assess whether differences between early and middle adolescent use patterns are primarily developmental or cohort effects. (PsycINFO Database Record

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BACKGROUND: Young adult use of alcohol mixed with energy drinks (AmEDs) has been linked with elevated risks of a constellation of problem behaviors. These risks may be conditioned by expectancies regarding the effects of caffeine in conjunction with alcohol consumption. The aim of this study was to describe the construction and psychometric evaluation of the Intoxication-Related AmED Expectancies Scale (AmED_EXPI), 15 self-report items measuring beliefs about how the experience of AmED intoxication differs from the experience of noncaffeinated alcohol (NCA) intoxication. METHODS: Scale development and testing were conducted using data from a U.S. national sample of 3,105 adolescents and emerging adults aged 13 to 25. Exploratory and confirmatory factor analyses were conducted to evaluate the factor structure and establish factor invariance across gender, age, and prior experience with AmED use. Cross-sectional and longitudinal analyses examining correlates of AmED use were used to assess construct and predictive validity. RESULTS: In confirmatory factor analyses, fit indices for the hypothesized 4-factor structure (i.e., Intoxication Management [IM], Alertness [AL], Sociability [SO], and Jitters [JT]) revealed a moderately good fit to the data. Together, these factors accounted for 75.3% of total variance. The factor structure was stable across male/female, teen/young adult, and AmED experience/no experience subgroups. The resultant unit-weighted subscales showed strong internal consistency and satisfactory convergent validity. Baseline scores on the IM, SO, and JT subscales predicted changes in AmED use over a subsequent 3-month period. CONCLUSIONS: The AmED_EXPI appears to be a reliable and valid tool for measuring expectancies about the effects of caffeine during alcohol intoxication.

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BACKGROUND: Young adult use of alcohol mixed with caffeinated energy drinks (AmEDs) has been globally linked with increased odds of interpersonal aggression, compared with the use of alcohol alone. However, no prior research has linked these behaviors at the event level in bar drinking situations. The present study assessed whether AmED use is associated with the perpetration of verbal and physical aggression in bar conflicts at the event level. METHODS: In Fall 2014, a community sample of 175 young adult AmED users (55% female) completed a web survey describing a recent conflict experienced while drinking in a bar. Use of both AmED and non-AmED alcoholic drinks in the incident were assessed, allowing calculation of our main predictor variable, the proportion of AmEDs consumed (AmED/total drinks consumed). To measure perpetration of aggression, participants reported on the occurrence of 6 verbal and 6 physical acts during the bar conflict incident. RESULTS: Linear regression analyses showed that the proportion of AmEDs consumed predicted scores for perpetration of both verbal aggression (ß = 0.16, p < 0.05) and physical aggression (ß = 0.19, p < 0.01) after controlling for gender, age, sensation-seeking and aggressive personality traits, aggressive alcohol expectancies, aggressogenic physical and social bar environments, and total number of drinks. CONCLUSIONS: Results of this study suggest that in alcohol-related bar conflicts, higher levels of young adult AmED use are associated with higher levels of aggression perpetration than alcohol use alone and that the elevated risk is not attributable to individual differences between AmED users and nonusers or to contextual differences in bar drinking settings. While future research is needed to identify motivations, dosages, and sequencing issues associated with AmED use, these beverages should be considered a potential risk factor in the escalation of aggressive bar conflicts.

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The popularity of energy drinks has increased rapidly in the past decade. One of the main reasons people use energy drinks is to counteract effects of insufficient sleep or sleepiness. Risks associated with energy drink use, including those related to sleep loss, may be disproportionately borne by racial minorities and those of lower socioeconomic status. In this review, a brief introduction to the issue of health disparities is provided, population-level disparities and inequalities in sleep are described, and the social-ecological model of sleep and health is presented. Social and demographic patterns of energy drink use are then presented, followed by discussion of the potential ways in which energy drink use may contribute to health disparities, including the following: 1) effects of excessive caffeine in energy drinks, 2) effects of energy drinks as sugar-sweetened beverages, 3) association between energy drinks and risk-taking behaviors when mixed with alcohol, 4) association between energy drink use and short sleep duration, and 5) role of energy drinks in cardiometabolic disease. The review concludes with a research agenda of critical unanswered questions.

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BACKGROUND: Despite the popularity of caffeinated energy drinks mixed with alcohol, the links between these beverages and patterns of problem drinking are not yet well understood. The aim of this short commentary is to review a current study investigating the environmental contexts within which AmED use occurs, and to examine its implications. MATERIALS AND METHODS: The strengths of Wells and colleagues? study are reviewed. The researchers used a field-based survey to survey 1,476 adult patrons at a range of New York City nightlife scenes. RESULTS: The importance of the study lies in its exploration of the urban nightlife venues within which energy drinks and alcohol are used concurrently by socially active adults. Previous research has largely been confined to investigations of either the physiological effects of alcohol/caffeine coadministration or the demographic, psychosocial, and problem-behavioral correlates of AmED use. The present study?s context-oriented approach offers a third avenue of inquiry. CONCLUSIONS: The findings are relevant in light of the growing consensus that regular AmED use should be a source of concern to advocates of public health. Future researchers will need to assess the relative importance of physiological, demographic, and contextual factors influencing relationships between AmED use and other health-risk behaviors, and their implications for public policy.

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OBJECTIVE: This study examined the confluence of several behaviors common to U.S. young adults: caffeinated energy drink use, alcohol use, and sexual risk-taking. The author examined relationships between the use of energy drinks mixed with alcohol (AmEDs) and three sexual risk behaviors: casual sex (i.e., intercourse with a nonexclusive and/or nonromantic partner), intoxicated sex (i.e., intercourse while under the influence of alcohol and/or illicit drugs), and unprotected sex (i.e., intercourse without use of a condom). METHOD: Logistic regression analyses were employed to analyze data from a cross-sectional survey of 648 sexually active undergraduate students at a large public university. RESULTS: After controlling for risk-taking norms and frequency of noncaffeinated alcohol use, AmED use was associated with elevated odds of casual sex and intoxicated sex but not unprotected sex. CONCLUSIONS: Although further studies are needed to test for event-level relationships, AmED use should be considered a possible risk factor for potentially health-compromising sexual behaviors.

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Although seatbelts save lives, adolescents may be disproportionately likely to omit their use. Using data from the 1997 Youth Risk Behavior Survey, a national survey of more than 16,000 U.S. public and private high school students, the authors employed a series of logistic regression analyses to examine cross-sectional associations between past year athletic participation and regular seatbelt omission. Controlling for the effects of gender, age, race, parental education, and school urbanicity, student athletes were significantly less likely than nonathletes to report seatbelt omission. Separate gender-specific analyses showed that this effect was significant for girls but only marginally significant for boys; in addition, the effect was strongest for adolescents who participated on three or more school or community sports teams. Possible explanations for the relationship between athletic participation and seatbelt omission, including Jessor's problem behavior syndrome, prosocial sport subcultures, and sensation seeking, are considered.

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Past research has linked physical activity and sports participation with improved mental and social well-being, including reduced risk of depression and suicidality. In this study we examined relationships among several dimensions of athletic involvement (team sport participation, individual sport participation, athlete identity, and jock identity), gender, and depression and suicidal behavior in a sample of 791 undergraduate students. Both participation in a team sport and athlete identity were associated with lower depression scores. Athlete identity was also associated with lower odds of a past-year suicide attempt, whereas jock identity was associated with elevated odds of a suicide attempt. The findings are discussed in light of the relationship between mental well-being and a larger constellation of health-risk behaviors linked to a "toxic jock" identity.

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Sport occupies a prominent space in the public lives and private identities of US adolescents. Using the retrospective reflections of college students, this analysis explores two questions about sport-related identities during high school: Are 'athletes' and 'jocks' distinctly separate identities? Are these identities explicitly gendered? In four gender-segregated focus groups conducted in early 2005, 32 student-athletes from two upstate New York colleges discussed their high school experiences of sport, status, gender, and identity. Three primary themes developed with regard to differences between the 'jock' and 'athlete' archetypes: academic focus, teamwork, and cockiness/aggression. Examining the intersection of gender, high-status/high-profile sport, and identity in both popular cultural imagery and the personal experiences of the focus group discussants provided support for the thesis of a 'toxic jock' phenomenon.

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Little attention has been paid to the multidimensional nature of athletic involvement, which includes identity formation as well as participation in sports activities. Five hundred eighty-one sport-involved undergraduate students completed a questionnaire assessing their sport-related identities, goal orientations, primary sport ratings, and conformity to masculine norms. F-tested mean comparisons and hierarchical linear regressions were used to explore the characteristics associated with two distinct sport-related identities ("athletes" and "jocks"). Jock identity was associated with an ego-oriented approach to sports (men only), whereas athlete identity was associated with a task-oriented approach (both genders). Jock identity was positively associated with conformity to masculine norms, particularly for men, whereas athlete identity was positively associated with some masculine norms (i.e., Winning) and negatively associated with others (i.e., Playboy). These findings help to identify the correlates of a "toxic Jock" identity that may signal elevated risk for health-compromising behavior.

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PURPOSE: This study examined relationships between energy drink consumption and problem behaviors among adolescents and emerging adults. It was hypothesized that frequent consumption of energy drinks would be positively associated with substance abuse and other risky behaviors, and that these relationships would be moderated by race. METHODS: Cross-sectional, self-report survey data were collected from 602 Western New York undergraduate students in the spring of 2006. Differences in problem behaviors by frequency of energy drink consumption were assessed with multivariate linear and logistic regressions, controlling for gender, race, age, parental education, and college grade point average. Follow-up regressions were conducted to test for a moderating effect of race. RESULTS: Frequency of energy drink consumption was positively associated with marijuana use, sexual risk-taking, fighting, seatbelt omission, and taking risks on a dare for the sample as a whole, and associated with smoking, drinking, alcohol problems, and illicit prescription drug use for white students but not for black students. CONCLUSIONS: These findings suggest that energy drink consumption is closely associated with a problem behavior syndrome, particularly among whites. Frequent consumption of energy drinks may serve as a useful screening indicator to identify students at risk for substance use and/or other health-compromising behavior.

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OBJECTIVE: The author examined gendered links among sport-related identity, endorsement of conventional masculine norms, risk taking, and energy-drink consumption. PARTICIPANTS: The author surveyed 795 undergraduate students enrolled in introductory-level courses at a public university. METHODS: The author conducted linear regression analyses of energy-drink consumption frequencies on sociodemographic characteristics, jock identity, masculine norms, and risk-taking behavior. RESULTS: Of participants, 39% consumed an energy drink in the past month, with more frequent use by men (2.49 d/month) than by women (1.22 d/month). Strength of jock identity was positively associated with frequency of energy-drink consumption; this relationship was mediated by both masculine norms and risk-taking behavior. CONCLUSIONS: Sport-related identity, masculinity, and risk taking are components of the emerging portrait of a toxic jock identity, which may signal an elevated risk for health-compromising behaviors. College undergraduates' frequent consumption of Red Bull and comparable energy drinks should be recognized as a potential predictor of toxic jock identity.

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Athough conventional wisdom suggests that organized sport deters delinquency by building character, structuring adolescents' time, and providing incentives for socially approved behavior, the empirical evidence to date has been mixed. Based on a sample of approximately 600 Western New York adolescents, the present study examined how self-reported jock identity, school athlete status, and frequency of athletic activity differentially influenced a range of delinquent behaviors. Neither athlete status nor frequency of athletic activity predicted these behaviors; however, jock identity was associated with significantly more incidents of delinquency. This finding was robust across both gender and race. Follow-up analyses indicated that jock identity facilitated both minor and major delinquency, with major delinquency effects for white but not black adolescents.