|Pediatricians Alerted to the Developmental Nature
of Underage Drinking in Special Journal Supplement
In a special supplement to Pediatrics, edited and sponsored by
the National Institute on Alcohol Abuse and Alcoholism (NIAAA),
physicians will have access in one place to the reviews and analyses
of current research on biological, behavioral, and environmental
changes during childhood and adolescence that foster the initiation,
maintenance, and acceleration of illegal use of alcohol by underage
youth. This is a first time collection of where science is in our
understanding of underage drinking as a developmental issue. NIAAA,
one of the institutes of the National Institutes of Health, is
committed to moving scientific discovery to strategic prevention
and intervention strategies in order to decrease the toll that
alcohol is taking on our youth — and as these youth grow — to
"We now recognize that underage drinking must be addressed, not
as an isolated phenomenon, but as one fully embedded in the context
of child and adolescent development," said NIAAA director Ting-Kai
Li, M.D. "From birth through adolescence, a complex cascade of
biological, psychological and social development interacts with
dynamic environmental influences, leading to behavior that may
either move individuals toward or away from underage drinking."
Looking at developmental perspectives to determine the risk of
alcohol dependence is a relatively new scientific approach that
is bearing results. For example, according to recent research,
binge drinking by young people makes them more vulnerable to the
development of alcohol dependence over a lifetime. Further, risk
of an individual’s becoming alcohol dependent is related to how
early the young person starts drinking. NIAAA’s Pediatrics supplement
includes researchers from a wide range of scientific disciplines.
A sampling of the resources available in the supplement includes:
Ann S. Masten, Ph.D., professor in the Institute of Child Development
at the University of Minnesota in Minneapolis, and colleagues,
present a rationale for the developmental approach to alcohol in
an article offering age-related data on patterns of onset, prevalence
and the course of alcohol use and disorders in young people.
Robert A. Zucker, Ph.D., professor of psychiatry at the University
of Michigan, Ann Arbor, and his team looked the relationship between
early developmental processes and the continuity of risk for underage
and problem drinking by summarizing the evidence on early pathways
toward and away from underage drinking. This article has a particular
focus on the risk and protective factors, mediators, and moderators
of risk for underage drinking that become evident during the preschool
and early school years.
In "Transitions into Underage Drinking and Problem Drinking:
Developmental Processes and Mechanisms between Ages 10-15" — Michael
Windle, Ph.D., professor & chair, Department of Behavioral Sciences
and Health Education at Emory University in Atlanta, and his group
examined pre- and mid-teen groups during the time when the initial
initiation and escalation of alcohol use commonly occurs, in relation
to puberty, structural and functional maturation of the brain,
and changes in social contexts.
Looking at the next age group, youth aged 16-20, Sandra Brown,
Ph.D., professor of psychology at the University of California,
San Diego, and colleagues review the normative neurological, cognitive,
and social changes that typically occur in late adolescence. Their
report discusses evidence for the impact of these transitions on
individual drinking trajectories. The team also describes evidence
linking heavy alcohol use in late adolescence with neurological
and social impairments.
"Ensuring that pediatricians have access to this new data and
a comprehensive view of how alcoholism affects our youth, matched
to their developmental processes, will help physicians take a new
look at these issues and the impact that early alcohol consumption
can have on the life of not only the child, and teenager, but for
the life of the individual," said Elias A. Zerhouni, M.D., director
of the NIH.
Examining prevention strategies, Richard Spoth, Ph.D., director
of the Partnerships in Prevention Science Institute at Iowa State
University, and his team reviewed the current evidence base for
preventive interventions addressing underage drinking. They recommend
applying emerging consumer-oriented and community-participatory
models for intervention development and research as a strategy.
In an article called, "Developmentally Informed Research on the
Effectiveness of Clinical Trials (DIRECT): A Primer for Directly
Assessing How Developmental Issues May Influence Treatment Response
among Adolescents with Alcohol Problems" Eric F. Wagner, Ph.D.,
associate professor in the Community-Based Intervention Research
Group at Florida International University, reviews the degree to
which developmental processes have been considered in adolescent
alcohol treatment research and discusses promising concepts and
methodologies from applied developmental science.
Alcohol treatment outcome studies discussed by Deborah Deas, M.D.,
M.P.H., professor of psychiatry at the Medical University of South
Carolina in Charleston, include family-based interventions, motivational
interviewing, behavioral therapy, cognitive behavioral therapy,
and limited pharmacotherapy studies.
"These papers comprehensively address the complex relationship
between development and underage drinking," noted Vivian B. Faden,
Ph.D. deputy director of NIAAA's Division of Epidemiology and Prevention
Research and co-editor of the Pediatrics supplement. "By providing
clinicians with this information, we anticipate that this supplement
will advance the goals set forth in the U.S. Surgeon General's
recent Call to Action to Prevent and Reduce Underage Drinking." (http://www.surgeongeneral.gov/topics/underagedrinking/calltoaction.pdf).
Released in March of 2007, the Surgeon General's first Call to
Action on underage drinking appealed to Americans to do more to
stop America's 11 million current underage drinkers from using
alcohol, and to keep other young people from starting to drink.
The National Institute on Alcohol Abuse and Alcoholism, part of
the National Institutes of Health, is the primary U.S. agency for
conducting and supporting research on the causes, consequences,
prevention, and treatment of alcohol abuse, alcoholism, and alcohol
problems and disseminates research findings to general, professional,
and academic audiences. Additional alcohol research information
and publications are available at www.niaaa.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.