Sexual Attraction and Trajectories of Mental Health and Substance Use During the Transition from Adolescence to Adulthood

Previous research suggests that sexual minority youth have poorer health-related outcomes than their heterosexual peers. The purpose of this study is to determine whether sexual orientation disparities in mental health and substance use increase, decrease, or remain the same during the transition from adolescence to adulthood. Data are from Waves 1–4 of the National Longitudinal Study of Adolescent Health (n = 8,322; 55% female). Respondents were in grades 7–12 at Wave 1 and aged 24–32 at Wave 4. Latent growth curve modeling is used to compare the mental health and substance use trajectories of youth who consistently report heterosexual attraction versus those who consistently report lesbian, gay, or bisexual (LGB) attraction, those who report a transition to LGB attraction, and those who report a transition to heterosexual attraction. Among women and men, sexual orientation disparities in depressive symptoms and suicidal thoughts persist, but do not increase, during the transition from adolescence to adulthood. The same pattern is observed for disparities in smoking, heavy drinking, and marijuana use among women. Among men, disparities in substance use are only observed between those who report consistent heterosexual attraction and those who transition to heterosexual attraction. Disparities between these groups persist over time for heavy drinking and marijuana use but decrease over time for smoking. While this study finds evidence of numerous disparities in mental health and substance use outcomes during adolescence and young adulthood, particularly among young women, there is no indication that these disparities get larger over time.     

Trajectories of Substance Use Among Young American Indian Adolescents: Patterns and Predictors

Substance use often begins earlier among American Indians compared to the rest of the United States, a troubling reality that puts Native youth at risk for escalating and problematic use. We need to understand more fully patterns of emergent substance use among young American Indian adolescents, risk factors associated with escalating use trajectories, and protective factors that can be parlayed into robust prevention strategies. We used growth mixture modeling with longitudinal data from middle-school students on a Northern Plains reservation (Wave 1 N = 381, M age at baseline = 12.77, 45.6 % female) to identify subgroups exhibiting different trajectories of cigarette, alcohol, and marijuana use. We explored how both risk (e.g., exposure to stressful events, deviant peers) and protective (e.g., positive parent–child relationships, cultural identity) factors were related to these trajectories. For all substances, most youth showed trajectories characterized by low rates of substance use (nonuser classes), but many also showed patterns characterized by high and/or escalating use. Across substances, exposure to stress, early puberty, and deviant peer relationships were associated with the more problematic patterns, while strong relationships with parents and prosocial peers were associated with nonuser classes. Our measures of emergent cultural identity were generally unrelated to substance use trajectory classes among these young adolescents. The findings point to the importance of early substance use prevention programs for American Indian youth that attenuate the impact of exposure to stressful events, redirect peer relationships, and foster positive parent influences. They also point to the need to explore more fully how cultural influences can be captured.     

Effects of Alcohol on Trajectories of Physical Aggression Among Urban Youth: An Application of Latent Trajectory Modeling

Several studies have investigated factors associated with physical aggression during adolescence. Yet, little is known about the longitudinal relationship between drug use, particularly alcohol use, and physical aggression among minority youth. The present study examined the effects of alcohol and substance use at age 11 on trajectories of physical aggression over time (ages 12–14) among urban adolescents from Chicago, IL. Data from the Project Northland Chicago (n = 3038, 49.4% female) was used. The current study sample included 1,160 Black, 1,015 Hispanic and 863 White/other adolescents for a total of 3,038 adolescents. Four trajectories of physical aggression were identified: Non-aggressive (16%), Desistors (9%), Escalators (20%) and Chronic Aggressive (55%). After adjusting for physical aggression behaviors, delinquent friends, lack of supervised time, demographic variables, smoking and marijuana use, past year alcohol users at age 11 were 2.1 times more likely to be “Escalators” and 1.9 times more likely to be in the “Chronic Aggressive” group. Gender and ethnic differences were also observed in the trajectories of physical aggression. Black youth were 2.5 times more likely to be in the “Chronic Aggressive” group. Findings highlight the importance of targeting alcohol prevention to reduce physical aggression among urban young adolescents.     

The Longitudinal Relationships Between Rural Adolescents’ Prosocial Behaviors and Young Adult Substance Use

While many adolescents and young adults experiment with substances (e.g., alcohol, cigarette smoking, marijuana), recent research suggests that rural youth and young adults may be more at risk for substance use than their urban counterparts. This study was designed to examine the longitudinal relationships between rural adolescents’ prosocial behaviors and substance use in young adulthood. Furthermore, we examined the potential mediating effects of adolescent substance use, academic investment, and delinquency. Rural youth (N = 531; 263 girls) were surveyed in grades 10–12 (Time 1; M age = 16.17; SD = .91) and again in early adulthood (Time 2). Measures of prosocial behaviors, substance use, academic investment, and deviant activities were assessed at Time 1. At Time 2, measures of marijuana use, cigarette smoking, and getting drunk were administered. Overall, the findings showed that rural adolescents who frequently exhibit prosocial behaviors are less likely to engage in substance use in young adulthood than those who exhibit relatively low levels of prosocial behaviors. These findings indicate that prosocial behaviors may have positive health consequences, establishing behavioral trajectories that lead to lower levels of risky health behaviors in adulthood in rural populations.     

The Influence of Pubertal Timing on Alcohol Use and Heavy Drinking Trajectories

Early pubertal timing has been associated with increased alcohol use, drunkenness, and alcohol use disorders in both boys and girls during adolescence. It is not clear, however, whether the effect of early pubertal timing persists into late adolescence and young adulthood, whether its effect differs by gender, and if contextual factors (e.g., peer alcohol use) amplify such effect. This study attempts to address these questions by examining the trajectories of alcohol use and heavy drinking from early adolescence to young adulthood in males and females using data from the National Longitudinal Study of Adolescent Health (Add Health). Results show that for both males and females, early pubertal timing was associated with higher alcohol use and heavy drinking trajectories. These effects persisted into young adulthood and were found to be stronger for males than for females. Moreover, there was a significant interaction effect between friends’ drinking and pubertal timing on alcohol use and heavy drinking trajectories; but the interaction effect also differed for males and females. These findings suggest that early pubertal timing is a risk factor for alcohol use and has long-term implication for individuals’ health. Michael Biehl’s research focuses on adolescent development and problem behaviors. He is particularly interested in developmental pathways leading to substance use and affective disorders and how different contexts influence these developmental pathways. Misaki Natsuaki is interested in how adolescent problem behavior changes over time. Her research focuses particularly on the effects and timing of transitional events, such as puberty, on trajectories of internalizing and externalizing behaviors in adolescence. Xiaojia Ge’s research focuses on interaction effects of biological and social contextual factors on socioemotional development. He is particularly interested in how pubertal timing affects adolescent development.     

Bullying and Depressive Symptomatology Among Low-Income,African–American Youth

Utilizing a risk and protective factors approach, this research examined the relationship between self-reported depressive symptomatology, group membership (bully, victim, bully–victim) risks, and protection among a sample of African–American youths. Self-report data were collected in spring, 2002. Youth in grades 5–12 were sampled (n = 1,542; 51% female) from an urban school district in the Southeast. African–American youths self-identifying as bullies, victims, or bully–victims, reported higher levels of depressive symptoms compared to their nonbullied–nonvictimized counterparts. Additionally, multivariate results highlight a significant set of risk and protective factors associated with depressive symptomatology, even after controlling for the effects of self-identified group membership. These findings further contribute to our general understanding of the interplay among bullying, victimization, risk and protective factors, and their effects on depressive symptoms among a group of understudied African–American youth.     

Risk and Protective Factors Associated with Alcohol,Cigarette, and Marijuana Use During Adolescence

The purpose of this study was to increase the knowledge base of adolescent substance use by examining the influences of risk and protective factors for specific substance use, namely alcohol, cigarettes, and marijuana. Participants included 271 adolescents and their primary caregivers referred for mental health services across North Carolina. A series of hierarchical multiple regressions showed that the relative influences of risk and protective factors differed depending on the target substance in some cases. History of parental felony predicted use of all 3 substances, although the direction of association was substance specific. Parental behavioral control (how families express and maintain standards of behavior) was predictive only of cigarette and marijuana use, not alcohol use. The different links among risk factors, protective factors, and specific substance use are discussed, and recommendations for both mental health and substance use professionals are offered.She received her M.A. in Psychology from Wake Forest University and is currently a doctoral student in Clinical Psychology at the University of North Carolina at Greensboro. Her major research interests include developmental pathways to aggressive behavior among females.An evaluator for the North Carolina Department of Health and Human Services, her major research interests include system of care intervention programming.She received her PhD in Clinical Psychology from Purdue University. Her major research interests include developmental psychopathology and early intervention.His research interests focus on youth violence and youth involved with the juvenile justice system.She received her PhD in Clinical Psychology from the University of North Carolina at Greensboro. Her research interests focus on early intervention with young children.     

Adolescents’ Media-related Cognitions and Substance Use in the Context of Parental and Peer Influences

Two cross-sectional studies investigated media influences on adolescents’ substance use and intentions to use substances in the context of exposure to parental and peer risk and protective factors. A total of 729 middle school students (n = 351, 59% female in Study 1; n = 378, 43% female in Study 2) completed self-report questionnaires. The sample in Study 1 was primarily African-American (52%) and the sample in Study 2 was primarily Caucasian (63%). Across the two studies, blocks of media-related cognitions made unique contributions to the prediction of adolescents’ current substance use and intentions to use substances in the future above and beyond self-reported peer and parental influences. Specifically, identification with and perceived similarity to media messages were positively associated with adolescents’ current substance use and intentions to use substances in the future, and critical thinking about media messages and media message deconstruction skills were negatively associated with adolescents’ intention to use substances in the future. Further, peer influence variables (e.g., peer pressure, social norms, peer substance use) acted as risk factors, and for the most part, parental influence variables (e.g., parental pressure to not use, perceived parental reaction) acted as protective factors. These findings highlight the importance of developing an increased understanding of the role of media messages and media literacy education in the prevention of substance use behaviors in adolescence.     

The Effect of Pubertal and Psychosocial Timing on Adolescents’ Alcohol Use: What Role Does Alcohol-Specific Parenting Play?

In scientific literature, early pubertal timing emerges as a risk factor of adolescents’ drinking, whereas alcohol-specific rules (the degree to which parents permit their children to consume alcohol in various situations) showed to protect against adolescents’ drinking. This study investigated whether alcohol-specific rules mediate and/or moderate the effect that early pubertal and psychosocial timing (personal, relational, socio-institutional) has on adolescents’ alcohol use. Mediation and moderation models were tested conducting ordinal logistic structural equation modeling in a cross-sectional sample of 1,893 Dutch adolescents (49% males), aged 13–15 years. Findings showed that early pubertal, relational and socio-institutional timers were at greater risk to initiate alcohol use and for heavy episodic drinking. Alcohol-specific rules more often mediated, rather than moderated, the effect of early timing on alcohol use. Alcohol-specific rules are mostly relaxed when adolescents mature, rather than reinforced, indicating that parents partly facilitate adolescents’ drinking.     

Trajectories of Organized Activity Participation Among Urban Adolescents: An Analysis of Predisposing Factors

Organized activity participation provides important opportunities for adolescents to develop assets and resources related to positive youth development. Predisposing factors, in addition to sociodemographics and self-selection factors, may influence how youth participate over time. In this study, we used growth mixture modeling with longitudinal data from African American adolescents attending urban high schools in Flint, MI to identify subgroups of participation trajectories (Wave 1 N = 681, mean age at Wave 1 = 14.86 years, 51 % female). We measured activity participation using psychological and behavioral engagement across multiple contexts over the 4 years of high school. We examined how predisposing risk and promotive factors were related to these trajectories, accounting for sociodemographic and self-selection factors. The results indicated three participation trajectories: a low group decreasing over time (74 %), a moderate, consistent participation group (21 %) and a moderate, increasing group (5 %). More substance use was associated with lower odds of being in the moderate/consistent versus low/decreasing participation group. More parental support was associated with lower odds of being in the moderate/increasing versus the moderate/consistent group. Our results suggest that addressing predisposing factors such as substance use may help facilitate participation over time.     

Psychological Distress,Substance Use,and HIV/STI Risk Behaviors Among Youth

Psychological distress has been inconsistently associated with sexual risk behavior in youth, suggesting additional factors, such as substance use, may explain this relationship. The mediating or moderating role of substance use on the relationship between psychological distress and sexual risk behaviors was prospectively examined over the four high school years in a sample of urban youth (N = 850; 80% African American; 50% female). Growth curve modeling was used to estimate changes in sexual risk across adolescence and to test its association to psychological distress symptoms and frequency of substance use. Substance use was associated with psychological distress. Greater psychological distress was associated with increased sexual intercourse frequency, decreased condom use, and increased number of partners. Substance use fully mediated the relationship between psychological distress and intercourse frequency and condom use, and partially mediated the relationship between psychological distress and number of partners. We found no differences in mediation by sex or race/ethnicity and no evidence to support moderation of psychological distress and substance use on sexual risk. Findings suggest that psychological distress is associated with sexual risk because youth with greater psychological distress are also more likely to use substances. Practical implications for adolescent HIV/STI prevention are discussed.     

Trajectories of HIV Risk Behavior from Age 15 to 25 in the National Longitudinal Survey of Youth Sample

This study utilized data from the National Longitudinal Survey of Youth to investigate youth risk trajectories for HIV and factors associated with different trajectories. The sample (N = 8,208) was 49.2% female, with a mean age of 14.31 (SD = 1.48). A group-based trajectory model was applied, which identified four distinct trajectories for both males and females: (1) consistently higher sexual risk levels, increasing to early adulthood followed by some decrease (“high”); (2) a short period of increase to late teens, followed by a longer period of decrease (“decreased”); (3) an initially slow increase, with the increase accelerating by late teens, and a slight decline beginning in early adulthood (“increased”); and (4) consistently lowest levels of sexual risk (“low”). More African Americans were found among the decreased trajectory group; among the low risk group a higher number of youth came from families with parents who spoke a language other than English. The high-risk group had a higher percentage of subjects in non-metropolitan areas and highest alcohol use. Among males, being employed and being in the military were associated with inclusion in the high-risk group. Results have implications for specializing prevention strategies for youth with different patterns of sexual risk.

Increased Substance Use and Risky Sexual Behavior Among Migratory Homeless Youth: Exploring the Role of Social Network Composition

Travelers are a migratory subgroup of homeless youth who may be especially prone to engaging in risky behavior. This study compared the substance use and sexual behavior of young homeless travelers and non-travelers to evaluate the extent and possible sources of travelers’ increased risk. Data came from face-to-face interviews with 419 homeless youth (36.6% female, 34.0% white, 23.9% African American, and 20.0% Hispanic) between the ages of 13 and 24 years (M = 20.1 years, SD = 2.5) who were randomly sampled from 41 shelters, drop-in centers, and street sites in Los Angeles. Travelers were almost twice as likely as non-travelers to exhibit recent heavy drinking, 37% more likely to exhibit recent marijuana use, and five times as likely to have injected drugs. Travelers also had more recent sex partners and were more likely to report having casual or need-based sexual partners and combining sex with substance use. Mediation analyses suggest that travelers’ deviant peer associations and disconnection to conventional individuals and institutions may drive their elevated substance use. Differences in sexual risk behaviors are likely attributable to demographic differences between the two groups. Overall, these differences between travelers and non-travelers suggest different service needs and the need for different service approaches.     

Risk and Protective Predictors of Trajectories of Depressive Symptoms Among Adolescents from Immigrant Backgrounds

Although there has been an increasing number of studies that has examined depression among adolescents from immigrant backgrounds, findings have been mixed, with some studies reporting that immigrant status is associated with risk, while others report that immigration status is linked to adequate or positive outcomes. Thus, it is important to explore how underlying predictors contribute to trajectories of depressive symptoms among adolescents from immigrant backgrounds. Using data from a nationally representative Canadian sample (N = 1,060; aged 12 to 23; 48.9% female), this longitudinal study examined the effects of risk and protective factors on trajectories of depressive symptoms using multilevel modeling. Predictors of depressive symptoms tended to be protective and suggest a universal positive influence of self-esteem, positive peer relationships, and parent–child cohesion. Host language proficiency was predictive of greater increases in depressive symptoms over time. Findings highlight the value of promoting protective factors and aspects of one’s heritage among immigrant adolescents.     

Youth Substance Use and Body Composition: Does Risk in One Area Predict Risk in the Other?

Both substance use and obesity are prevalent among youth. As youth age, substance use rates increase and over the past three decades, obesity rates among youth have tripled. While these two factors have both short- and long-term health impacts, little research has explored how substance use and obesity among youth may be related. This study explores the bi-directional longitudinal relationships between substance use and body composition. Participants (N = 704; 50.7% female) were mostly white (86.4%) with a baseline mean age of 14.7 years. Objectively measured body composition was used to calculate body mass index z-scores (BMI z-score) and percent body fat. Cross-lagged structural equation models, accounting for clustering at the school level, were run to determine the longitudinal association between body composition and self-reported substance use (alcohol, cigarette, and marijuana), adjusting for socio-demographic characteristics, pubertal status, and weight satisfaction. Baseline alcohol use predicted decreased BMI z-score at follow-up and a similar association with percent body fat approached significance. Baseline cigarette use predicted increased percent body fat. No longitudinal associations were seen between baseline body composition and future substance use. Our results suggest that substance use contributes to subsequent body composition; however, body composition does not contribute to subsequent substance use. Continued research that explores these relationships longitudinally is greatly needed.     

Protective Families in High- and Low-risk Environments: Implications for Adolescent Substance Use

This study used data from a sample of 6th to 12th grade students (N = 48,641, 51% female), nested in 192 schools, to determine if the influence of family-based protective factors varied across different school contexts. Hierarchical logistic regression models were used to examine the effects of individual-level family protective factors, relative to school-level aggregates of the same factors, on recent (past 30 days) use of cigarettes, alcohol, and marijuana. Cross-level interactions indicated that the effect of the student’s level of family protection, relative to other students in their school, differed depending on the aggregated school level of family protection. The results suggested that the benefit of belonging to a well-functioning family was more influential for students attending schools characterized by higher-than-average aggregated levels of protection compared to students attending schools of lower-than-average protection. Thus, family-level factors offered less protection for students in relatively high-risk school contexts. These results were consistent with a protective–reactive interaction and suggest that a thorough understanding of adolescent substance use must consider the complex interplay among adolescents, their families, and their social environments.     

Juvenile Offenders’ Alcohol and Marijuana Trajectories: Risk and Protective Factor Effects in the Context of Time in a Supervised Facility

The current study modeled trajectories of substance use from ages 15 to 20 among 1,095 male serious juvenile offenders (M age = 16.54; 42% African-American, 34% Latino, 20% European-American, and 4% other ethnic/racial backgrounds) and prospectively predicted trajectories from risk and protective factors before and after controlling for time spent in a supervised setting. Results indicated that supervised time suppressed age-related growth in substance use. Trajectories of offenders with no supervised time and low levels of supervised time increased in substance use across age, whereas offenders with high levels of supervised time showed no growth. Almost all risk and protective factors had effects on initial substance use but only adolescent history of substance use, impulse control, and psychosocial maturity had an effect on change in substance use over time. Findings highlight the importance of formal sanctions and interventions superimposed on normal developmental processes in understanding trajectories of substance use among serious juvenile offenders.

Intervention Induced Changes on Parenting Practices,Youth Self-Pride and Sexual Norms to Reduce HIV-Related Behaviors Among Rural African American Youths

AIDS is the leading killer of African Americans between the ages of 25 and 44, many of whom became infected when they were teenagers or young adults. The disparity in HIV infection rate among African Americans youth residing in rural Southern regions of the United States suggests that there is an urgent need to identify ways to promote early preventive intervention to reduce HIV-related risk behavior. The Strong African American Families (SAAF) program, a preventive intervention for rural African American parents and their 11-year-olds, was specially designed to deter early sexual onset and the initiation and escalation of alcohol and drug use among rural African American preadolescents. A clustered-randomized prevention trial was conducted, contrasting families who took part in SAAF with control families. The trial, which included 332 families, indicated that intervention-induced changes occurred in intervention-targeted parenting, which in turn facilitated changes in youths’ internal protective processes and positive sexual norms. Long-term follow up assessments when youth were 17 years old revealed that intervention-induced changes in parenting practices mediated the effect of intervention-group influences on changes in the onset and escalation of risky sexual behaviors over 65 months through its positive influence on adolescents’ self-pride and their sexual norms. The findings underscore the powerful effects of parenting practices among rural African American families that over time serve a protective role in reducing youth’s risk behavior, including HIV vulnerable behaviors.     

Measuring Alcohol Expectancies in Youth

Beliefs about the consequences of using alcohol, alcohol expectancies, are powerful predictors of underage drinking. The Alcohol Expectancies Questionnaire-Adolescent form (AEQ-A) has been widely used to measure expectancies in youth. Despite its broad use, the factor structure of the AEQ-A has not been firmly established. It is also not known whether it assesses similar constructs (i.e., measurement invariance) between boys and girls. This article reports on a confirmatory factor analysis (CFA) of a shortened version of the AEQ-A with 310 youth, ages 10–16, to determine whether a two factor, positive and negative expectancy structure held for this sample and to test measurement invariance across gender. The results support evidence of a 2-factor, positive and negative structure for the abbreviated version of the AEQ-A and show that it assesses equivalent alcohol expectancy constructs among males and females. These findings have important implications for cognitive based approaches to alcohol prevention.Florida State University College of Social Work. She received her Ph.D. in Social Work from the University of North Carolina at Chapel Hill. Her major research interests are youth at risk, substance use prevention, and family engagement in prevention interventionsFlorida State University College of Medicine. She received her Ph.D. in Social Psychology from Arizona State University. Her major research interests are women's health, disease prevention, and health communication.Prevention Research Center, Pacific Institute for Research and Evaluation. She received her Ph.D. in Criminal Justice from the University at Albany. Her major research interests are family-based prevention strategies for adolescent alcohol, drugs, and sexual risk taking; women's alcohol, and other drug problems; prevention of young adult alcohol and drug abuse, risky sexual behavior, and violence.     

Negotiating the Early Developing Body: Pubertal Timing,Body Weight,and Adolescent Girls’ Substance Use

Despite knowledge that early pubertal timing predicts adolescent girls’ substance use, it is still unclear whether this relationship persists beyond early adolescence and whether it is conditional on girls’ body weight. This study examined the moderating role of body weight in the association between early pubertal timing and adolescent girls’ substance use using three waves of data from the National Longitudinal Study of Adolescent Health. The analytic sample included 5,591 adolescent girls attending middle-schools and high-schools in the United States (ages 10–15, 71% White, 14% Black). Results indicated that early pubertal timing was associated with substance use risk but effects were attenuated after controlling for prior use. Body weight moderated the association between early pubertal timing and girls’ reported number of substances tried in middle adolescence. Body weight magnified the risk of having tried one substance, but buffered the risk of having tried three substances. Among those girls who did use substances, body weight did not moderate the relationship between early pubertal timing and heavy substance use. It is concluded that the substance use risk associated with early pubertal timing is most salient during the developmental period in adolescence when sensitivity to bodily changes may be heightened.