Internalizing Symptoms: Effects of a Preventive Intervention on Developmental Pathways from Early Adolescence to Young Adulthood

This study examined the mediated and moderated effects of a universal family-focused preventive intervention, delivered during young adolescence, on internalizing symptoms assessed in young adulthood. Sixth grade students (N=446; 52% female; 98% White) and their families from 22 rural Midwestern school districts were randomly assigned to the experimental conditions in 1993. Self-report questionnaires were administered at seven time points (pre-test to young adulthood-age 21) to those receiving the Iowa Strengthening Families Program (ISFP) and to the control group. Results showed that growth factors of adolescent internalizing symptoms (grades 6-12) were predicted by ISFP condition and risk status (defined as early substance initiation). Moderation of the condition effect by risk status was found, with higher-risk adolescents benefitting more from the ISFP. Results also supported the hypothesis that the ISFP's effect on internalizing symptoms in young adulthood was mediated through growth factors of adolescents' internalizing symptoms; risk moderation, however, was only marginally significant in young adulthood. The relative reduction rate on clinical or subclinical levels of young adult internalizing symptoms was 28%, indicating that for every 100 young adults displaying clinical or subclinical levels of internalizing symptoms from school districts not offering an intervention, there could be as few as 72 displaying those levels of symptoms in school districts that offered middle school prevention programming. These findings highlight how the positive effects of family-focused universal interventions can extend to non-targeted outcomes and the related potential public-health impact of scaling up these interventions.     

Parent-adolescent congruence for adolescent substance use

Parental reports of adolescent substance use were compared to the adolescents' self-reports using identical scales. Congruence was defined as exact agreement on whether adolescents were current users, ex-users, or never-users. Both parents were found to be less accurate in predicting their adolescents' alcohol use compared to cigarette or marijuana use. Single mothers were significantly less likely to be congruent than were mothers from two-parent households. Mother and father congruence on all substances was unrelated to the adolescent's sex, race, or after school employment. For both parents, congruence for adolescent marijuana use was significantly related to the age and GPA of the adolescent. Congruence may also reflect important properties of family functioning, as significant relations were found between both adolescent and parent ratings of family cohesion and parent-adolescent congruence on perceptions of marijuana use.This research was supported by Grant DA03706 from the National Institute of Drug Abuse (Hyman Hops, Principal Investigator).Jennifer Langhinrichsen is a doctoral candidate in psychology interested in adolescent and family interactions. The other authors are psychologists or data analysts working on family influences on substance use and mental health.     

Substance use and abuse among adolescent runaways: A four-year follow-up study

Using data from the National Longitudinal Study Youth Survey (NLSY), runaway status in early adolescence (ages 14–15) was associated with subsequent (four years later) substance abuse, alcohol problems, and school dropout status. Three runaway categories were formed—never runaway, runaway once, and runaway two or more times. Overall, the repeat runaways reported engaging in higher levels of substance use and abuse than never and once runaways. However, some degree of gender specificity in the relationships for repeat runaways and substance abuse was found. Female repeat runaways were particularly susceptible to abusing illicit drugs (and not acoohol), whereas male repeat runaways manifested a more generalized susceptability to abusing alcohol, cigarettes, marijuana, and other illicit drugs. Whereas substance use and abuse were linearly associated with runaway status, both the one-time and repeat runaways manifested equivalent proportions of school dropouts, and at levels far exceeding never runaways. Results are discussed with regard to the heterogeneous developmental pathways leading toward and away from adolescent runaways.Dr. Windle's major research interests involve the identification of high risk factors and then influences on adolescent substance use and other problem behaviors.     

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.     

The Long Arm of Community: The Influence of Childhood Community Contexts Across the Early Life Course

This study examines the longitudinal effects of childhood community contexts on young adult outcomes. The study uses a sample of 14,000 adolescents (52% female) derived from the 1990 US Census and the National Longitudinal Study of Adolescent Health (Addhealth). The study examines whether community and family environments exert separate and/or joint long-term influences on young adult achievement and depression. We found both direct and indirect long-term influences of childhood community adversity on young adult educational attainment. The indirect influences of childhood community adversity operated through family and individual-level factors. The long-term influence of childhood community adversity on young adult depression was only indirect. Overall, community influences on young adult achievement outcomes were mediated by family context and by the adolescents’ adjustments and transitions, including adolescent depression, school adjustment, and disruptive transitional events. The moderating effect of childhood community adversity suggests that the protective effects of family resources on young adult outcomes dissipate significantly in extremely adverse neighborhoods. The findings demonstrate the importance of integrating multiple theoretical perspectives for longitudinal research to capture pathways of community influence on adolescent developmental and young adulthood outcomes.     

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.     

Running Away From Home: A Longitudinal Study of Adolescent Risk Factors and Young Adult Outcomes

Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at Grade 10 and/or Grade 11. Controlling for demographics and general delinquency, running away from home was predicted by lack of parental support, school disengagement, greater depressive affect, and heavier substance use at Grade 9. In turn, runaways had higher drug dependence scores and more depressive symptoms at age 21 than non-runaways, even after taking these antecedent risk factors into account. Runaway status did not predict alcohol dependence risk at age 21. Results highlight the importance of substance use and depression, both as factors propelling adolescents to run away and as important long-term consequences of running away.     

Longitudinal Effects of a Universal Family-Focused Intervention on Growth Patterns of Adolescent Internalizing Symptoms and Polysubstance Use: Gender Comparisons

This study evaluated effects of the Iowa Strengthening Families Program, a family-focused universal preventive intervention, on growth patterns of adolescent internalizing (anxiety and depressive symptoms) and monthly polysubstance use (alcohol, tobacco, marijuana, inhalants, and other illicit drugs), as well as the association between internalizing and polysubstance growth factors. The sample consisted of rural Midwestern adolescents (N = 383), followed from sixth through twelfth grade. Compared to the control group, the intervention group adolescents showed a slower rate of increase in internalizing symptoms and polysubstance use. Intervention effects on internalizing symptoms were similar for boys and girls; however, girls demonstrated a higher overall level and a greater rate of increase across time. The intervention slowed the rate of increase in polysubstance use significantly more for girls than for boys, although overall levels of use were lower in the intervention group for both genders. Associations between internalizing and polysubstance use growth factors were found for girls, but not for boys, suggesting gender differences in psychosocial development.

Multilevel Modeling of Direct Effects and Interactions of Peers,Parents, School,and Community Influences on Adolescent Substance Use

This study tested a social-ecological model of adolescent substance use. Multilevel modeling was used to investigate how systems, such as parents, peers, schools, and communities, directly influence and interact together to influence adolescent substance use. Participants included 14,548 (50.3% female) middle school students who were 78.6% White, 5.4% Biracial, 4.8% Asian, 4.8% Black, and 3.6% Hispanic. Participants completed a survey with scales assessing substance use, peer influences, parental influences, and characteristics of their school and community. Hierarchical linear modeling (HLM) was used to consider the variation of parental and peer influences on substance use and how schools and communities relate to both substance use and the relationship between substance use and peer and parental factors. Results indicated that a positive school climate and a positive sense of community were associated with less adolescent substance use and that a positive sense of community moderated the relation between peer and parental influence on adolescent substance use, thereby acting as a protective factor.

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.     

Processes Linking Parents’ and Adolescents’ Religiousness and Adolescent Substance Use: Monitoring and Self-Control

Empirical evidence suggests that religiousness is related negatively to adolescent substance use; yet, we know little about how such protective effects might occur. The current study examined whether parents’ and adolescents’ religiousness are associated positively with parental, religious, and self-monitoring, which in turn are related to higher self-control, thereby related to lower adolescent substance use. Participants were 220 adolescents (45 % female) who were interviewed at ages 10–16 and again 2.4 years later. Structural equation modeling analyses suggested that higher adolescents’ religiousness at Time 1 was related to lower substance use at Time 2 indirectly through religious monitoring, self-monitoring, and self-control. Higher parents’ religiousness at Time 1 was associated with higher parental monitoring at Time 2, which in turn was related to lower adolescent substance use at Time 2 directly and indirectly through higher adolescent self-control. The results illustrate that adolescents with high awareness of being monitored by God are likely to show high self-control abilities and, consequently, low substance use. The findings further suggest that adolescents’ religiousness as well as their religious environments (e.g., familial context) can facilitate desirable developmental outcomes.     

Temporal Influences of Family Structure and Family Risk Factors on Drug Use Initiation in a Multiethnic Sample of Adolescent Boys

This study examines the effects of family structure and family environments on the initiation of illicit drug use among a sample of U.S.- and foreign-born Hispanic/Latino, African American, and White non-Hispanic adolescent boys (N = 3413). Bivariate and multivariate analyses with longitudinal data, three years, were used to assess transitional/temporal influences of family variables on the initiation of illicit drug use. Findings revealed large differences in family structure among the three race/ethnic groups. African American adolescents report the lowest incidence of illicit drug use initiation, and the weakest effects of family structure and environment on substance use. Cumulative effects of family risk factors were strongly associated with increased probabilities of illicit drug use initiation, but there were temporal as well as race/ethnic variations on these effects. Deteriorating changes in family environments were stronger predictors of the initiation of drug use among Hispanic immigrants than nonimmigrants, and family socioeconomic status was a predictor for immigrant Hispanics only. The relationship between family structure and drug use initiation varied in the context of temporal indicators of family environments, and the accumulation of family risk factors was a stronger predictor of illicit drug initiation than family structure.     

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.     

Trajectories of Peer Social Influences as Long-term Predictors of Drug Use from Early Through Late Adolescence

The present study analyzed the long-term effects of perceived friend use and perceived peer use on adolescents’ own cigarette, alcohol and marijuana use as a series of parallel growth curves that were estimated in two developmental pieces, representing middle and high school (N = 1,040). Data were drawn from a large drug abuse prevention trial, the Midwestern Prevention Project (MPP). Results showed that both perceived peer and friend cigarette use predicted own cigarette use within and across the adolescent years. For own alcohol and marijuana use, peer and friend influences were limited primarily to middle school. The findings suggest that strategies for counteracting peer and friend influences should receive early emphasis in prevention programs that are targeted to middle school. The findings also raise the question of whether cigarette use may represent a symbol of peer group identity that is unlike other drug use, and once formed, may have lasting adverse effects through the adolescent years.

A Prospective Examination of the Path from Child Abuse and Neglect to Illicit Drug Use in Middle Adulthood: The Potential Mediating Role of Four Risk Factors

This study examines prostitution, homelessness, delinquency and crime, and school problems as potential mediators of the relationship between childhood abuse and neglect (CAN) and illicit drug use in middle adulthood. Children with documented cases of physical and sexual abuse and neglect (ages 0–11) during 1967–1971 were matched with non-maltreated children and followed into middle adulthood (approximate age 39). Mediators were assessed in young adulthood (approximate age 29) through in-person interviews between 1989 and 1995 and official arrest records through 1994 (N = 1,196). Drug use was assessed via self-reports of past year use of marijuana, psychedelics, cocaine, and/or heroin during 2000–2002 (N = 896). Latent variable structural equation modeling (SEM) was used to test: (1) a four-factor model with separate pathways from CAN to illicit drug use through each of the mediating risk factors and (2) a second-order model with a single mediating risk factor comprised of prostitution, homelessness, delinquency and crime, and poor school performance. Analyses were performed separately for women and men, controlling for race/ethnicity and early drug use. In the four-factor model for both men and women, CAN was significantly related to each of the mediators, but no paths from the mediators to drug use were significant. For women, the second-order risk factor mediated the relationship between CAN and illicit drug use in middle adulthood. For men, neither child abuse and neglect nor the second-order risk factor predicted drug use in middle adulthood. These results suggest that for women, the path from CAN to middle adulthood drug use is part of a general “problem behavior syndrome” evident earlier in life.

Depression and substance use in two divergent high school cultures: A quantitative and qualitative analysis

Research has generally concluded that adolescent depression and substance use are strongly interrelated, but has rarely considered how this relationship may vary across diverse populations. In this study, we used quantitative and qualitative methods to explore the relationships among depression and cigarette, alcohol, marijuana, and harder drug use across two culturally disparate environments: a suburban and an inner-city high school. Our sample included 164 suburban and 242 inner-city high school students. The students completed Kovacs' Children's Depression Inventory of 1985 and substance use measures derived from various sources. In-depth semistructured interviews were conducted with subjects who scored in the top 10% of the CDI (N=19) from both schools. Our quantitative findings indicated a positive association between depression and cigarette, marijuana, and harder drug use among the suburban students, and no association between depression and the use of any substances for the urban students. There were no significant differences in levels of reported depression across samples. However, with the exception of marijuana use, suburban students reported greater involvement in substance use than urban students. Our qualitative analyses suggest that across-school differences in the relationships among depression and substance use may be related to the varied meanings of depression and substance use that are informed by cultural context.The research was funded by the National Institute of Drug Abuse (NIDA), Grant No. 1 R01 DA-06844, Perry London, principal investigator. The views, opinions, and findings contained in their article are not to be construed as NIDA's position or policy.B.A. from University of California, Berkeley, and Ed.D. from the Graduate School of Education, Harvard University. Research interests include the phenomenology of high-risk behavior and social development among urban adolescents.B.A. from Mount Holyoke College and Ed.M. from the Graduate School of Education, Harvard University. Research interests include the relationships among high-risk behavior, personality variables, and cultural context.B.A. from Michigan State University, M.A. from University of Minnesota-Duluth, and Ed.D. from Harvard Graduate School of Education. Research interests include integrating quantitative and qualitative methods in social science research and the phenomenology of high-risk behavior.Research interests included adolescent high-risk behavior and ethnic and religious identity development. Deceased June 1992.     

Are Family Meals as Good for Youth as We Think They Are? A Review of the Literature on Family Meals as They Pertain to Adolescent Risk Prevention

Regular family meals have been shown to reduce adolescents’ engagement in various risk behaviors. In this article, we comprehensively examine the literature to review the association between family meals and eight adolescent risk outcomes: alcohol, tobacco, marijuana and other drugs; aggressive and/or violent behaviors; poor school performance; sexual behavior; mental health problems; and disordered eating patterns. The majority of the studies reviewed found associations in the relationship between family meals and adolescents’ risk profiles. More specifically, studies reporting significant associations found that adolescents who frequently ate meals with their family and/or parents were less likely to engage in risk behaviors when compared to peers who never or rarely ate meals with their families. Additionally, the influence of family meal frequency on youth risk outcomes appears to be dependent on gender, with family meals being a protective factor for females and males differently, depending on the outcome examined. However, the studies available about family meals and adolescent risk only examined the effect of family meal frequency, and not other components of family meals that contribute to the protective effect, and, thus, hinder the understanding of the mechanisms unique to family meals’ protective characteristics. Regardless of these limitations, the studies examined indicate that family meals may be protective and, therefore, have practical implications for parents, clinicians, and organizations looking to reduce adolescent risk behaviors. However, further examination is needed to better understand the mechanisms that contribute to the protective effect afforded by family meal frequency on adolescents.     

Peer vs. parental influence in substance use among hispanic and Anglo children and adolescents

The relative influence of peer and parental influence on youths' use of alcohol and other drugs is explored among 446 Anglo and Hispanic youths, ages 9–17. Current users and abstainers are similar in age and gender. Among both groups, parental influence is more profound than that of peers. However, substance users, compared to abstainers, are more influenced by peers. Level of marijuana use by youths' friends is the most reliable predictor of drug use. Youths having viable relationships with parents are less involved with drugs and less influenced by drug-oriented peers.Funded by a grant (A-003-2) from the California Department of Alcohol and Drug Programs, R. H. Coombs, principal investigator.Research interests include comparative socialization patterns of adolescents and young adults in substance abuse vs. conventional careers.Research interests include domestic violence, child abuse, and substance abuse.Research interests include family interaction patterns, cross-cultural differences, and substance abuse prevention and treatment.     

Parents,Peers, Perceived Risk of Harm,and the Neighborhood: Contextualizing Key Influences on Adolescent Substance Use

Recent research has affirmed the need to examine contextual influences on adolescent substance use in a multilevel framework. This study examined the role of neighborhood opportunities for substance use in promoting adolescent substance use. Data came from two components of the Project on Human Development in Chicago Neighborhoods: the Longitudinal Cohort Study, consisting of interviews with youth and their primary caregivers across three waves of data with an average span of 4.5 years; and a Community Survey of neighborhood residents. Analysis used an Item-Response Theory-based statistical approach on 6556 substance use item responses from 1639 youth (49.0 % female) within 80 neighborhoods to assess the extent to which neighborhood opportunities for substance use had direct and indirect effects on adolescent substance use. Neither direct nor mediated effects of neighborhood opportunities for substance use on adolescent substance use were detected. But, analyses revealed moderating effects such that higher levels of neighborhood opportunities for substance use: (1) amplified the detrimental effects of parental substance use and peer substance use on youth substance use; and (2) attenuated the protective effect of adolescents’ perceived harm of substance use on adolescent substance use. The results suggest that the ways in which neighborhood characteristics impact adolescent behavior are nuanced. Rather than impact individual-level outcomes directly, neighborhood context may be particularly relevant by conditioning the effects of salient individual-level risk and protective factors for substance use.     

Peer Influence and Context: The Interdependence of Friendship Groups,Schoolmates and Network Density in Predicting Substance Use

This article focuses on the degree to which friends’ influence on substance use is conditioned by the consistency between their behavior and that of schoolmates (individuals enrolled in the same school, but not identified as friends), contributing to the literature on the complexity of interactive social influences during adolescence. Specifically, it hypothesizes that friends’ influence will diminish as their norms become less similar to that of schoolmates. The authors also propose that this conditioning relationship is related to the density of the friendship group. This study uses data from the National Longitudinal Survey of Adolescent Health (AddHealth) (n ~ 8,000, 55 % female) to examine the interactive relationship between friend and schoolmate influences on adolescent substance use (smoking and drinking). The sample contains students ranging from age 11 to 22 and is 60 % White. The findings demonstrate that, as the substance use of the friendship group becomes more dissimilar from schoolmates’ substance use, the friendship group’s influence on adolescent substance use diminishes. Further, the results demonstrate that this conditioning relationship does not emerge when the friendship group is highly dense.