Adolescent Risk: The Co-Occurrence of Illness,Suicidality, and Substance Use

Illness is rarely considered a “risk factor” in adolescence. This study tests illness, suicidality and substance use as outcome measures in a path analysis of 1028 Swiss adolescents in secondary prevention programs. The model showed that negative mood (depression and anxiety) predicted two paths. One path led from negative mood to suicidality and from there to substance use. The other path led directly from negative mood to illness. Traditional protective factors (good relationships, secure identity) protected against the negative mood-suicide-substance path, but not against the negative mood-illness path. Gebhard Hüsler, psychologist and psychotherapist, Director of the Centre for Rehabilitation and Health Psychology Research, University of Fribourg, rte Englisberg 7, CH 1763 Granges-Paccot, Switzerland. Ronny Blakeney is a senior researcher at University of Fribourg, Departement Erziehungswissenschaften, University of Fribourg, rue de Faucigny 2, CH-1700 Fribourg, Switzerland. Her major research interests are developmental approaches to the sociomoral challenges of adolescents. Egon Werlen is a junior researcher at Center of Rehabilitation and Health Psychology Research, rte Englisberg 7, CH 1763 Granges-Paccot, Switzerland. His major interests are the course of psychological well being, psychological processes in chronic diseases, and methodological issues.     

Multidimensional Impulsive Personality Traits Mediate the Effect of Parent Substance Use Disorder on Adolescent Alcohol and Cannabis Use

Journal of Youth and Adolescence - Theory suggests that behavioral undercontrol mediates the effect of parental substance disorder on offspring substance use, but no studies have tested...     

Differentiating Peer Contexts and Risk for Adolescent Substance Use

The peer context is perhaps the most salient, robust predictor of an adolescent's substance use. However, in previous studies, the peer context is often poorly defined. The current study examined 3 models to understand how substance use within best friendships, peer cliques, and social crowds predicts adolescents' substance involvement. A sample of 377 high school juniors and seniors completed surveys assessing substance use and peer relationships. Results suggest that each of these 3 dimensions of the peer context uniquely predict adolescent substance use. Moreover, these peer contexts interacted in the prediction of adolescents' substance use such that adolescents who were more highly embedded in substance-using peer contexts showed greater risk for substance use whereas adolescents with substance-using best friends showed a reduced risk for substance use if they had other close friends who were less involved with substances.     

Conceptual and Clinical Issues in the Treatment of Adolescent Alcohol and Substance Misusers

This paper describes a system of care and the clinical issues that are central to the delivery of alcoholism and for substance abuse services to adolescents. Adolescent services can be provided in a variety of settings. Criteria are identified which can distinguish which level of care is most appropriate for the presenting clinical condition of the adolescent.     

Efficacy, Self-Derogation, and Alcohol Use Among Inner-City Adolescents: Gender Matters

Prior studies have found inconsistent relationships between measures of self-concept and adolescent alcohol use. The current study explored whether the link between various measures of self-concept and alcohol use depends on gender. In addition, earlier work suggested a focus on negative self-esteem (i.e., self-derogation) might be more useful in predicting alcohol use. Students (N = 1459) attending 22 middle and junior high schools in New York City completed surveys that included measures of efficacy, self-derogation, and alcohol use. Participants completed surveys at baseline, 1-year follow-up, and 2-year follow-up. Data collectors administered the questionnaire following a standardized protocol during a regular 40-min-class period. On the basis of a longitudinal structural equation model, lower efficacy was related to greater self-derogation a year later across gender. Increased self-derogation predicted higher alcohol use for girls but not boys. These findings are congruent with a literature highlighting the importance of negative thoughts about the self in drinking behavior for women but not men. The results suggest that the alcohol prevention approaches should include material to enhance girls' self-esteem.     

An 18-Year Model of Family and Peer Effects on Adolescent Drug Use and Delinquency

The interrelationship of family and peer experiences in predicting adolescent problem behaviors was examined in an 18-year longitudinal sample of adolescents (N = 198) from conventional and nonconventional families. Positive associations among early childhood predictors and adolescent problem behaviors were consistent with problem behavior theory. The most powerful predictors of teen drug use and delinquent behaviors were similar behaviors by peers. Peer behaviors, however, were in turn predicted by earlier family-related variables and the quality of peer relationships in childhood. This study provides supporting evidence that strong peer effects in adolescence reflect even earlier processes in childhood and highlight the importance of linkages from early childhood experiences in family and peer contexts to the development of problem behaviors in adolescence. Implications for prevention and intervention programs are discussed.     

A Moving Target: Reasons Given by Adolescents for Alcohol and Narcotics Use, 1984 and 1999

Previous studies have investigated adolescents' reasons for alcohol and narcotics use, but have tended to neglect changes in the reasons over time. This study investigates the reasons given by Finnish adolescents for their own alcohol use, and for the use of alcohol and narcotics by others. In 1984, a questionnaire on reasons for alcohol and narcotics use was administered to a sample of adolescents aged 14–16 (N = 396). The questionnaire was administered again to a similar sample (N = 488) in 1999. An increase was found in reasons involving inner subjective experiences, referring to the good feeling and fun resulting from alcohol and narcotics use. In addition, the goals of alcohol consumption were increasingly perceived as drinking to get drunk, and for its own sake. The results suggest that adolescents' attitudes have become more liberal towards alcohol and narcotics use, and that prevention campaigns may be aiming at a moving target of culturally held opinion.     

Why Drink Less? Diffidence,Self-Presentation Styles,and Alcohol Use Among University Students

Through the theoretical lens of the self-presentation model, this paper addresses conflicting results from past research on the links between the components of diffidence (i.e., high levels of introversion and loneliness, and low levels of self-esteem) and alcohol use among undergraduate college students (N = 548). Correlational and multiple regression analyses were used to examine whether protective and acquisitive self-presentation expectancies about the effects of alcohol act as suppressing variables in the relationship between diffidence and alcohol use. Results supported the suppression hypothesis. A negative relationship between diffidence and alcohol use was revealed when self-presentation expectancies about the effects of alcohol were controlled statistically. The self-presentation model may provide new theoretical insights into the links between alcohol expectancies and alcohol use. Implications for campus-based intervention programs are discussed.     

The Relative Importance of Mothers’ and Youths’ Neighborhood Perceptions for Youth Alcohol Use and Delinquency

Prior studies have examined the influence of neighborhood perceptions on youth outcomes, but few studies have examined whose report of neighborhoods, parents’ or youths,’ are most important in predicting youth outcomes. This study addresses the relative associations of youths’ and mothers’ neighborhood perceptions with youth alcohol use and delinquency. The sample includes 499 mother-child dyads (youth age: 10 to 16 [mean=13.3; SD=2]). Structural equation modeling showed that youths’ perceived neighborhood problems were significantly associated with their delinquency but not their alcohol use. However, mothers’ perceived neighborhood problems were not related to either youth alcohol use or delinquency, suggesting that youths’ perceptions are better indicators of youth behavior. Youth reports may reflect their activities in the neighborhood and their exposure to different forms of deviance, so youths’ reports would be better indicators of exposure to neighborhood risk. Challenges for prevention are discussed. NIAAA Postdoctoral Fellow and Associate Research Scientist at the School of Public Health, University of California, Berkeley, and the Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA. Her research interests include psychosocial and environmental factors influencing youth problem behaviors. Interests are interventions for children with substance use or externalizing problems and their families. She is currently conducting alcohol, drug and other risky behavior prevention studies that include a focus on young adults in club settings as well as a variety of different family-based studies in different geographic regions (San Francisco Bay Area, Alaska, Thailand). Her work integrates both quantitative and qualitative research methods and centers on alcohol and other drug use, and related health issues among adolescents and young adults. She is especially interested in applying theoretical models of socially learned behaviors to populations with different cultural and social backgrounds     

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.     

Substance Use Attitudes among Urban Black Adolescents: The Role of Parent,Peer, and Cultural Factors

This study examined the influence of perceived parental, peer, and cultural factors on Black American adolescent attitudes toward substance use. One-hundred-eight Black American youth (grades 9–12) from economically disadvantaged urban neighborhoods of New York, completed self-report measures on: (a) parent-child involvement, parental supervision, and parent attitudes toward high risk behaviors; (b) peer bonds and peer attitudes toward high risk behaviors; and (c) ethnic identity, parental racial socialization, and extended family support. Youth disapproval of substance use was positively associated with higher perceived levels of peer and parental disapproval of high risk behaviors, parental supervision, and ethnic identity. Youth who reported parental messages about racial discrimination without balanced parental messages about racial pride and racial equality were more likely to approve substance use. Assistant Professor in the Department of Preventive Medicine and Community Health, State University of New York Downstate Medical Center. Her research interests include socio-cultural factors in the prevention of youth substance use, sexual risk, and violence. Director, Center for Ethics Education and Marie Ward Doty Professor of Psychology at Fordham University. Current research interests include research ethics with vulnerable populations, including children and adolescents.     

What Friends are for: The Relationships Between Body Image, Substance Use, and Peer Influence Among Finnish Adolescents

The study investigated the relationships between substance use, body image, and peer influence among Finnish adolescents. The participants (N=488, 240 boys and 248 girls), were eighth-grade high school students. The data were gathered using a questionnaire. In addition to background information, the study covered risk behaviors frequency, body satisfaction, and peer relationships. The results indicated that the levels of body satisfaction among the adolescent girls studied were lower than those among the adolescent boys. It was found that the girls engaged in more discussion with peers than the boys concerning both intimate and general matters. Moreover, having an intimate relationship with one's peers was associated with a greater tendency to drink purely in order to get drunk. However, a slightly more distant relationship with friends was associated with a greater risk for smoking. In general, dissatisfaction with one's physical appearance seemed to relate to substance use. By highlighting the relationships between adolescents’ body image, substance use, and peer influence the study gives pointers for further research, and may be suggestive in terms of the kinds of social policies that ought to be pursued in the future.MA (Educational Sciences) from the University of Turku. Research interests include substance use and the life processes of adolescents.Docent (Educational Sciences), PhD from the Karolinska Institute, Stockholm.     

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.

Patterns of Middle School Adjustment and Ninth Grade Adaptation of Rural African American Youth: Grades and Substance Use

The transition to high school has been identified as a potentially difficult time in adolescents’ lives. Reductions in both academic and social functioning often accompany this transition. While these effects have been documented in urban youth, the move to high school has not been extensively studied in rural minority youth. Toward that end, the academic grades and substance use in ninth grade of 447 (184 male and 263 female) African-American adolescents from two rural counties in a state in the deep South were examined in relation to configurations of adaptation from sixth through eighth grade. Results indicate that individual with consistently positive patterns across middle school had higher grades and lower rates of substance use compared to individuals with persistent difficulties or those that transitioned to problem behavior. Many individuals who improved in their patterns of adaptation had relatively high grades, but also rather high rates of substance use in the ninth grade. David B. Estell is an assistant professor of educational psychology at Indiana University Bloomington. He received his PhD in Developmental Psychology from the University of North Carolina at Chapel Hill. His major research interests include peer relations and the development of aggression. Thomas W. Farmer is an associate professor of education at Pennsylvania State University and director of the National Research Center on Rural Education Support. He received his PhD in Special Education from University of North Carolina at Chapel Hill. His major research interests include peer relations and the development of aggression in students with and without special needs. Matthew J. Irvin is a research scientist at the Center for Developmental Science at the University of North Carolina at Chapel Hill. He received his PhD in Educational Psychology from the University of North Carolina at Chapel Hill. His major research interests include resilience and student engagement. Jana H. Thompson is a research associate at the Center for Developmental Science at the University of North Carolina at Chapel Hill. Her research interests include peer social relations and developmental transitions into early adolescence. Bryan C. Hutchins is a research assistant at the Center for Developmental Science at the University of North Carolina at Chapel Hill. He is also a graduate student in the Educational Psychology, Measurement, and Evaluation Program at UNC. His research interests include child and adolescent social development and school based emotional and behavioral interventions and prevention programs. Erin M. McDonough is currently a doctoral candidate in School Psychology at the University of North Carolina at Chapel Hill. She received her Bachelor of Arts degree in Psychology from Emory University. As a research assistant at the Center for Developmental Science, she has been able to explore her interests in student achievement as well as rural education. Another major research interest of hers is school-based mental health.     

A Case Control Study of Adolescent Risky Sexual Behavior and Its Relationship to Personality Dimensions,Conduct Disorder,and Substance Use

In comparison to the general adolescent population, adolescents with a history of externalizing behaviors including substance use and conduct disorder are younger at first intercourse, have a larger number of sexual partners, and use condoms less often when they engage in intercourse, placing them at higher risk for sexually transmitted diseases as well as unplanned pregnancy (Morris, R. E., Baker, C. J., Valentine, M., and Pennisi, A. J. (1998). J. Adolesc. Health 23: 39–48). A primary goal of this paper was to examine linkages between Cloninger's novelty-seeking, harm avoidance, and reward dependence dimensions and risky sexual behavior among 200 boys in treatment for substance abuse and delinquency compared to 200 boys recruited from the community, and matched on age, ethnicity, and geographic location. Analyses indicated that though there were mean differences on all personality constructs examined, these differences in personality failed to account for observed differences in risky sexual behavior. The structure of problem behavior also differed in the 2 groups.     

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.