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.     

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.     

Social Competence and Substance Use Among Rural Youth: Mediating Role of Social Benefit Expectancies of Use

The present study examined the mechanisms by which social competence may be associated with substance use during early adolescence. The sample consisted of rural youth (N = 1,568) attending 36 junior high schools in a midwestern state. Structural equation modeling indicated that social competence had a direct protective association with substance use in that those youth who were more socially confident, assertive, and had better communication skills reported less smoking and drinking. Further analyses revealed that the relationship between social competence and substance use was fully mediated by social benefit expectancies of use. These findings suggest that poorly competent youth turn to smoking and alcohol use because they perceive that there are important social benefits to doing so, such as having more friends, looking grown up and cool, and having more fun. Prevention programs that teach youth interpersonal skills may reduce the initiation of substance use by improving social competence and providing youth with more adaptive means of gaining approval from peers.     

Peer Victimization Exposure and Subsequent Substance Use in Early Adolescence: The Role of Sleep Problems

Journal of Youth and Adolescence - While sleep problems are positively associated with both peer victimization and substance use, previous studies largely have ignored the indirect role sleep...     

Adolescent Alcohol Beverage Type Choices Reflect Their Substance Use Patterns and Attitudes

Alcoholic beverage type choices were studied in relation to adolescents' substance use patterns and attitudes towards substance use, utilizing the national 1999 Adolescent Health and Lifestyle Survey data (N = 4943) collected among Finns aged 14 and 16 years by mail. Frequencies of drinking, drunkenness and smoking, and chewing tobacco use as well as attitudes towards substance use and exposure to other drugs were all strongly related to beverage type choices. The amount of alcohol consumed was associated with the beverage choice. The relationships between beverage choices and substance use patterns were partly mediated through amounts drunk. Beverage type choices seemed to reflect substance use patterns and attitudes more generally. Wine and cider appeared beverages related to moderation and control in relation to substance use, but beer drinking may be interpreted as a sign of initiation into a substance use pattern favoring smoking and heavier use of alcohol and other drugs.     

Parental Cultural Affiliation and Youth Mental Health Service Use

Studies indicate that African American, Asian/Pacific Islander, and Latino youth have higher rates of unmet mental health needs and lower rates of mental health service utilization compared to non-Hispanic White youth, suggesting that obstacles may exist in the help-seeking and service utilization pathway for minority youth. Parental cultural factors may significantly impact youth service use, and acculturation is one way to measure adherence to culture specific values, beliefs, attitudes, and behaviors. In this study, parental acculturation level, conceptualized as cultural affinity to 1) mainstream American culture and 2) an alternative culture, were examined as potential mediators of the relationship between race/ethnicity and youth service use. The current subsample (n=1364) was drawn from the Patterns of Care study, a larger study of at-risk youth who were active to at least one of five public sectors of care. Our subsample included all youth aged 6–17 who were African American, Asian/Pacific Islander, Latino, or Non-Hispanic Whites (66.6% male). The results indicate that parental acculturation level as measured by affinity to an Alternative Culture was a partial mediator in the relationship between race/ethnicity and mental health service use for Asian/Pacific Islander and Latino youth. Doctoral student in the SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, Suite 100, San Diego CA, graduate research assistant, Child and Adolescent Services Research Center, Children’s Hospital, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123 Assistant Professor of Psychology, San Diego State University; Assistant Adjunct Professor of Psychiatry, University of California, San Diego, Research Scientist, Child and Adolescent Services Research Center, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123 Research Scientist, Child and Adolescent Services Research Center, Children’s Hospital, San Diego, Assistant Professor of Psychology, University of San Diego; Adjunct Assistant Professor of Psychiatry, University of California, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123 Research Professor of Psychiatry and Family and Community Medicine at the University of New Mexico, Adjunct Professor of Psychiatry at the University of California, San Diego; Emeritus Professor of Sociology at San Diego State University; Senior Research Scientist at the Child and Adolescent Services Research Center, Children’s Hospital, San Diego, 3020 Children’s Way (MC 5033), San Diego, CA 92123     

The Impact of Gender and Family Processes on Mental Health and Substance Use Issues in a Sample of Court-Involved Female and Male Adolescents

Greater empirical attention directed toward gender-sensitive assessment strategies that concentrate on family-specific factors is thought to be both timely and necessary, especially with regard to outcome variables associated with mental health and substance abuse in at-risk adolescent populations. A sample of 2,646 court-involved adolescents was used to test two competing models regarding relationships among disruptive family processes, mental health (as both internalizing and externalizing problems), and substance abuse issues according to gender. The results of multiple group structural equation modeling procedures indicated that disrupted family processes were significantly associated with higher levels of internalizing problems, externalizing problems, and substance abuse in both male and female youth. For females, however, disrupted family processes were more related to internalizing problems and substance abuse than externalizing problems. Further, the relationship between disrupted family processes and substance abuse was not mediated by mental health issues, indicating a lack of support for the alternative model tested in this study. Together, the findings underscore the primacy of the family’s impact on issues related to adolescent development and well-being in tandem with the need for a more gender sensitive approach to the needs of court-involved males and females.

Parental Authoritativeness,Social Support and Help-seeking for Mental Health Problems in Adolescents

Journal of Youth and Adolescence - Adolescents experience high rates of mental health problems but are reluctant to seek professional help. Parents play an integral role in the help seeking process...     

Contextual Socioeconomic Status and Mental Health Counseling Use Among US Adolescents with Depression

Most adolescents with depressive disorders do not receive any mental health services, even though effective treatments exist. Although research has examined numerous individual-level factors associated with mental health service use among depressed adolescents, less is known about the role of contextual factors. This study examines the relationship between contextual-level socioeconomic status (SES) and clinic-based mental health counseling use among US adolescents with high depressive symptoms in urban and suburban areas. Data from the first two waves of the National Longitudinal Study of Adolescent Health (N = 1,133; 59 % female) were analyzed using multilevel logistic models in which adolescents were nested within counties. After controlling for individual-level predisposing, enabling, and need characteristics, as well as county racial/ethnic composition, county SES was positively associated with clinic-based counseling use among depressed youth. A one standard deviation increase in the county affluence index was associated with 43 % greater odds of receiving any clinical counseling services. Furthermore, the positive relationship between county affluence and clinical counseling use was no longer significant after controlling for the county supply of mental health specialist physicians. The results indicate that county residential context is a key correlate of mental health service use among depressed adolescents, such that those who live in lower SES counties with fewer mental health specialists are less likely to receive treatment.     

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.     

Socioeconomic Context, Social Support, and Adolescent Mental Health: A Multilevel Investigation

This study examined whether the impact of contextual-level socioeconomic disadvantage on adolescent mental health is contingent upon individual-level perceptions of social support. Data are from the National Longitudinal Study of Adolescent Health (Add Health), a panel survey of a nationally representative United States sample (analytic N=18,417) of students in 7th through 12th grade. Effects of social support and social context on both internalizing problems (depressive symptoms) and externalizing problems (minor delinquency and violent behavior) are analyzed. Contextual-level socioeconomic disadvantage is positively associated with depressive symptoms, negatively associated with minor delinquency, and not directly associated with violent behavior. High perceived support from family, friends, and other adults offsets poor mental health, but is most protective in areas of low socioeconomic disadvantage. The mental health benefits of perceived social support are dampened in socioeconomically disadvantaged areas, compared to advantaged areas. Results suggest that interventions targeting only individual- or family-level processes within disadvantaged contexts may be inadequate at stemming psychological distress among adolescents. Richard G. Wight, Assistant Research Sociologist, conducts life course mental health research in the UCLA Department of Community Health Sciences. His work emphasizes the intersection of individual- and contextual-level factors that impact health within dyads, families, and neighborhoods. Amanda L. Botticello is a doctoral student in the UCLA Department of Community Health Sciences, where her work addresses the reciprocal relationships between depressive symptoms and problem drinking among adolescents. Carol S. Aneshensel is a Professor of Community Health Sciences at UCLA, where she applies principals of social stratification and life course theory to the analysis of quantitative data to better understand disparities in mental health risks.     

The Effects of Childhood and Adolescent Adversity on Substance Use Disorders and Poor Health in Early Adulthood

Childhood and adolescent adversity have been shown to predict later mental and physical health outcomes. Understanding which aspects and developmental timings of adversity are important, and the mechanisms by which they have their impact may help guide intervention approaches. A large subset of adolescents (N?=?457; Female 68.9?%) from the 10-year longitudinal Youth Emotion Project was examined to better understand the associations among childhood/adolescent adversity, substance use disorder, and later health quality. Adolescent (but not childhood) adversities were associated with poorer health in late adolescence/early adulthood, adolescent adversities were associated with subsequent onset of substance use disorder, and adolescent adversities continued to be associated with poorer health in late adolescence/early adulthood after accounting for the variance explained by substance use disorder onset. These associations were observed after statistically accounting for emotional disorders and socioeconomic status. Specific domains of adversity uniquely predicted substance use disorder and poorer health outcomes. In contrast with current recent research, our findings suggest the association between childhood/adolescent adversity and poorer health outcomes in late adolescence and emerging adulthood are not entirely accounted for by substance use disorder, suggesting efforts to curtail family-based adolescent adversity may have downstream health benefits.     

Alcohol and Drug Use in Young Apprentices: Effect of Social Control in the Family

In this research, social control used by the families of young apprentices related to certain deviant behaviors such as alcohol and drug use was examined. Finally it was found that most of the young people who use drugs and alcohol were battered frequently. The relationship between deviant acts of young people and social control used by their families was analyzed through theories concerning the socioeconomic status of family and the relations between family members.     

Delinquent Girls Grown Up: Young Adult Offending Patterns and Their Relation to Early Legal, Individual, and Family Risk

Although the number of girls served by the juvenile justice system has grown dramatically, little is known about the adult offending patterns of delinquent girls and the factors associated with their persistence and desistance from adult crime. To address this gap, we prospectively track 499 girls (62% Black, 16% Hispanic) discharged from juvenile justice facilities in the early 1990s and document their adult arrests, convictions, and incarcerations between the ages of 16–28. Trajectory analysis reveals four distinct early adult offending paths: Rare/Non-Offending (RN), Low Chronic (LC), Low-Rising (LR), and High Chronic (HC). Girls assigned to the LR and LC path are responsible for a disproportionate amount of adult arrests and are more likely than girls on the RN and LC path to come from homes characterized by high levels of family dysfunction and child maltreatment. Adoption of a therapeutic, trauma-sensitive and family-centered approach to female delinquency programming is recommended.

Testing a Model of Universal Prevention Effects on Adolescent Relationships and Marijuana Use as Pathways to Young Adult Outcomes

There are several interrelated knowledge gaps in the literature on skills-building interventions for middle schoolers designed to prevent initiation of substance use, all of which concern the limited study of the adolescent pathways of those intervention effects on distal young adult outcomes. Among the most important yet understudied pathways of influence on long-term effects are positive youth relationship outcomes of middle-school interventions. Other influential pathways for long-term effects are reductions in adolescent substance misuse, particularly marijuana use, considering the long-term consequences of early marijuana initiation. To address these knowledge gaps, data from a randomized controlled trial were used to test a longitudinal, developmental model positing pathways of intervention effects on age 21 illicit drug use and positive relationship affect, via earlier effects on adolescent relationships and marijuana use. Sixth-graders and their families enrolled in 22 Iowa schools were randomly assigned to the Iowa Strengthening Families Program or a control group (N?=?446). The average age of students at baseline was 11.3 years (10–13 year age range); 48% were male and 98% were Caucasian, reflective of the demographics in the participating rural Midwest communities. Measures included middle-school relationships (parents, peers, school), high school marijuana use, plus age 21 illicit drug use and relationship affect (parents, work, school), 10 years past intervention implementation. As expected, intervention effects on young adult variables were indirect, through effects on adolescent outcomes, with higher-risk participants showing greater intervention impact. The findings suggest preventive interventions with young adolescents have potential to demonstrate effects into young adulthood.

     

Self-control,Mental Health Problems,and Family Functioning in Adolescence and Young Adulthood: Between-person Differences and Within-person Effects

Journal of Youth and Adolescence - Adolescents’ self-control develops in the context of mental health and family functioning, but it is unclear how the interplay of self-control, mental...     

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.     

Longitudinal Associations between Social Relationships and Alcohol Use from Adolescence into Young Adulthood: The Role of Religiousness

Journal of Youth and Adolescence - As adolescence is a time characterized by rapid changes in social relationships as well as an increase in risk-taking behaviors, this prospective longitudinal...