Does Parental Monitoring Moderate the Impact of Community Violence Exposure on Probation Youth's Substance Use and Sexual Risk Behavior?

Association between early sexual initiation and forced sexual intercourse with polysubstance use among adolescents: Findings from a population-based study

Substance use among adolescents in the United States is a significant public health concern. Despite the use of single substances among adolescents being rare, existing literature focuses on single, rather than the more common polysubstance use (PSU). Furthermore, the relationship between early sexual initiation (ESI), forced sexual intercourse, and PSU is underexplored. This study addresses this gap in the literature by examining this intersection. Data for this study came from the 2021 Youth Risk Behavior Survey (YRBS) and the sample was comprised of 17,033 adolescents aged 14-18. Models were built sequentially using descriptive, bivariate, and finally complementary log-log models to evaluate these associations, while controlling for symptoms of depression, poor mental health during COVID-19, parental monitoring, and demographic characteristics. Of the 17,033 adolescents examined, 18.7 % engaged in PSU, 21.6 % engaged in ESI, and 8.5 % also reported experiencing forced sexual intercourse. In the final model, adolescents who engaged in ESI had more than fourfold higher odds of engaging in PSU when compared to their counterparts who did not engage in ESI (AOR = 4.24, p < .001, 95 % CI = 3.75-4.79). History of forced sexual intercourse was associated with 1.34 times higher odds of engaging in PSU. These results underscore that ESI is significantly associated with increased risk of forced sexual intercourse and PSU. This study highlights the need of future research to uncover the psychological pathways linking ESI, forced sexual intercourse, and PSU.

Effect of multi-level social risk factors on developmental trajectories of sexual risk behaviors among Bahamian middle-to-late adolescents

Background

Few studies have examined how multi-level social factors interact and affect developmental patterns of sexual risk among middle-to-late adolescents who are at risk of experiencing sexual risk behaviors. We examined developmental trajectories of sexual risk behaviors of boys and girls in middle-to-late adolescence and the effects of exposure to three social risk factors (poor parental monitoring, peer risk, and neighborhood risk).

Methods

We followed 2,332 Bahamian adolescents every six months from Grades 10-12. We used group-based trajectory modeling to identify distinct trajectories of sexual risk behaviors for boys and girls.

Results

We identified three trajectories each for boys and girls. Peer risk and neighborhood risk predicted a high sexual-risk trajectory for boys, and peer risk (alone or combined with other risk factors) had the greatest impact on the membership of moderate-to-high-risk trajectory for girls. Parental monitoring had a relatively small effect on adolescents' sexual risk behavior.

Conclusion

Our results underscore the importance of early identification of adolescents with sexual risk behavior and development of targeted prevention interventions to improve adolescent health outcomes.

Trajectories of parental harshness and exposure to community violence differentially predict externalizing and internalizing mental health problems in legal system-involved youth

Youth with legal system involvement are especially likely to experience parental harshness (PH) and exposure to community violence (ETV), two common forms of life stress. However, most studies examine these stressors separately or collapse across them in ways that preclude examination of their co-occurrence. Consequently, it is unclear 1) how PH and ETV simultaneously fluctuate across development and 2) how these fluctuations predict future mental health problems in legal system-involved youth. We used group-based multi-trajectory modeling to estimate simultaneous trajectories of PH and ETV in 1027 legal system-involved youth and regression analyses to understand how trajectory membership predicted mental health problems three years later. Four trajectories of co-occurrence were identified (1: Low; 2: Moderate and Decreasing; 3: Moderate PH/High ETV; 4: High PH/Moderate ETV). Compared to the Low trajectory, all trajectories with PH/ETV elevations predicted violent crime and substance problems; trajectory 3 (Moderate PH/High ETV) predicted nonviolent crime and depression/anxiety symptoms; trajectory 4 (High PH/Moderate ETV) predicted depression diagnosis. These results elucidate how PH and ETV typically co-occur across adolescence for legal system-involved youth. They also reveal important commonalities and dissociations among types of mental health problems.

Adverse childhood experiences, mental distress, self-harm and suicidality, and cumulative HIV risk by sex in Lesotho

BACKGROUND

Adverse childhood experiences (ACEs) have been understudied in low- and middle-income countries, especially in sub-Saharan Africa.

OBJECTIVES, PARTICIPANTS, SETTING

We explored associations between mental distress, self-harm or suicidality, and HIV risk and individual and cumulative ACEs (sexual, emotional, and physical violence; witnessing community and interparental violence; orphanhood) among youth aged 13-24 in Lesotho.

METHODS

Multivariable logistic regressions stratified by sex using nationally representative 2018 Lesotho Violence Against Children and Youth Survey (nfemale = 7101; nmale = 1467) data.

RESULTS

Over 75 % of males and females experienced at least 1 ACE. Among males, physical and community violence were significantly associated with mental distress; orphan status and emotional violence was associated with self-harm/suicidality. Males who witnessed interparental violence had higher odds of disclosing 2 types and 3 or more types of HIV risk versus none. Among females, being a double orphan and having experienced sexual, emotional, physical, community, and interparental violence were significantly associated with mental distress and any self-harm/suicidality in both models. Females who experienced physical violence had higher odds of disclosing 3 or more risk types versus no risk. Statistically significant associations emerged between cumulative ACEs and mental distress, self-harm/suicidality, and higher levels of HIV risk for both males and females.

CONCLUSIONS

Differential patterns of associations between ACEs and mental health problems and HIV risk emerged by sex. Scalable, integrated individual and community efforts to prevent ACEs, provide mental health supports, and encourage safer sexual behaviors among those exposed are needed and could benefit youth in Lesotho.

Social-Ecological Predictors of Opioid Use Among Adolescents With Histories of Substance Use Disorders

Adolescent opioid misuse is a public health crisis, particularly among clinical populations of youth with substance misuse histories. Given the negative and often lethal consequences associated with opioid misuse among adolescents, it is essential to identify the risk and protective factors underlying early opioid misuse to inform targeted prevention efforts. Understanding the role of parental risk and protective factors is particularly paramount during the developmental stage of adolescence. Using a social-ecological framework, this study explored the associations between individual, peer, family, community, and school-level risk and protective factors and opioid use among adolescents with histories of substance use disorders (SUDs). Further, we explored the potential moderating role of poor parental monitoring in the associations between the aforementioned risk and protective factors and adolescent opioid use. Participants included 294 adolescents (M _age = 16 years; 45% female) who were recently discharged from substance use treatment, and their parents (n = 323). Results indicated that lifetime opioid use was significantly more likely among adolescents endorsing antisocial traits and those whose parents reported histories of substance abuse. Additionally, adolescents reporting more perceived availability of substances were significantly more likely to report lifetime opioid use compared to those reporting lower perceived availability of substances. Results did not indicate any significant moderation effects of parental monitoring on any associations between risk factors and lifetime opioid use. Findings generally did not support social-ecological indicators of opioid use in this high-risk population of adolescents, signaling that the social-ecological variables tested may not be salient risk factors among adolescents with SUD histories. We discuss these findings in terms of continuing care options for adolescents with SUD histories that target adolescents' antisocial traits, perceived availability of substances, and parent histories of substance abuse, including practical implications for working with families of adolescents with SUD histories.

Community Violence Exposure and Externalizing Problem Behavior Among Chinese High School Students: The Moderating Role of Parental Knowledge

Adolescents' community violence exposure (CVE) has been demonstrated with a range of behavioral and psychological problems, but the processes that explain these correlations are not clear. In our 2017 study, the mediating role of deviant peer affiliation in the relationship between CVE and externalizing problem behaviors has been confirmed. However, the moderating effect of parental factors is still unclear. Therefore, a new group (high school group) was adopted in this study to further explore the moderating effect of parental knowledge based on also confirming the mediating effect of deviant peer affiliation. Stratified-cluster sampling was used to recruit 1,797 volunteers who completed questionnaires on CVE, deviant peer affiliation, parental knowledge, and externalizing problem behaviors. The results of the structural equation modeling were: on the basis of our previous research, we further analyzed the mediating role of deviant peer affiliation, and the mediated association was moderated by parental knowledge. Especially when the school climate is added as a covariate, the moderating effect of parental knowledge has changed, that is, the positive association between CVE and externalizing problem behaviors was much stronger for adolescents who reported lower levels of parental knowledge than for those who reported higher levels of parental knowledge. The results support the assumptions of social learning theory and have implications for interventions of community violence.

Surviving All the Way to College: Pathways Out of One of America's Most Crime Ridden Cities

The purpose of this study is to better understand the factors and processes related to resilience of youth who are among the most at risk for academic failure and involvement in the criminal justice system. To address the research questions about resilience and risk, in-depth interviews were conducted with a racially and ethnically diverse sample (N = 146) from one of the "most dangerous" cities in America. To obtain an objective assessment of risk, crime data were disaggregated by the city's census tracts. Respondents were recruited from a college campus that is located within the city limits of the research site. The retrospective interviews included questions related to family structure and dynamics, educational experiences and support, peers, mentors, extra-curricular activities, neighborhood attributes, inner traits of the respondent, and adverse childhood experiences (ACEs). Results suggest that this diverse sample of college students and recent graduates were not immune from the dangers and adversity known to exist within the northeastern city where they grew up. Crime rates and poverty indicators within the neighborhoods far exceeded national averages and findings indicate participants were exposed to serious forms and levels of community violence. Furthermore, outcome data suggest that participants also suffered from many traditional ACEs (e.g., high rates of parental separation, household substance abuse and mental illness, and family incarceration). The outcomes suggested a trifecta of protective factors in the respondent's resilience: engaged parenting, self-selected high schools, and the interaction of an individual's inner traits and local ecological supports. Community level suggestions include targeted parental programming, educational support, gang and crime resistance initiatives, and coping interventions for community violence exposure. Future resilience studies should consider an array of ecological factors that may help mediate the harms associated with exposure to community violence as well as data on household level stressors.

Parenting within residential neighborhoods: A pluralistic approach with African American and Latino families at the center

The intersection of SES and race-ethnicity impact youth development at the family and neighborhood levels. The confluence of neighborhood structural and social characteristics intersects to impact parenting multiple ways. Within lower-income neighborhoods, there is variability in economic and racial-ethnic demographics and social characteristics and a multitude of different lived experiences. We use a person-centered approach to understand how a plurality of neighborhood social characteristics shape parents' ethnic-racial socialization and monitoring strategies, normative parenting practices for diverse families. With 144 African American and Latino families in a new destination context-areas lacking an enduring historical and economic presence of same-ethnic populations-we examined whether we could replicate neighborhood profiles found in other neighborhood contexts using four neighborhood social process indicators (i.e., connectedness, cohesion and trust, informal social control, and problems), identified family- and neighborhood-level predictors of profiles, and explored differences in ethnic-racial socialization and parental monitoring knowledge by profile. We replicated three neighborhood profiles-integral (high on all positive social dynamics and low problems), anomic (low on all positive social dynamics and high problems), and high problems/positive relationships. Caregivers in these profiles differed in family SES and neighborhood disadvantage such that those in anomic neighborhoods had the lowest income-to-needs ratio whereas those in integral neighborhoods experienced the highest neighborhood disadvantage and lowest proportion of Hispanic residents. Egalitarianism, an ethnic-racial socialization message, and parental monitoring levels differed by neighborhood. Findings suggest African American and Latino families' unique experiences in a new destination context, signaling a complex interplay between race-ethnicity, SES, and place.

Substance Use and HIV Among Justice-Involved Youth: Intersecting Risks

PURPOSE OF REVIEW

This review discusses recent advances in research on the intersection of HIV prevention and substance use among youth involved with the justice system. We discuss current themes of recent findings and provide guidance for researchers, policymakers, and clinicians on the next steps in advancing work in this nascent area.

RECENT FINDINGS

Of the 46 studies that measured HIV risk and substance use among justice-involved youth, 56% were cross-sectional designs, 22% were intervention trials, and 22% were longitudinal designs. Cross-sectional studies suggested that substance use is highly associated with HIV risk behaviors. Longitudinal analyses underscored the importance of understanding contextual risk factors, such as trauma and violence. Intervention trials demonstrated improved scientific rigor of behavioral approaches. Despite recent advances, research in this field remains limited. Future directions include longer follow-up periods, consideration of biomedical HIV-prevention interventions, and a focus on dissemination and implementation science of efficacious interventions.