Understanding early-onset drug and alcohol outcomes among youth: the role of family structure, social factors, and interpersonal perceptions of use

Gender-based differences in abstention and desistance from drug use among American Indian adolescents

Informed by the social control theoretical perspective, this study intends to identify the factors more likely to differentiate American Indian (AI) adolescents who never used illicit drugs (abstainers) and those who used drugs in the past but did not report recent drug usage (desisters) from their peers who reported lifetime and recent drug usage (persisters). This secondary analysis is based on data from a multi-site study conducted between 2009 and 2013. It is based on a gender-balanced sample (N = 3,380) of AI adolescents (50.50% male; Mean age = 14.75; SD = 1.69) representing the major AI languages and cultural groups in the U.S. Half of the AI adolescents reported lifetime drug use (50.40%), 37.50% never used drugs, and 12.10% stopped using drugs. When controlling for the variables included in the analysis, AI boys were significantly more likely than AI girls to desist from drug use. Both boys and girls who never used drugs tended to be younger, were less likely to have delinquent friends and a lower level of self-control, had stronger bonds to school, but lower levels of family attachment, and reported increased parental supervision. Compared to drug users, desisters associated significantly less with delinquent peers. While school attachment, self-control, and parental monitoring did not differentiate female desisters from female drug users, adolescent boys who desisted from drug use were more likely to report higher levels of school attachment and parental monitoring and their level of self-control was less likely to be low.

Gene-environment transactions between peer cigarette use, parental supervision, and Chinese adolescent cigarette smoking initiation

INTRODUCTION

The initiation and continued use of tobacco products constitute an ongoing source of preventable disease that continues to pose a significant risk to global adolescent health. Scarce research has sought to explore the influences of two well-known environmental risk factors, parental supervision and peer cigarette use, on genetic and environmental contributions to adolescent cigarette use, especially in non-Western populations.

METHODS

Following 602 Chinese twin pairs (52% female, N = 1204) from early to middle adolescence at two-time points (Mage = 12 and 15) from 2006 to 2009 and using multivariate biometric modeling, this study examined gene-environment interplay (i.e., gene-environment correlation and interaction) between perceived parental supervision, peer cigarette use, and adolescent cigarette smoking initiation.

RESULTS

From early to middle adolescence, genetic influences on cigarette smoking initiation became more pronounced, whereas shared environmental influences that promote similarity between family members diminished. Genetic factors primarily explained the links between parental supervision and cigarette smoking initiation in mid-adolescence. Peer cigarette use displayed stronger associations with and moderating potential in adolescent cigarette smoking initiation than parental supervision. High levels of peer cigarette use amplified genetic risk for cigarette smoking initiation in mid-adolescence.

CONCLUSIONS

Chinese adolescent cigarette smoking initiation involves dynamic gene-environment transactions primarily with peer processes over development. Mid-adolescence constitutes a developmental period wherein underlying genetic risk for cigarette smoking initiation is particularly sensitive to peer influences. Targeted interventions aimed at reducing Chinese adolescent cigarette smoking initiation should focus on peer processes during this developmental period.

Mexican-origin parent and child reported neighborhood factors and youth substance use

Background

Structural oppression affects health behaviors through residence in suboptimal neighborhoods and exposure to community violence. Youth and parents report perceptions of neighborhood factors that can affect youth substance use behaviors. Given that Latinx youth report higher levels of perceived community violence than other racial and ethnic groups, it is imperative to examine how youth- and parent-perceived neighborhood-level factors may relate to youth substance use.

Methods

Data were collected using clinical interviews with family triads (fathers, mothers, and youth) and parent-child dyads (father or mother and youth) enrolled in the Seguimos Avanzando study of 344 Mexican-origin families in Indiana. Neighborhood measures, including perceptions of exposure to violence, neighborhood characteristics, and neighborhood collective efficacy, were included in parent and youth surveys. Self-report measures for past year alcohol and drug use were included in the youth survey only. T-tests were conducted to estimate differences in neighborhood reports among the sample triads. A series of linear regression models were used to estimate the associations between youth-, mother-, and father-reported perceptions of neighborhood factors and youth substance use.

Results

Preliminary results indicate that fathers reported higher levels of exposure to violence than mothers [t(163) = 2.33, p = 0.02] and youth [t(173) = 3.61, p < 0.001]. Youth reported lower negative neighborhood characteristics than mothers [t(329) = 6.43, p < 0.001] and fathers [t(169) = 3.73, p < 0.001]. Youth reported significantly better neighborhood collective efficacy than mothers [t(296) = 3.14, p = 0.002], but not statistically different from fathers. Results from the primary analysis showed that youth exposure to violence was positively associated with youth substance use (b = 0.24, SE = 0.06, p < 0.0001), but the youth's neighborhood characteristics and collective efficacy were not significantly associated with youth substance use. None of the parent-reported neighborhood variables were associated with youth substance use.

Conclusion

The discrepant findings between parent and youth reports of perceived neighborhood characteristics and substance use have important implications for researchers and community stakeholders, and for developing targeted interventions and prevention strategies. Our study highlights the need to address youth experience of community violence and to prioritize creating safe and inclusive neighborhood environments. Potential strategies include improving community resources, strengthening social support networks, promoting open communication about neighborhood risks, and fostering collaborative efforts to address substance use behaviors.

Widening Gaps and Disparities in the Treatment of Adolescent Alcohol and Drug Use Disorders

INTRODUCTION

The overall prevalence of alcohol use disorders and drug use disorders in adolescents has been declining in recent years, yet little is known about treatment use for these disorders among adolescents. This study aimed to examine the patterns and demographics of treatment of alcohol use disorders, drug use disorders, and both conditions among U.S. adolescents.

METHODS

This study used publicly available data for adolescents aged 12-17 years from the annual cross-sectional surveys of the National Survey on Drug Use and Health, 2011-2019. Data were analyzed between July 2021 and November 2022.

RESULTS

From 2011 to 2019, fewer than 11%, 15%, and 17% of adolescents with 12-month alcohol use disorders, drug use disorders, and both conditions received treatment, respectively, with significant decreases in treatment use for drug use disorders (OR=0.93; CI=0.89, 0.97; p=0.002). Overall, treatment use in outpatient rehabilitation facilities and self-help groups was most common but decreased over the course of the study period. Extensive disparities in treatment use were further identified on the basis of adolescents' gender, age, race, family structure, and mental health.

CONCLUSIONS

To improve adolescent treatment use for alcohol and drug use disorders, assessments and engagement interventions that are gender specific, developmentally appropriate, culturally sensitive, and contextually informed are especially needed.

Unpacking the linkages between single parent households and early adolescent adjustment

Living with an unmarried mother is consistently associated with adjustment issues in adolescence, but these associations can vary by both time and place. Following life course theory, this study applied inverse probability of treatment weighting techniques to data from the National Longitudinal Survey of Youth (1979) Children and Young Adults study (n = 5,597) to estimate various treatment effects of family structures through childhood and early adolescence on internalizing and externalizing dimensions of adjustment at age 14. Young people who lived with an unmarried (single or cohabiting) mother during early childhood and adolescence were more likely to drink and reported more depressive symptoms by age 14 than those with a married mother, with particularly strong associations between living with an unmarried mother during early adolescence and drinking. These associations, however, varied according to sociodemographic selection into family structures. They were strongest for youth who more closely resembled the average adolescent living with a married mother.

Societal and cultural norms that expose children to early alcohol use in Amhara Region rural community, Ethiopia

BACKGROUND

Research on underage drinking reveals several factors that expose children to alcohol consumption, ranging from a child's personality to contextual factors. We examined societal and cultural norms that expose children to the early age of onset for alcohol use, and how community members perceive child alcohol consumption.

METHODS

Three focus group discussions were conducted with 36 religious leaders, elders, and locality officials; and semi-structured interviews were held with 11 women who sell alcoholic drinks near schools.

RESULTS

The findings showed nine underlying norms and assumptions that contribute to alcohol provision to minors. These norms and assumptions are mostly related to the knowledge gap regarding how alcohol harms children (and adults) and the perception of the social norms that support the drinking culture as unproblematic.

CONCLUSION

Effective intervention and educational programs should aim at addressing the basic knowledge gap about alcoholic drinks and alcohol use disorder. In addition, challenging the harmful child-rearing practices and the feeling of resignation in life in these communities is necessary. Suggestions for short-term training and long-term educational programs are provided.

Adolescents' lived experiences of substance abuse in the Greater Giyani Municipality

BACKGROUND

 Adolescence is a unique and distinct stage of development that involves changes in the physical, psychological and social aspects of adolescents. It is a critical transition into adulthood whereby heightened risk-taking and sensation-seeking takes place, such as substance abuse. In a South African context, this transition sometimes occurs under economic stress, poverty, unemployment, high levels of crime and political instability. This can place adolescents at risk of substance abuse.

OBJECTIVES

 To explore and describe the lived experiences of adolescents abusing substances in the Greater Giyani Municipality in the Limpopo province, South Africa.

METHOD

 A qualitative, exploratory, descriptive and contextual research design with a phenomenological approach was used. Data were collected through individual, in-depth, phenomenological interviews and field notes. Thematic coding was utilised to analyse the collected data, and literature was reviewed to support the findings. Moreover, measures to ensure trustworthiness and ethical principles were applied throughout the research process.

RESULTS

 Five themes were identified: substance abuse behaviour among adolescents, adolescents' motivation for continuing substance abuse, the effects of substance abuse on the lives of adolescents, factors affecting adolescents' discontinuation of substance abuse and a need to discontinue substance abuse.

CONCLUSION

 The study concluded that adolescents abusing substances in the Greater Giyani, Limpopo province, experience loss of control, broken relationships, poor academic performance, stigma attached to mental illness and negative emotions. The adolescents foresaw their future as uncertain and without direction. It is recommended that mental healthcare professionals introduce and implement interventions that will assist the adolescents who abuse substances in the Greater Giyani, Limpopo province.Contribution: The findings in this study could add knowledge in developing and implementing of strategies for psychiatric nurses to support adolescents abusing substances in the Greater Giyani, Limpopo province.

Investigating and Developing a Practical Domestic-Medication System of Public Health for Chinese Family

(1) Background: The main research aim of this paper is to investigate the commonly stocked medicines in Chinese households. Firstly, a large number of questionnaires were collected to uncover the problem: most Chinese families have the habit of stocking their family medicine boxes. However, there is a lack of a standardized, systematic, and scientific list of household medicine stockpiles. As a result, there are major problems in stocking medicines in households: (1) There is little connection between the type and quantity of medicines stocked and real life; (2) The expiration date of medicines leads to misuse and waste of medicines; (3) The existing list of medicines can provide little help. (2) Methods: The preliminary drug stock list was summarized through case studies; the authenticity of the questions and the credibility of the list were verified through interviews; the number of different types of drugs and the relationship between the resident's perception of the importance of drugs and their frequency of use was determined through questionnaires; the authenticity of the list was verified through interviews with senior doctors. (3) Results: We finally composed a scientific and practical list of common household medicines, developed a practical domestic-medication system for Chinese families, and conducted validation studies, which received the approval of senior doctors. (4) Conclusions: (1) Chinese families need to prepare medicines according to the actual composition of the family; (2) Chinese families need a scientific and systematic list of commonly prepared medicines; and (3) in addition to the types of medicines, it is also necessary to consider the number of individual types of medicines to be stocked.

A cross-national comparison of the linkages between family structure histories and early adolescent substance use

Family structure can influence adolescent health with cascading implications into adulthood. Life course theory emphasizes how this phenomenon is dynamic across time, contextualized in policy systems, and grounded in processes of selection and socialization. This study used data from the U.S. (National Longitudinal Survey of Youth 1979 Child and Young Adults, n = 6,236) and U.K. (Millennium Cohort Study, n = 11,095) to examine associations between a single mother family structure between ages 0-14 and early adolescent substance use at age 14 across time and place, using inverse probability of treatment weighting to explore how results varied by selection into family structure. In both countries, single parenthood, regardless of its timing during childhood, consistently predicted adolescent substance use when samples were re-weighted to resemble the overall population. However, when samples were re-weighted so that their background characteristics resembled those of actual single parent families, there was little evidence that single parenting posed risks, suggesting that single parenting might matter less for adolescents who are likely to experience it (and vice versa). In addition, more generous welfare policy in the U.K. than in the U.S. did not appear to have ameliorated the observed role of single parenting in adolescent substance use. Findings supported a model of disadvantage saturation, where single parenting has little additional impact over the myriad other disadvantages that single parent families tend to experience, rather than a model of cumulative disadvantage, where single parenting compounds or adds to other disadvantages. Policy and interventions might more valuably focus on these other disadvantages than on family structure.

Cannabis Use and Parenting Practices among Young People: The Impact of Parenting Styles, Parental Cannabis-Specific Rules, and Parental Cannabis Use

Cannabis is the most commonly used illicit drug. Its use typically starts in adolescence, and parents play a key role in young people’s cannabis use. Our study aimed to examine and compare the effects of parenting styles, parental cannabis-specific rules, and parental cannabis use on young people’s cannabis use. The research sample consisted of 839 students from various secondary education programs in Slovenia, aged 14 to 21. Associations between the young people’s lifetime cannabis use and their experience of parenting practices were assessed using logistic regression, with demographic, socioeconomic, educational, health, and risk behaviors controlled in a multivariate model. Maternal authoritative parenting (in comparison with permissive parenting), strict maternal, cannabis-specific rules, and parental cannabis non-use statistically significantly reduced the likelihood of young people’s cannabis use. Its strongest predictor was parental cannabis use, followed by the mother’s specific cannabis-use rules and maternal parenting style. The findings of our study can contribute to the development of public health policies to more effectively prevent cannabis use among adolescents and emerging adults, including by designing prevention programs aimed at strengthening parents’ general and cannabis-specific practices and competences.

The 'big four' health risk behaviors among Vietnamese adolescents: co-occurrence and socio-cultural risk factors

Background

Health Risk Behaviors (HRBs) represent significant health threats for adolescents. However, there has been relatively little research on multiple HRBs in low-and-middle-income countries (LMIC), where the majority of the world’s youth reside. This study’s objective was to investigate common HRB, their co-occurrence, and socio-demographic risk and protective factors among Vietnamese adolescents.

Methods

A cross-sectional self-report survey examined four major HRBs (tobacco use, alcohol consumption, physical inactivity, unhealthy diet) among 431 adolescents aged 15–17 years in five Vietnam provinces. Key HRB risk and protective factors assessed included perceived social norms, parental monitoring of adolescents’ behavior, and health behavior literacy.

Results

Forty-one percent of participants reported no HRB, 39% reported one, and 20% reported two or more HRBs. The four HRBs appeared to be independent, with an exploratory factor analysis indicating no common factors. The most prevalent HRB was unhealthy diet (45%), the least prevalent smoking (1%). The most frequent co-occurring HRBs were unhealthy diet and physical inactivity. Adolescents’ perceptions of norms regarding HRBs and related healthy behaviors were the most consistent risk factor for the HRB. Diet was the HRB most influenced by the social variables perceived norms, monitoring, and health literacy.

Conclusions

Results highlight the importance of future research identifying the temporal order of co-occurrence of multiple HRB, how differing conceptualizations of socio-cultural roles impact on HRB, and health-related effects of HRB co-occurrence. Such information will be useful for maximizing the efficiency and effectiveness of prevention and intervention programs in LMIC.

Discrepant Parent-Adolescent Reports of Parenting Practices: Associations with Adolescent Internalizing and Externalizing Symptoms

Discrepancies in multi-informant reports of parenting practices represent a meaningful clinical construct that can be harnessed to predict adolescent mental health outcomes and shed light on the nature of parent-adolescent relationships. To date, however, no research has sought to examine discrepancies in perceptions of parenting practices among adolescents with histories of substance use disorders, a population for whom supportive parenting is a critical protective factor during the recovery process. This study examined parent-adolescent informant discrepancies of parenting practices and their associations with externalizing and internalizing symptomology among a sample of adolescents with substance use disorder histories. Data were analyzed from 294 adolescents (M adolescent age = 16 years; 45% female, 72% white) and their parents (87% female, 83% white) from a larger longitudinal study. Parenting practices of interest were positive parenting, inconsistent discipline, and poor monitoring. Polynomial regression analyses were used to test the discrepancy hypotheses. The results generally suggested null associations between single informant reports and internalizing and externalizing symptoms. Discrepancies were noted, however, in multi-informant reports of positive parenting, such that higher levels of adolescent-reported positive parenting were associated with higher levels of internalizing symptoms at high (but not low) levels of parent-reported positive parenting. Similarly, discrepancies were noted in multi-informant reports of poor monitoring, such that lower levels of adolescent-poor monitoring were associated with higher externalizing symptoms at low levels of parent-reported poor monitoring. The findings are discussed in terms of research and clinical implications of collecting and utilizing multi-informant data among clinical samples of adolescents with unique risk profiles.

Family's Subjective Economic Status and Children's Matrix Reasoning: Blacks' Diminished Returns

BACKGROUND

Due to a pattern known as Marginalization-related Diminished Returns (MDRs), historically oppressed non-Hispanic Black Americans show weaker effects of economic status on health and development, when compared to socially privileged non-Hispanic White Americans. Such MDRs are also documented for the effects of economic status on the school performance of non-Hispanic Black children. However, the existing knowledge is minimal on similar diminished returns on children's intelligence.

AIM

To compare racial and ethnic groups for the effect of subjective economic status on children's cognitive performance, we compared non-Hispanic White and non-Hispanic Black children for the effects of subjective economic status on children's matrix reasoning.

METHODS

This cross-sectional study included 7898 children from the Adolescent Brain Cognitive Development (ABCD) study. The predictor variable was subjective economic status, which was treated as a continuous measure. The primary outcome was children's matrix reasoning, a domain of cognitive performance, measured by the Wechsler Intelligence Scales for Children-IV (WISC-V) matrix reasoning total score.

RESULTS

Overall, high subjective economic status was associated with higher matrix reasoning score. Race showed a statistically significant interaction with subjective economic status on children's matrix reasoning score. This interaction suggested that high subjective economic status has a smaller boosting effect on increasing matrix reasoning score for non-Hispanic Black children relative to non-Hispanic White children.

CONCLUSION

The degree by which subjective economic status correlates with matrix reasoning score, an important domain of cognitive performance, depends on race and racialization. Non-Hispanic Black children may show weaker gains in matrix reasoning from their subjective economic status than their non-Hispanic White counterparts. To minimize the racial gap in cognitive performance, we need to address diminished returns that occur as a result of the racialization of racial and ethnic minority children. Not only should we equalize economic status, but also increase the marginal returns of economic status for racial minorities, particularly non-Hispanic Black families. Such efforts require public policies that go beyond access and also consider how we can empower non-Hispanic Black communities and families so they can more effectively leverage and utilize their economic resources to secure measurable and tangible outcomes. Structural and societal barriers such as residential and school segregation may hinder non-Hispanic Black children from receiving the full effects of their family-level economic status on a variety of outcomes, including their cognitive performance.

The Intersection Between Sex and Race in Understanding Substance Co-Use Patterns in Adolescents From the Fragile Families Study

The current study examined the prevalence of alcohol, cigarette, and cannabis co-use among a longitudinal cohort of youth predominately born to single-parent families. Data were drawn from wave six of the Fragile Families and Child Wellbeing Study ( N = 2976; M age = 15.6; 49% female; 53% non-Hispanic Black, 27% Hispanic, 20% White). Adolescents’ reports of their past 30-day use of alcohol, cigarettes, and cannabis were used to construct eight mutually exclusive use groups. Multinomial logistic regressions adjusting for sociodemographic factors revealed that Black adolescents were at lower relative risk of using Alcohol Only compared to White adolescents. Black males were at greater relative risk of using Cannabis Only than both White males and Black females. Finally, Hispanic males were at a marginally increased relative risk of co-using Alcohol and Cannabis compared to White males. Prevention efforts targeting Black and Hispanic males’ use of cannabis (both alone and in combination with alcohol) may be beneficial.

Attention-Deficit/Hyperactivity Disorder and Alcohol and Other Substance Use Disorders in Young Adulthood: Findings from a Canadian Nationally Representative Survey

AIM

(a) To document the prevalence and odds of (i) alcohol use disorders, (ii) cannabis use disorders, (iii) other drug use disorders and (iv) any substance use disorder (SUD), among young adults with and without ADHD, and (b) to investigate the degree to which the association between ADHD and SUDs is attenuated by socio-demographics, early adversities and mental health.

METHOD

Secondary analysis of the nationally representative Canadian Community Health Survey-Mental Health (CCHS-MH). The sample included 6872 respondents aged 20-39, of whom 270 had ADHD. The survey response rate was 68.9%.

MEASUREMENTS

Substance Use Disorder: World Health Organization's Composite International Diagnostic Interview criteria, SUDs, were derived from lifetime algorithms for alcohol, cannabis and other substance abuse or dependence. ADHD was based on self-report of a health professional's diagnosis.

FINDINGS

One in three young adults with ADHD had a lifetime alcohol use disorder (36%) compared to 19% of those without ADHD (P < 0.001). After adjusting for all control variables, those with ADHD had higher odds of developing alcohol use disorders (OR = 1.38, 95% CI: 1.05, 1.81), cannabis use disorders (OR = 1.46, 95% CI: 1.06, 2.00), other drug use disorders (OR = 2.07, 95% CI: 1.46, 2.95) and any SUD (OR = 1.69, 95% CI: 1.28, 2.23). History of depression and anxiety led to the largest attenuation of the ADHD-SUD relationship, followed by childhood adversities and socioeconomic status.

CONCLUSIONS

Young adults with ADHD have a high prevalence of alcohol and other SUDs. Targeted outreach and interventions for this extremely vulnerable population are warranted.

An Ecological Latent Class Model of Adolescent Risk and Protective Factors: Implications for Substance Use and Depression Prevention

To provide a comprehensive view of the unique contexts shaping adolescent development in the United States we utilized latent class analysis (LCA) with indicators of risk and protection across multiple domains (family, peers, school, neighborhood) and examined how latent class membership predicted heavy episodic drinking, illicit substance use, and depression in adolescence and six years later when participants were young adults. Data came from wave 1 and wave 3 of the nationally-representative United States-based Add Health study (N = 6,649; M age W1= 14.06; M age W3 = 20.38; 53.8% female; 56.1% White/European American; 22.8% Black/African American, 9.5% Hispanic, 6.7% Biracial, Asian or Pacific Islander 4.2%, American Indian/Native American 0.7%;). A 6-class solution was selected with classes named: Two-Parent: Low Risk, Two-Parent: Relationship Risks, Two-Parent: Neighborhood Risks, Single Parent: Low Risk, Single Parent: Relationship Risks, and Single Parent: Multidimensional Risk. Subsequent analyses suggested that adolescent social relationships are particularly important for prevention interventions as the classes marked by substance using peers and a lack of closeness to parents and teachers in adolescence (Two-Parent: Relationship Risks and Single Parent: Relationship Risks) had consistently poorer outcomes in adolescence and young adulthood.

Parents' Perceived Neighborhood Safety and Children's Cognitive Performance: Complexities by Race, Ethnicity, and Cognitive Domain

BACKGROUND AIM

To examine racial/ethnic variations in the effect of parents' subjective neighborhood safety on children's cognitive performance.

METHODS

This cross-sectional study included 10,027 children from the Adolescent Brain Cognitive Development (ABCD) study. The exposure variable was parents' subjective neighborhood safety. The outcomes were three domains of children's cognitive performance: general cognitive performance, executive functioning, and learning/memory. We used mixed-effects regression models for data analysis.

RESULTS

Overall, parents' subjective neighborhood safety was positively associated with children's executive functioning, but not general cognitive performance or learning/memory. Higher parents' subjective neighborhood safety had a more positive influence on the executive functioning of non-Hispanic White than Asian American children. Higher parents' subjective neighborhood safety was associated with higher general cognitive performance and learning/memory for non-White children relative to non-Hispanic White children.

CONCLUSION

The race/ethnicity of children moderates the association between neighborhood safety and cognitive performance. This becomes more complicated, as the patterns seem to differ across race/ethnicity and cognitive domains. It is unknown whether the observed racial/ethnic variations in the effect of neighborhood safety on cognitive performance are due to neighborhood characteristics such as residential segregation. Addressing neighborhood inequalities is needed if we wish to reduce racial/ethnic inequities in the cognitive development of children.

Associations Between Family and Peer E-Cigarette Use With Adolescent Tobacco and Marijuana Usage: A Longitudinal Path Analytic Approach

INTRODUCTION

Research indicates a link between adolescent e-cigarette use and combustible tobacco cigarette (CTC) initiation, and recent studies suggest their connection with marijuana uptake. Our 3-year longitudinal cohort study investigated the implications of adolescent, peer, and family e-cigarette use with adolescents' expectations and willingness to initiate CTC use, and subsequent CTC and marijuana use.

AIMS AND METHODS

Relationships were examined in a secondary analysis of a 3-year longitudinal cohort subsample involving adolescents enrolled in alternative California high schools (N = 1025). Analyses examined responses over three yearly observations. Family, peer, and respondents' e-cigarette use, respondents' positive cigarette expectancies and willingness to use CTCs were assessed in the study's first year (T1). CTC use in the survey's second year (T2) and marijuana use in the third year (T3) were assessed via path analysis.

RESULTS

Respondents reporting at least one family member or peer using e-cigarettes were more likely to use e-cigarettes at T1 than those whose peers/family members did not. They reported more positive expectancies about CTCs and greater willingness to initiate use. These variables predicted CTC use at T2, which directly anticipated marijuana use in the survey's third year (T3), as did adolescents' use of e-cigarettes at T1. All model relations were statistically significant.

CONCLUSIONS

Analysis demonstrated the strong association of family members' and peers' behaviors with adolescent e-cigarette use, and the temporal precedence of e-cigarette use with subsequent CTC and marijuana uptake. The predictive implications of e-cigarettes for other dangerous substance use should be examined in future prevention campaigns.

IMPLICATIONS

The presented study expands upon existing literature connecting adolescent e-cigarette use and later CTC and marijuana use. The findings indicate the significant implications of exposure to e-cigarette use by parents and peers and demonstrate in a longitudinal 4-year panel survey the direct and indirect predictive implications of e-cigarette use for CTC and marijuana uptake. The research illustrates the utility of programs and campaigns that target peer and family groups to maximize impacts on adolescent willingness to try CTCs, positive expectancies, and possible onset of CTC and marijuana use.

Effects of Fathers on Adolescent Daughters' Frequency of Substance Use and Risky Sexual Behavior

This research: (1) implements a genetically informed design to examine the effects of fathers' presence-absence and quality of behavior during childhood/adolescence on daughters' frequency of substance use during adolescence; and (2) tests substance use frequency as mediating the relation between paternal behavior and daughters' sexual risk taking. Participants were 223 sister dyads from divorced/separated biological families. Sisters' developmental exposure to socially deviant paternal behavior predicted their frequency of tobacco, alcohol, and cannabis (TAC) use. Older sisters who co-resided with fathers who were more (vs. less) socially deviant reported more frequent TAC use during adolescence. More frequent TAC use predicted more risky sexual behavior for these daughters. No effects were found for younger sisters, who spent less time living with their fathers.

Adolescent drug use initiation and transition into other drugs: A retrospective longitudinal examination across race/ethnicity

BACKGROUND

Understanding adolescent drug use mechanisms is critical for drug use prevention. Although some theories such as the gateway theory suggest that drug users gradually transition into using more addictive drugs, there is no consensus about such a hypothesis. One important factor that hinders the advancement of knowledge in this area is the scarcity of longitudinal studies examining the type of drugs adolescents initially use and the different pathways adolescents take to transition into using other drugs as they grow older.

METHODS

Using the pooled sample of adolescent dug users (14-17 years old; n = 10,644) from the National Survey on Drug Use and Health (2015-2018), we constructed longitudinal data on adolescents' illicit drug use history other than the use of tobacco and alcohol based on the age of drug initiation. This allowed us to investigate what drugs were initially used by adolescents, how the use of these drugs may have progressed into a new drug, and whether there were racial/ethnic differences in the initiation and progression. The retrospective longitudinal data analyses applied life table method and Cox regression models.

RESULTS

Two thirds of the adolescent drug users initiated their drug use trajectories with marijuana, one quarter with inhalants, and the remaining with hallucinogens, prescription drugs, and hard drugs. Adolescent drug users who initiated with different drugs showed unique trajectories to the use of a new drug. By year 8, the probability of using a new drug was about 40% and 70% to 80% for adolescents who initiated with inhalants and other drugs, respectively. The probability of using a new drug for adolescents who initiated with marijuana and inhalants accumulated stably over time, and its difference with that of other drug users diminished over time. The multivariate Cox regression models suggest the observed discrepancies generally held after controlling for covariates. There were also racial/ethnic differences in adolescent drug use initiation and progression, with Black/African American adolescents being the least likely to switch to the use of a new drug.

CONCLUSION

Adolescents' initial use of marijuana and inhalants may lead to substantial risks of using other drugs over time. It is therefore important to screen adolescent drug use comprehensively and provide early interventions to prevent an escalation to more detrimental drugs. The findings provide new evidence to support aspects of both the gateway and generalized risk drug use theories.

The Roles of Family, Community, and Services in the Prevention of Illicit Drug Use: Findings From a Sample of Released Prisoners

Studies show that the deterioration of family bonds and financial difficulty are barriers to a successful reintegration after incarceration. However, how family, community, and correction agencies simultaneously affect individuals’ illicit drug use during reentry is rarely examined. This study draws insights from the systemic model of social disorganization and examines the joint effects of private, parochial, and public levels of social control on post-release drug use. We used a longitudinal data set that captured family relationships, community cohesiveness, and reentry program participation of released prisoners. Findings provide empirical support for the application of the systemic model of social disorganization on illicit drug during reentry. The various levels of social control defined by this theory were found to exhibit significant and inhibitory effects on individuals’ drug use after release. This study advances our understanding of individuals’ reentry outcomes by highlighting the joint influence of family, community, and correction agencies. Policy implications for addressing post-release drug use are presented.

Sex Differences in the Association between Household Income and Children's Executive Function

The study aimed to investigate sex differences in the boosting effects of household income on children's executive function in the US. This is a cross-sectional study using data from Wave 1 of the Adolescent Brain Cognitive Development (ABCD) study. Wave 1 ABCD included 8608 American children between ages 9 and 10 years old. The independent variable was household income. The primary outcome was executive function measured by the stop-signal task. Overall, high household income was associated with higher levels of executive function in the children. Sex showed a statistically significant interaction with household income on children's executive function, indicating a stronger effect of high household income for female compared to male children. Household income is a more salient determinant of executive function for female compared to male American children. Low-income female children remain at the highest risk regarding poor executive function.

Household Income and Children's Depressive Symptoms: Immigrants' Diminished Returns

Introduction

Relative to socially privileged groups, socially marginalized people experience weaker health effects of household income and other economic resources, a pattern known as Minorities' Diminished Returns (MDRs). These MDRs are frequently seen in racial and ethnic minorities, but less is known about the relevance of such MDRs in immigrant families. To investigate the MDRs of household income on children's depression as a function of immigration, we compared non-immigrant and immigrant children for the effect of household income on children's depressive symptoms.

Methods

This cross-sectional study was conducted across multiple cities in the United States. Baseline data from the Adolescent Brain Cognitive Development (ABCD) study collected in 2018 was used. A total of 6,412 children between the ages of 9-10-year-old were included. The predictor variable was household income. The primary outcome was children's depression measured by the Child Behavior Checklist (CBCL). Race, ethnicity, age, sex, parental marital status, parental employment, and financial difficulties were the covariates. Immigration status was the effect modifier.

Results

Overall, high household income was associated with lower children's depressive symptoms. Immigration status showed a statistically significant interaction with household income on children's depression. This interaction term suggested that high household income has a smaller protective effect against depression for immigrant children than non-immigrant children.

Conclusion

The protective effect of household income against children's depression is diminished for immigrant than non-immigrant children.

Not Race or Age but Their Interaction Predicts Pre-Adolescents' Inhibitory Control

Background

African American pre-adolescents are at a higher risk of risky behaviors such as aggression, drug use, alcohol use, and subsequent poor outcomes compared to Caucasian pre-adolescents. All these high-risk behaviors are connected to low levels of inhibitory control (IC).

Aim

We used the Adolescent Brain Cognitive Development (ABCD) data to compare Caucasian and African American pre-adolescents for the effect of age on pre-adolescents IC, a driver of high-risk behaviors.

Methods

This cross-sectional analysis included 4,626 pre-adolescents between ages 9 and 10 from the ABCD study. Regression was used to analyze the data. The predictor variable was age measured in months. The main outcome was IC measured by a stop-signal task (SST). Race was the effect modifier.

Results

Overall, age was associated with IC. Race also showed a statistically significant interaction with age on pre-adolescents' IC, indicating weaker effects of age on IC for African American than Caucasian pre-adolescents.

Conclusion

Age-related changes in IC are more pronounced for Caucasian than African American pre-adolescents. To eliminate the racial gap in brain development between African American and Caucasian pre-adolescents, we should address structural and societal barriers that alter age-related development for racial minority pre-adolescents. Social and public policies, rather than health policies, are needed to address structural and societal barriers that hinder African American adolescents' brain development. Interventions should add resources to the urban areas that many African American families live in so their children can have better age-related brain development. Such changes would be essential given IC in pre-adolescents is a predictor of a wide range of behaviors.

Youth Social, Emotional, and Behavioral Problems in the ABCD Study: Minorities' Diminished Returns of Family Income

BACKGROUND

To investigate ethnic differences in the protective effects of family income against youth social, emotional, and behavioral problems in the US. As proposed by the Marginalization-related Diminished Returns (MDRs), family income may generate fewer tangible outcomes for ethnic minority compared to NHW families. Our existing knowledge is minimal about diminished returns of family income on parental reports of youth social, emotional, and behavioral outcomes.

AIM

To compare ethnic groups for the effects of family income on parental reports of youth social, emotional, and behavioral problems.

MATERIALS AND METHODS

In this cross-sectional study, data from wave 1 of the Adolescent Brain Cognitive Development (ABCD) study were included. The ABCD, an ongoing national cohort of American youth brain development, included 10,762 American youth between ages 8 and 11 years old. The independent variable was family income. The primary outcomes were 1) anxious and depressed mood, 2) withdrawn and depressed affect, 3) somatic complaints, 4) social and interpersonal problems, 5) thought problems, 6) rule-breaking behaviors, 7) attention problems, and 8) violent and aggressive behaviors. These outcomes were generated based on parent-reported behavioral problems measured using the Child Behavior Checklist (CBCL).

RESULTS

Overall, high family income was associated with lower levels of parental reports of youth social, emotional, and behavioral problems across all domains (p <0.05 for all beta coefficients across multivariable regression models). Ethnicity showed statistically significant interactions with family income on youth fewer social, emotional, and behavioral problems (all domains), net of all confounders (p <0.05 for all beta coefficients that reflected interaction terms across multivariable regression models), indicating smaller tangible gains from their family income for NHB and HW compared to NHW youth.

CONCLUSION

The protective effects of family income against behavioral problems are systematically diminished for HW and NHB youth compared to NHW youth. To minimize the ethnic gap in youth social, behavioral, and emotional problems, diminished returns of family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder HW and NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB and HW families. Thus, SES can similarly secure tangible outcomes in the presence of SES resources.

Parental Human Capital and Adolescents' Executive Function: Immigrants' Diminished Returns

Racial minorities, particularly non-Hispanic Blacks in the US, experience weaker effects of family socioeconomic position (SEP) on tangible outcomes, a pattern called Minorities' Diminished Returns (MDRs). These MDRs are frequently shown for the effects of family SEP on immigrant adolescents' school performance. As a result of these MDRs, immigrant adolescents from high SEP families show worse than expected cognitive outcomes, including but not limited to poor school performance. However, the existing knowledge is minimal about the role of executive function in explaining diminished returns of family SEP on adolescents' outcomes. To investigate racial differences in the effects of parental human capital on adolescents' executive function, we compared non-Hispanic White non-immigrant and immigrant adolescents for the effect of parental human capital on adolescents' executive function. This was a cross-sectional analysis that included 2,723 non-twin non-Hispanic White adolescents from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental human capital (parental educational attainment), treated as a continuous measure with a higher score reflecting higher subjective socioeconomic status. The primary outcome was adolescents' executive function measured by the stop-signal task (SST). Age, sex, parental marital status, parental employment, family income, and financial difficulties. Immigration status was the effect modifier. Overall, high parental human capital was associated with higher task-based executive function. Immigration status showed statistically significant interactions with parental human capital on adolescents' executive function outcomes. This interaction term suggested that high parental human capital has a smaller effect on increasing immigrants' executive function compared to non-immigrant adolescents. The boosting effect of parental human capital on executive function is diminished for immigrants compared to non-immigrant adolescents. To minimize the inequalities in executive function-related outcomes such as school performance, we need to address the diminishing returns of existing resources for immigrants. Not only should we equalize groups based on their SEP but also equalize the marginal returns of their existing SEP. Such efforts require public policies that aim for equal processes. As such, social policies should address structural and societal barriers such as xenophobia, segregation, racism, and discrimination that hinder immigrant families' ability to effectively utilize their resources. In a fair society, immigrant and non-immigrant families should be equally able to leverage their SEP resources and turn them into tangible outcomes.

A review of psychosocial factors linked to adolescent substance use

PURPOSE

Informed by ecological theories and models of influence, this review discusses various psychosocial risk and protective factors that contribute to adolescent substance use behavior. Given typical patterns of substance use initiation during this developmental period, an emphasis is placed on alcohol, cigarette, and marijuana use.

FINDINGS

Consistent with bioecological theories, peers and parents tend to have the strongest effect on adolescent substance use behavior. Influences can be both direct, such as offers and availability to use substances, as well as indirect influences, such as the perception of substance use approval. Schools and neighborhoods also contribute to adolescent substance use behavior, but this effect is often less direct. Moreover, the effect of neighborhoods on adolescent behavior reflects both structural components (e.g., neighborhood racial composition, teacher-student ratios) in addition to social process (e.g., neighborhood social cohesion, school connectedness). A review of parallel studies conducted with animals is also provided.

SUMMARY

Adolescent substance use behavior does not occur in a vacuum. Investigations must encompass the relevant social ecologies that affect adolescent behavior, including family, peer, school, and neighborhood contexts to provide a more complete understanding of substance use etiology.

Subjective Family Socioeconomic Status and Adolescents' Attention: Blacks' Diminished Returns

Background: Racial minorities, particularly non-Hispanic blacks (NHBs) in the US, experience weaker effects from their families' socioeconomic status on tangible outcomes, a pattern called the Minorities' Diminished Returns (MDRs) theory. These MDRs are frequently shown in the effects of the families' socioeconomic status (SES) on NHB adolescents' school performance. As a result of these MDRs, NHB adolescents from high SES families show a worse than expected school performance. The existing knowledge is, however, minimal about the role of attention in explaining the diminished returns of the families' SES with regard to the adolescents' outcomes. Aim: To investigate the racial differences in the effects of the subjective family SES on adolescents' attention, we compared non-Hispanic white (NHW) and NHB adolescents to assess the effect of the subjective family SES on adolescents' attention. Methods: This was a cross-sectional analysis that included 4188 adolescents from the Adolescent Brain Cognitive Development (ABCD) Study. The independent variable was the subjective family SES. The primary outcome was the adolescents' attention to be measured by the stop-signal task (SST). The attention domain of the Child Behavior Checklist (CBCL) was also measured. Results: Overall, a high subjective family SES was associated with a higher task-based and CBCL-based attention. Race showed statistically significant interactions with subjective family SES in terms of adolescents' attention outcomes. These interactions suggested that a high subjective family SES has smaller tangible effects on increasing the attention of NHB than NHW adolescents. Conclusion: The boosting effect of subjective family SES on attention is diminished for NHB rather than NHW adolescents. To minimize the racial gap in attention-related behaviors, such as school performance, we need to address the diminished returns of resources in the lives of NHB families. Not only should we equalize SES, but also increase the marginal returns of SES for racial minorities, particularly NHB families. Such efforts require public policies that empower NHB families to better leverage their SES resources and turn them into tangible outcomes. In addition, social policies should directly aim to alter the societal barriers that limit NHB families' ability to effectively utilize their resources. Discrimination, segregation, and racism should be targets of our policy solutions.

African American Children's Diminished Returns of Subjective Family Socioeconomic Status on Fun Seeking

Background: Reward sensitivity (fun-seeking) is a risk factor for a wide range of high-risk behaviors. While high socioeconomic status (SES) is known to reduce reward sensitivity and associated high-risk behaviors, less is known about the differential effects of SES on reward sensitivity. It is plausible to expect weaker protective effects of family SES on reward sensitivity in racial minorities, a pattern called Minorities' Diminished Returns (MDRs). Aim: We compared Caucasian and African American (AA) children for the effects of subjective family SES on children's fun-seeking. Methods: This was a cross-sectional analysis of 7061 children from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was subjective family SES. The main outcome was children's fun-seeking measured by the behavioral approach system (BAS) and behavioral avoidance system (BIS). Age, gender, marital status, and household size were the covariates. Results: In the overall sample, high subjective family SES was associated with lower levels of fun-seeking. We also found a statistically significant interaction between race and subjective family SES on children's fun-seeking in the overall sample, suggesting that high subjective family SES is associated with a weaker effect on reducing fun-seeking among AA than Caucasian children. In race-stratified models, high subjective family SES was protective against fun-seeking of Caucasian but not AA children. Conclusion: Subjective family SES reduces the fun-seeking for Caucasian but not AA children.

Reward Responsiveness in the Adolescent Brain Cognitive Development (ABCD) Study: African Americans' Diminished Returns of Parental Education

(1) Background: Reward responsiveness (RR) is a risk factor for high-risk behaviors such as aggressive behaviors and early sexual initiation, which are all reported to be higher in African American and low socioeconomic status adolescents. At the same time, parental education is one of the main drivers of reward responsiveness among adolescents. It is still unknown if some of this racial and economic gap is attributed to weaker effects of parental education for African Americans, a pattern also called minorities' diminished returns (MDRs). (2) Aim: We compared non-Hispanic White and African American adolescents for the effects of parent education on adolescents RR, a psychological and cognitive construct that is closely associated with high-risk behaviors such as the use of drugs, alcohol, and tobacco. (3) Methods: This was a cross-sectional analysis that included 7072 adolescents from the adolescent brain cognitive development (ABCD) study. The independent variable was parent education. The main outcome as adolescents' RR measured by the behavioral inhibition system (BIS) and behavioral activation system (BAS) measure. (4) Results: In the overall sample, high parent education was associated with lower levels of RR. In the overall sample, we found a statistically significant interaction between race and parent education on adolescents' RR. The observed statistical interaction term suggested that high parent education is associated with a weaker effect on RR for African American than non-Hispanic White adolescents. In race-stratified models, high parent education was only associated with lower RR for non-Hispanic White but not African American adolescents. (5) Conclusion: Parent education reduces RR for non-Hispanic White but not African American adolescents. To minimize the racial gap in brain development and risk-taking behaviors, we need to address societal barriers that diminish the returns of parent education and resources in African American families. We need public and social policies that target structural and societal barriers, such as the unequal distribution of opportunities and resources. To meet such an aim, we need to reduce the negative effects of social stratification, segregation, racism, and discrimination in the daily lives of African American parents and families. Through an approach like this, African American families and parents can effectively mobilize their resources and utilize their human capital to secure the best possible tangible outcomes for their adolescents.

Parental Education on Youth Inhibitory Control in the Adolescent Brain Cognitive Development (ABCD) Study: Blacks' Diminished Returns

BACKGROUND

Non-Hispanic Black (NHB) youth are at a higher risk of high-risk behaviors compared to non-Hispanic White (NHW) youth. Some of this racial gap is shown to be due to weaker effects of parental educational attainment on reducing the prevalence of behavioral risk factors such as impulsivity, substance use, aggression, obesity, and poor school performance for NHBs, a pattern called Minorities' Diminished Returns. These diminishing returns may be due to lower than expected effects of parental education on inhibitory control.

AIM

We compared NHW and NHB youth for the effect of parental educational attainment on youth inhibitory control, a psychological and cognitive construct that closely predicts high-risk behaviors such as the use of drugs, alcohol, and tobacco.

METHODS

This was a cross-sectional analysis that included 4188 youth from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was parental educational attainment. The main outcome was youth inhibitory control measured by the stop-signal task (SST), which was validated by parent reports on the Child Behavior Checklist (CBCL).

RESULTS

In race/ethnicity-stratified models, high parental educational attainment was associated with a higher level of inhibitory control for NHB than NHW youth. In the pooled sample, race/ethnicity showed a statistically significant interaction with parental educational attainment on youth inhibitory control suggesting that high parental educational attainment has a smaller boosting effect on inhibitory control for NHB than NHW youth.

CONCLUSION

Parental educational attainment boosts inhibitory control for NHW but not NHB youth. To minimize the racial gap in youth brain development, we need to address societal barriers that diminish the returns of family economic and human resources, particularly parental educational attainment, for racial and ethnic minority youth. Social and public policies should address structural and societal barriers such as social stratification, segregation, racism, and discrimination that hinder NHB parents' abilities to effectively mobilize their human resources and secure tangible outcomes for their developing youth.

Recreational drug use among Nigerian university students: Prevalence, correlates and frequency of use

Background

Given the paucity of data on recreational drug use and the recent media attention on the abuse of drugs such as codeine cough syrups and tramadol, in Nigeria, our study examined the prevalence and frequency of recreational drug use among young adults from two Nigerian universities. We drew from the Socio-ecological Model to examine the influence of factors at the individual and family level on recreational drug use among adolescents and young adults.

Methods

This cross-sectional study was conducted between February and March 2018 among a final sample of 784 male and female university students selected using stratified random sampling. Binary logistic regression was used to identify significant predictors of ever use and current use of drugs.

Results

Our analyses showed that 24.5% of students had ever used drugs for recreational purposes, and 17.5% are current users. The median drug use frequency over the past month was six days among current users (n = 137). In the multivariable analyses, living in the same household as one's mother (AOR 0.28 95% CI 0.16–0.49), adequate family support (AOR 0.48 95% CI 0.26–0.89) and frequent attendance of religious fellowships (AOR 0.13 95% CI 0.07–0.25) were significantly associated with a lower likelihood of recreational drug use. However, male sex (AOR 1.52 95% CI 1.05–2.21) was associated with higher odds of recreational drug use.

Conclusion

The family should be considered as an important unit to sensitize young people on the harmful effects of drug use. It is also vital that religious leaders speak against drug use in their various fellowships. There is a need to address recreational drug use on Nigerian campuses by educating students about its adverse impacts.

Alcohol Use, Binge Drinking, and Drunkenness Experience in Adolescence: Complex Associations with Family, Peers, Social Context, and Risk Perceptions

Background: A number of correlates to adolescent substance use have been shown, yet their unique predictive influence is unclear. We investigated the incremental validity of demographics, family background, school variables, risk perception, parental alcohol attitudes, age of first alcohol use, peer group influence, and behavioral variables as they concurrently predicted last month alcohol use, binge drinking, and drunkenness experience frequency. Methods: Hierarchical multiple regression analyses in a sample of N = 743 adolescents (mean age = 15.01). Results: All predictors explained 26-40% of the total variance. Alcohol use was predicted by age, gender, having two working parents, academic family background, relationship to parents, relative risk perception, parental acceptance of alcohol use, age of first use, talking about positive aspects of alcohol, normality of alcohol use among peers, time spent with friends, and going out to clubs. Binge drinking was predicted by age, working parents, school problems, relative risk perception, parental alcohol acceptance, age of first use, talking about positive aspects of alcohol, time spent with friends, and going out to clubs. Drunkenness was predicted by age, relationship to parents, school problems, relative risk perception, age of first use, talking about positive aspects of alcohol, and going out to clubs. Conclusions: Researchers need to take the complexity of adolescent substance use into account when designing studies and interventions. Relative risk perception emerged as the strongest (positive) predictor, indicating that adolescents are able to rather accurately assess their own risk and risk awareness alone does not suffice to engage in protective behavior.

Diminished Protective Effects of Household Income on Internalizing Symptoms among African American than European American Pre-Adolescents

AIM

To investigate the differential role of race on the effect of household income on pre-adolescents' internalizing symptoms in a national sample of U.S. pre-adolescents.

METHODS

This is a cross-sectional study that used data from the Adolescent Brain Cognitive Development (ABCD) study. Wave 1 ABCD data included 5,913 adolescents between ages 9 and 10 years old. The independent variable was household income. The primary outcome was internalizing symptoms measured by the teacher report of the Brief Problem Monitor (BPM) scale.

RESULTS

Overall, high household income was associated with lower levels of pre-adolescents internalizing symptoms. Race showed statistically significant interaction with household income on pre-adolescents' internalizing symptoms, controlling for all confounders, indicating weaker protective effect of high household income on internalizing symptoms for African American than European pre-adolescents.

CONCLUSION

High household income is a more salient protective factor against internalizing symptoms of socially privileged European American pre-adolescents than of historically marginalized African Americans pre-adolescents. Elimination of internalizing behavioral gaps across racial groups requires more than equalizing socioeconomic status. Future research should study the moderating role of institutional and structural racism experienced by African American families across all income levels. Such research may explain why pre-adolescent African Americans with high household income remain at high risk of internalizing symptoms.

An examination of the association between early initiation of substance use and interrelated multilevel risk and protective factors among adolescents

One of the major goals of drug use prevention programs is to delay the age of onset of substance use. What is called early initiation, usually occurring in adolescents under the age of 15, is a salient predictor of Substance Use Disorders later in adulthood. The causes of early initiation are complex and multifaceted and this has led to the identification of a rich set of risk and protective factors that influence age of onset. Nonetheless, there is little knowledge about the interdependence of these factors in their impact on early initiation. This paper addresses this question by applying Multiple Correspondence Analysis to data on family, community and social risk and protective factors from over 1200 adolescents. We find that community and to a lesser extent social factors are the most clearly associated to early initiation and we compare our results to those obtained from linear regression analyses of the same data that do not incorporate interdependence and find opposite results. We discuss the differences between linear regressions and MCA to evaluate the interplay of risk and protective factors and the implications of our findings for health policy and the design of prevention interventions aimed at delaying age of onset.

Family structure and past-30 day opioid misuse among justice-involved children

BACKGROUND

To prevent opioid-related overdose among high risk youth, research on the predictors of opioid misuse (OM) initiation among justice-involved children (JIC) is needed. Living in a single-parent household, an important adverse childhood experience, is prevalent among JIC and linked to substance abuse. It is hypothesized that JIC who live in single-parent households will have a higher likelihood of meeting criteria for past-30 day OM than those who live in two-parent households.

METHODS

The data in this paper were obtained from the Florida Department of Juvenile Justice (FLDJJ). Cross-sectional data on 79,960 JIC from FLDJJ were examined. To test the hypothesis, multivariate logistic regression analyses were employed.

RESULTS

Over 2,000 JIC in the sample met criteria for past-30 day (P30D) OM. Over 27.1% of those who met criteria for past-30 day OM lived in a two-parent household while 21.3% of those who were non-past-30 day users lived in two-parent households. Contrary to our hypothesis, JIC who lived in grandparent-only households were 28% as likely to report P30D OM as those who lived in single-parent households. Those who lived in two-parent households were 16% as likely to meet criteria for P30D OM as those in single-parent households. These relationships varied by age.

CONCLUSION

Two-parent and grandparent-only households maybe associated with increased access to opioids compared to other family structures with fewer adults. The risk of increased access may be more harmful than the strain of a single-parent household. Disposal of prescription medication initiatives should target households with multiple adults and grandparents.

Family and Peer Influences on Substance Attitudes and Use among Juvenile Justice-Involved Youth

Juvenile justice-involved youth experience high rates of substance use, which is concerning given associated negative consequences, including health and functional deficits. Family and peer factors are associated with a high risk of substance use among justice-involved youth. It is hypothesized that this risk process operates through pro-drug attitudes. However, limited research has been conducted on the mechanisms through which family and peer factors increase risk for substance use among juvenile justice involved youth. The current study examined both the direct and indirect effects of family and peer substance use on youth's substance use (alcohol and illicit drug use). We also examined whether this relationship differs by race. 226 detained youth (81.9% male; 74.3% Black) were recruited from an urban county in the Midwest and completed a clinical interview and substance use assessment battery. A direct effect of family/peer risk on illicit drug use was found for all youth, though the effect was stronger among White youth. Results also supported the indirect effect pathway from family/peer risk to both illicit drug use and alcohol use through pro-drug attitudes. This pathway did not vary by race. These findings suggest that interventions should focus on targeting both family/peer risk and pro-drug attitudes to reduce substance use. Given the racial difference in the direct effect of family/peer risk on illicit drug use, there may be other factors that influence risk more strongly for White youth, which warrants further investigation.

Person-Environment Fit, Substance Use Attitudes, and Early Adolescent Substance Use

BACKGROUND

Adolescent substance use is a national health concern. While the literature is clear on the prevalence of substance use during the adolescent developmental period, a dearth of literature is available on the developmental contexts, particularly the influence of school factors, in which substance use occurs.

OBJECTIVES

This study examined the intermediary role of substance use attitudes on the relationship between school racial composition and alcohol and marijuana use in a sample of sixth to eighth graders.

METHODS

The sample consisted of 4228 middle school students (89% White; 53% female) in the Midwest. A moderated mediation analysis was conducted on the relationship between school racial composition, substance use attitudes, and substance use, with race as the moderator.

RESULTS

Results indicated a significant relationship between the percentage of White or Black students in a school and alcohol or marijuana use and that this relationship was mediated by substance use attitudes. These relationships did not differ significantly by student race. Conclusions/Importance: Preliminary findings indicate the importance of considering school racial composition as a systems level risk or promotive factor for attitudes toward substance use as well as substance use outcomes.

The Mediating Effect of Social Controls on Marijuana Use Among Adolescent Bullies, Victims, and Bully-Victims: A Comparison of Various Approaches to Mediation

This study examines the impact of social control measures (e.g. parental attachment and prosocial peer attachment) on marijuana use among adolescents who were pure bullies, pure victims, and bully-victims. Data from the Health Behavior in School-Aged Children survey was utilized and consisted of a nationwide cross-section of 12,642 adolescents. Results revealed that adolescents who were pure bullies and bully-victims were more likely to use marijuana. Additionally, parental and peer attachments were significant in decreasing the likelihood of marijuana use for two of the bullying statuses (pure bullies and bully-victims). Further, the social control measures partially mediated the relationship between two of the bullying statuses and marijuana use despite having no significant relation of bullying victimization to marijuana use. Considering that parental and peer attachments had significant and direct effects on adolescent marijuana use in the predicted (inverse) direction, prevention programs should focus on building and strengthening these relationships as a means of reducing deviant behaviors such as marijuana use among adolescents.

Addressing Adolescents' and Young Adults' Substance Use Disorders

Adolescents and young adults (AYAs) have unique needs and important biopsychosocial differences when compared with older adults who use substances. As their brains continue to develop, youth are especially susceptible to the reinforcing effects of substances in the context of a still-developing capacity for executive control and decision making. In this article, the authors highlight key differences in the neurobiologic, epidemiologic, and relational aspects of substance use found in AYA. They also discuss how best to engage with youth who use substances and how prevention and intervention can be adapted for optimal effectiveness for this distinct and high-risk population.

Marihuana y drogas ilícitas en jóvenes mexicanos: Factores de riesgo y protección asociados a la edad de inicio del consumo

Objetivo: Determinar factores de riesgo y protección asociados a la edad de inicio del consumo de mariguana y drogas ilícitas en jóvenes mexicanos. Método: Se analizaron datos de 40,366 jóvenes participantes de la Encuesta de Cohesión Social para la Prevención de la Violencia y la Delincuencia (ECOPRED). Las variables asociadas con la edad de inicio del consumo de mariguana y otras drogas ilícitas fueron determinadas mediante dos modelos de riesgos proporcionales. Resultados: La edad mediana de inicio en consumo de drogas ilícitas osciló entre los 15 y 18 años, mientras que en consumo de marihuana fue de 17 años. En ambos modelos, tener un par consumidor de marihuana fue el factor más fuertemente asociado al inicio de consumo. Discusión: La edad de inicio de consumo revelada en el presente estudio resultó similar a aquella propuesta en investigaciones previas. A pesar de las diferencias de factores en cada modelo, tener un par consumidor de marihuana y el consumo previo de tabaco (variable moderadora) resultaron los factores más fuertemente asociados en ambos modelos.

Effects of Role-Playing Scenarios on the Self-efficacy of Students in Resisting Against Substance Addiction: A Pilot Study

During the first phases of adolescent development, young people have little self-efficacy and resistance against substance use. The aim of this study was to demonstrate the effectiveness of role-playing scenarios on the self-efficacy of students in resisting substance use. A pre test and post test study design was used with a single group. The study was carried out with 245 secondary school students. The scenario-based training, developed by the researchers, was presented by the school counselors once a week for 4 weeks. For this purpose, a booklet of scenarios was prepared for the teachers. The role-playing scenarios were intended to improve adolescents’ abilities to say “no” to substance offers, to prevent them from becoming addicted to certain substances, and to call for help if needed. The data of the study were collected using the Personal Information Form and the Self-Efficacy for Adolescences Protecting Substance Abuse Scale . The obtained data were assessed using percentages, chi-square, t test, and F test in the SPSS software. Results showed that, after the training, the mean score in the Self-Efficacy for Adolescences Protecting Substance Abuse Scale increased significantly (103.20 ± 20.00) compared with before the training (92.11 ± 17.08) (P < .05). Short-term outcomes of the class-based scenario training were observed to be effective in the development of students’ self-efficacy to resist the temptations of substance use.

Adolescent Alcohol Use: Protective and Predictive Parent, Peer, and Self-Related Factors

Adolescent alcohol use has been linked with a multitude of problems and a trajectory predictive of problematic use in adulthood. Thus, targeting factors that enhance early prevention efforts is vital. The current study highlights variables that mitigate or predict alcohol use and heavy episodic drinking. Using Monitoring the Future (MTF) data, multiple path analytic models revealed links between parental involvement and alcohol abstinence and initiation. Parental involvement predicted enhanced self-esteem and less self-derogation and was negatively associated with peer alcohol norms for each MTF grade sampled, with stronger associations for 8th and 10th graders than 12th graders. For younger groups, self-esteem predicted increased perceptions of alcohol risk and reduced drinking. Self-derogation was associated with peers' pro-alcohol norms, which was linked to lower risk perceptions, lower personal disapproval of use, and increased drinking. Peer influence had a stronger association with consumption for 8th and 10th graders, whereas 12th graders' drinking was related to personal factors of alcohol risk perception and disapproval. In all grades, general alcohol use had a strong connection to heavy episodic drinking within the past 2 weeks. Across-grade variations in association of parent, peer, and personal factors suggest the desirability of tailored interventions focused on specific factors for each grade level, with the overall goal of attenuating adolescent alcohol use.

What can parents do? Examining the role of parental support on the negative relationship between racial discrimination, depression, and drug use among African American youth

African American youth who experience racial discrimination are at heightened risk to use drugs as a coping response to distress. Based on the buffer-stress hypothesis, we proposed that parental support would attenuate this effect. Participants were 1,521 African American youth between 4^th and 12^th grade. As hypothesized, a mediation pathway was observed between racial discrimination, depression symptoms, and drug use. This effect was observed for both genders, although the pathway was partially mediated for males. Additionally, as hypothesized, parental support buffered the negative effect of depression symptomatology on drug use as a consequence of discrimination. Our findings highlight the impact racial discrimination has on health outcomes for African American youth and the importance of managing youth's emotional responses to discrimination. Moreover, findings illuminate the protective role of supportive parenting within the risk model and should thus be considered as an important component within prevention programming for this population of youth.

The Enduring Impact of Parents' Monitoring, Warmth, Expectancies, and Alcohol Use on Their Children's Future Binge Drinking and Arrests: a Longitudinal Analysis

Binge drinking is associated with many health and financial costs and is linked to risks of legal consequences. As alcohol use typically is initiated during adolescence, the current study assessed the relationship between parental behaviors and strategies in forecasting adolescents' likelihood of binge drinking and later arrest. Restricted data from waves I-IV of the National Longitudinal Study of Adolescent Health were used to assess hypotheses. A weighted path analytic model (N = 9421) provided a multifaceted picture of variables linked to later antisocial behavior. Low parental monitoring, low parental warmth, parent alcohol use, and parent expectancies regarding their children's alcohol use were associated with higher incidence of adolescent binge drinking. In turn, low monitoring, low warmth, parent alcohol use, parent expectancies, and underage consumption were associated with binge drinking in early adulthood. Binge drinking during both adolescence and young adulthood were predictive of respondents' likelihood of arrest 8-14 years later. Findings demonstrated the substantial, enduring effects of parental behaviors on child alcohol-related actions and have implications for parent-targeted interventions designed to reduce excessive alcohol consumption. They suggest campaigns focus on parenting strategies that involve setting effective and strict alcohol-related rules and guidelines, while maintaining a warm and supportive family environment.

The Association of Low Parental Monitoring With Early Substance Use in European American and African American Adolescent Girls

OBJECTIVE

Research indicates that low parental monitoring increases the risk for early substance use. Because low parental monitoring tends to co-occur with other familial and neighborhood factors, the specificity of the association is challenging to establish. Using logistic regression and propensity score analyses, we examined associations between low parental monitoring and early substance use in European American (EA) and African American (AA) girls, controlling for risk factors associated with low parental monitoring.

METHOD

Participants were 3,133 EA and 523 AA girls from the Missouri Adolescent Female Twin Study with data on parental monitoring assessed via self-report questionnaire, and with ages at first use of alcohol, tobacco, and cannabis queried in at least one of three diagnostic interviews (median ages = 15, 22, and 24 years).

RESULTS

The rate of early alcohol use was greater in EA than AA girls, whereas the proportion of AA girls reporting low parental monitoring was higher than in EA girls. EA girls who experienced low parental monitoring were at elevated risk for early alcohol, tobacco, and cannabis use, findings supported in both logistic regression and propensity score analyses. Evidence regarding associations between low parental monitoring and risk for early substance use was less definitive for AA girls.

CONCLUSIONS

Findings highlight the role of parental monitoring in modifying risk for early substance use in EA girls. However, we know little regarding the unique effects, if any, of low parental monitoring on the timing of first substance use in AA girls.

Alcohol and Psychoactive Substance Use among University Students in Edirne and Related Parameters

INTRODUCTION

Alcohol and psychoactive substance use and their effects are an important issue among adolescents and young adults. Different results have been reported about the frequency of alcohol and psychoactive substance use among university students in studies conducted both in Turkey and in different places worldwide.

METHODS

The frequency of alcohol and psychoactive substance use among Trakya University students (n=1385) and the related parameters were studied cross-sectionally using a self-reporting questionnaire.

RESULTS

Alcohol was the most common substance used (30%), followed by tobacco (29.9%) and marijuana (3.1%). The frequency of alcohol and psychoactive substance use was found to be higher among males with higher amounts of pocket money, whose parents experienced more conflict in their relationship, and who belong to families with a higher education and income level.

CONCLUSION

The frequency of alcohol and psychoactive substance use among Trakya University students was found to be lower than other regions in Turkey and particularly lower than the levels reported in studies conducted in other countries.