Longitudinal Trajectory of the Relationship Between Self-Esteem and Substance Use From Adolescence to Young Adulthood

Factors Associated With Cocaine Use at 17 and 20 Years Old: A Longitudinal Analysis of a Nationally Representative Cohort

PURPOSE

Despite growing concerns about trends in cocaine use, there is a shortage of longitudinal research that prospectively examines risk and protective factors associated with cocaine initiation and use in general youth populations. This study addresses this gap.

METHODS

Growing Up in Ireland is a nationally representative cohort. Individual, family, and socio-environmental exposures associated with incident past-year cocaine use at ages 17 (N = 5965) and 20 (n = 4549) were assessed with survey-weighted logistic regression using generalised estimating equations. Prevalent past-year cocaine use at 20 (N = 4679) was analysed using generalised estimating equations complemented by gradient-boosted decision trees and Shapley explanations.

RESULTS

221 (3.7%) self-reported cocaine use at 17 and 1072 (22.9%) at 20. Alcohol use at 14 or younger was associated with eight times the odds of cocaine use at 17 (aOR 8.0, 95% CI 1.7-37.3) and 19 times at 20 (aOR 19.2, 95% CI 8.6-43.2). Peer cannabis use was associated with 7 times the odds of cocaine use at 17 (aOR 7.3, 95% CI 2.9-18.3) and double at 20 (aOR 2.4, 95% CI 1.8-3.2). Growing up in a neighbourhood where substance use was common doubled the odds of cocaine use at 17 (aOR 2.4, 95% CI 1.3-4.4). Shapley explanations revealed individual-specific positive or negative impacts of exposures.

DISCUSSION

Cocaine use among 20-year-olds in Ireland is higher than reported internationally, and increases sharply between the ages of 17 and 20, suggesting a need for interventions targeting this age group. However, associations with early adolescent factors suggest that early interventions may also be important.

Trajectories of adolescent poly-substance use and their long-term social and economic outcomes for males from low-income backgrounds

Substance abuse is a significant public health concern that disproportionately burdens males and low-income communities. This study examined (1) longitudinal profiles of male adolescent poly-substance use and (2) their association with social and economic participation across early adulthood. Drawing on a cohort of males (n = 890) from low-income neighborhoods, we used group-based multi-trajectory modeling to identify profiles of poly-substance use (alcohol, tobacco, cannabis, illicit drugs) from age 13-17 years. Regression models were used to link substance use profiles to high school graduation, criminal convictions, personal and household earnings, welfare receipt and partnership from age 19-37 years, obtained from administrative records. Child IQ, family adversity and behavioral problems were adjusted for. Four poly-substance use profiles were identified: abstinent (n = 128, 14.4%), late-onset (n = 412, 46.5%), mid-onset (n = 249, 28.1%), and early-onset (n = 98, 11.1%). Relative to the late-onset (reference) group, participants in the early-onset profile were 3.0 times (95%CI = 1.68-5.53) more likely to have left school without a diploma, 2.7 times (95% CI = 1.56-4.68) more likely to have a criminal conviction by age 24 years, earned 10,185 USD less (95% CI =  - 15,225- - 5144) per year at age 33-37 years and had 15,790 USD lower (95% CI =  - 23,378- - 8218) household income at age 33-37 years, a 1.3 times (95%CI = 1.15-1.57) higher incidence of annual welfare receipt and a 24% (95% CI = 5-40) lower incidence of marriage/cohabitation from age 18-35 years. We show that adolescent-onset poly-substance use by age 13 is associated with poor social and economic outcomes. Delaying the onset of substance use and reducing exposure to additional substance classes has potential for high societal cost savings.

Weight misperception and substance use: Brazilian Study of Cardiovascular Risks in Adolescents (ERICA)

BACKGROUND

Adolescence is a crucial period for body image formation. Weight misperception is the discrepancy between individuals' body weight perception and their actual nutritional status. Both weight concerns and substance use are common among adolescents, and there is evidence of an associations between these two variables. Thus, the aim of this study was to assess the association between weight misperception and substance use (smoking and alcohol) in a national sample of normal weight Brazilian adolescents.

METHODS

Data were obtained from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, multicenter, national, school-based survey, carried out in 124 municipalities with more than 100,000 inhabitants from Brazil. The sample included adolescents aged 12-17 years, classified as normal weight by nutritional status evaluation. The following measures were collected: weight underestimation and overestimation (exposure); having tried cigarette smoking, current smoking, current alcohol consumption, binge drinking and current smoking and alcohol consumption(outcomes); macro-region, sex, type of school, and excessive screen time (confounders). The frequency of variables was calculated with 95% confidence intervals (CI). Poisson regression models were used to estimate prevalence ratios (PR).

RESULTS

In total, data from 53,447 adolescents were analyzed. Weight misperception was present in a third of the adolescents, with similar prevalence of weight underestimation and overestimation. In adolescents aged 12-14 years, weight underestimation and overestimation were associated with having tried cigarette smoking (PR: 1.18 and 1.43, respectively), current alcohol consumption (PR: 1.33 for both weight misperception categories), and binge drinking (PR: 1.96 and 2.01, respectively). Weight underestimation was associated with both having tried cigarette smoking and current alcohol consumption in boys (PR: 1.14 and 1.16, respectively) and girls (PR: 1.32 and 1.15, respectively). In girls, weight overestimation was associated with all substance use variables (PR between 1.19 and 1.41).

CONCLUSIONS

Our results showed an association between weight misperception and having tried cigarette smoking, alcohol consumption, and binge drinking in younger adolescents. In addition, weight overestimation was associated with all substance use indicators in girls. Based on our findings, interventions aimed to improve weight perception in normal weight adolescents may contribute to the reduction of substance use in this population.

How Influential are Adverse Childhood Experiences (ACEs) on Youths?: Analyzing the Immediate and Lagged Effect of ACEs on Deviant Behaviors

Although the effect of adverse childhood experiences (ACEs) on antisocial behaviors is well established in the literature, limited research, if any, has analyzed the effect that ACEs have on behaviors at two different times. Limited research also has analyzed the effect that specific ACEs have on deviant behaviors after statistically controlling for respondents' protective factors. This study expands the literature in this area by analyzing in a sample of 555 adolescents the immediate and lagged effect that individual ACEs, and exposure to a number of ACEs, have on three deviant behaviors after controlling for respondents' protective factors not previously examined in ACEs studies. Results obtained from multivariate logistic regression models revealed that stealing things was predicted by being hit hard, being sexually molested, and having lived with a depressed or suicidal individual; and receiving threats over the internet predicted physical fights. Only being hit hard and living with an alcoholic had a lagged effect on smoking marijuana. Results also showed that the protective factors of school connection, anger management skills, and parental supervision reduced the effect of ACEs on the behaviors analyzed. Research, theory, and policy implications are discussed.

Adolescents' Psychoactive Substance Use During the First COVID-19 Lockdown: A Cross Sectional Study in Italy

Background

Italy was one of the first European countries to be affected by Covid-19. Due to the severity of the pandemic, the Italian government imposed a nationwide lockdown which had a great impact on the population, especially adolescents. Distance-learning, moving restrictions and pandemic-related concerns, resulted in a particularly stressful situation.

Objective

This cross-sectional study aims to analyse substance consumption and its associated factors during the Covid-19 lockdown imposed by the Italian government.

Methods

ESPAD is a questionnaire that is administered yearly in Italian high schools. In 2020, it was administered online during dedicated hours of distance learning, collecting data from 6027 Italian students (52.4% were male) aged 15-19. Data collected from the 2020 questionnaire was matched with that collected in 2019, in order to make them comparable.

Results

The prevalence of consumption of each substance decreased during the restriction period, and the most used substance during the lockdown period was alcohol (43.1%). There were some changes in factors associated with psychoactive substance use, especially painkillers and non-prescription drugs. For instance, unlike what was observed in the 2019 model, in 2020 spending money without parental control was associated with painkillers and non-prescription drug use while risk perception was not.

Conclusions

The restrictions and the increased difficulties in obtaining psychoactive substances did not prevent their consumption, and students with particular risk factors continued to use them, possibly changing the substance type of substance. This information is useful in order to better understand adolescents' substance use during the ongoing pandemic.

The association of self-esteem and psychosocial outcomes in young adults: a 10-year prospective study

BACKGROUND

This study investigates the association between self-esteem assessed either in adolescence or in adulthood with adult academic and psychosocial outcomes.

METHOD

One hundred and thirty-one junior high school students were selected based on their experience of academic difficulty or success, and both groups were selected equally from regular or low-performing schools. Ten years later, 100 of these individuals participated in a follow-up assessment of academic, socioprofessional, and health-related outcomes. Logistic and linear regression models were performed to estimate the association of self-esteem (measured by the Rosenberg Self-Esteem Scale) at baseline and at follow-up, as well as change in self-esteem categories (high vs. low) on all outcomes.

RESULTS

Fifty-four percent of adolescents were consistently high in self-esteem over the 10-year period, 17% experienced an improvement, 21% a decrease, and 8% stayed at a low level. Outcomes at follow-up were more consistently associated with young adult self-esteem than adolescent self-esteem. Self-esteem was associated with several outcomes (i.e., personal goals, life satisfaction, alcohol, and health outcomes) and its effects were different depending on the period considered and categories of self-esteem change.

CONCLUSIONS

The self-esteem difficulties which are common in adolescence raise concerns about their potential impact on important outcomes later in life. However, self-esteem difficulties in young adulthood were more associated with negative outcomes at this phase of life (whether low self-esteem persisted into adulthood, or emerged only during adulthood). Relative to outcomes in young adulthood, the period of greatest interest for improving well-being may be concentrated in the years immediately surrounding the studied outcomes.

KEY PRACTITIONER MESSAGE

Self-esteem change from adolescent to adulthood is associated with a large diversity of outcomes. Less is known concerning the extent to which adolescent self-esteem may independently determine outcomes in young adulthood as compared to more temporally proximal self-esteem levels. Only self-esteem difficulties in young adulthood were associated with negative outcomes at this phase of life (whether they persisted from adolescence into adulthood, or emerged for the first time during adulthood). Targeting self-esteem difficulties that are temporally proximal to the period of interest may improve mental health and well-being.

How Does Substance Use Affect Personality Development? Disentangling Between- and Within-Person Effects

Little is known about the effects of substance use on changes in broad personality traits. This 10-year longitudinal study sought to fill this void using a large, representative sample of the Dutch population ( N = 10,872), which provided annual assessments of drug use (tobacco, alcohol, sedatives, soft drugs, ecstasy, hallucinogens, and hard drugs), Big Five personality traits, life satisfaction, and self-esteem. Using multilevel models, we examined the longitudinal associations between drug use and personality both between and within persons. Results indicated that individuals with low levels of conscientiousness, life satisfaction, and self-esteem, as well as high levels of neuroticism, used more drugs on average (between-person effects). In contrast, we found little evidence for personality change following substance use (within-person effects). We discuss these findings in the context of previous empirical and theoretical work and highlight opportunities for future research.

Self-esteem, Acculturative Stress, and Marijuana Use Among Hispanic College Students

Previous research has found mixed results regarding the association between acculturation and substance use in Hispanic populations. Additional research is warranted to examine relations among facets of acculturation, particularly acculturative stress, and marijuana use. The purpose of this study was to examine whether self-esteem mediates the relation between acculturative stress and a lifetime history of marijuana use among a sample of Hispanic college students. Hispanic college students ( N = 204; Mean age = 20.3 years) from a large southwestern university participated in an online study and reported on lifetime marijuana use, self-esteem, and acculturative stress. We evaluated the hypothesis that self-esteem would mediate the relation between acculturative stress and the likelihood of reporting a history of marijuana use, utilizing Hayes’ SPSS macro, which provides estimates of boot-strapped confidence intervals for the indirect effect. Results showed that self-esteem did not significantly mediate the relation between acculturative stress and likelihood of marijuana use [ b = .157, 95% CI (−.003, .017)]. Future studies might examine other facets of acculturation in relation to substance use, utilizing a longitudinal approach to better understand these associations.

Why are Spanish Adolescents Binge Drinkers? Focus Group with Adolescents and Parents

Binge drinking in adolescents is a worldwide public healthcare problem. The aim of this study was to explore the perceptions about determinants of binge drinking in Spanish adolescents from the perspective of adolescents and parents. A qualitative study using fourteen semi-structured focus groups of adolescents was conducted during the 2014/2015 school year (n = 94), and four with parents (n = 19), based on the I-Change Model for health behaviour acquisition. Students had a low level of knowledge and risk perception and limited self-efficacy. Girls reported more parental control, and when they get drunk, society perceives them worse. Adolescents suggested focus preventive actions to improve self-efficacy and self-esteem. Parents were permissive about alcohol drinking but rejected binge drinking. They offered alcohol to their children, mainly during celebrations. A permissive family environment, lack of control by parents, adolescents’ low-risk perception, low self-esteem and self-efficacy, as well as the increase of binge drinking in girls as part of the reduction of the gender gap, emerge as risk factors for binge drinking. Future health programmes aimed at reducing binge drinking should focus on enhancing motivational factors, self-esteem, and self-efficacy in adolescents; supervision and parental control; as well as pre-motivational factors by increasing knowledge and risk awareness, considering gender differences.