Latino adolescent substance use: A mediating model of inter-parental conflict,deviant peer associations,and parenting

Substance use among Latino adolescents continues to be a growing concern for researchers and clinicians. This paper reviews relevant literature regarding the impact of inter-parental conflict (IPC), deviant peer associations (DPA) and parenting behaviors, namely as parental support, psychological control, and parental monitoring knowledge on substance use among Latino adolescents. Although mediating models of IPC and similar parenting behaviors on adolescent externalizing behaviors have been represented in empirical studies, none have included the influence of peer associations or have analyzed these factors with substance use among Latino adolescents in the U.S. This study investigated direct relationships of IPC and DPA with adolescent substance use, and tested parental support, psychological control and parental monitoring knowledge as mediators between those relationships in Latino adolescents. Structural equation modeling was used to analyze direct and indirect relationships of the variables mentioned among 744 Latino adolescents. Results indicated that DPA was positively associated with substance use, parental monitoring knowledge was negatively associated with substance use and that parental monitoring knowledge partially mediated the relationship between DPA and substance use. Implications of the findings are discussed in terms of areas of focus for interventions.     

Adolescent substance use and family-based risk and protective factors: a literature review

Adolescent substance use has become a serious concern nationwide. Although there are many ways of viewing adolescent substance use, family influence has been established as one of the strongest sources of risk and protection. A review of the literature indicated relevant theories for understanding adolescent substance use and specific family-based variables influencing adolescent substance use. In general, there seems to be a relationship between adolescent substance use and family-based risk and protective factors. Relevant theories identified in the literature review include family systems theory, social cognitive theory, social control theory, and strain theory. Specific family-based risk and protective factors include family relationships such as with siblings and parents and family characteristics such as ethnicity and religious backgrounds. Future implications for research and prevention/intervention in relation to family-based risk and protective factors are discussed.     

Substance use in youth adopted from foster care: Developmental mechanisms of risk

Children who enter foster care are at unique risk for developing substance abuse due to experiencing early life stressors. A large body of research has revealed robust effects of various stressors on later substance use, implicating the role of early neurobiological changes that create chronic internalizing problems. However, less literature has investigated externalizing behavior as a mechanism underlying this relationship. Moreover, few studies have examined these mechanisms through a model of cumulative risk. The present study examined whether the prospective association between cumulative pre-adoptive risk (e.g., maltreatment, age at placement, foster placement instability, ever having lived with birth parent) and adolescent/young-adult substance use was mediated by childhood internalizing and externalizing problems in youth adopted from foster care. Participants included 82 adoptees, most with histories of prenatal substance exposure (72%). We tested parent-rated internalizing and externalizing problems across 5 years in childhood as simultaneous mediators of cumulative risk and level of substance use 11–15 years later. Bootstrapping mediation procedures, controlling for age, prenatal substance exposure, adolescent/young adult mental health symptomatology, and youth participation in follow-up, revealed a significant indirect effect of cumulative risk on substance use through childhood internalizing problems, but not externalizing problems. These results underline the importance of mitigating early risk for children in the child welfare system and call for targeting childhood emotion dysregulation to reduce likelihood of substance abuse among previously high-risk adoptees. Nevertheless, low rates of substance use overall in the present sample underscore the positive impact of adoptive placement on mitigating risk for substance abuse among foster youth.     

Differences by gender, ethnicity, and acculturation in the efficacy of the keepin' it REAL model prevention program

This study examined whether the efficacy of keepin' it REAL, a model program for substance use prevention in schools, was moderated by gender, ethnicity, and acculturation. Gender differences in program efficacy may arise through boys' higher risk of drug use, inadequate attention to girls' developmental issues, or cultural factors like polarized gender expectations. Data came from a randomized trial in 35 Phoenix, Arizona, middle schools involving 4,622 mostly Latino 7th graders. Using multi-level mixed models and multiple imputation missing techniques, results for the total sample showed no gender differences in program effects on recent substance use, but the program was more effective in fostering boys' than girls' anti-drug norms. Subgroup analyses demonstrated several more beneficial program effects for boys than girls (less alcohol and cigarette use and stronger anti-drug norms), but only among less acculturated Latinos. There were no gender differences in program effects among more acculturated Latinos, nor among non-Latino whites.     

Influence of a Family‐Focused Substance Use Preventive Intervention on Growth in Adolescent Depressive Symptoms

Preparing for the Drug Free Years (PDFY) is a preventive intervention that targets parenting behaviors, family interaction patterns, and adolescent substance use, factors that have been shown to predict depression among teenagers. Effects of PDFY on trajectories of self‐reported adolescent depressive symptoms from 6th through 12th grade were examined. Latent growth curve modeling was used to analyze data from 429 rural adolescents from schools assigned randomly to an intervention or a control condition. PDFY reduced the rate of increase in depressive symptoms during adolescence. Mediation of the intervention effect on depressive symptoms through reduced polysubstance use was tested; the indirect effect was only marginally significant. Findings have implications for understanding the relationship between adolescent depressive symptoms and substance use, and for preventing these outcomes.     

An Ecological Approach to Understanding Youth Violence: The Mediating Role of Substance Use

The authors tested an ecological model that posits mediating variables (substance use and mental health) in the association between ecological factors (family closeness, school closeness, and peer closeness) and youth violence in a sample of 4,783 adolescents. Model including substance use present significantly less total effect between ecological factors and youth violence than do models without substance use. Additional probing of significant mediation effect using the Sobel test was performed and suggested that substance use did function as a mediator in the hypothesized path. Considerations of adolescent violence should recognize the possible role of ecological factors and how their influence may vary by substance use.     

Neighborhoods, Family, and Substance Use: Comparisons of the Relations across Racial and Ethnic Groups

This study examines how substance use among adolescents is related to several risk and protective factors derived from two ecological contexts: the neighborhood and the family. It explicitly investigates how the relationships between substance use and the factors vary across different racial and ethnic groups. Findings suggest many common correlates and processes of substance use for adolescents, regardless of race or ethnicity, including that neighborhood safety is associated with substance use. There are also some racial and ethnic group differences in relationships, including that low attachment to and lack of social opportunities in neighborhoods more strongly predict substance use among whites than among other racial and ethnic groups and that family management decreases the relationship between neighborhood safety and substance use among African Americans. A better understanding of the associations among factors that influence substance use across racial and ethnic subgroups can help effectively target preventive interventions for different groups.     

An Ecological Approach to Understanding Youth Violence: The Mediating Role of Substance Use

The authors tested an ecological model that posits mediating variables (substance use and mental health) in the association between ecological factors (family closeness, school closeness, and peer closeness) and youth violence in a sample of 4,783 adolescents. Models including substance use present significantly less total effect between ecological factors and youth violence than do models without substance use. Additional probing of significant mediation effect using the Sobel test was performed and suggested that substance use did function as a mediator in the hypothesized path. Considerations of adolescent violence should recognize the possible role of ecological factors and how their influence may vary by substance use.     

School performance, academic aspirations, and drug use among children and adolescents

The relationship between drug use, school performance, and academic aspirations among 446 Anglo and Hispanic youths, age nine to seventeen, is explored. Two groups of subjects--current substance users and non-users--were interviewed. Subjects in each comparison group were similar in age, ethnicity, and gender. Overall results, consistent with prior research, indicate a significant relationship between current school performance, future educational aspirations, and drug use. No difference was noted between substance use groups on indicators of general interest in school work or probability of dropping out of school. Important differences in response patterns occurring with age, ethnicity, and gender were found.     

Anabolic-Androgenic Steroids and Condom Use: Potential Mechanisms in Adolescent Males

Previous research has revealed a significant bivariate relationship between anabolic-androgenic steroid (AAS) use and reduced condom use among adolescent boys. However, to date, no known studies have explored the psychological mechanisms that may explain this relationship. Thus, the current study sought to examine two possible mediators in the association between AAS and condom use: depressive symptoms and substance use. Data were extracted from a nationally representative sample of U.S. adolescents. Participants were 3,780 U.S. high school boys who responded to self-report items assessing a number of health behaviors, including symptoms of depression, substance use, AAS use, and use of condoms during their most recent act of intercourse. Both depression and substance use were significant mediators in the relationship between AAS and condom use. However, when these effects were contrasted, the indirect effect of substance use was significantly stronger in magnitude than the effect of depression. Although AAS use was associated with sexual risk behaviors among adolescent boys, significant variance in this relationship was accounted for by elevated levels of depression and substance use, with substance use demonstrating a particularly salient pathway.     

Risk Factors for Adolescent Pregnancy Reports Among African American Males

This study examined childhood and adolescent risk factors for males' reports of getting someone pregnant during adolescence. These questions were examined in an urban sample of 335 African American males involved in a prospective, longitudinal study. Childhood aggression significantly predicted reported pregnancies during adolescence. Boys who were stably aggressive across 3rd through 5th grades were at particularly high risk for reporting getting a female pregnant. Adolescent substance use and deviant peer involvement incrementally added to the prediction of pregnancy reports over and above the effects of childhood aggression. Adolescent aggressive problems did not contribute to reports of pregnancy once childhood aggression was accounted for in the model. These results highlight that precursors for males' pregnancy reports can be identified by as early as age 8. Findings also emphasize the importance of an expanded developmental focus to understand risk factors for adolescent pregnancy. The implications of these results are discussed for preventive interventions to reduce adolescent pregnancy.     

The impact of the positive action program on substance use,aggression, and psychological functioning: Is school climate a mechanism of change?

The social emotional learning (SEL) conceptual model posits that SEL programs lead to increased knowledge and skills, improved attitudes about self, others, and school, and supportive learning environments, which in turn improve student emotional, behavioral, and academic outcomes. Positive Action (PA) is an SEL program for elementary-, middle-, and high-school students. Extensive research documents the effectiveness of PA in decreasing adolescent risk factors and enhancing protective factors, however, minimal research has examined the mechanisms of change responsible for these effects. The current study examined whether PA was associated with SEL outcomes (i.e., alcohol use, aggression, depression, and anxiety) through school hassles (a proxy for school climate). The analytic sample consisted of 8333 ethnically/racially diverse, rural adolescents (51% female) in grades 6 through 12. Structural Equation Modeling was used to analyze the data. Engagement in PA was significantly associated with decreased school hassles, indicating an improvement in school climate. Subsequently, decreases in school hassles were significantly associated with decreased alcohol use, aggression, depression, and anxiety. Thus, there was an indirect effect between PA, decreased school hassles, and improved adolescent outcomes. Implications were discussed.     

Examining the impact of gender, race/ethnicity, and family factors on mental health issues in a sample of court-involved youth

Faced with anywhere between one half and two thirds of its youth having a diagnosable mental illness, the identification and treatment of mental health concerns is a critically important endeavor for professionals working with youth who have contact with the juvenile justice system. In addition, the literature suggests that factors related to both the family and to the gender of the adolescent must be incorporated into any approach to assessment and intervention within this special population. Further, prior work that has documented the interaction of gender and family issues with adolescent race/ethnicity warrants further empirical attention, as does the intermediary role that the family may play in the development of both internalizing and externalizing behaviors. The present study extends this literature by examining factors related to gender, race/ethnicity, family factors, and mental health issues in a sample of 2,549 Caucasian and African American youth coming to the attention of juvenile courts. Multivariate analysis of variance results indicated significant main effects for gender and race/ethnicity, as well as a significant gender x race/ethnicity interaction for the family and externalizing variables. A multiple group structural equation modeling procedure was employed in order to test the hypothesis that family environment mediates the relationship between gender and mental health problems, as well as to test for potential differences in these relationships as a function of race/ethnicity. Results indicated support for the mediation model in the sample of African American youth but not in the sample of Caucasian youth.     

Female adolescent smoking: a Delphi study on best prevention practices

The present researchers used a multi-wave Delphi methodology to determine what 14 knowledgeable substance abuse professionals believe are the most appropriate smoking prevention practices for female adolescents. While there was some agreement with the emerging literature, particularly on weight control issues and parental involvement, there was also endorsement of items that appear to be equally salient for both males and females. While the panelists generally acknowledged differential risk factors for females, and the need for prevention programming around these risk factors, more research on gender specific programming is needed before prevention experts are ready to agree on clear and specific practices for adolescent females.     

Parental Influence on Adolescent Cigarette,Alcohol and Marijuana Use: A Focus on Race/Ethnicity and Age

This study examined the racial/ethnic differences in the influence of perceived parental attitudes on adolescent cigarette, alcohol, and marijuana use. The 2014 National Survey on Drug Use and Health (NSDUH) was used and included African American, Hispanic, non-Hispanic White, and other race youth (N?=?13,600), aged 12–17. We tested the direct and moderating effects of perceived parental attitudes by race/ethnicity and age on adolescent substance use. Results show that perceived parental disapproval decreased cigarette and alcohol use among older adolescents. Perceived parental disapproval also varied by race/ethnicity and the type of substance used in that non-Hispanic White adolescents were more influenced by perceived parental disapproval for cigarette use, and perceived parental disapproval influenced Hispanic adolescents’ use for all three substances. African American adolescents were less influenced by perceived parental disapproval for all three substances. We also examined perceived harm in substance use and found that only 22.5% of the sample perceived the use of marijuana as harmful compared to cigarette and alcohol use (66 and 62.1%, respectively). Implications for preventive and intervention measures are discussed.     

Linking Self‐Regulation and Risk Proneness to Risky Sexual Behavior: Pathways through Peer Pressure and Early Substance Use

The linkages between self‐regulation in childhood, risk proneness in early adolescence, and risky sexual behavior in mid‐adolescence were examined in a cohort of children (N=518) from the National Longitudinal Survey of Youth. The possible mediating role of two early adolescent variables (substance use and negative peer pressure) was also examined. Self‐regulation was assessed by maternal report at ages 8–9, and risk proneness, comprising aspects of sensation seeking and decision making, was assessed by adolescent self‐report at ages 12–13. Structural equation models predicting risky sexual behavior at ages 16–17 indicated that self‐regulation operated partly through early adolescent substance use, whereas risk proneness operated through early adolescent substance use and negative peer pressure. The overall model did not differ significantly for boys and girls, although there were gender differences in the strength of particular paths. These long‐term longitudinal results support the importance of early self‐regulation and risk proneness in setting the stage for adolescent sexual risk taking and implicate substance use and negative peer pressure as processes through which risk proneness and poor self‐regulation lead to risky sexual behavior.     

Substance use among adolescent mothers: A review

Maternal substance abuse is a critical problem, and adolescent mothers appear to be at high risk for such behaviors. We review studies on postpartum adolescent substance use to explore the extent of this problem and avenues for new research. Authors screened 1300 studies, identifying 12 articles on substance use among postpartum adolescent mothers for this review. Adolescent mothers reported greater substance use before pregnancy compared to other adolescent females. Although some adolescents continued substance use during pregnancy, most stopped using only to resume within six months after birth. Comparisons of use to national samples of nulliparous adolescent females showed a higher prevalence of substance use in this population. Substances used often varied by race/ethnicity, with white mothers more likely to smoke cigarettes and use marijuana, and Black mothers more likely than whites to drink and use drugs. Of all identified studies, only one focused on Hispanics. Beliefs about drug use grew less negative as girls transitioned from pregnancy to parenthood. As they transitioned to adulthood, substance use remained prevalent and stable. Psychological distress and low self-esteem appeared to influence continued use. Friends' cigarette smoking predicted early initiation of and persistent smoking, while increased education predicted quitting. Early initiation of substances often predicted problem behaviors. Adolescent mothers are a vulnerable population, implicating use of problem behavior theory or the self-medication hypothesis in future research. Multiple avenues for new studies are needed to help identify effective treatment and intervention for this understudied population.     

Substance Abuse Treatment with Adolescent African American Males

Abstract

The use of substances by adolescent African American males is of particular concern because of the damaging effect that drug abuse has not only on the individual and his family but also on the African American community. The literature is scant regarding treatment services and few therapeutic interventions have been specifically designed to holistically meet the needs of these youth. This article proposes the use of Afrocentricity and Reality Therapy as therapeutic bases for substance abuse treatment with this population.     

The Role of Stress,Family Coping,Ethnic Identity,and Mother-Daughter Relationships on Substance Use Among Gang-Affiliated Hispanic Females

ABSTRACT

Hispanic adolescent females are the largest group of minority adolescents in the nation and appear to be at great risk for substance use. This research is based on data generated from a cross-sectional study of 150 Mexican American gang-affiliated adolescent females to predict substance-use recurrence. Findings reveal that positive family relationships, and in particular, mother-daughter relationships are protective factors for alcohol- and tobacco-use recurrence. Furthermore, the ability of the immediate family to cope with difficulties, stress, and conflicts were significant in averting illicit drug recurrence. This research provides evidence of the role of the family as a protective factor among these adolescents, despite their gang affiliation and street orientation. Discussed is how these findings contribute to formulating effective intervention, prevention, and treatment responses aimed at this “beyond risk” population.     

An Examination of Correlates for Adolescent Engagement in Nonsuicidal Self‐Injury,Suicidal Self‐Injury,and Substance Use

Little research has examined potential risk factors for direct versus indirect self‐injury among adolescents. To address this limitation, 541 clinically referred adolescents were assessed using the interRAI Child and Youth Mental Health Assessment. Logistic regression analyses revealed that older females who experienced heightened depressive symptoms and neighborhood violence were at increased risk for direct self‐injury, specifically nonsuicidal and suicidal self‐injury. Additionally, adolescents who experienced higher levels of caregiver distress were at greater risk of suicidal self‐injury. In contrast, older adolescents who experienced heightened aggressive behavior were at increased risk for one form of indirect self‐injury, substance use. Findings suggest that nonsuicidal self‐injury, suicidal self‐injury, and substance use are associated with differential risk factors. Implications for targeted prevention strategies are discussed.