Evaluating the Impact of a Substance Use Intervention Program on the Peer Status and Influence of Adolescent Peer Leaders

The current study involved an examination of the impact of a peer-led substance use intervention program on the peer leaders beyond the substance use-related goals of the intervention. Specifically, unintended consequences of an adult-sanctioned intervention on the targeted peer leader change agents were investigated, including whether their participation affected their peer status, social influence, or self perceptions. Twenty-two 7th grade peer-identified intervention leaders were compared to 22 control leaders (who did not experience the intervention) and 146 cohort peers. Three groups of measures were employed: sociometric and behavioral nominations, social cognitive mapping, and leadership self-perceptions. Results indicated that unintended consequences appear to be a legitimate concern for females. Female intervention leaders declined in perceived popularity and liked most nominations over time, whereas males increased in total leader nominations. Explanations for these results are discussed and further directions suggested.     

Recovery High School Attendance Effects on Student Delinquency and Substance Use: the Moderating Role of Social Problem Solving Styles

Prevention Science - Recovery high schools (RHSs) provide educational programming and therapeutic support services for young people in recovery from substance use disorders (SUDs). The objectives...     

Perceived Discrimination and Longitudinal Increases in Adolescent Substance Use: Gender Differences and Mediational Pathways

Objectives. This study was designed to test hypotheses about the prospective association of adolescents’ perceptions of discrimination with increases in substance use and the processes that mediate this association.Methods. African American youths residing in rural Georgia (n = 573; mean age = 16.0 years) provided longitudinal data on their experiences with discrimination, substance use, school engagement, and affiliations with substance-using peers.Results. For male youths, perceived discrimination was significantly related to increases in substance use, and, as hypothesized, this association was mediated by the contributions of perceived discrimination to decreases in school engagement and increases in affiliations with substance-using peers. Analyses also indicated that discrimination influences substance use rather than vice versa.Conclusions. Results are consistent with the hypothesis that high levels of discrimination are linked to increases in substance use for African American male adolescents.Historically, rural residence has protected African American adolescents from high-risk behaviors prevalent in urban areas. Recent epidemiologic data, however, indicate that African American adolescents in rural areas are engaging in substance use at rates equal to or exceeding those of youths who live in densely populated inner cities.1–3 Substance use is a leading cause of accidents, injuries, and disability among African Americans aged 15 to 24 years.4 It predicts the likelihood of infection with HIV/AIDS and other sexually transmitted infections; affects future educational attainment, behavior problems, depressive symptoms, unintended pregnancies, involvement with the criminal justice system, ability to find and keep employment, establishment and maintenance of family relationships; and leads to drug abuse and dependence during adulthood.5–8 The experience of discrimination has been identified as a stressor with the potential to increase African American youths’ vulnerability to a host of problems during adolescence, including substance use.9 The primary purpose of this study was to test hypotheses regarding the influence of perceived discrimination on substance use and the psychosocial processes that account for these effects.Research has established that the experience of unfair treatment based on race is common among African American adults10 and adolescents.11 Associations have been documented between self-reported discrimination and various forms of substance use, including smoking,12 alcohol consumption,13 and use and abuse of other drugs.14 The stress-coping model that has framed much of the research on the effects of discrimination15,16 posits that frequent experiences with discrimination deplete coping resources and increase the attractiveness of avoidant coping strategies, such as substance use, because drug use offers temporary respite from discrimination-induced stress. Almost all of these studies, however, were cross-sectional (see Gibbons et al.17 for an exception), which limits their ability to determine whether substance use is a consequence or a cause of discrimination and to examine the intermediate processes that account for the influence of discrimination on substance use. The primary purposes of this study were to test the hypothesis that perceived discrimination will forecast increases in substance use across adolescence rather than the reverse. Recent research suggests that racial discrimination may affect male and female youths differently.9,18 For example, Brody et al.9 found that discrimination was a more powerful predictor of conduct problems for male adolescents than for female adolescents. Given the comorbidity of substance use and conduct problems, we hypothesized that the influence of discrimination would be more apparent among male than female youths.A secondary purpose of this study was to investigate the processes through which perceived discrimination results in increases in substance use. We propose that African American adolescents who feel devalued and demoralized by perceived discrimination become less inclined to accept conventional values and pursuits; hence, they come to view school, a major social institution, as irrelevant and gravitate toward peers who also reject conventional values. This is consistent with findings that youths who experience racial discrimination report more negative beliefs about the usefulness of school, lower academic efficacy,19 and lower grade point averages.20 These youths subsequently become more prone to affiliate with like-minded peers who sanction and encourage nonconventional and risky behavior.21 Because declines in school engagement and affiliations with substance-using peers are proximal risk mechanisms known for onset and escalation of substance use,21 we expected an indirect effect of perceived discrimination on increases in substance use mediated through its effect on decreasing school engagement and increasing affiliations with substance-using peers.22,23     

Effects of Differential Family Acculturation on Latino Adolescent Substance Use*

Abstract: This study examined links between parent‐youth differential acculturation and youth substance‐use likelihood in a sample of 73 recently immigrated Latino families with middle‐school‐aged youth. Multiple agents were utilized to assess family functioning and youth outcomes. Findings suggested that a greater level of differential acculturation between parents and youth was associated with greater likelihood of future youth substance use. However, the relationship between differential acculturation and youth substance use was mediated by family stress processes and effective parenting practices. Differential acculturation was related to increases in family stress and decreases in effective parenting practices, and each of these, in turn, was related to increases in future substance‐use likelihood among Latino youth. Findings implicate the need for advancing policies and practices that address acculturation as a family process, rather than as merely an individual psychological phenomenon.     

HIV Risk Among Displaced Adolescent Girls in Ethiopia: the Role of Gender Attitudes and Self-Esteem

Prevention Science - Adolescent girls in sub-Saharan Africa have been deemed one of the most critical populations to address in the campaign for an HIV-free generation. Experiences of intimate...     

The Effects of the Going Places Program on Early Adolescent Substance Use and Antisocial Behavior

This study evaluated the effects of a school-based intervention on growth trajectories of smoking, drinking, and antisocial behavior among early adolescents. Seven middle schools were randomized to intervention or comparison conditions and students in two successive cohorts (n = 1484) provided five waves of data from sixth to ninth grade. The Going Places Program, included classroom curricula, parent education, and school environment components. Latent growth curve analyses demonstrated significant treatment group effects, including reducing increases in friends who smoke, outcome expectations for smoking, and smoking progression, but had non-significant effects on drinking or antisocial behavior. The Going Places Program was effective in preventing increases in smoking progression, but its efficacy as a more cross-cutting problem behavior preventive intervention was not confirmed.     

Discrimination and Substance Use Disorders Among Latinos: The Role of Gender,Nativity, and Ethnicity

Objectives. We examined the relationship between discrimination and substance use disorders among a diverse sample of Latinos. We also investigated whether the relationship between discrimination and substance use disorders varied by gender, nativity, and ethnicity.Methods. Our analyses focused on 6294 Latinos who participated in the National Epidemiologic Survey on Alcohol and Related Conditions from 2004 to 2005. We used multinomial logistic regression to examine the association between discrimination and substance use disorders.Results. Discrimination was significantly associated with increased odds of alcohol and drug use disorders among Latinos. However, the relationship between discrimination and substance use disorders varied by gender, nativity, and ethnicity. Discrimination was associated with increased odds of alcohol and drug use disorders for certain groups, such as women, US-born Latinos, and Mexicans, but this relationship did not follow the same pattern for other subgroups.Conclusions. It is important to determine which subgroups among Latinos may be particularly vulnerable to the negative effects of discrimination to address their needs.Latinos are the largest ethnic or racial minority group in the United States1 and the fastest growing group entering substance abuse treatment programs.2 Although Latinos are disproportionately affected by substance abuse,3 they have been understudied.4 Previous research shows that high levels of poverty, minority status, and residential concentration in areas with widespread drug and alcohol distribution have been considered to be factors that may put Latinos at risk for substance use disorders.5 More recently, discrimination has also been considered to be a risk factor.6,7 As studies aim toward filling the gap in the literature, the heterogeneity of Latinos must also be considered.Discrimination has been associated with alcohol and drug use8–13 and substance use disorders among Latinos.6,7 Stress-coping frameworks and the minority stress model have been applied to hypothesize that individuals belonging to various marginalized groups respond to experiences of discrimination with unhealthy coping behaviors, such as substance use.14,15 Moreover, discrimination may lead to underemployment, lower wages, and limited access to health services and other resources that can affect health outcomes.16 In this way, discrimination operates at both the interpersonal and institutional levels simultaneously to situate individuals on different health trajectories, fostering and reinforcing poor health behaviors and outcomes.16,17The association between discrimination and substance use has been previously documented for Latinos and other groups. However, reviews of the literature have called for more granular analysis of specific risk patterns. One specific area needing analysis is whether some subgroups of Latinos are at higher risk of substance use related to discrimination than others. The identification of subgroups is an important first step toward the development of targeted population-level approaches and tailored interventions.In the present study, we focused on subgroups based on gender, nativity, and ethnicity (country of origin or heritage country). These subgroups were based on ascribed characteristics that refer to immutable characteristics (vs achieved characteristics, such as education) that are given status value.18,19 The status value placed on these characteristics can drive discrimination; for example, when men are considered more valuable than women and when US-born individuals are considered more valuable than immigrants.18,19 At the same time, these characteristics (gender, nativity, and ethnicity) are also associated with substance use disorders.Gender differences in substance use disorders are not unique to Latinos. Across racial/ethnic groups, men consistently have higher prevalence of substance use disorders. Using data from the National Latino and Asian American Study, the lifetime prevalence of alcohol use disorders was 16.7% for Latino men and 4.3% for Latina women.20 Research also shows that Latino men generally reported higher levels of discrimination compared with Latina women.13,21 Data from the National Latino and Asian American Study showed that 39% of Latino men, compared with 29% of Latina women, reported discrimination.22 These authors suggested that these patterns might be the result of minority men being more exposed and vulnerable to racial bias from social institutions. These higher rates of substance use and discrimination among men also appeared to be jointly related. A recent study found that discrimination was associated with increased risk of drug abuse among Latino men, but not Latina women.6 This interaction might occur because of greater cultural acceptability among men overall to use substances to cope with stress compared with women. In contrast, women were found to rely on social support and to turn to food to cope with stress.23–25 Other specific factors, such as abuse history,26 were found to be more central in predicting risk of substance use disorders among Latina women. Thus, we expected that discrimination would have a stronger relationship with substance use disorders among Latino men than Latina women.Similar to health differences by gender, differences by nativity are not unique to Latinos. Overall, foreign-born individuals tend to be healthier than their US-born counterparts. Lifetime rates of substance use disorders were higher among US-born than foreign-born Latinos (19.6% vs 5.5%, respectively).20 Previous studies also found greater reporting of discrimination among US-born Latinos; 47% of US-born compared with 25% of foreign-born Latinos reported discrimination.22 However, discrimination might be more harmful to foreign-born Latinos because they are less likely to enjoy citizenship rights (e.g., voting privileges, access to educational scholarships) that might help temper some of the stressful effects of discrimination. From this perspective, we expected that discrimination would have a stronger relationship with substance use disorders among foreign-born than US-born Latinos.Finally, it is also important to consider ethnicity. There is some indication of variation in rates of substance use across these groups. Cubans were found to have lower odds of substance use disorders compared with Puerto Ricans.27 In addition, there was good evidence for variation in reporting of discrimination.28 For example, 40% of Puerto Ricans reported discrimination compared with 34% of Mexicans and 16% of Cubans.22 This variation might be attributed to gradations based on socioeconomic resources that differ by Latino ethnicity.29 Gradations based on socioeconomic resources could dictate the risks and resources individuals have exposure and access to, affecting coping mechanisms. Thus, we expected the relationship between discrimination and substance use disorders to vary by ethnicity as well.In sum, based on this literature, we hypothesized that discrimination would be associated with increased risk of substance use disorders among Latinos overall, and that the relationship between discrimination and substance use disorders would vary by ascribed characteristics. Specifically, we theorized that the relationship between discrimination and substance use disorders would be stronger among men compared with women, among foreign-born Latinos compared with US-born Latinos, and among Mexicans and Puerto Ricans compared with Cubans.     

Pubertal Timing and Substance Use: The Effects of Gender, Parental Monitoring and Deviant Peers

PURPOSE: Early pubertal timing is associated with early initiation of cigarettes and alcohol; we evaluated parental monitoring and affiliation with deviant peers in a moderated, mediational model of this relationship for both genders. METHODS: We tested a prospective model explaining the process through which pubertal timing is related to early use of cigarettes and alcohol for 360 fourth and fifth graders, following them for 4 years. RESULTS: We found a relation between early pubertal maturation and trying cigarettes and alcohol without parents' knowledge for both boys and girls. In addition, for both genders, parental monitoring moderated the association between pubertal timing and trying alcohol, but not trying cigarettes. Affiliation with deviant peers mediated the effect of pubertal timing on both alcohol and cigarette initiation for girls only. CONCLUSIONS: Although pathways to substance use differ by gender, both early maturing girls and boys should be regarded as high-risk populations for initiation of substances, and intervention programs may be more effective if they are targeted accordingly.     

Explaining Associations between Adolescent Substance Use and Condom Use

PurposeThis study examined different explanations for associations between adolescent substance use and lower condom use, in terms of the event-specific effects of alcohol or drugs, psychosocial factors, and sexual behaviors (intercourse frequency, greater number of partners and pill use).MethodsPupils from 25 schools in Scotland, UK provided data on use of alcohol, tobacco, cannabis and psychosocial factors at ages 14 and 16 years; and sexual behaviors at age 16 years. Logistic regression was used to examine associations between substance use and condom use in those reporting intercourse more than once (n = 1322), adjusting for explanatory variables.ResultsRegular use of any of the three substances at age 14 or 16 was associated with lower condom use at age 16, adjusting for gender and social background. The greatest attenuation of the substance use odds ratios was achieved by adjusting for all behaviors and psychosocial factors. This finding applied to different substance use groups, although cigarette-only and alcohol-only groups at age 16 differed in the relative importance of being “drunk or stoned” to other factors explaining condom use.ConclusionsAmong adolescent substance users, being “drunk or stoned” at intercourse was only one factor related to not using condoms. Psychosocial factors (including attitudes to sexual risks and peer sexual norms) and having more sexual partners also explained substance users’ condom use, with lesser effects due to greater intercourse frequency and pill use. Multiple explanations for substance use/condom use associations may guide counseling and education services.     

Adolescent and Young Adult Crash Risk: Sensation Seeking,Substance Use Propensity and Substance Use Behaviors

In a national youth sample, the propensity to use substances was more strongly related to motor vehicle crashes than use of any specific substance studied (cigarette, alcohol, marijuana). Substance use propensity was associated with sensation seeking, suggesting that increased crash risk for these youth is likely a result of general risk-taking tendencies.     

Variation in Sexual Behaviors in a Cohort of Adolescent Females: The Role of Personal,Perceived Peer,and Perceived Family Attitudes

PurposeLittle is known about how adolescent sexual behaviors develop and the influence of personal or perceived social attitudes. We sought to describe how personal, perceived peer, and perceived family attitudes toward adolescent sexual activity influence sexual behaviors of adolescent females' over time.MethodsBetween the years of 1999 and 2006, 358 English-speaking female adolescents, aged 14–17 years, were recruited from three urban adolescent clinics. Participants completed quarterly and annual questionnaires over a span of 4 years. Primary outcomes included engagement in any of the following eight sexual behaviors: kissing, having breasts touched, having genitals touched, touching partners' genitals, oral giving, oral receiving, anal, or vaginal sex. Three attitudinal scales assessed personal importance of abstinence, perceived peer beliefs about when to have sex, and perceived family beliefs that adolescent sex is negative. We used generalized estimating equations to identify predictors of each sexual behavior and compared whether personal, perceived peer, or perceived family attitudes predicted sexual behaviors over time.ResultsThe odds of reporting each sexual behavior increased with age but were lower among those whose personal or perceived family attitudes were less positive. Participants' personal attitudes toward adolescent sex were the strongest predictor of engagement in all eight sexual behaviors even after controlling for perceived peer and perceived family attitudes.ConclusionsFemale adolescent's personal attitudes toward abstinence appear to be the strongest predictor of engagement in a variety of sexual behaviors. Efforts to influence adolescent attitudes toward abstinence may be an important approach to reducing sexual behaviors that increase the risk of pregnancy and sexually transmitted infections.     

Adolescent Neurological Development and its Implications for Adolescent Substance Use Prevention

Recent technological advancements have facilitated the study of adolescent neurological development and its implications for adolescent decision-making and behavior. This article reviews findings from the adolescent neurodevelopment and substance use prevention literatures. It also discusses how findings from these two distinct areas of adolescent development can complement each other and be used to build more developmentally appropriate interventions for preventing adolescent substance use. Specifically, a combination of child-centered and family-based strategies is advocated based on extant neurological and prevention literature. Editors’ strategic implications: Researchers are encouraged to take up the authors’ challenge and study the links between adolescent neurological development/decision making ability and the long term efficacy of comprehensive interventions for preventing adolescent substance use.     

The Direct and Indirect Effects of Mothers' and Adolescents' Family Cohesion on Young Adolescents' Attitudes Toward Substance Use

This study examined the influence of parental, school, and peer bonding for rural youth making the transition into middle school. Survey data were collected from 225 adolescents and their mothers answering parallel items on family cohesion, school attachment, and attitudes toward substance use by minors. Adolescents also reported on social support from friends, and mothers reported on the family's involvement in religious activities. Using structural equation modeling, greater family cohesion at the start of middle school / junior high was directly and indirectly related to negative attitudes toward substance use by the adolescent one year later. Factors that mediated family cohesion were school and peer attachment, the family's involvement in religious activities, and the mothers' attitudes toward substance use by minors. Implications for prevention and recommendations for parents are discussed.     

Parental and Peer Influences on the Risk of Adolescent Drug Use

Using a probability sample of 4,230 adolescents from grades 7–12, we used negative binomial regression to estimate the effects of peer and six family variables on the risk of adolescent drug use. Peer drug use had relatively strong effects of adolescent drug use. Parental drug attitudes, sibling drug use, and adult drug use had significant direct effects net of peer influences. In addition, they had significant indirect effects that were mediated by peer drug use. The influences of parental monitoring, attachment to mother, and attachment to father were statistically significant but relatively small. The findings applied to alcohol, binge drinking, cigarettes, marijuana, and other illicit drugs. Editors' Strategic Implications: The authors interpret their findings as being more consistent with social learning than social control theory. This research, although cross-sectional and limited to adolescents' self-reports, contributes to a growing literature on the direct and indirect influences of parents on their teens' substance use rates. It speaks to the need for school- and community-based prevention efforts to focus on families as well as peers.     

Masculine Gender Role Stress and Substance Abuse Among Substance Dependent Males

Masculine gender role stress (MGRS) occurs in men who are highly committed to the male role. We hypothesized that among substance dependent men, high MGRS men would show more severe alcohol and drug abuse than low MGRS men. Additionally, we explored the types of substance abuse triggers to which high MGRS men are most vulnerable and their confidence in coping with these triggers. Our results indicate that high MGRS males had more severe alcohol dependence and, among drug dependent individuals, more severe drug dependence than did low MGRS men. Additionally, high MGRS men were found to be more likely to abuse substances in response to negative emotions, physical discomfort, conflict, and the belief that they can control their substance use.     

Peer Influences: The Impact of Online and Offline Friendship Networks on Adolescent Smoking and Alcohol Use

PurposeOnline social networking sites (SNSs) have become a popular mode of communication among adolescents. However, little is known about the effects of social online activity on health behaviors. The authors examined the use of SNSs among friends and the degree to which SNS activities relate to face-to-face peer influences and adolescent risk behaviors.MethodsLongitudinal egocentric friendship network data along with adolescent social media use and risk behaviors were collected from 1,563 10th-grade students across five Southern California high schools. Measures of online and offline peer influences were computed and assessed using fixed-effects models.ResultsThe frequency of adolescent SNS use and the number of their closest friends on the same SNSs were not significantly associated with risk behaviors. However, exposure to friends' online pictures of partying or drinking was significantly associated with both smoking (β = .11, p < .001) and alcohol use (β = .06, p < .05). Whereas adolescents with drinking friends had higher risk levels for drinking, adolescents without drinking friends were more likely to be affected by higher exposure to risky online pictures (β = −.10, p < .05). Myspace and Facebook had demographically distinct user characteristics and differential effects on risk behaviors.ConclusionsExposure to risky online content had a direct impact on adolescents' risk behaviors and significantly interacted with risk behaviors of their friends. These results provide evidence that friends' online behaviors should be considered a viable source of peer influence and that increased efforts should focus on educating adolescents on the negative effects of risky online displays.