Identifying sensitive periods when changes in parenting and peer factors are associated with changes in adolescent alcohol and marijuana use

Purpose

There are well-established associations between parental/peer relationships and adolescent substance use, but few longitudinal studies have examined whether adolescents change their substance use in response to changes in their parents’ behavior or peer networks. We employ a within-person change approach to address two key questions: Are changes in parenting and peer factors associated with changes in adolescent marijuana and alcohol use? Are there sensitive periods when changes in parenting and peer factors are more strongly associated with changes in adolescent marijuana and alcohol use?

Methods

We analyzed longitudinal data collected annually on 503 boys, ages 13–19, recruited from Pittsburgh public schools. Questionnaires regarding parental supervision, negative parenting practices, parental stress, physical punishment, peer delinquency, and peer drug use were administered to adolescents and their caretakers. Alcohol and marijuana use were assessed by a substance use scale adapted from the National Youth Survey.

Results

Reductions in parental supervision and increases in peer drug use and peer delinquency were associated with increases in marijuana frequency, alcohol frequency, and alcohol quantity. Increases in parental stress were associated with increases in marijuana and alcohol frequency. The magnitudes of these relationships were strongest at ages 14–15 and systematically decreased across adolescence. These associations were not due to unmeasured stable confounders or measured time-varying confounders.

Conclusions

Reducing or mitigating changes in parenting and peer risk factors in early adolescence may be particularly important for preventing substance use problems as adolescents transition into young adulthood.

     

Does parental permissiveness toward cigarette smoking and alcohol use influence illicit drug use among adolescents? A longitudinal study in seven European countries

Purpose

Adolescents’ perceptions of parental norms may influence their substance use. The relationship between parental norms toward cigarette and alcohol use, and the use of illicit substances among their adolescent children is not sufficiently investigated. The purpose of this study was to analyze this relationship, including gender differences, using longitudinal data from a large population-based study.

Methods

The present study analyzed longitudinal data from 3171 12- to 14-year-old students in 7 European countries allocated to the control arm of the European Drug Addiction Prevention trial. The impact of parental permissiveness toward cigarettes and alcohol use reported by the students at baseline on illicit drug use at 6-month follow-up was analyzed through multilevel logistic regression models, stratified by gender. Whether adolescents’ own use of cigarette and alcohol mediated the association between parental norms and illicit drug use was tested through mediation models.

Results

Parental permissive norms toward cigarette smoking and alcohol use at baseline predicted adolescents’ illicit drug use at follow-up. The association was stronger among boys than among girls and was mediated by adolescents’ own cigarette and alcohol use.

Conclusion

Perceived parental permissiveness toward the use of legal drugs predicted adolescents’ use of illicit drugs, especially among boys. Parents should be made aware of the importance of norm setting, and supported in conveying clear messages of disapproval of all substances.

     

Evidence for similarities between adolescents and parents in sleep patterns

ObjectiveSleep in adolescence may vary according to strain and environmental factors. In particular, parents’ behavior may affect their children’s psychological functioning and sleep. However, no data have been gathered with respect to parents and their adolescent children’s concurrent sleep patterns. This was the aim of the present study, together with exploration of the possible influence of parenting style on adolescents’ sleep.MethodsA total of 293 adolescents (mean age: 17.55; 214 females, 79 males) completed several questionnaires regarding their own psychological functioning as well as a sleep log for seven consecutive days. Additionally, adolescents rated parents’ sleep and parenting styles.ResultsAdolescents’ and parents’ sleep patterns proved to be correlated. Moreover, mother’s sleep was related to adolescents’ psychological functioning. However, SEM showed that mother’s sleep influenced adolescents’ sleep not directly, but indirectly, via parenting style and adolescents’ psychological functioning.ConclusionsSleep patterns of parents and their adolescent children show similarities. Moreover, mother’s poor sleep has a direct impact on parenting style, which in turn affects adolescents’ psychological functioning and sleep. Therefore, sleep problems in adolescents may mirror an unfavorable parenting style and sleep complaints among mothers. These conclusions might usefully inform family counseling and treatment of adults’ and adolescents’ sleep complaints.     

Parental attributes and adolescent drug use

While many studies have examined the relationship of family and parent factors to adolescent drug use, few have had the opportunity to examine these longitudinally. Most measures of various family patterns, including discipline, conflict and rejection, have been concurrent with the adolescents' drug use and usually are reported by the youths themselves. The study reported here is unique in its thirty year data base on 133 subjects and their families. Data collection in the New York Longitudinal Study included extensive interviews with the parents during the subjects' very early childhood which detailed their parenting attitudes and practices. Five of these clusters as reported in other concurrent studies were used to test whether the parental factor scores could discriminate between those adolescent subjects who were users of alcohol, tobacco and marijuana and those who were not users. Results of the Discriminant Function analyses showed that parental conflict in childrearing practices, inconsistent discipline, restrictive discipline and maternal rejection were associated with marijuana and alcohol use in older adolescents. The need for early parent education and skill building in order to prevent later developmental difficulties is indicated.     

Clinical correlates of cannabis use among adolescent psychiatric inpatients

ObjectivesThis study sought to determine the clinical correlates of adolescents with cannabis use and no additional drug use (CU) compared to adolescents with no drug use (NDU) among a group of adolescent psychiatric inpatients in Israel.MethodsTwo hundred and thirty-six patients consecutively admitted to an adolescent inpatient unit at a university-affiliated mental health center in Israel during a 3-year period were screened. Individuals with polydrug use were excluded from the study.ResultsPrevalence of cannabis use was 13%. In the CU group, 39% were diagnosed with attention deficit and disruptive behavior disorders compared with 16% in the NDU group. Antipsychotics were the most common medications prescribed in both groups. Mood stabilizers were more frequently prescribed to CU than to NDU patients (39% vs 16%, respectively). A higher prevalence of alcohol abuse and criminal behaviors was found among CU compared to NDU patients (61% and 39% vs 6% and 4%, respectively).ConclusionsThe high prevalence of disruptive behaviors and frequent treatment with antipsychotics and mood stabilizers in the CU group may be related to the strong association between externalizing behavior and cannabis use and the non-specific pharmacological treatment of disruptive behaviors. Formal screening for cannabis use should be considered in psychiatric facilities. Specifically, adolescents with disruptive behaviors could benefit from early interventions, before and after cannabis initiation.     

Parent substance use as a predictor of adolescent use: A six-year lagged analysis

The present study investigated the role of parental use of alcohol, cigarettes, and marijuana on lagged changes in the specific substance use of their adolescent offspring over a six-year period. The analyses also examined the relative influence of mothers and fathers and their interaction as moderated by marital status and age and gender of the adolescent. A generalized estimating equations approach, analogous to quasi-like-lihood, was employed to estimate regression coefficients via an iterative weighted least squares algorithm. Findings indicated that, when employed as time-varying covariates, parental substance use resulted in substance-specific effects on fluctuations in the adolescent’s own use. Age, parent marital status, and each parent’s marijuana use independently were jound to significantly affect adolescent marijuana use. In contrast, the complex relationship between parent and adolescent use of alcohol and cigarettes showed variation by substance, age, and gender of both parents and adolescents. Within a developmental context, the results suggest that parent use of substances must be considered risk factors with particular effects on their younger offspring. Thus, prevention efforts should be directed at middle childhood and include components aimed at parents as well as their children.

     

The relationship between parental mediation and Internet addiction among adolescents,and the association with cyberbullying and depression

ObjectiveThis study examined the relationships between parental mediation and Internet addiction, and the connections to cyberbullying, substance use, and depression among adolescents.MethodThe study involved 1808 junior high school students who completed a questionnaire in Taiwan in 2013.ResultsMultiple logistic regression analysis results showed that adolescents who perceived lower levels of parental attachment were more likely to experience Internet addiction, cyberbullying, smoking, and depression, while adolescents who reported higher levels of parental restrictive mediation were less likely to experience Internet addiction or to engage in cyberbullying. Adolescent Internet addiction was associated with cyberbullying victimization/perpetration, smoking, consumption of alcohol, and depression.ConclusionInternet addiction by adolescents was associated with cyberbullying, substance use and depression, while parental restrictive mediation was associated with reductions in adolescent Internet addiction and cyberbullying.     

Adolescent social withdrawal,parental psychological control,and parental knowledge across seven years: A developmental cascade model

IntroductionSocial withdrawal can be problematic for adolescents, increasing the risk of poor self-efficacy, self-esteem, and academic achievement, and increased levels of depression and anxiety. This prospective study follows students across adolescence, investigating links between social withdrawal and two types of parenting hypothesized to impact or be reactive to changes in social withdrawal.MethodsAdolescent social withdrawal and parenting were assessed across seven years in a U.S. sample, beginning when students were in 6th grade and ending in 12th grade. The sample consisted of 534 adolescents (260 girls and 274 boys, 82% Euro- and 16% African-American). Social withdrawal was assessed in four grades using at least two informants (teachers, mothers, and/or adolescents). Mothers' and fathers' psychological control and monitoring-related knowledge were assessed by adolescents at two time points. A developmental cascade analysis was conducted using structural equation modeling to assess how withdrawal and control-related parenting impact each other transactionally over time. Analyses included a test for gender differences in the model.ResultsThe cascade model revealed that, controlling for previous levels of social withdrawal and parenting, earlier social withdrawal positively predicted psychological control and negatively predicted monitoring knowledge, and earlier parental psychological control—but not monitoring knowledge—predicted later social withdrawal. No adolescent gender differences were identified in the associations between social withdrawal and parental knowledge.ConclusionsThis study offers insight into the mechanisms by which adolescents become more or less withdrawn over time, and suggests psychological control as a point of psychoeducation or intervention for parents.     

A longitudinal investigation of sleep and technology use in early adolescence: does parental control of technology use protect adolescent sleep?

ObjectiveA bi-directional relationship between technology use and adolescent sleep is likely, yet findings are mixed, and it is not known whether parental control of technology use can protect sleep. The current study examined bi-directionality between technology use on school nights and morning/eveningness, sleep duration and daytime sleepiness in early adolescents. We also examined whether time spent using technology mediated the relationship between parental control of technology and adolescent sleep.MethodsAdolescents and their primary caregiver (96% mothers) completed questionnaire measures of sleep, technology use and parental control across three, annual waves: Wave 1 (N = 528, M_age = 11.18, SD = 0.56, range = 10–12, 51% male), Wave 2 (N = 502, M_age = 12.19, SD = 0.53, 52% male) and Wave 3 (N = 478, M_age = 13.19, SD = 0.53, 52% male).ResultsWhen examining the direct relationship between sleep and technology use, cross-lagged panel models showed that time spent using technology predicted shorter sleep duration and greater daytime sleepiness in adolescence, and evening diurnal preference and shorter sleep duration contributed to increased technology use over time. The relationship between technology use and sleep duration was bi-directional. Time spent using technology and adolescent sleep predicted, yet were not predicted by, parental control of technology use.ConclusionsWhile normative changes in sleep (eg, increased eveningness) may promote increased technology use, technology use may further impinge upon sleep. Results suggest it may be pertinent to instead find creative ways in which adolescents themselves can mitigate their risk of inadequate sleep.     

Alcohol use among 10th-graders: Distinguishing between high-intensity drinking and other levels of use

IntroductionDrinking at levels beyond standard binge drinking thresholds poses particularly high risks to youth. Few studies have examined high-intensity drinking (HID; 10+ drinks in a row) in high school students and none have tested whether peer drunkenness and parental knowledge (e.g., about youth's whereabouts) distinguish between binge and high-intensity drinkers.MethodsWe used data from the Monitoring the Future study collected from nationally-representative samples of U.S. 10th graders (modal age 16 years old) in 2016–2018 (n = 14,824; 48.3% girls, 46.8% boys). We conducted multinomial logistic regression to examine odds of drinking at one of four mutually-exclusive levels: HID in the past 2 weeks, binge (5+) drinking in the past 2 weeks, any alcohol use in the past year, and no alcohol use in the past year.ResultsLow parental knowledge and peer drunkenness were both associated with higher odds of each drinking level, including HID vs. binge, binge vs. alcohol use, and alcohol use vs. no alcohol use. Boys had higher odds than girls of HID compared to binge drinking and of no alcohol use compared to alcohol use.ConclusionsParent and peer risk factors differentiate HID from other levels of drinking.     

Parental influence,pessimism and adolescent suicidality

Abstract

As part of a series of studies into the early detection of suicidal behaviour in adolescence, this study investigated relationships between adolescents' self-reports of perceived parental style, pessimism, and the spectrum of suicidal behaviour in a sample of Australian high school students (Mean age = 15.8). Three hundred and seven students completed a questionnaire that included demographic details. the Influential Relationships Questionnaire (IRQ), the Beck Hopelessness Scale, and the Adolescent Suicide Questionnaire. There was a high level of suicidal behaviour reported with suicidal adolescents perceiving their pants to be significantly more critical, less caring and more overprotective. Multiple regression analyses examining a proposed pathway from perceived parental style to suicidality through the mediation of hopelessness found that both parental style and hopelessness made unique contributions to a composite suicidality score. The quality of parenting is relevant to the assessment of adolescent suicidality and the KRQ may be useful for the detection of perceived parenting difficulties in suicide prevention programmes.     

Gender, perceived parental monitoring, and behavioral adjustment: influences on adolescent alcohol use

This study examined relationships among gender, perceived parental monitoring, externalizing behaviors, and adolescent alcohol use in a 2-wave longitudinal study. Females reported more perceived parental monitoring and less alcohol use than males. Perceived maternal and paternal monitoring were related to less alcohol use over time. Increases in alcohol use were associated with increases in externalizing behaviors over time. Perceived maternal monitoring mediated the relationship between gender and youth drinking and was also a significant predictor of changes in adolescent drinking over time. Perceived paternal monitoring was not a predictor of adolescent drinking in the context of perceived maternal monitoring and externalizing behaviors. The importance of gender in implementation of prevention programs is discussed.     

Trajectories of childhood aggression and inattention/hyperactivity: differential effects on substance abuse in adolescence

ObjectiveAggression and hyperactivity/inattention each are linked to risk of alcohol use disorder (AUD), but their unique contributions remain ambiguous. The present study disaggregated these two domains developmentally and examined the relation between childhood behavior trajectories and adolescent substance use.MethodA total of 335 children of alcoholic and nonalcoholic fathers were studied prospectively. Parallel process latent trajectory class analysis was developed with behavioral ratings by parents and teachers of aggression and inattention/hyperactivity across ages 7 to 16. Membership in the four latent classes was used as a predictor for problem adolescence alcohol use and substance onset.ResultsYouths in the four latent trajectory classes differed in number of alcohol problems at age 16: healthy class (39% of sample, mean 2.1 alcohol-related problems), inattentive/hyperactive but not aggressive (33%; mean 2.7 problems), aggressive but not inattentive/hyperactive (4%, mean 5.0 problems), and comorbid (24%; mean 4.0 problems). Survival analysis revealed that the aggressive, comorbid, and inattentive/hyperactive classes had significantly earlier onsets of drinking, drunkenness, and marijuana use than the healthy class. Illicit drug use was also significantly increased in the comorbid, aggressive, and inattentive/hyperactive classes compared to the healthy class.ConclusionsThree levels of behavioral risk of substance abuse exist, the highest having trajectories of increased aggressive and inattentive/hyperactive problems throughout childhood, the next involving only an increased inattentive/hyperactive behavioral trajectory, and the lowest involving those with neither type of problem. Children with both inattention/hyperactivity and aggression have the greatest need for childhood intervention to prevent substance abuse in adolescence.     

Parenting,self-concept,and attitudes about romantic relationships

IntroductionThis study examined associations among the perceived parenting, self-concept, and adolescent attitudes of Chinese adolescents regarding romantic relationships.MethodsA survey of 729 high school students in Macau was carried out to collect information on the degree to which they perceived their fathers and mothers as demanding or responsive, their general self-concept, and their attitudes about romantic relationships.ResultsStructural equation modeling showed that maternal and paternal responsiveness positively associated with adolescents’ self-concept, which then positively contributed to their attitudes about romantic relationships. Maternal demandingness could link directly to positive adolescent attitudes about romantic relationships and indirectly to negative self-concept.ConclusionsThe present study's findings suggest that perceived maternal parenting may be more important than perceived paternal parenting regarding adolescents' romantic attitudes, and parental responsiveness is particularly critical to positive self-concept and positive romantic attitudes in Chinese culture.     

Alcohol Use and Associated Environmental Factors Among Middle and High School Students in Sfax (Tunisia)

Our objective was to investigate the prevalence and the environmental determinants of alcohol use among students in the region of Sfax in Tunisia. We carried out a cross-sectional study among 315 middle and high school students. We used the Alcohol Use Disorders Identification Test (AUDIT) to identify risky alcohol consumption, and we used the Parenting Styles and Dimensions Questionnaire (PSDQ) to assess the students’ perceptions of their parents’ parenting styles. The results show that 19.7% reported drinking alcohol at least once in their lifetime. Among them, 21% scored as dependent alcohol users, according to the AUDIT. Those who drank alcohol at least once were more likely to have parents with a permissive parenting style (p < 0.001; Cramer’s V = 0.287), and a father (p < 0.001; Cramer’s V = 0.258), a mother (p = 0.025; Cramer’s V = 0.158), or a friend (p < 0.001; Cramer’s V = 0.341) who drinks. Students perceiving their parents’ parenting style as permissive had the highest AUDIT score (p = 0.005; partial η² = 0.132). The authoritarian style score was significantly higher for students who were current alcohol users (p = 0.028; Cohen’s d = 0.57). Our study highlights the influence of peers, family drinking, and parenting styles on alcohol use among middle and high school students. Therefore, particular attention should be given to students that are at risk of having the abovementioned environmental determinants of alcohol use. And, prevention strategies should involve parents, as well as enhanced guidance and counseling for these students.

     

Understanding perceptions underlying the self-reported stress among parents of adolescents with autism spectrum disorder: Considerations for supporting families

BackgroundParents raising adolescents with autism spectrum disorder (ASD) often report higher stress than other parents. The influence of parents’ internal, or cognitive, experiences (i.e., their own perceptions) on this elevated stress has yet to be explored. Addressing this gap may reveal opportunities for enhancing support for families by elucidating malleable targets for reducing parents’ self-reported stress and/or informing family-focused intervention. The Double ABCX Model of Family Adaptation is a framework for understanding how perceptions, social support, and personal resources (i.e., coping) may affect stress.MethodsWe examined parents’ perceptions about ASD, perceived support, and coping among 214 parents of adolescents with ASD. Regression analyses were used to explore whether these factors were associated with parenting stress among those raising adolescents with ASD. Moderation effects of positive coping on the relationship between parent perceptions and parenting stress were also explored.ResultsParent perceptions about within family support, the extent of ASD symptom predictability, and treatment being able to ‘control’ ASD were related to parenting stress. However, positive coping did not moderate the relationship between these perceptions and parenting stress.ConclusionsStudy findings emphasize significant associations between specific parental perceptions and the self-reported stress among families of adolescents with ASD. Particularly important to parenting stress were how much parents’ perceived adequate support within the family, that treatment was useful for controlling their adolescent’s ASD, and that their adolescent’s symptoms were predictable. These findings suggest that the way parents think about their adolescents’ ASD and the adequacy of the support within their own families are associated with parenting stress, and therefore may serve as treatment targets for positively affecting whole family outcomes, as well as foundations for additional research.     

Tobacco and alcohol use among adolescents in South Africa: shared and unshared risks

Objective: Tobacco and alcohol use by adolescents are major public health concerns in South Africa. However, the extent to which key psychosocial risk factors for tobacco use and alcohol use by adolescents in South Africa are shared or unshared is unclear. This study sought to examine the shared and unshared risk factors for tobacco and alcohol use among adolescents in Johannesburg.

Method: Participants comprised 736 males and females aged 12–17 years who were recruited via a household survey conducted during 2004. The participants were interviewed using a questionnaire comprising measures of personal, family (parental bonding and family legal drug use) and contextual (school and neighbourhood) factors. Separate multiple logistic regression analyses were conducted to predict lifetime alcohol use and lifetime tobacco use from variables within each domain (personal, family and contextual), controlling for demographic factors.

Results: Personal, family (parental bonding) and contextual factors (school factors) were primarily shared risk factors for tobacco and alcohol use, while family legal drug use and neighbourhood factors were largely unshared.

Conclusions: Interventions addressing personal, parenting and schooling factors are likely to have an impact on preventing both tobacco and alcohol use, whereas interventions focused on ameliorating family drug use and neighbourhood factors may need to be more substance-specific.     

The association between parental attributions of misbehavior and parenting practices in caregivers raising children with prenatal alcohol exposure: A mixed-methods study

Background and aimsLimited research has focused on parenting practices used by caregivers raising children with fetal alcohol spectrum disorders (FASD). The current study hypothesized that parental attributions of children’s misbehavior would relate to the parenting strategies caregivers utilize with children with FASD. This study also aimed to develop a coding scheme to allow quantification of these treatment-relevant constructs in future intervention trials.MethodsThirty-one caregivers of children with FASD (age 4–8) were interviewed with the Parenting Practices Interview (PPI), a study-developed qualitative interview. Quantitative measures of FASD knowledge, parenting sense of competence and stress, and child behavior problems were included. Mixed-method analyses assessed the relationship between parental attributions of misbehavior and parenting practices.ResultsCaregivers who attributed their child’s misbehavior to underlying neurodevelopmental disabilities were more likely to use antecedent strategies and feel more confident in managing their child’s behavior. Parents who attributed their child’s misbehavior to willful disobedience were more likely to rely on consequence strategies and feel more ineffective.ConclusionsResults are consistent with theoretical models for FASD parent training interventions. Assessment of theorized mechanisms of change in intervention trials is needed; the development of the PPI and quantitative coding system will facilitate this type of research.     

Theory-driven development of a mobile phone supported intervention for adolescents with perinatal depression

Purpose

This paper describes the design of a theory-informed pragmatic intervention for adolescent perinatal depression in primary care in Nigeria.

Methods

We conducted Focus Group Discussions (FGDs) among 17 adolescent mothers and 25 maternal health care providers with experience in the receipt and provision of care for perinatal depression. The Consolidated Framework for Implementation Research (CFIR) was used to systematically examine the barriers and facilitators affecting adolescent mothers' use of an existing intervention package for depression. The Theoretical Domain Framework (TDF) and the Capability, Opportunity, Motivation, Behaviour (COM-B) model were used to analyze the results of the data across the five CFIR domains.

Results

FGD analysis revealed that care providers lacked knowledge on approaches to engage young mothers in treatment. Young mothers had poor treatment engagement, low social support, and little interest in parenting. A main characteristic of the newly designed intervention is the inclusion of age-appropriate psychoeducation supported with weekly mobile phone calls, to address treatment engagement and parenting behaviours of young mothers. Also in the outer setting, low social support from relatives was addressed with education, “as need arises” phone calls, and the involvement of "neighborhood mothers”. In the inner settings, care providers’ behaviour is addressed with training to increase their capacity to engage young mothers in treatment.

Conclusion

A theory-based approach helped develop an age-appropriate intervention package targeting depression and parenting skills deficit among perinatal adolescents in primary maternal care and in which a pragmatic use of mobile phone was key.

     

Perceived parental sacrifice,filial piety and hopelessness among Chinese adolescents: A cross-lagged panel study

IntroductionThere is a dearth of research on examining the longitudinal effects of cultural family processes on adolescent hopelessness, and the mechanisms through which the effects happen. Hence, the present study examined the relationship among parental (paternal and maternal) sacrifices, filial piety and adolescent hopelessness in the Chinese context.MethodsThe study was based on a three-wave longitudinal data from a sample of 1569 Chinese adolescents (Time 1: mean age = 13.15 ± .92 years; 50.8% girls). The adolescents were invited to fill out a questionnaire containing measurements of studied variables thrice, at an interval of one year.ResultsThe results of cross-lagged panel analysis indicated that maternal sacrifice was associated with filial piety, which in turn was linked with hopelessness among Chinese adolescents. Moreover, there was bidirectional effects of adolescent hopelessness at earlier time point on paternal and maternal sacrifice at later time point via filial piety.ConclusionsThe study showed that maternal sacrifice serves as a protective factor that reduces adolescents’ sense of hopelessness via the development of filial piety. At the same time, the bidirectional indirect effects of filial piety on the relationship between parental sacrifice and adolescent hopelessness also alert family researchers and youth practitioners on the child effects on parental behavior in Chinese families. Theoretical and practical implications of the findings are discussed.