Acculturation and perceived discrimination: Predictors of substance use trajectories from adolescence to emerging adulthood among Hispanics

Purpose

Previous studies have documented associations between cultural factors and substance use among Hispanic adolescents. Negative cultural experiences such as discrimination have been associated with an increased risk of substance use among Hispanic adolescents, whereas positive cultural resources, such as maintenance of Hispanic cultural orientations, have shown protective effects. However, few studies have examined the continuing influence of cultural factors on substance use from adolescence to emerging adulthood.

Methods

We surveyed a cohort of Hispanic adolescents in Southern California in 9th, 10th, and 11th grades, and 3–4 years after high school. Growth curve analyses were conducted to examine the effects of U.S. acculturation, Hispanic acculturation, ethnic identity, and perceived discrimination on change in tobacco, alcohol, and marijuana use over time.

Results

Higher perceived discrimination at baseline was significantly associated with a higher intercept (initial level) of tobacco, alcohol, and marijuana use. Higher initial level of Hispanic acculturation was significantly associated with a lower slope of tobacco, alcohol, and marijuana use.

Conclusions

Cultural phenomena such as acculturation and perceived discrimination can continue to affect substance use through the transition to emerging adulthood. Health education interventions are needed to help Hispanics navigate this developmental transition without engaging in substance use.     

Surveying the Literature on Acculturation and Alcohol Use among Hispanic College Students: We're Not All on the Same Page

During the past several years, a steadily growing body of literature examining acculturation and alcohol use among Hispanic college students has emerged. A review of this literature suggests that there have been (and continues to be) mixed findings regarding the association between acculturation and alcohol use in this population. Thus, the exact nature of this association is not clear. This paper provides an overview of this literature and outlines recommendations for future research that will help to elucidate the complexities inherent in this line of work.     

Alcohol Use Severity Among Adult Hispanic Immigrants: Examining the Roles of Family Cohesion,Social Support,and Gender

Background: This study examined (a) the direct association of family cohesion on alcohol use severity among adult Hispanic immigrants; (b) the indirect association of family cohesion on alcohol use severity via social support; and (c) if gender moderates the direct and indirect associations between family cohesion and alcohol use severity. Method: Mediation and moderation analyses were conducted on a cross-sectional sample of 411 (men = 222, women = 189) participants from Miami-Dade, Florida. Results: Findings indicate that higher family cohesion was directly associated with higher social support and lower alcohol use severity. Higher social support was also directly associated with lower alcohol use severity. Additionally, family cohesion had an indirect association with alcohol use severity via social support. Moderation analyses indicated that gender moderated the direct association between family cohesion and alcohol use severity, but did not moderate the indirect association. Conclusions: Some potential clinical implications may be that strengthening family cohesion may enhance levels of social support, and in turn, lower alcohol use severity among adult Hispanic immigrants. Furthermore, strengthening family cohesion may be especially beneficial to men in efforts to lower levels of alcohol use severity.     

College-Related Alcohol Beliefs and Problematic Alcohol Consumption: Alcohol Protective Behavioral Strategies as a Mediator

Background: College-related alcohol beliefs, or beliefs that drinking alcohol is central to the college experience, have been shown to robustly predict alcohol-related outcomes among college students. Given the strength of these associations, it is imperative to understand more proximal factors (i.e., closer in a causal chain leading to alcohol-related outcomes) that can explain these associations. Objectives: The current research examined alcohol protective behavioral strategies (PBS) as a potential mediator of the association between college-related alcohol beliefs and alcohol outcomes among college student drinkers. Method: Participants were undergraduate students from a large southeastern university (Sample 1; n = 561) and a large southwestern university (Sample 2; n = 563) in the United States that consumed alcohol at least once in the previous month. Results: Path analysis was conducted examining the concurrent associations between college-related alcohol beliefs, PBS use (both as a single facet and multidimensionally), alcohol consumption, and alcohol-related consequences (i.e., double mediation). In both samples, there was a significant double-mediated association that suggested that higher college-related alcohol beliefs is associated with lower PBS use (single facet), which is associated with higher alcohol consumption and alcohol-related consequences. Multidimensionally, only one double-mediation effect (in Sample 2 only) was significant (i.e., college-related alcohol beliefs → manner of drinking PBS → alcohol consumption → alcohol-related consequences). Conclusions/Importance: These results suggest that targeting these college-related alcohol beliefs as well as PBS use are promising targets for college alcohol interventions. Limitations and future directions are discussed.     

Attitudes of College Students in a Predominately Hispanic University Regarding Alcohol Use

ABSTRACT

The focus of this particular study is to determine the drinking-related attitudes of college students in a predominantly Hispanic university, and to determine if there are ethnic and gender-related differences in two areas: acceptable levels of consumption; and situational alcohol use. Study findings reflect the need to insure that substance abuse initiatives, planning, informational and counseling programs for students take into account the cultural implications associated with alcohol use as well as acculturation issues.     

Alcohol expectancies,protective behavioral strategies,and alcohol-related outcomes: A moderated mediation study

Aims: The influence of alcohol expectancies on alcohol consumption and the negative consequences of alcohol consumption among college students has been well documented. Protective behavioral strategies are associated with decreases in alcohol use and related consequences. This study examined the extent to which the use of protective behavioral strategies mediated the influence that alcohol expectancies had for alcohol consumption and negative alcohol-related consequences.

Methods: Measures of expectancies about alcohol consumption, protective behavioral strategies used when consuming alcohol, amount of alcohol consumed and negative consequences associated with alcohol use were completed by 679 traditional age undergraduate students via a secure website. A moderated mediation data analytic strategy was employed because of the gender differences that have been observed for alcohol expectancies, consumption, and consequences.

Findings: The use of protective behavioral strategies was found to mediate the associations that positive expectancies had with both the amount of alcohol consumed and the negative consequences of alcohol consumption only for women.

Conclusions: Education and harm reduction efforts for college student drinkers, including expectancy challenge initiatives, would benefit from including information about use of protective behavioral strategies.     

Psychiatric Symptoms,Parental Attachment,and Reasons for Use as Correlates of Heavy Substance Use Among Treatment-Seeking Hispanic Adolescents

In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents. Methods: This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14–17 years old (N = 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents. Results: Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use. Conclusion: These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use.     

Enrollment in Hispanic Serving Institutions as a Moderator of the Relationship Between Drinking Norms and Quantity of Alcohol Use Among Hispanic College Students

Background: Hispanic college students represent a growing proportion of the college population. Studies have found that an individual's perception of the drinking of others is linked to one's own personal use and that college students frequently overestimate the drinking of their peers. The current study builds on previous college student drinking literature by examining the influence that attending a Hispanic-serving institution (HSI) has on the personal alcohol use and perception of peers’ drinking norms among Hispanic college students. Methods: This secondary data analysis utilized data from the American College Health Association's National College Health Assessment. Participants were self-identified Hispanics between the ages of 18 and 25 (N = 4336). Results: Results indicated that there was a significant interaction between attending an HSI and the perception of the number of drinks of a typical student. Specifically, the perception of others’ drinking was more strongly linked to personal drinking for students in non-Hispanic serving institutions. Conclusions: The protective effect of attending a Hispanic-serving institution may be related to a more culturally affirming college environment.     

Gender Differences in Alcohol and Drug Use Among Hispanic Adults: The Influence of Family Processes and Acculturation

We examines the influence of family processes and acculturation for gender differences in alcohol and drug use among a sample representative of the Hispanic population in Miami-Dade County, Florida (N = 734). We found that (a) increases in age at marriage and acculturation were associated with greater substance use, (b) the associations between age at marriage, acculturation, and substance use were found to be greater for Hispanic women than men, and (c) with each additional child born, Hispanic women are increasingly less likely to use substances than Hispanic men. Data reveal that family processes and acculturation jointly impact substance use.     

Daily Reports of Positive and Negative Affect and Alcohol and Marijuana Use Among College Student and Nonstudent Young Adults

Background: Daily affect and substance use covary among college students, but little is known about these associations among young adults not in college. Objectives: The current pilot study examines associations between positive and negative affect and alcohol and marijuana use, with a focus on differences between college student and nonstudent young adults. Methods: High school seniors completed a baseline survey during the spring of 2012 and were then randomly selected to participate in an intensive measurement follow-up. Participants in the follow-up (N = 72, 40.3% men, 77.8% White, 66.7% full-time college students) completed up to 14 consecutive web-based daily surveys during the fall after high school completion. Multilevel models in which days (Level 1) were nested in persons (Level 2) were estimated. Results: Weekend days were associated with increased alcohol use among all young adults, increased marijuana use among college students, and decreased marijuana use among nonstudents. For young adults not in college, greater daily positive affect was associated with increased likelihood of binge drinking, consuming a greater number of drinks, and lower odds of marijuana use; greater daily negative affect was associated with lower odds of alcohol use and lower odds of binge drinking for non-students. For college students, greater daily negative affect was associated with lower odds of marijuana use. Conclusions/Importance: Daily affect and alcohol and marijuana use covary among young adults, though these associations differ between students and non-students. Results highlight the need to examine predictors of alcohol and marijuana use among young adults who do not attend college.     

Simultaneous Use of Alcohol and Marijuana: Patterns and Individual Differences

Background: Simultaneous alcohol and marijuana (SAM) use, or using alcohol and marijuana in such a way that their effects overlap, is associated with negative health and behavioral outcomes. Objectives: Our study sought to fill gaps in our knowledge on this emerging public health concern by comparing SAM users and alcohol-only users on individual-level factors and substance use outcomes as well as examining associations of SAM use frequency, within users. Methods: Participants were recruited through online postings. Our analytic sample consisted of 1017 young adults (18–25?years) who reported past-month alcohol use. Most were male (67.8%), Caucasian (71.5%), and had attended at least some college (74.8%). Results: Past-year SAM users reported higher levels of sensation seeking and greater perceptions of their close friends’ drinking behavior in comparison to alcohol-only users. SAM users reported heavier and more frequent alcohol use than alcohol-only users. Within past-year SAM users, 70% reported SAM use at least weekly. More frequent SAM use was associated with all alcohol use outcomes (e.g., weekly quantity, frequency, alcohol-related problems) and marijuana use outcomes (e.g., quantity, frequency, peak use) and higher drinking norms. Conclusions/Importance: It is clear that SAM users are a vulnerable sub-population of young adult drinkers. SAM users are differentiated from alcohol-only users in terms of their personality characteristics and perceptions of peer groups’ drinking. SAM users and more frequent users are also at heightened risk for substance use outcomes. Prevention and intervention efforts targeting high-risk drinking may benefit from also assessing whether they simultaneously use alcohol and marijuana.     

Use of Alcohol Protective Behavioral Strategies as a Moderator of the Alcohol Use–Consequences Relationship: Evidence from Multiple Replications

Background: The use of protective behavioral strategies (PBS) has been found to attenuate the relationship between alcohol use and related consequences. Objectives: The current study examined PBS use as a moderator of the association between alcohol use and consequences in multiple samples (N?= 9) of college students with different sample sizes (e.g., ns 125–736). We also examined sex as a moderator of the PBS moderation analyses. Across all samples, we predicted that the use of more PBS would attenuate the use–consequences relation. Methods: In total, 3,524 college students completed online measures of alcohol use, consequences, and PBS use (i.e., PBSS) across two sites. Conclusions/importance: In the analyses, 3 two-way interactions were consistent with the literature (i.e., use–consequences relation weakest among those with high PBS use), 6 were opposite of what was reported in the literature (i.e., use–consequences relation strongest among those with high PBS use), and 39 were not statistically significant. These results corroborate, contradict, and extend the current body of knowledge in the extant alcohol PBS literature. In the examination of three-way interactions in the combined sample, serious harm reduction (SHR) PBS was found to moderate the use–consequences relation among female, but not among male students. Specifically, the use–consequences relation was weakest among female students who used more SHR PBS indicating that SHR PBS may be an important intervention target for female college students. Additional experimental and longitudinal studies are needed to examine the effects of PBS use on the use–consequences relation.     

Moderators of the Effects of Alcohol Protective Behavioral Strategies: Three Attempts of Replication and Extension

Background: Protective behavioral strategies (PBS) can be used to reduce alcohol-related harm when drinking. Despite much research demonstrating that use of protective behavioral strategies (PBS) is associated with decreased alcohol use/problems, few studies have examined moderators of these associations. Moderation tests are important as they define the boundary conditions of the protective effects of PBS use (i.e., identify for whom and in what context PBS use reduces harm). Objectives: We aimed to replicate and extend the findings from three published studies that have examined putative moderators of PBS-alcohol associations: self-regulation, negative urgency, and drinking refusal self-efficacy. Method: Participants were recruited from a psychology department participant pool at a large, southwestern university in the United States (N = 628). Results: Although we replicated most main effects and bivariate correlations, we failed to replicate any of the moderation effects (i.e., interaction effects). Conclusions/Importance: We urge PBS researchers to attempt to replicate moderation effects in independent samples to determine these effects' reproducibility. Limitations and future directions are discussed.     

Alcohol Use,Depressive Symptoms,and Cultural Characteristics in Two Mexican-American Samples

We modeled associations of quantity and frequency of alcohol use with depressive symptoms (negative affect, lack of positive affect, somatic disturbance, interpersonal problems) in two household surveys of Mexican-Americans (Ns = 1,313 and 3,577). Multivariate analyses controlled cultural (immigration, acculturation) and demographic (age, income, household size, marital status, employment status) characteristics, and assessed interactions of these two classes of predictors. Alcohol use was inconsistently related to depression. In some analyses, cultural characteristics accounted for associations of alcohol use with depression. In others, associations of alcohol use with depression depended on cultural characteristics. Associations of drinking with depression tended not to be robust across samples     

The Role of Alcohol Expectancies in the Associations Between Close Friend,Typical College Student,and Personal Alcohol Use

Background Perceptions of peer drinking and alcohol expectancies have been consistently associated with alcohol use among college students. There is evidence that perceived peer drinking also shapes alcohol expectancies. Research has yet to address the potential differential impact of perceived drinking by close friends versus by typical college students on alcohol use among first-semester college students. Relatedly, mediation of these associations by specific domains of alcohol expectancies has yet to be examined. Objectives: The first aim of the present study was to investigate whether perceptions of close friend drinking were more strongly associated with alcohol expectancies, alcohol use, and consequences of alcohol use than perceptions of typical college student drinking. The second aim focused on which alcohol expectancy domains partially accounted for the association between close friend drinking, typical college student drinking, and alcohol use and consequences. Method: Participants (n = 400 first-semester college students) completed survey questionnaires, which included measures of perceived close friend/typical student alcohol use, alcohol expectancies, and drinking behaviors. Results: Results showed that close friend alcohol use was more strongly associated with alcohol use and consequences compared to typical college student use both directly and indirectly through expectancies about alcohol enhancing social behaviors. Conclusions/Importance: These findings suggest that first-semester college student drinking is more influenced by perceived alcohol use among close friends than typical college students. Future intervention efforts for alcohol use on college campuses may benefit from including close friend network components along with targeting alcohol expectancies regarding social behaviors.     

Acculturation and drug use among dually diagnosed Hispanic adolescents

With drug abuse among Hispanic youth on the rise, examining cultural factors such as acculturation may provide insight into understanding and addressing this problem. This study examined the relationship between acculturation and severity of drug use among a sample of severely impaired Hispanic adolescents referred for residential substance abuse treatment. As recent studies with clinical samples have found, it was hypothesized that lower levels of acculturation would be associated with higher levels of substance use. Results indicated that youth born outside the United States reported greater frequency of drug use at intake into treatment than those born in the United States, supporting the hypothesis.     

Depressive Symptoms and Drinking Outcomes: The Mediating Role of Drinking Motives and Protective Behavioral Strategies Among College Students

Background: College students with depressive symptoms tend to engage in more hazardous drinking and experience more alcohol-related consequences to cope with their symptoms. Given the perceived tension reducing effects of alcohol among these students, it is important to explore how protective factors, such as protective behavioral strategies, account for the relationships among depressive symptoms, drinking motives, and alcohol-related outcomes. Objective: To examine the mediating role of drinking motives and protective behavioral strategies on the associations that depressive symptoms have with typical weekly alcohol consumption, hazardous drinking, and alcohol-related negative consequences in a sample of college student drinkers. Methods: Traditional age college students (n = 566, 73% women; 58% White, non-Hispanic) completed measures of depression, drinking motives, protective behavioral strategies, weekly alcohol use, hazardous drinking, and alcohol-related negative consequences. Results: Coping with depression motives and controlled consumption PBS explained the association between depression and weekly alcohol consumption and hazardous drinking whereas coping with depression motives and serious harm reduction PBS explained the depression-negative consequences relationship. Conformity motives and serious harm reduction PBS explained the association between depression and hazardous drinking and alcohol-related negative consequences. Conclusions: Findings suggest that students with more depressive symptoms would benefit from clinical interventions tailored to address negative reinforcement drinking motives and, by extension, increase student utilization of PBS related to minimizing harm. Clinical and research implications are provided.     

Are Dimensions of Parenting Differentially Linked to Substance Use Across Caucasian and Asian American College Students?

Background: Parental warmth and autonomy granting are commonly thought of as protective factors against substance use among Caucasians. However, limited research has examined whether associations between parenting dimensions and substance use outcomes are the same or different among Asian Americans. Method: A final analytic sample of 839 college students was used to test whether race (Caucasian vs. Asian American) moderated the relations between parenting dimensions and substance use outcomes across Caucasians and Asian Americans. We utilized the Parental Bonding Instrument (Parker, Tupling, & Brown, 1979) to measure maternal and paternal warmth, encouragement of behavioral freedom, and denial of psychological autonomy. Results: Multivariate regression models controlling for covariates including age, gender, and paternal education indicated four significant parenting by race interactions on alcohol problems and/or marijuana use. Specifically, maternal warmth was inversely associated with both alcohol problems and marijuana use among Caucasians but not among Asian Americans. Both maternal and paternal denial of psychological autonomy were positively associated with alcohol problems among Caucasians but not among Asian Americans. Conclusions: Consistent with emerging cross-cultural research, the associations between parenting dimensions and substance use behaviors observed in Caucasian populations may not be readily generalized to Asian Americans. These findings highlight the importance of considering different parenting dimensions in understanding substance use etiology among Asian Americans. Future research should use longitudinal data to replicate these findings across development and seek to identify other parenting dimensions that may be more relevant for Asian American youth.     

The Role of Acculturation and Alcohol Problems on Frequency of Cannabis Use Among Latinas at Risk of an Alcohol-Exposed Pregnancy

Background: Along with alcohol, cannabis is one of the most commonly used substances among women of childbearing age. Recent studies indicate detrimental effects of prenatal cannabis use. Because many women use these substances before realizing they are pregnant, these serious health consequences for women and their offspring are of great concern. Despite the recent upsurge in cannabis use, little is known about individual and sociocultural factors that may contribute to risk of a cannabis-exposed pregnancy, particularly among Latinas of child-bearing age also at risk of an alcohol-exposed pregnancy (AEP). Objectives: Examine the relationships of acculturation, alcohol use, alcohol problems, and psychological distress with frequency of cannabis use among adult Latinas at risk of an AEP. Methods: The hypothesized model included 76 Latinas and was analyzed using path analysis. The study used baseline data from a randomized controlled trial of an intervention targeting risky drinking and tobacco use among women at risk of an AEP in primary care clinics. Results: Greater acculturation was associated with more frequent cannabis use and greater psychological distress. There was a positive indirect relationship between acculturation and alcohol use and alcohol problems through psychological distress. Greater alcohol problems were associated with more frequent cannabis use. Greater psychological distress and alcohol use were indirectly related to more frequent cannabis use through alcohol problems. Conclusions: Findings underscore the critical role of acculturation and alcohol-related problems in cannabis use frequency and have relevant implications for preventive efforts addressing cannabis use among Latinas at risk of an AEP.     

Social Influences on College Student Use of Tobacco Products,Alcohol, and Marijuana

Objective: This study investigated associations between the use of alternative tobacco products (e.g., cigarettes, little cigars/cigarillos, hookah, e-cigarettes), alcohol, and marijuana among college students and use by their parents, siblings, and friends. A large literature exists for social influences on adolescent substance use, but few studies have focused on college samples. Participants: 3,418 college students from seven universities in the state of Georgia participated in this study. Methods: Web-based surveys were completed by students (45–60 minutes) during the fall semester, 2014. Results: Findings largely indicated specificity of associations between college student use and use by social influences for similar tobacco products and other substances. For each tobacco product or substance, the highest associations were for friends' use. Structural equation analyses further supported the specificity of associations and highlighted the relative strength of friends' use on student use. Conclusion: Similar to findings with adolescents, the use of alternative tobacco products, alcohol, and marijuana by parents, siblings, and friends is associated with higher levels of use among college students, and friends' use was the most potent correlate for this phase of the lifespan.