Alcohol Use in Adolescent Twins and Affiliation with Substance Using Peers

Affiliation with substance using peers is one of the strongest predictors of adolescent alcohol use. This association is typically interpreted causally: peers who drink incite their friends to drink. This association may be complicated by uncontrolled genetic and environmental confounds because teens with familial predispositions for adolescent substance use may be more likely to select into social networks where drinking is common. We test this alternative hypothesis using a sample of 1,820 twin and sibling pairs, and their same-sex best friends, from three waves of the National Longitudinal Study of Adolescent Health. Across all three waves, peer report of substance use did not influence adolescent alcohol use when genetic and shared environmental predispositions for drinking were considered. The association between alcohol use and peer behavior may be a spurious association attributable to a shared genetic liability to drink alcohol and associate with peers who drink alcohol.     

Violent offenses associated with co‐occurring substance use and mental health problems: Evidence from CJDATS

The present study examines the relationship between substance use, mental health problems, and violence in a sample of offenders released from prison and referred to substance abuse treatment programs. Data from 34 sites (n = 1,349) in a federally funded cooperative, the Criminal Justice Drug Abuse Treatment Studies (CJDATS), were analyzed. Among parolees referred to substance abuse treatment, self‐reports for the six‐month period before the arrest resulting in their incarceration revealed frequent problems with both substance use and mental health. For most offenders with substance use problems, the quantity of alcohol consumed and the frequency of drug use were associated with a greater probability of self‐reported violence. Mental health problems were not indicative of increases in violent behavior, with the exception of antisocial personality problems, which were associated with violence. The paper emphasizes the importance of providing substance abuse treatment in relation to violent behavior among offenders with mental health problems being discharged to the community. Copyright © 2009 John Wiley & Sons, Ltd.     

Risk as a Moderator of the Effects of Prevention Programs for Children from Divorced Families: A Six-Year Longitudinal Study

Program by risk interactions were assessed to evaluate whether the long-term effects of two preventive interventions for children from divorced families were moderated by baseline levels of risk. Six-year prospective relations between childhood (ages 9-12) and adolescence (ages 15-19) were examined in 68 children who comprised the control group of a randomized trial. Analyses indicated that two childhood variables predicted multiple adolescent outcomes: environmental stressors and externalizing problems. A risk index composed of these 2 variables was highly predictive of internalizing and externalizing problems, competence, substance use, and mental disorder 6 years later. Analyses of the full sample (N = 218) indicated that program effects were greater for children with higher risk scores and that the programs attenuated the relation between risk and adolescent internalizing and externalizing problems, competence, and mental disorder.     

A genetically informed study of marital instability and its association with offspring psychopathology

Parental divorce is associated with a number of emotional and behavioral problems in young-adult offspring, but theoretical and empirical considerations suggest that the relation may be partially or fully accounted for by passive gene-environment correlation or environmental selection characteristics. The current study used the Children of Twins Design to explore whether shared environmental or genetic factors confound the relationship between parental marital instability and measures of psychopathology. Comparisons of the offspring of adult twins in Australia on 3 factors of abnormal behavior, including drug and alcohol, behavioral, and internalizing problems, suggest that environmental influences associated with divorce account for the higher rates of psychopathology. The results are consistent with a causal connection between marital instability and psychopathology in young-adult offspring.     

Substance use and violent behavior in adolescence

The relation between substance use and violent behavior in adolescence is reviewed, and each of five competing models of this relation is examined. I begin by presenting background material on adolescent substance use and adolescent violence. I then describe five different models that have been proposed to explain the association between substance use and violent behavior. Next, I review the adolescent literature concerning substance use and violence, noting methodological weaknesses that have plagued this research. I conclude with an evaluation of the five models and suggestions for future research.     

Prospective Associations of Internalizing and Externalizing Problems and Their Co-Occurrence with Early Adolescent Substance Use

The literature is equivocal regarding the role of internalizing problems in the etiology of adolescent substance use. In this study, we examined the association of internalizing and externalizing behavior problems and their co-occurrence with early adolescent substance use to help clarify whether internalizing problems operate as a risk or protective factor. A large community sample (N?=?387; mean age at the first assessment 12 years old; 83 % White/non-Hispanic) was assessed annually for 3 years. Externalizing problem behavior in the absence of internalizing problems showed the strongest prospective association with alcohol, cigarette, and marijuana use. A weaker, albeit statistically significant prospective positive association was found between co-occurring internalizing and externalizing behavior problems and substance use. Internalizing problems in the absence of externalizing problems protected adolescents against cigarette and marijuana use. Clarifying the role of internalizing problems in the etiology of adolescent substance use can inform the development of early intervention and prevention efforts. Our results highlight the importance of further considering the co-occurrence of internalizing and externalizing behavior problems in developmental pathways to substance use.     

Well-being and Need for Support of Adolescents with a Chronically Ill Family Member

This study investigates whether there are differences in the well-being, need for help and use of support services between adolescents with and without a chronically ill or disabled family member. It also examines the role played by the type of illness, the relationship to the family member and the nature and intensity of the help provided by the adolescent. A Dutch sample of 1581 adolescents (average age 14.6?years) completed a questionnaire in 2010 about mental health problems, pro-social behavior, need for and use of support and the illness of family members and any care tasks performed by the respondent. Young people with a sick family member had more mental health problems than their counterparts without a chronically ill family member. They also reported a greater need for and use of help and support. Performing domestic tasks was found to be a predictor for overall mental health problems. The intensity of the help given was related to the need for help by the adolescent. It is concluded that growing up with a chronically ill family member and spending a lot time performing (domestic) tasks are risk factors for adolescent mental health problems and adolescents’ need for help. Special attention is warranted for those who need support but who do not translate that need into reality by seeking help.     

The impact of mental health problems and religiosity on African-American girls' HIV-risk

We investigated the relationship between religiosity, mental health problems, and two sexual risk behaviors-condom use and number of partners. Participants were 80 sexually active African American girls in psychiatric care and their caregivers. Results indicated differential relationships, depending on parent versus youth report. Mother's religiosity was positively related to girls' condom use and not to girls' number of partners. Controlling for other predictors in the models, mother's religiosity explained as much as 15% of the variance in girls' condom use. Whereas parent and adolescent reports of girls' depression/anxiety and rule-breaking were positively associated with number of partners, reports of aggression were associated with having fewer partners. Neither parent nor youth reports of girls' mental health problems were associated with condom use. Controlling for other predictors in the models, girls' mental health problems accounted for as much as 31% of the variance in number of partners. Findings underscore the importance of adopting an ecological framework to understand both the risk and promotive factors for sexual risk taking among troubled girls. The roles of specific aspects of psychopathology and religiosity in relation to sexual risk behavior among African American girls in psychiatric care are discussed.     

The Relation Between Parental Mental Illness and Adolescent Mental Health: The Role of Family Factors

Children of parents with a mental illness are often found to be at high risk of developing psychological problems themselves. Little is known about the role of family factors in the relation between parental and adolescent mental health. The current study focused on parent–child interaction and family environment. This cross-sectional questionnaire study included 124 families with a mentally ill parent and 127 families without a mentally ill parent who at the time of the study had children aged 11–16 years old. Parents completed questionnaires about their mental health, parent–child interaction (i.e., parental monitoring and parental support), and family environment (i.e., cohesion, expressiveness, and conflict). Adolescents reported their internalizing and externalizing problems. Path analyses were used to examine the direct associations between parental mental illness and adolescent problems as well as the indirect relations via parent–child interaction and family environment. The results showed that interaction between parents with a mental illness and their child was significantly worse compared to parents without a mental illness. The family environment of parents with mental illness was also more negative. Mentally ill parents monitored their adolescents less, which in turn related to more externalizing problems of the adolescents. No factors mediated the relation between parental mental health and adolescent internalizing problems. Moreover, no direct effects of parental support, family cohesion, and family expressiveness with externalizing problems were found. These findings imply that parental monitoring should get a specific focus of attention in existing interventions designed to prevent adolescents with a mentally ill parent from developing problems.     

The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication

Parents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11?h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.     

Risk Reduction Therapy for Adolescents: Targeting Substance Use and HIV/STI-Risk Behaviors

This paper describes a family-based intervention for addressing both substance use and unprotected sexual behavior in adolescents presenting for outpatient substance use treatment. The intervention combines contingency management (CM) for adolescent substance use, which is a behavioral intervention modeled on the Community Reinforcement Approach, with a sexual risk reduction protocol that mirrors aspects of the CM model. As a family-based intervention, caregivers attend every session and actively collaborate with the therapist to address their youth’s behavior problems. The treatment is criterion-based with treatment duration determined by the youth’s achievement of reduced substance use and unprotected sexual behavior goals. A case study describes the implementation of this treatment with an adolescent presenting a history of polysubstance use and unprotected sexual intercourse. Following the adolescent and caregiver’s participation in weekly sessions, the adolescent demonstrated improvements in substance use, unprotected sexual behavior, and other behavior problems. Clinical summary data from two outpatient clinics reveal similar positive outcomes for youth receiving the intervention. This paper illustrates the potential utility of an integrated treatment approach targeting substance use and unprotected sexual behavior in an adolescent population.     

Mechanisms of change in adolescent life satisfaction: A longitudinal analysis

This study explored the psychosocial mechanisms of change associated with differences in levels and linear change of adolescents' global life satisfaction across a 2-year time period. Based on a theoretical model proposed by Evans (1994), this study tested the relations between selected personality (i.e., extraversion and neuroticism) and environmental (stressful life events) variables and global life satisfaction when mediated by internalizing and externalizing problems. The results suggested support for internalizing problems as a mediator of the relationship of personality and environmental variables with life satisfaction. Pathways mediated by internalizing problems significantly predicted levels and linear change of life satisfaction across a 2-year time span. Furthermore, pathways mediated by externalizing problems significantly predicted the level but not the linear change of life satisfaction. Thus, behavior problems and their antecedents appear to relate significantly to adolescents' perceptions of their quality of life. Implications for adolescent mental health promotion were discussed.     

Affective and Autonomic Reactivity During Parent–Child Interactions in Depressed and Non-Depressed Mothers and Their Adolescent Offspring

Depression presents risks that are profound and intergenerational, yet research on the association of depression with the physiological processes that might be associated with impaired mental and physical health has only recently been contextualized within the family environment. Participants in this multi-method case–control study were 180 mother-adolescent dyads (50% mothers with a history of depression treatment and current depressive symptoms). In order to examine the association between maternal depression and affective and autonomic reactivity amongst these mothers and their adolescent offspring we collected self-reported measures of positive and negative affect, as well as measures of cardiovascular and electrodermal autonomic activity, during mother-adolescent interaction tasks. Findings indicated that depressed mothers and their adolescent offspring exhibited greater self-reported negative affect reactivity during a problem-solving interaction and blunted (i.e., low) sympathetic activity as measured via skin conductance level across both interaction tasks. These effects remained significant after controlling for a range of potential covariates, including medication use, sex, age, adolescents own mental health symptoms, and behavior of the other interactant, along with correcting for multiple comparisons. Findings indicate that depressed mothers and their adolescent offspring both exhibit patterns of affect and physiology during interactions that are different from those of non-depressed mothers and their offspring, including increased negative affect reactivity during negative interactions and blunted sympathetic activity across both positive and negative interactions. These findings have potential implications for understanding the role of family processes in the intergenerational transmission of risk for depressive disorders.

     

Neighborhood deprivation affects children's mental health: environmental risks identified in a genetic design

The possibility that neighborhood conditions affect children's development has captured much attention because of its implications for prevention. But does growing up in deprived neighborhoods matter above and beyond a genetic liability to behavior problems, if genetically vulnerable families tend to concentrate in poor neighborhoods? A nationwide study of 2-year-old twins shows that children in deprived neighborhoods were at increased risk for emotional and behavioral problems over and above any genetic liability. Environmental factors shared by members of a family accounted for 20% of the population variation in children's behavior problems, and neighborhood deprivation accounted for 5% of this family-wide environmental effect. The results suggest that the link between poor neighborhoods and children's mental health may be a true environmental effect, and demonstrate that genetic designs are environmentally informative and can be used to identify modifiable risk factors for promoting child health.     

Adolescent socialization and use of licit and illicit substances: Impact on adult health

Abstract

This study examined the impact of adolescent substance use on young adult health. Longitudinal data from 825 participants were assessed when the participants were junior high school and high school students (1969-1973) and again in 1981. Latent variable models were used to determine what effect adolescent drug use had on later health. General substance use, which included tobacco, alcohol, stimulants, sedatives, and other hard drugs, had a small effect on adult health problems associated with substance use, and also predicted accidents related to substance use. In addition, the specific use of tobacco and cannabis in adolescence predicted later respiratory problems, while cigarette smoking during adolescence also predicted decreased physical hardiness. Lower adolescent socialization predicted post high school accidents (automobile and other) serious enough to require medical attention, and predicted increased psychosomatic and seizure symptoms, as well as general psychiatric distress. Implications of these results for the successful prevention or intervention of drug use are discussed. In addition to these results, gender differences are also examined.     

A genetically informed study of the processes underlying the association between parental marital instability and offspring adjustment

Parental divorce is associated with problematic offspring adjustment, but the relation may be due to shared genetic or environmental factors. One way to test for these confounds is to study offspring of twins discordant for divorce. The current analyses used this design to separate the mechanisms responsible for the association between parental divorce, experienced either before or after the age of 16, and offspring well-being. The results were consistent with a causal role of divorce in earlier initiation of sexual intercourse and emotional difficulties, in addition to a greater probability of educational problems, depressed mood, and suicidal ideation. In contrast, the increased risk for cohabitation and earlier initiation of drug use was explained by selection factors, including genetic confounds. ((c) 2006 APA, all rights reserved).     

遗传、环境和青少年的吸烟饮酒行为：芬兰双生子研究的回溯与前瞻

本文介绍的两个“芬兰双生子（Finn Twin）”研究是对10个出生组的青少年双生子及其家庭的长期跟踪研究。本文概述了这两个项目对遗传与环境的关联和互动对吸烟饮酒行为影响的研究。这些研究的结果提示个体差异对吸烟饮酒行为的长期变动的影响受到兄弟姐妹互动、同伴互动以及父母教养方式的调节。环境对吸烟饮酒的影响主要表现在学校、居住社区与家庭环境的差异上。环境与遗传影响的程度和持久度有城乡差异。遗传的影响受居住社区的制约。多阶段模型的分析揭示了遗传与环境的互动对这些行为的演变（从试吸试饮到发展到滥用）的动态的影响,遗传似乎对吸烟饮酒的共同轨迹更有影响。这些结果对今后本项目对这约1万对芬兰成年双生子的分子遗传学研究提供了有益的线索     

Psychological Model of Military Aggressive Behavior: Findings From Population-Based Surveys

The U.S. military has expressed concern about the influence of deployment and combat exposure on the criminal behavior of personnel returning from Iraq and Afghanistan. This study examines the role of behavioral health risk and protective factors associated with combat exposure and criminal and aggressive behavior in active duty Army and Naval personnel. Data from this cross-sectional study are based on two large anonymous, population-based health-related behavior surveys. Findings show that the proportion of all active duty Army and Naval service personnel who reported encounters with law enforcement or committed one or more aggressive acts in the past year increased from 19.41% in 2005 to 22.58% in 2008. Substance use, especially illicit drug use, and mental health problems were significant correlates of criminal and aggressive behavior, as were younger age, male sex, high impulsivity, and work/family stress. Path modeling suggested that several variables, notably combat exposure and history of childhood abuse, appeared to manifest their influence on criminal or aggressive behavior through increases in substance use and mental health problems. The potential mediating influence of substance use and mental health on combat and other trauma experiences has significant implications for preventing criminal and aggressive behavior among U.S. active duty military personnel.     

Prevalence and correlates of substance use among school children in six African countries

An increasing trend of noncommunicable diseases is a worldwide phenomenon, also including the developing countries. Few studies focus on adolescents' substance use in relation to mental distress and protective factors in African countries. The purpose of this study was to assess the prevalence and correlates (mental distress and protective factors) of substance use among school-going adolescents in six African countries. The sample included 20,765 students aged from 13 to 15 years from six African countries (Kenya, Namibia, Swaziland, Uganda, Zambia, Zimbabwe), chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The measure used was part of the Global School-Based Health Survey (GSHS) questionnaire, including various domains of health behaviour. Results indicate a prevalence of 12.6% tobacco use (past month), 6.6% risky alcohol use (two or more per day for at least 20 days or more in the past month), and 10.5% of illicit drug use (three or more times ever) in school-going adolescents in six African countries. School truancy, loneliness, sleeping problems, sadness, suicidal ideation, suicide plans, and poverty were associated with substance use (tobacco, alcohol, illicit drugs), while school attendance and parental supervision and connectedness were protective factors for substance use, and peer support protective for tobacco use. It is concluded that tobacco use, risky drinking and illicit drug use were common, clustered together and were associated with school truancy, mental distress, and lack of parental and peer support among adolescent African school children. These findings stress the need for early and integrated prevention programmes.