A multivariate analysis of adolescents' orientations toward physician use

Health professionals know surprisingly little about the origins of the health beliefs and orientations they often seek to change, and they do not know about when, or if, changes in these orientations are likely to occur. This study is aimed at increasing our understanding of the origins and development of health beliefs and attitudes by focusing on the impact of parents' orientations toward physician utilization (inclination to consult a doctor when experiencing somatic symptoms) on the comparable orientations of their adolescent children. Hypotheses regarding direct parent-adolescent links are examined within a multivariate structural equations model relating demographics, adolescents' interpersonal competencies, and parental variables to adolescents' orientations toward physician utilization. Evidence for the development of these orientations is obtained by comparing influences across two groups of adolescents: 12- to 13-year-olds and 16- to 18-year-olds. Findings indicate that adolescents' orientations toward physician use are associated with those of their parents and that this link is generally stronger and more specific during late adolescence. The model also suggests that these orientations conform to social and cultural variables related to differences in social stratification.     

Parent-child relations and orientations toward sport

Same-sex (mother-daughter, father-son) and cross-sex (mother-son, father-daughter) parent-child relationships were examined with regard to whether these social interactions were differentially related to children's orientations toward sport. “Winning” and “achievement” were defined as traditional male sport orientations while “fair play” and “everyone participates” were viewed as traditional female sport orientations. The theory of parent-child interaction developed suggested that parents as a result of their own sex-role socialization transmit their own sex-value orientations to their same-sex children, but nonsex-linked sport orientations to their cross-sex children. Comparisons were made among 898 male and 800 female adolescents who participated in a nationally sponsored youth sports program. The analysis revealed that mother-son relationships were associated with more traditional female sport orientations in boys; contrary to expectation, father-daughter relationships were also related to stronger female sport orientations in girls. Explanations for why both parents may reinforce traditional sex-linked orientations in their daughters, but not their sons, are discussed.     

Alcohol-specific parenting,adolescent alcohol use and the mediating effect of adolescent alcohol-related cognitions

Objectives : Previous research indicated that alcohol-specific parenting is an important precursor of adolescent alcohol use, but failed to define the underlying mechanism. Based on social cognitive theory, alcohol-related cognitions such as alcohol refusal self-efficacy and alcohol-related expectancies were hypothesised to mediate this link.

Design : A cross-sectional survey included 1349 mothers and their sixth grade (11–12?years old) adolescent offspring. Structural equation modelling was employed to test the association between alcohol-specific parenting and adolescent alcohol use, mediated by adolescent alcohol-related cognitions.

Main outcome measures : Adolescent alcohol use, drinking refusal self-efficacy and alcohol expectancies.

Results : The associations between frequency of communication, maternal alcohol use and adolescent alcohol use were mediated by negative alcohol-related expectancies. The associations between quality of communication, rules and disclosure and adolescent alcohol use were mediated by self-efficacy.

Conclusions : The present study provides a first indication that the underlying mechanism of the association between the most important alcohol-specific parenting practices and adolescent alcohol use can be contributed to the mediating effect of alcohol-refusal self-efficacy.     

Longitudinal associations between adolescent alcohol use and parents' sources of knowledge

The aim of this study was to test the direction of effect in the relationship between parents' sources of knowledge (parental monitoring and child disclosure) and adolescent alcohol use. The participants were 215 adolescents and their mothers, randomly selected from urban and rural areas in Cyprus. A 3‐month, two‐timepoint longitudinal design was used in which adolescents completed the alcohol use disorders identification test while mothers completed a parental knowledge questionnaire. The results of this study showed that parental monitoring did not predict subsequent adolescent alcohol use. However, child disclosure at Time 1 negatively predicted adolescent alcohol use at Time 2. Moreover, adolescents' alcohol dependence symptoms at Time 1 negatively predicted both sources of parental knowledge at Time 2.     

Social orientations and adolescent health behaviours in Hungary

Adolescent health behaviours are influenced by a variety of social factors, including social orientations, such as social comparison or competitiveness. The main goal of the present study was to investigate the role that these social orientations might play in health behaviours (both health‐impairing and health‐promoting). Data were collected from high school students (N = 548; ages 14–20 years; 39.9% males) in two counties of the Southern Plain Region of Hungary. The self‐administered questionnaires contained items on sociodemographics, such as age, sex, parental schooling, and socioeconomic status (SES) self‐assessment; school achievement, health behaviours, competitiveness and social comparison. Multiple regression analyses suggest that those who scored higher on competitiveness engaged in more substance use, a pattern that was not present for health‐promoting behaviours. Social comparison, however, was associated with lower levels of substance use. In addition, in relation to health‐impairing behaviours, both competitiveness and social comparison interacted with sex; both social orientation variables proved to be more important for boys. Social comparison also contributed to health‐promoting behaviours among boys. Findings support the idea that the role of social orientations, such as competitiveness and social comparison, can be quite different depending on sex and the nature of the health behaviour. While competitiveness may act as a risk factor for substance use among boys, social comparison may act as a protection. It appears that social orientations play less of a role in girls' health‐related behaviours. More focus is needed on gender differences in influences on adolescents' health‐related behaviours.     

Variables associated with adolescent alcohol use: a multiethnic comparison

The authors examined the influence of sociodemographic variables on the frequency and intensity of alcohol use among a nationally representative sample of Black, Hispanic, and White adolescents who had participated in the 1991 National Household Survey on Drug Abuse (U.S. Department of Health and Human Services, 1993). The sample consisted of 8,756 U.S. adolescents aged 12 to 18 years. The authors found that (a) approximately 19% of the respondents had used alcohol in the last 30 days: (b) among the respondents who had used alcohol, 21% had consumed 1 or more drinks per drinking episode; and (c) there were important similarities as well as important differences in variables that promoted alcohol use among Black. Hispanic, and White adolescents.     

Clinical issues in the assessment of adolescent alcohol and other drug use

Clinicians working with adolescents are routinely faced with the issue that alcohol and other drug (AOD) involvement may be part of the clinical picture either as a primary problem or a contributing factor to other problems or disorders. Fortunately, assessment research in this area has produced several behaviorally oriented and psychometrically sound tools from which to choose for problem identification, referral and treatment of youth suspected of AOD abuse. The aim of this paper is to provide an overview of several issues related to the clinical utility of such assessment tools.     

Cross-sex best friendship influences on early adolescent cigarette and alcohol expectancies and use

In this study, the author investigates the influences of cross-sex best friends in early adolescence in regard to cigarettes and alcohol. Specific goals include determining the prevalence of cross-sex best friendships, investigating expectancies and perceived approval of the use of cigarettes and alcohol, and examining substance use levels. A group of urban sixth, seventh, and eighth graders completed a survey that addressed these issues. Results indicate the presence of cross-sex best friendships in the sample. Significant findings on cross-sex best friends' influence include positive expectancies for alcohol in sixth (p = .006) grade, the perception of seventh graders that the best friend's attitudes about smoking (p = .003) and drinking (p = .001) are less negative, and higher levels of cigarette use in sixth (p = .001) and eighth (p = .024) grade and alcohol use in sixth (p = .008), seventh (p = .002), and eighth grades (p = .039).     

Incorporating adolescent females' perceptions of their partners' attitudes toward condoms into a model of female adolescent condom use

The highest rates of sexually transmitted infections in the U.S. occur among adolescent females. One prevention strategy promoted for sexually active adolescents is condom use: therefore, influences on correct and consistent condom use are worth examining. Because interventions and observational research into predicting and increasing condom use have yielded mixed results, we hypothesized that a theoretically driven model incorporating female adolescents' perceptions about partner sentiments along with their own perceptions, intentions, and behaviours would improve condom use predictions. We also measured condom use errors and consistency for a more precise estimate of effective use than is common in the literature. In three structural equation models tested on a sample of 519 female adolescents, we found that intentions were associated with both correct and consistent condom use; that females' expectancy beliefs about condom use were associated with intentions; and that females' expectancy beliefs about partners' sentiments reduced the impact of their expectancy beliefs about condom use. The implications of these relations upon condom use correctness and consistency are discussed with respect to informing interventions, among other future research.     

Changing adolescent attitudes toward stuttering

Purpose

Live oral or recorded video presentations on stuttering were delivered to high school students in order to determine the extent to which their attitudes toward stuttering could be improved.

Methods

A classroom teacher administered the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) to two health classes before and after an oral live presentation by a person who stutters. She also gave the POSHA-S to two other similar classes before and after a True Life^®: I Stutter video presentation. The stuttering person in the oral condition was one of three people featured in the video. Also, following the video condition, students filled out the POSHA-S a third time after a short oral presentation by the same person who stutters.

Results

Measured attitudes improved overall on the POSHA-S and on selected items.

Conclusions

High school students hold similar attitudes toward stuttering and stutterers as adults, and these attitudes can be improved, at least temporarily, by a presentation on stuttering but more via a live presentation than a professionally prepared video.Educational objectives: (1) The reader will identify different ways to improve attitudes toward stuttering in high school students. (2) The reader will list advantages and disadvantages of live oral presentations and recorded video presentations as strategies to change attitudes toward stuttering. (3) The reader will identify characteristics of a speaker that can assist in attitude changes of high school students.     

The prospective relation between dimensions of anxiety and the initiation of adolescent alcohol use

Examined the relation between early anxiety symptomatology (generalized and separation) and initiation of alcohol use 4 years later in an epidemiological sample of 936 children (45% girls), assessed at ages 9, 11, and 13, while controlling for the effects of depression. Although earlier overall anxiety symptomatology was unrelated to later onset of drinking, children with early symptoms of generalized anxiety were found to be at increased risk for initiation of alcohol use, whereas children with early symptoms of separation anxiety were at decreased risk. The magnitude of these relations was equally strong for boys and girls. In addition, early depressive symptomatology was associated with increased risk for initiation of alcohol use in adolescence. Results indicate that it is important to consider specific dimensions of anxiety symptomatology when attempting to identify those individuals at risk for early initiation of alcohol use.     

Correspondence and mediational properties of the Fishbein model: An application to adolescent alcohol use

The generalizability of the Fishbein model for behavior prediction was extended to a new field behavior, alcohol drinking by adolescents. The model's two components (i.e., attitudes and normative beliefs) varied in their predictive importance depending on the behavior's situational context. Following this field demonstration, two issues related to properties affecting the model's predictive effectiveness were investigated. First, it was found that the predictability of alcohol-drinking intentions (BI) declined when attitudes (A_act) and normative beliefs (NB) did not correspond with BI in terms of alcohol type (beer, liquor, or wine) and drinking situation (home, party, or pub). A second experiment tested the hypothesis that exogenous variables (those other than A_act and NB) would have a direct influence on BI. A comprehensive test was provided within the context of Jessor's multivariate predictive system for adolescent alcohol use. Present data indicate only a marginal increase in explained variance occurred when applying this system, thereby generally indicating the sufficiency of the Fishbein model's two components.     

A family-focused randomized controlled trial to prevent adolescent alcohol and tobacco use: The moderating roles of positive parenting and adolescent gender

Four years of longitudinal data from 2,153 families with a 5th- or 6th-grade preadolescent participating in a family-focused pediatric primary-care-based prevention program were used to examine whether prevention effects were moderated by positive parenting and/or adolescent gender. Alcohol and tobacco use, internalizing problems, and externalizing problems were examined. Although findings revealed no main effect of the prevention program, positive parenting and adolescent gender were moderators of internalizing problems and adolescent gender was a moderator of externalizing problems. Clinical implications and future directions for research are discussed.     

Concurrent and prospective effects of multi‐dimensional aggression and anger on adolescent alcohol use

This study examined the relationship between alcohol, anger, and aggression in high school students. Anger and three types of aggressive expression (verbal, physical toward people, and physical toward objects) were evaluated cross‐sectionally and prospectively, via structural equation modeling for relationships to alcohol use in Mexican American and white non‐Latino 9–10th (Time 1) and 11–12th grade (Time 2) students. At both times cross‐sectionally, anger and aggressive anger expression tended to correlate positively with alcohol use in each ethnicity/gender group. However, prospectively, aggressive forms of anger expression tended not to be related to alcohol use two years later. Only verbally aggressive anger expression was related to alcohol use two years later and then, only for Mexican American and white non‐Latino females. There was, therefore, little basis for causal links between aggressive anger expression and alcohol use in a general population of high school students. Aggress. Behav. 30:356–372, 2004. © 2004 Wiley‐Liss, Inc.     

Father absence and adolescent "problem behaviors": alcohol consumption, drug use and sexual activity

Among the issues faced by adolescents are problems relating to alcohol consumption, drug use, and sexual behavior. A survey of 813 adolescents found that adolescents are most likely to discuss these problems with peers and least likely to discuss them with parents, especially fathers. However, father absence from the home resulted in greater use of and problems with alcohol, marijuana, and sexual activity. This was the case especially for boys. The results obtained underscore the significance of the father as a key figure in the transmission of values and as a deterrent to certain behaviors. The results point to adolescents from fatherless homes, especially boys, as being at risk for problems in the areas noted. This suggests that community agencies providing services to adolescents should make special efforts to incorporate into their programs specially designed services to meet the particular needs of this group. Aspects of such programs are discussed.     

The relationship between drinking control strategies and college student alcohol use.

Interventions designed to reduce heavy drinking among college students often contain suggestions for drinking control strategies. However, little is known about the relationship between the use of these strategies and alcohol consumption. The authors developed a measure of drinking control strategies and investigated its psychometric properties in a sample of 250 college drinkers. Strategies clustered into three factors: selective avoidance of heavy drinking activities and situations, strategies used while drinking, and alternatives to drinking. These three types of strategies were independently associated with alcohol use; however, the first and last types were negatively associated with alcohol consumption, whereas the second type was positively associated with alcohol use. The findings from this study suggest that the type of strategy recommended may be important when the goal is alcohol reduction.     

Attitudes of adolescents toward adolescent psychiatric treatment

Perceptions held by adolescents about the value and social stigma of both psychiatric hospitalization and outpatient therapy for adolescents are examined. Perceptions about preferred forms of treatment for specific adolescent problems are also analyzed. The results indicate that attitudes are significantly influenced by proximity to treatment setting, i.e., adolescents currently being treated are more positive than adolescents who have been previously or never treated. Contextual and attributional explanations are considered.