Child,parent, and peer predictors of early-onset substance use: a multisite longitudinal study

The purpose of this study was to identify kindergarten-age predictors of early-onset substance use from demographic, environmental, parenting, child psychological, behavioral, and social functioning domains. Data from a longitudinal study of 295 children were gathered using multiple-assessment methods and multiple informants in kindergarten and 1st grade. Annual assessments at ages 10, 11, and 12 reflected that 21% of children reported having initiated substance use by age 12. Results from longitudinal logistic regression models indicated that risk factors at kindergarten include being male, having a parent who abused substances, lower levels of parental verbal reasoning, higher levels of overactivity, more thought problems, and more social problem solving skills deficits. Children with no risk factors had less than a 10% chance of initiating substance use by age 12, whereas children with 2 or more risk factors had greater than a 50% chance of initiating substance use. Implications for typology, etiology, and prevention are discussed.     

Affect and peer context interactively impact adolescent substance use

Risk factors, such as emotional distress and peer substance involvement, are often tested as competing influences on adolescent substance use. However, the current study examined how affect (both positive and negative) and peers (both in terms of relationship quality and substance involvement) are interactive influences on adolescent substance use. A sample of 398 high school juniors and seniors completed surveys assessing each of these domains. Results of hierarchical regression analyses showed strong associations between an adolescent's and his or her best friend's substance use. Complex interactions supported the study hypothesis in that relations between affect and adolescent substance use were context dependent, with some peer contexts enhancing risk for substance use and others dampening this risk. Implications of these findings for interventions and preventions concerning adolescent substance use are discussed.     

Natural Mentors, Mental Health, and Risk Behaviors: A Longitudinal Analysis of African American Adolescents Transitioning into Adulthood

Patterns of substance use are examined in a sample of over 1,200 youth in a non-metropolitan region of New England. Self-reported history and frequency of alcohol, tobacco, marijuana, inhalants, pain medications, and other hard drug use was assessed for 9th and 10th grade students. Latent class analyses identified four patterns of substance use: non-users (22%), alcohol experimenters (38%), occasional polysubstance users (29%), and frequent polysubstance users (10%). Contextual risk and protective factors in the individual, family, peer, and community domains predicted substance use patterns. Youth report of peer substance use had the largest effects on substance use class membership. Other individual characteristics (e.g., gender, antisocial behavior, academic performance, perceived harm from use), family characteristics (e.g., parental drinking, parental disapproval of youth use), and community characteristics (e.g., availability of substances) demonstrated consistent effects on substance use classes. Implications for prevention are discussed from a social-ecological perspective.     

Personality and the predisposition to engage in risky or problem behaviors during adolescence

Longitudinal data from a representative sample of 1,978 Black and White adolescents were used to examine the role of personality in multiple risk or problem behaviors. Results indicate that covariation among diverse behaviors (educational underachievement, delinquent behavior, substance use, sexual behavior) can be adequately modeled by a single higher order factor, and that impulsivity and avoidance coping serve as generalized risk factors for involvement in these behaviors. Whereas none of the personality variables examined explained change in problem behaviors once established, avoidance coping prospectively predicted involvement among a subgroup of adolescents with little or no prior involvement. Results suggest that dysfunctional styles of regulating emotions and emotionally driven behaviors are core features of risky or problem behaviors during adolescence.     

Ethnic pride and self-control related to protective and risk factors: test of the theoretical model for the strong African American families program.

OBJECTIVE: To test a theoretical model of how ethnic pride and self-control are related to risk and protective factors. DESIGN: A community sample of 670 African American youth (mean age = 11.2 years) were interviewed in households. MAIN OUTCOME MEASURES: Measures of cigarette smoking, alcohol use, and sexual behavior (lifetime to past month). RESULTS: Structural modeling analyses indicated parenting was related to self-control and self-esteem, and racial socialization was related to ethnic pride. Self-control and self-esteem variables were related to levels of deviance-prone attitudes and to perceptions of engagers in, or abstainers from, substance use and sexual behavior. The proximal factors (behavioral willingness, resistance efficacy, and peer behavior) had substantial relations to the criterion variables. Participant gender and parental education also had several paths in the model. Results were generally similar for the 2 outcome behaviors. CONCLUSIONS: In this population, self-esteem and self-control are related to parenting approaches and have pathways to attitudes and social perceptions that are significant factors for predisposing to, or protecting against, early involvement in substance use and sexual behavior.     

Transmission risk behaviors in a subset of HIV-positive individuals: The role of narcissistic personality features

Most people living with HIV/AIDS (PLWHA) take steps to protect their sexual partners. However, a minority of PLWHA continue to engage in sexual risk behaviors that might contribute to the transmission of HIV. Psychiatric conditions, including certain pathological traits, are associated with sexual risk behaviors. Research examining the association between narcissistic traits as they relate to HIV transmission risk is limited. In the present study, 303 PLWHA were recruited from an infectious disease clinic and completed questionnaires assessing narcissistic characteristics, substance use, sexual risk behavior, and intentions to use condoms in the future. Narcissistic traits predicted unprotected sex with partners who are HIV-negative or whose HIV status was unknown as well as lower intentions to use condoms, after controlling for demographic factors and substance use. Interventions focused on reducing the transmission of HIV should take into account associations between sexual risk behavior and narcissism.     

Preliminary Evidence for Associations of CHRM2 with Substance Use and Disinhibition in Adolescence

Evidence for shared heritable influences across domains of substance use suggests that some genetic variants influence broad risk for externalizing behaviors. Theories of externalizing psychopathology also suggest that genetic liability for substance use manifests as temperamental risk factors, particularly those related to behavioral disinhibition, during adolescence. The cholinergic muscarinic receptor 2 gene (CHRM2) is a promising candidate for studying genetic influences on broad-based risk for externalizing traits. This study examined a candidate CHRM2 polymorphism (rs1455858) in relation to substance use and personality measures of disinhibition in a sample of high-risk adolescents (n?=?124). Bivariate analyses and structural equation modeling (SEM) evaluated associations of rs1455858 with measures of drug involvement (alcohol, tobacco and marijuana) and disinhibition (indexed by impulsivity and sensation seeking scores). Bivariate analyses showed significant associations of CHRM2 with several behavioral phenotypes. In SEM analyses CHRM2 related significantly to latent measures of substance use and disinhibition; additionally, disinhibition mediated the association of CHRM2 with substance use. These results suggest that CHRM2 variants are potentially relevant for adolescent substance use and that temperamental risk factors could contribute to these associations.     

Differential Determinants of Young Adult Substance Use and High‐Risk Sexual Behavior1

This investigation evaluated how personality traits, self‐efficacy, and outcome expectancies differentially relate to young adult substance use and high‐risk sex. Experiments I (N= 481) and 2 (N= 73) report the development of a new questionnaire to assess self‐efficacy for substance use and sexual behavior. Experiment 3 (N= 375) tested self‐efficacy, outcome expectancies, and trait measures of social conformity and sensation seeking as correlates of substance use and high‐risk sex. Using structural equation modeling, cross‐sectional analyses revealed that positive outcome expectancies had the largest association with substance use, whereas self‐efficacy had the largest association with sexual behavior. Further, personality traits were related to substance use and sexual behavior indirectly through outcome expectancies, with social conformity also having a direct effect on behavior. When examined longitudinally, past alcohol and drug use served as the final pathway by which expectancies and personality impacted substance use, whereas past behavior, self‐efficacy, and social conformity all contributed to high‐risk sex. Results support the utility of different models for explaining, and possibly preventing, young adult substance use and high‐risk sex.     

Coping Strategies,Substance Use,Sexual Activity,and HIV Sexual Risks in a Sample of Gay Male STD Patients1

The relationships of coping strategies with levels of substance use and sexual activity, and with HIV sexual risks, are examined in a sample of gay male STD clinic patients (n = 416). Previous research has suggested that use of problem-focused coping strategies should be negatively related to levels of substance use, levels of sexual activity, and HIV sexual risks; use of emotion-focused coping strategies should be positively related to these outcomes. It is argued that substance use and sexual activity clearly fit within a coping perspective, but that the HIV sexual risks/coping relationship is less clear. In multivariate analysis, the problem-focused strategy of advice seeking is negatively related to the number of types of drugs used and to the number of sexual partners; the problem-focused strategy of support seeking is negatively related to the number of days using drugs; and the use of emotion-focused strategies is positively related to the number of types of drugs used. Problem-focused coping strategies are less directly related to engaging in HIV sexual risks when measures of substance use and of sexual activity are included in the prediction; emotion-focused coping strategies are more stably related to HIV risk. Indirect effects of coping on HIV risk are also identified through the effects of coping on the number of types of drugs used, number of sex partners, and number of times having sex. It is proposed that the relationships between coping and levels of substance use and sexual activity reflect the use of these activities as ways of relieving strain, but that relationships between coping and HIV sexual risks involve less clearly understood direct and indirect relationships.     

Verbal Sexual Coercion Experiences,Sexual Risk,and Substance Use in Women

Research has linked sexual assault, substance use, and sexually transmitted infection (STI) risk in women. Sexual assault by means of verbal sexual coercion (VSC) is more common than sexual assault by means of physical tactics, but VSC is rarely assessed independently. In addition, past work has established global connections among substance use, sexual assault history, and STI risk; however, assessing substance use during sexual behavior is less common. This study examined the relations among VSC, STI risk behavior, and substance use and attitudes. We hypothesized that women with larger numbers of VSC experiences would report more frequent sexual risk behaviors and substance use and attitudes. Participants with larger numbers of VSC experiences reported larger numbers of anal sex partners, more frequent penile–vaginal sex and sexual activity after substance use, and stronger sex-related alcohol expectancies. These findings suggest that VSC is associated with higher levels of STI risk in women.     

Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy

The aims of the present review are to apply a recent risk factor approach (H. C. Kraemer et al., 1997) to putative risk factors for eating disorders, to order these along a timeline, and to deduce general taxonomic questions. Putative risk factors were classified according to risk factor type, outcome (anorexia nervosa, bulimia nervosa, binge-eating disorder, full vs. partial syndromes), and additional factor characteristics (specificity, potency, need for replication). Few of the putative risk factors were reported to precede the onset of the disorder. Many factors were general risk factors; only few differentiated between the 3 eating disorder syndromes. Common risk factors from longitudinal and cross-sectional studies were gender, ethnicity, early childhood eating and gastrointestinal problems, elevated weight and shape concerns, negative self-evaluation, sexual abuse and other adverse experiences, and general psychiatric morbidity. Suggestions are made for the conceptualization of future risk factor studies.     

The Protective Effects of Religious Beliefs on Behavioral Health Factors Among Low Income African American Adolescents in Chicago

Religious involvement has long been argued to have protective effects for negative behavioral health outcomes for vulnerable youth. This study builds on the existing resilience literature and need for more studies that examine protective factors associated with behavioral health. A sample of 638 low-income African American adolescents in Chicago to examine within group variations of the influence of religious involvement on delinquency, school engagement, substance use and sexual risk behaviors, and whether such relationships differ by gender, sexual orientation, and socioeconomic status. Logistic regression findings documented that greater religious involvement was protective with regards to lower rates of delinquency, drug use, risky sexual behaviors and higher rates of school engagement, and that gender, sexual orientation and socioeconomic status varied for several of these relationships. Overall findings are discussed with regards to future research.     

Family risk factors and adolescent substance use: moderation effects for temperament dimensions

This research tested for moderation in the relation of family risk factors (parent-child conflict, family life events, and parental substance use) to adolescent substance use (tobacco, alcohol, and marijuana). A sample of 1,810 participants was surveyed at the mean age of 11.5 years and followed with 2 yearly assessments. Temperament dimensions were assessed with the Revised Dimensions of Temperament Survey and the Emotionality, Activity, and Sociability Inventory. Multiple-group latent growth analyses indicated moderation occurred through (a) alteration of effects of parental variables on the adolescent substance use intercept and on the peer substance use intercept and slope and (b) alteration of the effect of the peer substance use intercept on the adolescent substance use slope. The impact of parental risk factors was decreased among participants with higher task attentional orientation and positive emotionality (resilience effect) and was increased among participants with higher activity level and negative emotionality (vulnerability effect). Results from self-report data were corroborated by independent teacher reports.     

Does Parental Monitoring Moderate the Impact of Community Violence Exposure on Probation Youth’s Substance Use and Sexual Risk Behavior?

The present study examined whether parental monitoring buffers the negative effects of communtity violence exposure on probation youth’s substance use and sexual risk behaviors. Among a sample of 347 Chicago youth on probation, ages 13–17 years, parental monitoring did not moderate the relationship between community violence exposure and probation youth’s sexual risk and substance use. However, parental monitoring was independently associated with less engagement in sexual risk and substance use, and community violence exposure was independently associated with more risk behavior among probation youth. The present study contributes to the growing literature on the impact of community violence exposure and parenting on adjudicated youth risk.     

Integrated Cognitive-Behavioral Therapy for Social Anxiety and HIV/STI Prevention for Gay and Bisexual Men: A Pilot Intervention Trial

Given the alarmingly high HIV and sexually transmitted infection (STI) incidence among gay and bisexual men (GBM) worldwide, there is a critical need for HIV prevention interventions specifically for GBM. Social anxiety, or anxiety about being evaluated in interpersonal situations, is a risk factor for condomless anal sex (CAS) among GBM (e.g., Hart & Heimberg, 2005; Hart, James, Purcell, & Farber, 2008). Social anxiety may also increase substance use in sexual situations, which is another risk factor for HIV/STIs in this risk group (Semple, Strathdee, Zians, McQuaid, & Patterson, 2011). The goal of the Sexual Confidence Study was to provide initial evidence of efficacy for a 10-session integrated cognitive-behavioral therapy for social anxiety, substance use management in sexual situations, and HIV sexual risk reduction for HIV-negative GBM. Diagnostic and self-report assessments were completed at baseline, posttreatment, 3-month follow-up, and 6-month follow-up. In this open trial design, we observed a 50% reduction in engagement in HIV/STI sexual risk behavior at 6-month follow-up. We also observed large uncontrolled treatment effect sizes for reductions in social anxiety disorder and problematic alcohol use. These preliminary findings suggest that the present treatment may offer an efficient way of concurrently reducing social anxiety, problematic alcohol use, and the risk of contracting HIV and STIs via CAS with serodiscordant partners among HIV-negative GBM.     

HIV risk after release from prison: a pilot case-control study in Canada,France, Ivory Coast and South Africa

This study aimed to assess HIV knowledge, risk perception and risk behaviour of ex-offenders at risk of new infection and to compare them with the general population. A case-control interview study was conducted with conveniently sampled ex-offenders and persons with no history of incarceration in four countries (Canada, France, Ivory Coast, South Africa). The total sample included 232 participants with a mean age of 33.9 years (SD=9.8 years). Results indicate various high HIV risk behaviours including multiple sexual partners, irregular sexual partner, and commercial sexual partner. Other risk factors were unprotected sex at last intercourse with a regular partner, with an irregular partner and with a commercial sexual partner. A history of incarceration did not differentiate risk for infection. Younger age, coming from the Ivory Coast, and higher HIV risk perception were found to be associated with HIV risk behaviour. Prevention efforts should focus on education, promotion of safe sex and substance abuse treatment.     

Metaanalysis of Mood and Substance Use Disorders in Proximal Risk for Suicide Deaths

Evidence for proximal risk factors for suicide is based on case–control psychological autopsy studies, with these reports showing that mood and substance use disorders are the most prevalent mental disorders among suicide decedents worldwide and are associated with marked risk. However, moderators of risk and the degree of risk associated with (nonalcohol) drug use disorder are unknown. A comprehensive search was used to identify 35 case–control psychological autopsy studies published worldwide over a 30‐year period that were metaanalyzed using random effects models. Major depression, odds ratio (95% confidence interval) = 9.14 (5.53, 15.09), and drug use disorder, OR (95% CI) = 7.18 (3.22, 16.01), had large effect sizes, among other results. Risk estimates associated with major depression were greater in studies with a larger proportion of women and those conducted in Asia compared with other regions. There was no evidence of publication bias or that any one study had a disproportionate impact on findings. Risk for suicide associated with major depression appears to be moderated by sex and/or world region. Drug use disorder is a potent risk factor, illustrating the importance of assessing drug use in clinical risk assessment.     

Pornography use and sexual aggression: the impact of frequency and type of pornography use on recidivism among sexual offenders

In this study, we examined the unique contribution of pornography consumption to the longitudinal prediction of criminal recidivism in a sample of 341 child molesters. We specifically tested the hypothesis, based on predictions informed by the confluence model of sexual aggression that pornography will be a risk factor for recidivism only for those individuals classified as relatively high risk for re-offending. Pornography use (frequency and type) was assessed through self-report and recidivism was measured using data from a national database from the Royal Canadian Mounted Police. Indices of recidivism, which were assessed up to 15 years after release, included an overall criminal recidivism index, as well as subcategories focusing on violent (including sexual) recidivism and sexual recidivism alone. Results for both frequency and type of pornography use were generally consistent with our predictions. Most importantly, after controlling for general and specific risk factors for sexual aggression, pornography added significantly to the prediction of recidivism. Statistical interactions indicated that frequency of pornography use was primarily a risk factor for higher-risk offenders, when compared with lower-risk offenders, and that content of pornography (i.e., pornography containing deviant content) was a risk factor for all groups. The importance of conceptualizing particular risk factors (e.g., pornography), within the context of other individual characteristics is discussed.     

Emotional health predictors of substance use initiation during middle school

This study aimed to evaluate whether emotional health factors, including anxiety and depression, stress, and social support, are associated with earlier youth initiation of alcohol and illicit substances during middle school (from the sixth to the eighth grade). Data for this study were from the Developmental Pathways Project, a longitudinal study of 521 youth sampled from the Seattle Public Schools. Discrete time survival analyses were used to assess the effects of depression, anxiety, stress, and support on initiation of substance use, measured every 6 months at five time points between sixth and eighth grade. Youth who had initiated prior to sixth grade had significantly higher levels of depressive symptoms. In multivariate survival analyses controlling for child race/ethnicity, gender, and socioeconomic status, and accounting for conduct problems, youth who reported higher levels of separation anxiety/panic symptoms were at decreased risk for early alcohol initiation. Children with higher levels of perceived teacher support had a significantly lower risk of alcohol initiation during early follow-up periods. Recent stressful life events in Grade 6 were associated with significantly greater risk of initiating an illicit substance by Grade 8. The current findings highlight the role of stress in the initiation of illicit substance use and suggest that teacher support is associated with lower risk for very early alcohol use. Future research examining anxiety as a predictor of substance use should distinguish between subtypes of anxiety.