Is the Continuity of Externalizing Psychopathology the Same in Adolescents and Middle–Aged Adults? A Test of the Externalizing Spectrum’s Developmental Coherence

Externalizing psychopathology (EXT) is a framework for understanding diagnostic comorbidity and etiology of antisocial and substance-use behaviors. EXT indicates continuity in adulthood but the structure of adolescent EXT is less clear. This report examines whether adolescent EXT is trait-like, as has been found with adults, or categorical. We use tests of measurement invariance to determine how diagnostic indicators of EXT differ in adolescents compared to adults. The EXT measures employed were DSM-IIIR diagnoses of adult antisocial behavior, conduct disorder, and alcohol, marijuana, and drug dependence. Latent trait, latent class, and hybrid models were fit to two separate data sets: 2,769 seventeen-year-old adolescents and 2,619 adults from the Minnesota Twin Family Study. The best model in both samples was a single-trait LT model. Parameters from the adolescent and adult models were equivalent for all disorders except alcohol dependence. It appears that EXT in adolescence can be accurately represented by a single-trait model, and the measurement properties of EXT are similar during these time periods with the exception of alcohol dependence.     

Multidimensional Family Therapy HIV/STD Risk-Reduction Intervention: An Integrative Family-Based Model for Drug-Involved Juvenile Offenders

Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies ( http://www.cjdats.org ). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.     

A test of the relations between avoidance of panic-related situations and substance use, substance dependence, and depression among subclinical panickers

The hypotheses that among subclinical panickers, avoidance of panic-related situations would be associated with elevated substance use levels and increased likelihood of lifetime diagnoses of substance dependence and major depressive disorder (MDD) were tested. Findings confirmed that panic-related avoidance was associated with an elevated likelihood of lifetime diagnoses of nicotine and alcohol dependence as well as MDD, but not drug dependence. Panic avoidance was also related to relatively greater daily levels of cigarette and alcohol use.     

Characteristics of children of alcoholics: putative risk factors, substance use and abuse, and psychopathology.

A sample of 253 children of alcoholics (COAs) and 237 children of nonalcoholics (non-COAs) were compared on alcohol and drug use, psychopathology, cognitive ability, and personality. COAs reported more alcohol and drug problems, stronger alcohol expectancies, higher levels of behavioral undercontrol and neuroticism, and more psychiatric distress in relation to non-COAs. They also evidenced lower academic achievement and less verbal ability than non-COAs. COAs were given Diagnostic Interview Schedule alcohol diagnoses more frequently than non-COAs. The relation between paternal alcoholism and offspring alcohol involvement was mediated by behavioral undercontrol and alcohol expectancies. Although gender differences were found, there were few Gender X Family History interactions; the effects of family history of alcoholism were similar for men and women. When gender effects were found, they showed greater family history effects for women.     

Comparing Students From Substance Abusing and Dysfunctional Families: Implications for Counseling

This research compared family role dysfunction, college adjustment, chemical dependence, and family functioning among a sample of 245 college students from three groups: homes in which significant alcohol or other chemical abuse or dependence dysfunction existed; dysfunctional homes in which substance abuse was not a significant problem; and nonabusing, nondysfunctional homes. The results suggest that chemical abuse or dependence in families is associated with slowed adult role assimilation and increased risk for alcohol and other drug abuse among children.     

The Relationship Between Parental Alcoholism and Adolescent Psychopathology: A Systematic Examination of Parental Comorbid Psychopathology

The relationship between parental alcohol dependence (with and without comorbid psychopathology) and adolescent psychopathology was examined in a sample of 665 13-17 year-old adolescents and their parents. Results indicated that adolescents who had parents diagnosed with alcohol dependence only did not significantly differ from adolescents who had parents with no psychopathology in regard to any of the measures of psychological symptomatology (substance use, conduct disorder, and depression) or clinical diagnoses (alcohol dependence, marijuana dependence, conduct disorder, or depression) assessed. In contrast, adolescents who had parents diagnosed with alcohol dependence and either comorbid drug dependence or depression were more likely to exhibit higher levels of psychological symptomatology. In addition, adolescents who had parents diagnosed with alcohol dependence, depression, and drug dependence were most likely to exhibit psychological problems. These findings underscore the importance of considering parental comorbid psychopathology when examining the relationship between parental alcoholism and offspring adjustment.     

Family Factors Predicting Categories of Suicide Risk

We compared family risk and protective factors among potential high school dropouts with and without suicide-risk behaviors (SRB) and examined the extent to which these factors predict categories of SRB. Subjects were randomly selected from among potential dropouts in 14 high schools. Based upon suicide-risk status, 1,083 potential high school dropouts were defined as belonging to one of four groups; 573 non-suicide risk, 242 low suicide risk, 137 moderate suicide risk and 131 high suicide risk. Results showed significant group differences in all youth self-reported family risk and protective factors. Increased levels of suicide risk were associated with perceived conflict with parents, unmet family goals, and family depression; decreased levels of risk were associated with perceived parental involvement and family support for school. Perceived conflict with parents, family depression, family support satisfaction, and availability of family support for school were the strongest predictors of adolescent SRB. Our findings suggest that suicide vulnerable youth differ from their non-suicidal peers along the dimensions of family risk and protective factors.     

Sibling correlates of young adults' status attainment: ethnic group differences

I used longitudinal data to examine relationships between sibling variables and young adults' status attainment at different levels, based on earlier measures of adolescents' educational and occupational aspirations. My analyses involved 21-year-old Australians from Anglo-Australian, Greek, and Southern Italian families. Regression surfaces were plotted from models that included terms to test for possible linear, interaction, and curvilinear associations among the variables. My study showed that the number of children in a family and birth order continue to be significantly associated with young adults' status attainment, even after incorporating the mediating influences of adolescents' aspirations. The investigation also suggested ethnic group differences among sibling variables, adolescents' aspirations, and young adults' status attainment.     

A network of influences on adolescent drug involvement: neighborhood, school, peer, and family

The interrelationship of neighborhood, school, peer, and family factors and adolescent drug involvement was investigated. Data were collected separately from 518 adolescents and their mothers when the children were between 9 and 18 years of age and again two years later. Neighborhood and school effects were not directly related to adolescent drug use. Neighborhood effects were mediated through the domains of school, peer, and family; school effects were mediated through the peer domain. Family and peer variables had a direct impact on adolescent drug involvement. Risk factors in the adolescents' peer environment can be ameliorated by protective factors in their school environment. Implications for the prevention of drug use are discussed.     

Parent–Adolescent Conflict,Negative Emotion,and Estrangement From the Family of Origin

Adolescence is a developmental period in which parents and children renegotiate roles in light of the children's blossoming individuality and autonomy on one hand and parent–child emotional connectedness on the other hand. The renegotiation process often involves difficulties in communication, which generate tension and conflict and also amplify emotional intensity. In this study, I examined sociocontextual differences between families who maintain contact during the child's young adulthood and those who "repair" the relationship only through separation or detachment. Three waves of panel data I utilized for this investigation reveal that emotional closeness to a parent during adolescence and a rewarding romantic relationship and religiosity during young adulthood play protective roles in maintaining the parent–child relationship beyond adolescence. A parent's alcohol use, high levels of parent–adolescent conflict, family economic hardship during adolescence, and delinquent behavior and depressive symptoms in the adolescent increase the risks for termination of the parent–child relationship. The findings provide evidence for the long-term impact of parent–child conflict and negative emotion during adolescence.     

Coping and Positive Affect in Adolescents of Mothers With and Without a History of Depression

The adolescent children of depressed mothers are at increased risk for depression, but little is known about protective factors for these children. Maintenance of positive affect in a stressful context may be an important marker of resilience. Mothers with (n = 34) and without (n = 38) a history of depression and their adolescent children completed questionnaires regarding adolescents’ coping and depressive symptoms and engaged in a 15 min videotaped interaction about family stress. Adolescents’ observed behaviors were coded using the Iowa Family Interaction Rating Scales. No significant differences emerged in observed behavior between adolescents of mothers with and without a history of depression. Higher levels of primary and secondary control coping and lower levels of disengagement coping were related to higher levels of observed positive mood and fewer depressive symptoms in adolescents. Observed positive mood was related to fewer depressive symptoms in adolescents, even after accounting for maternal history of depression and current maternal depressive symptoms. Results suggest the importance of considering positive affect in the context of family stress as a marker of resilience in adolescents at risk for depression. The current study provides evidence for coping as a protective factor, related to higher levels of positive affect and fewer depressive symptoms, in adolescents exposed to maternal depressive symptoms.     

Correlations for perceived family environmental factors with substance use among adolescents in South Africa

Perceived family environmental factors were used to predict self-reported use of substances (drugs or alcohol) among adolescents in South Africa. 435 high school students (ages 15 to 19 years, M=17.2 yr., SD=1.34) answered a questionnaire which included questions on demographic variables, the Family Environmental Scale, and questions on substances used (drugs or alcohol). Logistic regression analysis indicated that scores on family conflict and low family moral-religious emphasis were significantly associated with drug use (57.9% of the variance was accounted for) and use of alcohol (62.3% of the variance was accounted for). Programmes for the reduction of substance use among adolescents should include activities designed to reduce family conflict and strengthen family moral-religious emphasis.     

Family Protection and Prevention of Alcohol Use Among Hispanic Youth at High Risk

Research regarding prevention strategies for Hispanic youth stress the importance of family interventions because of the particular importance of family as a protective factor within the Hispanic community. Starting in 1995, the Center for Substance Abuse Prevention conducted the National Cross-Site Evaluation of High Risk Youth Programs, a 5-year drug and alcohol prevention study with a sample of approximately 10,500 youth, including nearly 3,000 Hispanic youth. Youth were surveyed regarding their alcohol use patterns and risk and protective factors, with several measures of family relationships, including family connectedness, family supervision, and parental attitudes toward their child's alcohol use. Analyses indicate that family factors are highly linked to alcohol use among Hispanics, particularly among Hispanic females. Longitudinal growth curve analyses indicate that improving the connections that young Hispanic females have to their parents can have positive long-term effects on delaying or reducing their alcohol use. This evaluation was conducted under the direction of Dr. Soledad Sambrano, Ph.D. of the Center for Substance Abuse Prevention under contract #2777-95-5002 with EMT Associates, Inc. and ORC Macro. The views expressed herein represent the opinions and analyses of the individual authors and may not necessarily reflect the opinions, official policy, or position of the U.S. Department of Health and Human Services, the Public Health Service, the Substance Abuse and Mental Health Service Administration, or the Center for Substance Abuse Prevention.     

Stress and Alcohol,Cigarette, and Marijuana Use Among Latino Adolescents in Families with Undocumented Immigrants

Families in which one or more members are undocumented immigrants experience unique hardships. Yet, little is known about stress and substance use among adolescents growing up in these families. The present study examined associations between two sources of adolescent stress (i.e., low parental involvement due to contextual constraints and family economic insecurity) and lifetime alcohol, cigarette, and marijuana use among adolescents in families with undocumented members. The sample was comprised of 102 adolescents (10–18 years old) and one of his or her parents. Participants responded a survey in English or Spanish. Adolescent lifetime use of alcohol, cigarette, and marijuana was 51, 32.4, and 37.3 %, respectively. Chi-square analyses found no significant gender differences in lifetime substance use. Logistic regression models showed that adolescent stress due to hindered parental involvement increased the odds of both lifetime cigarette and marijuana use after controlling for gender, age, linguistic acculturation, familism, parental control, and negative peer affiliation. Being a girl increased the odds of lifetime alcohol use. Family economic stress was not associated with lifetime substance use. Results suggest that hindered parental involvement might be a stressor and a risk factor for cigarette and marijuana use among adolescents growing up in families with undocumented members. Because parents in these families are likely to be undocumented, policies that allow immigrants to apply for legal status could improve parents’ working conditions and facilitate parental involvement; in turn, such policies could decrease the risk for adolescent substance use among children of Latino immigrants.     

The Relationships of Family Socioeconomic Status, Parent–Adolescent Conflict, and Filial Piety to Adolescents’ Family Functioning in Mainland China

This study used structural equation modeling to examine the relationships of family socioeconomic status (SES), parent–adolescent conflict, and filial piety to family functioning among middle school and high school students in mainland China. A total of 2,341 students (1,218 girls and 1,096 boys; mean age = 15.42) completed the Chinese Family Assessment Instrument, Family Status Survey, Parent–adolescent Conflict Scale, and Filial Piety Scale. The main results showed that: (a) family SES, parent–adolescent conflict, and filial piety were significantly linked to family functioning; (b) parent–adolescent conflict and filial piety contributed more to family functioning than family SES; (c) parent–adolescent conflict mediated the relationship between reciprocal filial piety and family functioning. The results promote understanding of family processes that influence the relationships between family SES, parent–adolescent conflict, filial piety, and family functioning among middle school and high school adolescents in mainland China.     

Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD

Children diagnosed with attention-deficit/hyperactivity disorder (ADHD; n = 142) were prospectively monitored into adolescence (13-18 years old) to evaluate their risk for elevated substance use relative to same-aged adolescents without ADHD (n = 100). Probands reported higher levels of alcohol, tobacco, and illicit drug use than did controls. Group differences were apparent for alcohol symptom scores but not for alcohol or marijuana disorder diagnoses. Within probands, severity of childhood inattention symptoms predicted multiple substance use outcomes: childhood oppositional defiant disorder/conduct disorder (ODD/CD) symptoms predicted illicit drug use and CD symptoms. Persistence of ADHD and adolescent CD were each associated with elevated substance use behaviors relative to controls. Further study of the mediating mechanisms that explain risk for early substance use and abuse in children with ADHD is warranted.     

Parenting in moderation: family routine moderates the relation between school disengagement and delinquent behaviors among African American adolescents

To address gaps in the literature regarding the role of family routine on school disengagement and delinquent behaviors, we tested whether family routine moderated relations between school disengagement and delinquent behaviors in an urban, low socioeconomic status (SES), African American sample of adolescents (N = 204, 48% male). Adolescents reported on school disengagement and delinquent behaviors. Family routine was assessed with mother report. Hierarchical regression analyses examined the independent and interactive effects of school disengagement and family routine on delinquent behaviors. After controlling for adolescent and mother age, marital status, and employment, school disengagement was independently associated with delinquent behaviors. Family routine was found to moderate school disengagement. Specifically, among adolescents exhibiting higher levels of school disengagement, lower levels of family routine were associated with higher levels of delinquent behaviors; however, higher levels of family routine were not associated with lower levels of delinquent behaviors. Findings suggest that lower levels of routine may be a particularly salient risk factor of delinquent behaviors among African American adolescents experiencing higher levels of school disengagement in low SES, urban communities.     

A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety, and depression

This study tested the specificity of parent alcoholism effects on young adult alcohol and drug abuse/dependence, anxiety, and depression, and tested whether adolescent symptomatology and substance use mediated parent alcoholism effects. Participants were from a longitudinal study in which a target child was assessed in adolescence and young adulthood with structured interview measures (N = 454 families at Time 1). Results showed unique effects of parent alcoholism on young adult substance abuse/dependence diagnoses over and above the effects of other parental psychopathology. There was some evidence of parent alcoholism effects on young adult depression and of maternal alcoholism effects on young adult anxiety, although these were not found consistently across subsamples. Mediational models suggested that parent alcoholism effects could be partially (but not totally) explained by adolescent externalizing symptoms.     

家庭功能与青少年消极冒险行为的关系:一个有调节的中介模型

为探讨家庭功能影响青少年消极冒险行为的作用机制及条件,采用青少年冒险行为问卷、家庭功能问卷、自尊问卷、同伴群体特征问卷对山东省日照市940名初高中学生进行调查。结果发现:(1)家庭功能不良不仅可直接预测青少年更多的消极冒险行为,而且也可通过使青少年交往更多不良同伴进而使其冒险行为进一步增多;(2)不良同伴交往对青少年消极冒险行为的预测受到个体自尊的调节。低自尊个体更容易受到不良同伴交往的影响而发生更多的消极冒险行为,表现出两风险因素的叠加效应。研究结果提示,家庭是青少年健康成长的基础,家庭功能不良可使青少年适应不良,塑造良好的同伴环境、培养良好的自我素质或可降低这一风险。     

Family Conflict and Children's Internalizing and Externalizing Behavior: Protective Factors

The current investigation examined whether the positive association of family conflict to adolescent depression and conduct problems is attenuated by maternal, paternal, and peer attachment, and maternal and paternal monitoring, within a low-income, multiethnic sample of 284 adolescents. Parental attachment and monitoring moderated the link from family conflict to conduct problems but not depression; the relationships among family conflict, the hypothesized protective factors, and conduct problems were further modified by adolescent gender but not ethnicity. In general, higher levels of the hypothesized protective factors attenuated the relationship between family conflict and conduct problems for girls but exacerbated this relationship for boys. These findings suggest that, in general, parental attachment and monitoring served as protective factors for girls while serving as additional risk factors for boys in conflictual families.