Social Risk and Protective Factors in Adolescents' Reduction and Cessation of Alcohol Use

BACKGROUND

Adolescents' alcohol use is related to many health problems, injuries, and violent acts, some with fatal consequences. A gap exists in the literature discussing risk/protective factors in change from non-heavy drinking to non-drinking, and also for change from heavy drinking to non-heavy drinking or non-drinking.

OBJECTIVE

This secondary study examined some risk and protective factors involved when adolescent non-heavy drinkers and adolescent heavy drinkers curb or terminate their drinking.

METHOD

The temporal-ordered analysis evaluated 570 nonheavy drinkers and 374 heavy drinkers (all adolescents), a sample extracted from Wave 1 and Wave 2 of the National Longitudinal Study of Adolescent to Adult Health, or Add Health.

RESULTS

We observed positive associations between likelihood of change from heavy/non-heavy drinking to nondrinking and 5 characteristics: neighborhood attachment, maternal receipt of public assistance, African American ethnicity, maternal involvement, physical maltreatment, depressive feelings, and substance-abuse treatment. We observed negative associations between this outcome and peer drinking, delinquent behaviors, drug use, and emotional maltreatment. Positive associations were found between likelihood of change from heavy drinking to non-heavy drinking and both maternal involvement and depressive feelings, while a negative association was found between this outcome and delinquent behaviors.

CONCLUSIONS

Reduction/cessation interventions should, at the individual level, focus on ending adolescent drinkers' associations with alcohol-using and delinquent peers. Interventions require supportive roles for parents, schools, and communities.

Racial/Ethnic Differences in Emotional Health: A Longitudinal Study of Immigrants' Adolescent Children

First, discrimination was conceptualized as a major source of stress for immigrants' adolescent children. Next, such children's emotional health (indicated by measures of self-esteem and depression) was examined for possible associations with discrimination, psychosocial supports, and social structure; additionally, race/ethnicity's possible moderating role in such associations was evaluated. Data from the first 2 waves of the Children of Immigrants Longitudinal Study (1991-2006) were employed, focusing on 3 groups: Asians, Hispanics, and Whites. Linear regression analyses were used to weigh how discrimination, psychosocial supports, and social structure measured at Wave 1 and Wave 2 related to self-esteem and depression measured at Wave 2. Asians exhibited the highest level of depression and were most likely to perceive discrimination; Asians' self-esteem was also low, compared to other groups'. Discrimination and psychosocial supports appeared to operate differentially in explaining the 3 groups' emotional health.

Racial Disparities in Intimate Partner Violence Examined Through the Multiple Disadvantage Model

This research adopted the perspective of the multiple disadvantage model to explore racial disparities in intimate partner violence (IPV) against women and IPV's links to social structural factors, social relationships, substance use, and health/mental health and access to related services. The study used data from 6,588 women who completed the National Violence Against Women Survey; linear regression was conducted separately for four ethnic groups. Results consistently showed physical assaults to increase with posttraumatic stress disorder symptoms. For African Americans, increases in assaults were linked to injury, disclosing IPV to friends/family as well as medical professionals, Medicaid use, and drug use; decreases, in turn, were linked to past assault by ex-partners. For Latinas, increases in assaults were associated with eight factors: being married, number of ex-partners, depression, disclosing IPV to friends/family and disclosing to mental-health professionals, drug use, alcohol abstinence, and partner's frequent alcohol use. For European Americans, increases in assaults were linked to number of ex-partners, injury, low income, Medicaid use, disclosing IPV to friends/family as well as mental-health professionals, and alcohol abstinence; decreases were associated with age and with other health insurance coverages. For women of other ethnicity, increases were linked to number of ex-partners, disclosing IPV to mental-health professionals, Medicaid use, drug use, and woman's own as well as partner's alcohol abstinence; decreases in this ethnicity category were linked to past assault by ex-partners. Intervention and policy implications are discussed.

Racial Disparities in Intimate Partner Violence and in Seeking Help With Mental Health

Applying Aday and Andersen's health services utilization model, this examination of racial disparities in women's experience of intimate partner violence also looked at racial disparities in mental disorders and in use of mental health professionals' help. We conducted a secondary data analysis of 6,589 women completing the National Violence Against Women Survey. Per our linear regression results, minority women, versus White, tended proportionally to seek less help from mental health professionals. Help seeking by African American women was less likely if they were using illegal drugs; among Hispanic women, additional threats from partner curtailed help seeking from mental health professionals. "Other ethnic minority" women's help seeking decreased with their use of stimulants. Implications for intervention are discussed.

Change in Adolescents’ Alcohol-Use Patterns, From Non-Drinking to Non-Heavy Drinking or Heavy Drinking

This study examined risk and protective factors at work when adolescents change from a non-drinking alcohol-use pattern to either non-heavy drinking or heavy drinking. Using a sample of 1,725 non-drinkers extracted from the National Longitudinal Study of Adolescent to Adult Health, we conducted multinomial logistic regression and found that likelihood of change from non-drinking to non-heavy drinking was associated positively with safe neighborhood, female, peers’ drinking, emotional maltreatment, and delinquent behaviors. We found a negative association between such likelihood and being African American. We found that likelihood of change from non-drinking to heavy drinking was associated positively with peers’ drinking, depressive feelings, drug use, and repeating a grade(s) at school. We found a negative association between such likelihood and having a married mother, being African American or some other non-Hispanic minority ethnicity, and maternal supervision. Implications for intervention and future research are discussed.

Race, Employment Disadvantages, and Heavy Drinking: A Multilevel Model

We intended to determine (1) whether stress from employment disadvantages led to increased frequency of heavy drinking and (2) whether race had a role in the relationship between such disadvantages and heavy drinking. Study data came from the National Longitudinal Survey of Youth, a prospective study that has followed a representative sample of youth since 1979. Our study employed data from 11 particular years, during which the survey included items measuring respondents' heavy drinking. Our final sample numbered 10,171 respondents, which generated 75,394 person-waves for data analysis. Both of our hypotheses were supported by results from multilevel mixed-effects linear regression capturing the time-varying nature of three employment disadvantages and of the heavy-drinking outcome. Results show that more-frequent heavy drinking was associated with employment disadvantages, and that disadvantages' effects on drinking were stronger for Blacks and Hispanics than for Whites. That worsening employment disadvantages have worse effects on minority groups' heavy drinking (compared to Whites) probably contributes to the racial health disparities in our nation. Policies and programs addressing such disparities are especially important during economic downturns.

Marital status and work-related health limitation: a longitudinal study of young adult and middle-aged Americans

OBJECTIVES

The literature establishes clearly the health benefit of marriage. Much less clear from published data is whether work-related health (dis)advantages accruing to marital transitions persist over time or are limited to the short term. Informed by the marital resources and marital crisis perspectives, this study sought links between marital status measured via three approaches and work-related health limitation, exploring these relationships across genders.

METHODS

The study employed data from eight recent waves (1996-2010) of the National Longitudinal Survey of Youth. It applied generalized estimating equations to estimate the impacts, on work-related health limitation, of current marital status; of marital transition 2 years in the past; and of marital transition 8 years in the past.

RESULTS

Our gender-specific results indicated that lower likelihood of work-related health limitation was associated with a married status, a stable married status, and an entry into marriage.

CONCLUSIONS

Results are consistent overall with the marital resources perspective. The use of three different approaches to evaluate the relationship of marital status to work-related health limitation may explain the gender-specific results.

Depression and Substance Use: A Temporal-Ordered Model

BACKGROUND AND OBJECTIVES

This study sought empirical evidence for the self-medication hypothesis. It asked whether diagnosis of depression, together with the use of mental-health care, leads to substance use.

METHODS

Data came from the 5-wave, longitudinal Fragile Families and Child Wellbeing (FFCW) Study, an investigation of a cohort of nearly 5,000 births, which over sampled non-marital births. FFCW examined newborns' biological mothers and fathers, all of whom lived in the United States. The adults were initially interviewed between 1998 and 2000 (the period of the cohort's births); they were then re-interviewed for four times over 10 years. FFCW measured mental health-related variables, level of drug use, and social structural and demographic factors, all of which are also measured by the present study. Respondents in our study's two final subsamples had responded to every FFCW interview item we would use in constructing our final model's variables. Our subsample of mothers totaled 3,477 women, from whom 5,987 person-waves were derived. Our subsample of fathers totaled 2,096 men, yielding 3,543 person-waves.

RESULTS

We used STATA generalized estimating equations for panel data, and found some evidence to support the self-medication hypothesis. In addition, our results indicated that the relationship of substance use to the use of mental-health care was gender-specific. Conclusions/Importance: Empirical evidence from this study only partially supported the self-medication hypothesis; the co-occurrence of depression and substance abuse in our sample was also reflective of social structural and demographic variables and of prior substance use variables.

Racial disparities in age at time of homicide victimization: a test of the multiple disadvantage model

This study sought the factors associated with race/ethnicity disparities in the age at which homicide deaths tend to occur. We used the multiple disadvantage model to take race into account as we evaluated associations between age at time of homicide victimization and several social structural, mental health-related, and lifestyle factors. Data were derived from the 1993 National Mortality Followback Survey, a cross-sectional interview study of spouses, next of kin, other relatives, and close friends of individuals 15 years and older who died in the United States in 1993. Our results showed age at time of homicide mortality to be related to the three types of factors; race moderated some of these relationships. In general, being employed, married, and a homeowner appeared associated with reduced victimization while young. The relationship of victimization age and employment was not uniform across racial groups, nor was the relationship of victimization age and marital status uniform across groups. Among Blacks, using mental health services was associated with longer life. Homicide by firearm proved important for our Black and Hispanic subsamples, while among Whites, alcohol's involvement in homicide exerted significant effects. Our results suggest that programs and policies serving the various racial/ethnic groups can alleviate multiple disadvantages relevant in homicide victimization at an early age.

Domestic Violence and Treatment Seeking: A Longitudinal Study of Low-Income Women and Mental Health/Substance Abuse Care

A study with 591 low-income women examined domestic violence's role in treatment seeking for mental health or substance abuse problems. (The women resided in one of two California counties.) Following Aday's behavioral model of health services utilization, the secondary data analysis considered the women's need, enabling, and predisposing factors. Generalized estimating equations analyzed the women's longitudinal records of treatment seeking. Results showed that those in the sample who were likely to seek treatment had experienced three or more controlling behaviors and only one abusive behavior. Multivariate data analysis showed treatment-seeking women were likely to be white and older; responsible for few dependent children; not graduates of high school; employed; not participating in Medicaid; diagnosed; and perceiving a need for treatment. The implications of these results for services and policies are discussed.

Problem drinking's associations with social structure and mental health care: race/ethnicity differences

This research used a nationally representative sample of 12,756 respondents self-identified as White, Black, Hispanic, or Asian to examine problem drinking in relationship to social structure and mental healthcare factors. Associations between problem drinking and particular factors varied by racial/ethnic group. Results also indicated that Whites' problem-drinking rates were higher than those of Hispanics, Blacks, and Asians. Americans sometimes use alcohol to manage stress stemming from social disadvantage and inadequate material resources. Across racial/ethnic groups, drinking level was associated with the type and degree of such disadvantage. Additionally, the presence of a mental health problem was associated with problem drinking.

The role of immigration status in heavy drinking among Asian Americans

We examined the role of Asian Americans' immigration status in their heavy drinking, using a national sample of 3,574 Asian American adults during 2008 to 2011 when surveyed by the National Health Interview Survey. Our results, with relevant social structural factors controlled, show that U.S.-born Asian Americans exhibited the highest heavy-drinking levels, followed by long-time-resident Asian immigrants, then recent-resident Asian immigrants (our three main subsamples). The higher heavy-drinking levels characterizing U.S.-born Asians who were male and younger, as compared to immigrant Asians who were male and younger, helped explain differential heavy-drinking levels across subsamples. The study's limitations are noted.

A spatial analysis of student binge drinking, alcohol-outlet density, and social disadvantages

BACKGROUND AND OBJECTIVES

This paper examined whether and how student binge drinking at the individual level was influenced by population disadvantages, community instability, alcohol-outlet density, and protective factors generated by community and school.

METHODS

We used a dataset collected in 2002 by the Alabama Department of Mental Health, with additional materials generated by the 2000 Census and from the Alabama State Department of Education. School-catchments were employed as geographic units of analysis. The final sample comprised 78,138 public-school students in grades 6-12 who attended schools located in the 566 school-catchments.

RESULTS

We hypothesized the presence of spatial processes that, once identified, would enhance understanding of student binge drinking. Our results confirmed that student binge drinking in a focal area was affected by that area's structural factors and also by individual-level risk and protective factors. The results did not support the hypothesized impact of surrounding areas' characteristics on student binge drinking in the focal area.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

The results of our study clearly indicate that both environment-based factors and individual-level risk and protective factors are important in explaining student binge drinking in Alabama.

Urban-rural differentials: a spatial analysis of Alabama students' recent alcohol use and marijuana use

BACKGROUND AND OBJECTIVES

This study of Alabama public school students sought urban-rural differences in social and spatial mechanisms connecting structural factors to recent use of alcohol and marijuana.

METHODS

Its dataset comprised a state-sponsored 2002 need-assessment survey of Alabama students; Alabama education department data; U. S. Census data; and alcohol-outlet locations listed by Alabama's Alcoholic Beverage Control Board. It measured structural-disadvantage factors (population disadvantages, community instability, alcohol-outlet density), social-organization factors (protective role of community, protective role of school), and recent-use factors. Using Geographic Information Systems (GIS), it generated maps of school catchment areas (SCAs)-the units of analysis for the study-that outline spatial patterns (across areas deemed urban or rural) of students' recent use of alcohol and marijuana.

RESULTS

In the final sample of 370 SCAs, significant urban-versus-rural differences were observed for certain structural factors and in how these factors were associated with substance use. These differences aside, spatial analysis weighing the SCAs' particular geographic characteristics suggested location's importance, showing that a school playing a strong protective role significantly reduced not just its own students' recent substance use, but that of students in neighboring SCAs as well.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

The findings show students' recent use of alcohol and marijuana are associated with characteristics of the environment. (Am J Addict 2013; 22:188-196).

Problem drinking by race and nativity: what is learned from social structural and mental health-related data of US-born and immigrant respondents?

BACKGROUND AND OBJECTIVES

 Although heavy drinking is considered a health risk, research demonstrates that some adults turn to alcohol in an effort to manage disabling stress or mental health problems. Race and nativity may be associated with such decisions to "self-medicate" with alcohol. This study identified and compared links between problem drinking and social structural and mental health-related factors for four race-nativity groups.

METHODS

 Using data from the 2009 National Health Interview Survey, the final sample comprised 7,905 US-born Whites, 390 foreign-born Whites, 2,110 US-born Blacks, and 193 foreign-born Blacks. Investigated were the social structural variables of demographic factors (age, gender), socioeconomic status (employment, income, education), and social integration factors (family size, living with a partner). Mental health-related variables included chronic mental illness and access to and use of mental health services.

RESULTS

 Overall, both types of variables were found to be associated with large-quantity drinking and frequent binging, with the strength of association varying-for some factors-by race and/or nativity. Further, the findings indicated that, in the presence of chronic mental illness, both US- and foreign-born Black Americans engaged in relatively frequent binge-drinking when health-care variables were controlled.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

 These results underscore the need for mental health professionals to identify co-occurring mental illness and alcohol abuse among Black clients and, where it is found, to seek the root causes of the persistent stress that tends to accompany this co-occurrence.

The role of mental illness in alcohol abuse and prescription drug misuse: gender-specific analysis of college students

The present study examined whether and how collegians' misuse of prescription drugs and alcohol abuse are associated with mental illness and with a lack of mental health care. Nationally representative data were derived from 5,241 full-time American college students who completed the 2010 National Survey on Drug Use and Health. We observed the presence of alcohol abuse/dependence and the nonmedical use of prescription drugs to be associated with relatively serious mental illness and with lack of health care. In pursuing gender-specific results, we found that the association between alcohol abuse and mental illness was stronger among females than males.

Factors leading African Americans and black Caribbeans to use social work services for treating mental and substance use disorders

This secondary analysis of 5,000 African Americans and black Caribbeans explored how their use of social work services to address mental and substance use disorders was associated with the disorder involved as well as their perceived need for services, belief system, family resources, proximity to services, social-structural factors, and demographic characteristics. The sample was extracted from a national data set. Results of multinomial logistic regression showed that use of social work services was increased by dual diagnosis, substance use disorder alone, and mental disorder alone; by deteriorating mental health; by perceived stigma in treatment use; by welfare receipt and insurance coverage for mental health services; and by college graduation. Results also showed that use of services outside social work was promoted by dual diagnosis, substance use disorder alone, and mental disorder alone; by deteriorating mental health; by experience of racial discrimination; by insurance coverage for mental health services; by college education or graduation; and by female gender and increasing age. The findings' implications for social work intervention and education are discussed.

Intimate partner violence and welfare participation: a longitudinal causal analysis

This longitudinal study examined the temporal-ordered causal relationship between intimate partner violence (IPV), five mental disorders (depression, generalized anxiety disorder, social phobia, panic attack, posttraumatic stress disorder [PTSD]), alcohol abuse/dependence, drug abuse/dependence, treatment seeking (from physician, counselor, and self-help group), employment, child support, and welfare participation. It was a secondary data analysis of records of 571 women; the records were extracted from the study "Violence Against Women and the Role of Welfare Reform" (VAWRWR). Results from generalized estimating equations (GEE) showed that experiencing controlling behaviors reduced likelihood of welfare participation whereas experiencing physical abuse increased it. Significant impact on welfare participation was wielded by panic attack, drug abuse/dependence, and employment; treatment seeking and child support made no significant impact. The study found no significant mediating effect wielded by panic attack, drug abuse/dependence, employment, or child support on welfare participation's relationship to controlling behaviors or physically abusive behaviors experienced. Implications for intervention are discussed.

IR photodissociation spectroscopy of H7(+), H9(+), and their deuterated analogues

Cluster ions of H7(+)/D7(+) and H9(+)/D9(+) produced in a supersonic molecular beam with a pulsed discharge source are mass selected and studied with infrared laser photodissociation spectroscopy. Photodissociation occurs by the loss of H2 (D2) from each cluster, producing resonances in the 2000-4500 cm(-1) region. Vibrational patterns indicate that these ions consist of an H3(+) (D3(+)) core ion solvated by H2 (D2) molecules. There is no evidence for the shared proton structure seen previously for H5(+). The H3(+) ion core vibrational bands are weakened and broadened significantly, presumably by enhanced rates of intramolecular vibrational relaxation. Computational studies at the DFT/B3LYP or MP2 levels of theory (including scaling) are adequate to reproduce qualitative details of the vibrational spectra, but neither provides quantitative agreement with vibrational frequencies.

The role of social structural factors in treatment of mental health disorder

BACKGROUND

Mental disorder implies a biopsychosocial condition, so adequate mental health treatment involves not just medical and pharmacological care but also psychotherapy or counseling.

AIMS

The present study determined how social structural factors might explain accessing of primary care providers and specialty care providers in response to mental disorder, hypothesizing that the two broad types of care differ as to the likelihood of offering minimally adequate treatment.

METHOD

We analyzed data from the cross-sectional study called "2000-2001 Healthcare for Communities", employing five imputed data sets to handle missing data and defining minimally adequate treatment of mental disorder as "at least four counseling sessions at any provider and prescribed medication". Results While mental disorder can be treated in primary care or specialty facilities, our results show that minimally adequate treatment (as defined) is most likely to be obtained via specialty care.

CONCLUSION

For individuals with mental disorder, accessing only primary care creates social inequity, because care from specialty facilities is comparatively more adequate.

Racial differences in co-occurring substance use and serious psychological distress: the roles of marriage and religiosity

The study examined how marriage and religiosity can protect members of certain racial/ethnic groups against co-occurring substance use and serious psychological distress. Using the national dataset 2007 National Survey on Drug Use and Health, we analyzed data via multinomial logistic regression, observing several important results. Our findings generally support the deprivation-compensation thesis, in that religiosity elevates the mental health of racial/ethnic minority individuals more than that of Whites. We also found, however, that race/ethnicity moderates effects of education and poverty on the co-occurring behaviors, with Whites' mental health benefiting more from wealth and education than Blacks' or Hispanics' mental health did.