Protective Predictors of Alcohol Use Trajectories Among Canadian Aboriginal Youth

Optimism, pessimism, and physical health among youth: a scoping review

OBJECTIVE

High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in youth. The present study aimed to review the literature investigating optimism, pessimism, and physical health in children and adolescents from populations with and without health conditions.

METHODS

We conducted a scoping review up until February 2024. Studies were included if they sampled youth (average age ≤18 years) and treated optimism or pessimism as predictors of health behaviors or outcomes. Data on study and sample characteristics, health outcome, optimism construct, and findings were extracted from eligible papers and results were synthesized.

RESULTS

Sixty studies were retained. Most studies were conducted in North America, with adolescents, and used cross-sectional designs and self-reported measures of health. Measures of optimism and pessimism differed across studies. Roughly one-third of studies sampled medical populations. Health categories included substance use, diet and physical activity, sexual health practices, medical adherence, other health behaviors, cardiometabolic health, subjective health/health-related quality of life, pain, sleep, and oral health. Generally, we observed adaptive associations between optimism and health. Higher optimism and lower pessimism were most consistently associated with lower rates of substance use and lower cardiometabolic risk.

CONCLUSIONS

The presence of optimism or the absence of pessimism appears to be associated with various adaptive health outcomes among youth with and without health conditions. Developmental, methodological, and clinical considerations for future research are discussed, such as conducting longitudinal studies with objective measures of health and psychometrically validated instruments.

The Protective Role of Grit against Alcohol and Cannabis Use through Young Adulthood

Introduction: Problematic substance use in young adulthood is consistently related to negative outcomes later in life. Understanding the factors that protect against problematic substance provides opportunities for early preventive intervention. We examine the protective role of grit - passion and perseverance for long-term goals - on substance use through young adulthood, a period of heightening risks for substance use. Methods: In this research, we use cross-lagged panel models and data from the Victoria Healthy Youth Survey (N = 477, 52% female) to test the reciprocal within-time associations and the directional relationships between grit (passion and perseverance) and substance use (cannabis and alcohol) across three assessments (6 years, ages 18-29). All models controlled for sex and SES. Results: Significant findings show negative within-time associations between passions and perseverance and cannabis use at T1 (ages 18-24) and at T2 (ages 20-26), and significant, negative within-time associations between passion and perseverance and alcohol use (heavy episodic drinking) at T1 but not at T2. No significant across-time associations between passion and perseverance and substance use were found. Conclusion: Preventive interventions to enhance passion and perseverance may provide important targets for interventions for young adults to reduce current substance use. However, grit did not have an effect beyond the stability of cannabis use or alcohol use over time, suggesting effects may act by substituting proactive goals for current substance use.

Substance use behavior among Hispanic emerging adults in Los Angeles, California

This research examined illicit drug use and substance abuse disorders among Hispanic emerging adults using a two time-point study. Hypothesized predictors included concurrent use of different types of substances in adolescence and early adulthood (illicit drug use, binge alcohol use, and cigarette-smoking), along with the socialization context (family, peer, school, and other contextual factors) in adolescence. Overall, the findings showed that emerging adults who engaged in binge use of alcohol reported higher levels of illicit drug use and substance abuse disorders. Smoking cigarettes was associated with higher levels of illicit drug use in emerging adulthood, but not substance use disorders. Illicit drug use and binge alcohol use in adolescence were linked to higher levels of illicit drug use in emerging adulthood. Further, respondents who engaged in higher levels of illicit drug use, binge drinking, and smoking in adolescence were more likely to report higher levels of substance use disorders in early adulthood, signaling the importance of assessing adolescent drug use as a critical period for curbing long-term substance use-related impairment. Sibling alcohol use, college aspirations, and perceived discrimination during adolescence were also predictive of higher levels of substance use disorders in early adulthood. Higher academic achievement in adolescence, however, was associated with lower levels of illicit drug use in emerging adulthood. Lastly, males reported higher levels of illicit drug use and substance abuse disorders than females.

Alcohol consumption and dependence is linked to the extent that people experience need satisfaction while drinking alcohol in two Aboriginal and Torres Strait Islander communities

BACKGROUND

Unhealthy alcohol use is a key concern for Aboriginal and Torres Strait Islander ('Indigenous Australian') communities. Due to systematic disadvantage and inter-generational trauma, Indigenous Australians may be less likely to have satisfied basic psychological needs (autonomy, competence, and relatedness). When people are need-thwarted, they may engage in compensatory behaviours to feel better in the short-term. We explore the relationship between perceived basic psychological needs satisfaction and alcohol consumption use among Indigenous Australians. Better understanding the functions that alcohol may play for some Indigenous Australian drinkers may aid communities, clinicians, and policy makers in improving programs for reducing drinking-related harms.

METHODS

We performed a cross-sectional survey of Indigenous Australians (aged 16 years or older) living in two South Australian communities. Participants were eligible if they had consumed any alcohol in the past 12 months. Spearman correlations and linear regressions were used to determine if feeling more autonomous, competent, and related to others (need satisfied) while drinking, was linked to alcohol consumption and dependence.

RESULTS

Controlling for participant demographics, reporting feeling need satisfied while drinking was linked to drinking more alcohol per day, reporting more frequent symptoms of alcohol dependence, spending more money on alcohol, and scoring higher on the AUDIT-C.

CONCLUSIONS

Unhealthy drinking may partly stem from attempts to satisfy basic psychological needs. Programs which support Indigenous Australians to meet basic psychological needs could reduce attempts to meet psychological needs through alcohol consumption.

Optimism and Mental Health in Adolescence: a Prospective Validation Study of the Dutch Life-Orientation Test-Revised (LOT-R-A) for Adolescents

The study aimed to examine the psychometric properties of the Dutch Life Orientation Test-Revised for Adolescents (LOT-R-A), a self-report questionnaire assessing dispositional optimism, and to evaluate the two-factor structure (optimism, pessimism). The LOT-R-A and the questionnaires measuring well-being (MHC-SF-A) and psychological problems (SDQ) were completed by 459 Dutch adolescents (178 boys and 281 girls) between the ages of 11 and 18 years at baseline and 281 adolescents at a four-week follow-up. The results confirmed the two-factor structure (optimism, pessimism) of the LOT-R-A. The findings provided evidence of internal consistency of scores ranging from low to good, and evidence of good test-retest reliability of scores. Further, scores of optimism were cross-sectionally positively associated with scores of positive emotions and well-being and negatively with scores of psychological problems and negative emotions, providing evidence of convergent and divergent validity of optimism scores with emotions, well-being, and psychological problems. Lastly, scores of optimism were prospectively positively associated with scores of well-being and negatively with scores of psychological problems, providing evidence of criterion validity of optimism scores with well-being and psychological problems. Based on these findings it can be concluded that the LOT-R-A is a valid instrument to examine optimism among adolescents. Future research can help to elucidate the role of optimism in mental health interventions and can gather knowledge on how these interventions can be refined to optimally cultivate optimism during the developmental period of adolescence.

Identifying Competing Life Reinforcers for Substance Use in First Nation Adolescents

Background: Indigenous youth are at increased risk of initiating substance use at early ages and suffer greater negative consequences related to substance use as compared to non-Indigenous youth. Behavioral Theories of Choice suggests that substance use is contingent on the availability of substances and the availability of alternatives to substance use. Objectives: The present study aimed to investigate risk and protective factors associated with substance use in one group of First Nation adolescents. Methods: Using a modified grounded theory approach, the present study conducted qualitative focus groups and individual interviews with fifteen reserve-dwelling (75% female, M age = 15.2 years) First Nation adolescents to assess categories of risk and protective factors based upon Behavioral Theories of Choice. Results: Adolescents identified peer influences, parental/family influences, and community influences and issues as risk and protective factors associated with substance use. Conclusions: Results highlight possible targets of culturally appropriate prevention strategies for Indigenous populations.

Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action

OBJECTIVES

Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in life, higher rates of trauma and self-medication with alcohol and other substances.

DESIGN AND SETTING

Retrospective data were collected from a sample recruited through referral from diverse social and health agencies in Winnipeg and Vancouver.

PARTICIPANTS

Eligibility included being 19 years or older, current mental disorder and homelessness.

MEASURES

Data were collected via interviews, using questionnaires, on sociodemographics (eg, age, ethnicity, education), mental illness, substance use, physical health, service use and quality of life. Univariate and multivariable models were used to model the association between Indigenous ethnicity and dependent variables.

RESULTS

A total of 1010 people met the inclusion criteria, of whom 439 self-identified as Indigenous. In adjusted models, Indigenous ethnicity was independently associated with being homeless at a younger age, having a lifetime duration of homelessness longer than 3 years, post-traumatic stress disorder, less severe mental disorder, alcohol dependence, more severe substance use in the past month and infectious disease. Indigenous participants were also nearly twice as likely as others (47% vs 25%) to have children younger than 18 years.

CONCLUSIONS

Among Canadians who are homeless and mentally ill, those who are Indigenous have distinct histories and current needs that are consistent with the legacy of colonisation. Responses to Indigenous homelessness must be developed within the context of reconciliation between Indigenous and non-Indigenous Canadians, addressing trauma, substance use and family separations.

TRIAL REGISTRATION NUMBER

ISRCTN42520374, ISRCTN57595077, ISRCTN66721740.

Correlates of Illicit Drug Use Among Indigenous Peoples in Canada: A Test of Social Support Theory

Relying on a national stratified random sample of Indigenous peoples aged 19 years old and above in Canada, this study investigates the correlates of illicit drug use among Indigenous peoples, paying special attention to the association between social support measures and illegal drug use. Results from multivariate logistical regression show that measures of social support, such as residential mobility, strength of ties within communities, and lack of timely counseling, are statistically significant correlates of illicit drug use. Those identifying as Christian are significantly less likely to use illegal drugs. This is the first nationwide analysis of the illicit drug usage of Indigenous peoples in Canada. The results are robust because we have controlled for a range of comorbidity variables as well as a series of sociodemographic variables. Policy implications from these findings are discussed.

The mental health of Indigenous peoples in Canada: A critical review of research

Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.

Healing of the canoe: preliminary results of a culturally tailored intervention to prevent substance abuse and promote tribal identity for Native youth in two Pacific Northwest tribes

Using Community-based and Tribal Participatory Research (CBPR/TPR) approaches, an academic-tribal partnership between the University of Washington Alcohol and Drug Abuse Institute and the Suquamish and Port Gamble S'Klallam Tribes developed a culturally grounded social skills intervention to promote increased cultural belonging and prevent substance abuse among tribal youth. Participation in the intervention, which used the Canoe Journey as a metaphor for life, was associated with increased hope, optimism, and self-efficacy and with reduced substance use, as well as with higher levels of cultural identity and knowledge about alcohol and drugs among high school-age tribal youth. These results provide preliminary support for the intervention curricula in promoting positive youth development, an optimistic future orientation, and the reduction of substance use among Native youth.

Religiosity/spirituality and substance use in adolescence as related to positive development: a literature review

Positive youth development interventions are strategies to address adolescent health risk behaviors and are recommended in Healthy People 2020. Although the incorporation of spirituality into these programs has been recommended, much of the empirical literature actually addresses religiosity rather than spirituality. The purpose of our review of 36 studies published between 2007 and 2013 was to (1) examine the relationship of religiosity and/or spirituality to substance use and abuse in adolescence, (2) discuss the measurement and meaning of the concept of spirituality in contrast to religiosity in adolescence, and (3) discuss the implications of these empirical studies for the concept of positive youth development. Findings from this literature review supported earlier findings of an inverse relationship between religiosity and substance use, a lack of or inconsistent definition of spirituality and religiosity as well as limited measures to address these constructs. Recommendations from this review include dedicated work by interdisciplinary teams to address consistency in definitions and creation of consistent tools that include consideration of the stages of development included in the adolescent years. From a research and clinical perspective, an interprofessional approach to clarify the concepts of spirituality and spiritual development would not only benefit research but could inform the substance abuse prevention field. This work is essential to insure that evidence-based strategies, which include religiosity and spirituality, are developed with the goal of protecting youth and supporting positive development of adolescents.

Investigating the interlinkages of alcohol use and misuse, spirituality and culture - Insights from a systematic review

Religious values are part of cultures, but spirituality is an internal dimension which may be present in varying degrees across all nations. As both cultural and spiritual factors are important in determining the pattern of alcohol consumption by individuals, it is important to study the relationships between them. The present systematic review aims to summarize the knowledge on the relationship between alcohol use and misuse, religiousness/spirituality and culture drawn from medical studies. Data from the medical literature to date indicate that for some racial and ethnic minorities a return to the traditional culture linked with concepts of spiritual or religious factors can produce a major degree of support for people trying to maintain abstinence from alcohol. This can be seen even in the worst environments. On the other hand, among the general population, religion and/or spirituality can play a positive role in the maintenance of abstinence, but a local heavy drinking culture is a strong risk factor for relapse. These factors are important and can be used for interventions and prevention strategies. However, possible mediating effects need to be explored further. It is likely that both types of intervention (classical medical treatment plus spiritual-based treatment) may work in individuals.

Health research involving First Nations, Inuit and Métis children and their communities

Canadian and international guidelines address the ethical conduct of health research in general and the issues affecting Indigenous populations in particular. This statement summarizes, for clinicians and researchers, relevant ethical and practical considerations for health research involving Aboriginal children and youth. While not intended to duplicate findings arising from lengthy collaborative processes, it does highlight 'wise practices' that have successfully generated knowledge relevant to, respectful of and useful for Aboriginal children, youth and their communities. Further research on current health issues and inequities should lead to practical, effective and culturally relevant applications. Expanding our knowledge of ways to address the health disparities facing Canada's Aboriginal children and youth can inform health policy and the provision of services. Community-based participatory research is proposed as a means to achieve this goal.