Adolescent drinking behaviour and family socialization factors: a meta-analysis

Exploring Triadic Family Relationship Profiles and Their Implications for Adolescents' Early Substance Initiation

This study examined combinations of warmth and hostility in mother-father-adolescent triadic relationships when adolescents were in 6th grade and associations with adolescent middle school substance initiation. We conducted a latent profile analysis with a sample of 687 two-parent families (52.4% of adolescents were female, mean age = 11.27 at 6th grade). These analyses revealed five profiles of triadic relationships, labeled as: cohesive families (46%, high warmth and low hostility in all three dyads), compensatory families (24%, low interparental warmth but high parent-adolescent warmth), disengaged families (13%, average to low warmth and hostility in three dyads), distressed families (9%, high hostility and low warmth in all three dyads), and conflictual families (8%, high hostility and average warmth in all three dyads). There were significant differences across triadic relationship profiles in rate of alcohol initiation during middle school. Specifically, adolescents in distressed families and conflictual families initiated alcohol at higher rates than adolescents in other types of families. Cohesive families and compensatory families initiated alcohol at the lowest rates among all five types of families. Similar patterns appeared for drunkenness and cigarettes. Implications for family-based interventions to decrease adolescent substance use and future research directions are discussed.

Parental drinking according to parental composition and adolescent binge drinking: findings from a nationwide high school survey in Japan

Background

Alcohol problems in parents have been revealed to affect adolescent alcohol misuse. However, few studies examine the effects of parental drinking on adolescent risky drinking (including binge drinking) in the general population. In particular, previous study findings are inconsistent regarding the influence of parental drinking according to parental composition. In this study, we aimed to examine the relationship between parental drinking, according to parental composition, and binge drinking among high school students in Japan.

Methods

We performed a secondary analysis of the Nationwide High School Survey on Drug Use and Lifestyle 2018, Japan. A total of 46,848 valid surveys from high school students of 78 schools were included for analysis. Logistic regression analysis with a generalized linear mixed model was conducted with binge drinking as the dependent variable and “parental drinking according to parental composition” (e.g., father’s drinking, mother’s drinking, father’s absence, mother’s absence, both parents drinking, and neither parent at home) as the independent variable, after adjusting with covariates. Binge drinking was defined as five or more alcoholic drinks for male adolescents or four or more alcoholic drinks for females on the same occasion within two hours.

Results

In the fully adjusted models, adolescents whose mothers drink (adjusted odds ratio (AOR): 1.50, 95% confidence interval (CI): 1.06–2.12) were significantly associated with adolescent binge drinking. This risk was significantly higher among students with neither parent living at home (AOR: 4.35, 95% CI: 2.10–9.02).

Conclusion

Parental drinking and absence do affect adolescent binge drinking; our findings show that adolescents are more likely to engage in binge drinking if their mothers drink or if they are not living with either parent. Therefore, it is important to engage parents and non-parental family members in future programs and interventions to prevent adolescent binge drinking.

Latent profiles of family background, personality and mental health factors and their association with behavioural addictions and substance use disorders in young Swiss men

Background:

Recent theories suggest that behavioural addictions and substance use disorders may be the result of the same underlying vulnerability. The present study investigates profiles of family background, personality and mental health factors and their associations with seven behavioural addictions (to the internet, gaming, smartphones, internet sex, gambling, exercise and work) and three substance use disorder scales (for alcohol, cannabis and tobacco).

Methods:

The sample consisted of 5287 young Swiss men (mean age = 25.42) from the Cohort Study on Substance Use Risk Factors (C-SURF). A latent profile analysis was performed on family background, personality and mental health factors. The derived profiles were compared with regards to means and prevalence rates of the behavioural addiction and substance use disorder scales.

Results:

Seven latent profiles were identified, ranging from profiles with a positive family background, favourable personality patterns and low values on mental health scales to profiles with a negative family background, unfavourable personality pattern and high values on mental health scales. Addiction scale means, corresponding prevalence rates and the number of concurrent addictions were highest in profiles with high values on mental health scales and a personality pattern dominated by neuroticism. Overall, behavioural addictions and substance use disorders showed similar patterns across latent profiles.

Conclusion:

Patterns of family background, personality and mental health factors were associated with different levels of vulnerability to addictions. Behavioural addictions and substance use disorders may thus be the result of the same underlying vulnerabilities.

Viewing images of alcohol use in PG-13-rated movies and alcohol initiation in Mexican-heritage youth

Mexican American adolescents report high rates of alcohol consumption as well as media use. Viewing alcohol images in the media is associated with increased alcohol consumption; however, to date, this association has not been examined across different ethnic groups in the United States. To bridge this gap, we examined the association between viewing alcohol use images in PG-13-rated movies and alcohol initiation in Mexican-heritage adolescents. A cohort of 1,154 Mexican-heritage youth, average age 14 years, was followed for 2 years; in 2008-2009, participants reported alcohol use in the past 30 days and again in 2010-2011. Exposure to alcohol use images in PG-13-rated movies was estimated from 50 movies randomly selected from a pool of 250 of the top box office hits in the United States using previously validated methods. A series of generalized linear models, adjusting for age, gender, peer and family alcohol use, family functioning, anxiety, sensation-seeking tendency, and acculturation were completed. Multiple imputation was utilized to address missing data. Overall, N = 652 participants reported no alcohol use in 2008-2009; by 2010-2011, 33.6% (n = 219) had initiated alcohol use. Adjusted models indicated an independent association between exposure to alcohol use images in PG-13-rated movies and alcohol initiation (comparing quartiles 3 to 1: RR =1.53; 95% CI [1.11, 2.10]). The findings emphasize that the relationship between viewing alcohol use scenes in American films and alcohol initiation holds among Mexican-heritage adolescents and underscore the need to limit adolescents' exposure to such powerful images in PG-13-rated movies.

Perceptions of alcohol use in UK 12–14 year olds

Purpose

A continuing challenge in the design of effective interventions to prevent adolescents’ alcohol misuse is understanding adolescent drinking behaviour. Although previous research has indicated a number of factors that might predict drinking behaviour, there has been less qualitative exploration of adolescents’ own views. The purpose of this paper is to gain a further understanding of adolescents’ views towards alcohol use and the types of environment in which adolescents drink alcohol.

Design/methodology/approach

A qualitative design was employed with eight focus groups conducted in groups of 3–5 with 27 adolescents (12 girls and 15 boys) aged between 12 and 14.

Findings

Thematic analysis identified overarching themes evident across groups suggesting key influences on adolescent drinking behaviour are “social norms”, “enjoyment of alcohol”, “images” and “creation of drinking spaces”.

Research limitations/implications

This research highlights the importance of environments, parents, friends and peers in understanding adolescent’s alcohol use.

Practical implications

The implications of this research suggest that interventions should consider targeting peer groups.

Social implications

These themes highlight the importance of more socially based interventions.

Originality/value

This paper explores adolescents’ own views of their drinking behaviours.

Polygenic risk, family cohesion, and adolescent aggression in Mexican American and European American families: Developmental pathways to alcohol use

Poor family cohesion and elevated adolescent aggression are associated with greater alcohol use in adolescence and early adulthood. In addition, evocative gene-environment correlations (rGEs) can underlie the interplay between offspring characteristics and negative family functioning, contributing to substance use. Gene-environment interplay has rarely been examined in racial/ethnic minority populations. The current study examined adolescents' polygenic risk scores for aggression in evocative rGEs underlying aggression and family cohesion during adolescence, their contributions to alcohol use in early adulthood (n = 479), and differences between Mexican American and European American subsamples. Results suggest an evocative rGE between polygenic risk scores, aggression, and low family cohesion, with aggression contributing to low family cohesion over time. Greater family cohesion was associated with lower levels of alcohol use in early adulthood and this association was stronger for Mexican American adolescents compared to European American adolescents. Results are discussed with respect to integration of culture and racial/ethnic minority samples into genetic research and implications for alcohol use.

Parents who exit and parents who enter. Family structure transitions, child psychological health, and early drinking

This paper seeks to extend prior research by exploring whether family structure transition is associated with an increase in early alcohol consumption and whether this association is mediated by; children's socio-emotional problems, providing information on whether the effects of the transition; differ according to the number of changes, the family's initial status, or the time of exposure. The; data have been drawn from the UK Millennium Cohort Study to explore associations framed with; a life-course approach. Our findings suggest that types of family transitions (such as distinguishing; parental exits from and parental entrances to the family) are more important than the number of; family changes during childhood. The results show that moving from a two-parent household to a single-parent household directly increased the probability of being a frequent alcohol consumer among early adolescent boys, whereas the indirect effect on girls was found via socio-emotional difficulties. Our findings also show an increase in socio-emotional and behavioural difficulties in boys due to the entrance of a step-parent only if the transition occurred in the earliest childhood. Indeed, a sensitivity analysis of the time to which the children were exposed to the transition to a new family structure showed stronger effects for those who experienced a family structure change in the early life course, consistent with the cumulative disadvantage process.

Identifying demographic and psychosocial factors related to the escalation of smoking behavior among Mexican American adolescents

Cigarette smoking is the leading preventable cause of death in the United States; smoking in Mexican American adolescents, a rapidly growing population, remains a major concern. Factors associated with escalation or progression along the smoking trajectory have not been studied in adolescent Mexican Americans. A better understanding of escalation is needed for cancer prevention and overall health. N=1,328 Mexican American adolescents joined a cohort in 2005-06. At baseline participants provided demographic, acculturation and psychosocial data, and reported their smoking status using the Minnesota Smoking Index. Those that never tried a cigarette or only had a few puffs in their life were included in this study. The primary outcome of interest, escalation in smoking status, was defined as moving up the Minnesota Smoking Index by 2010-2011. The current analysis is based on 973 participants of whom 48.2% were male, mean age=11.8 (SD=0.8), and 26.0% were born in Mexico. By 2010-2011, 283 (29%) escalated their smoking status and 690 (71%) remained the same. Being older (OR=1.30; CI=1.07-1.57), male (OR=1.88, CI=1.40-2.53), having higher levels of anxiety (OR=1.03, CI=1.02-1.05), intending to smoke (OR=1.70, CI=1.18-2.46), having friends who smoke (OR=1.73, CI=1.12-2.70) and having parents' friends who smoke (OR=1.38, CI=1.02-1.88) increased risk for smoking escalation. Higher levels of subjective social status (OR=0.91, CI=0.83-0.99) were protective against smoking escalation. Contrasting previous work in smoking experimentation, parents' friends influence was a stronger predictor than the family household influence. Preventative interventions for Mexican American youth could address this risk factor to reduce smoking escalation.

Adolescent drinking-a touch of social class?

AIMS

To estimate whether parental socio-economic status (SES) is associated with adolescent drinking, and the degree to which a possible association may be accounted for by various parental factors.

DESIGN AND SETTING

Cross-sectional Norwegian school survey from 2006 (response rate: 86%).

PARTICIPANTS

Students aged 13-14 years (n = 5797), 15-16 years (n = 6613) and 17-18 years (n = 5351), of whom 51% were girls.

MEASUREMENTS

Parents' education was our main SES indicator, and we distinguished between low (7%) and middle/high (93%) educational level. The outcomes comprised past-year drinking and intoxication. We also applied measures on general parenting, parents' alcohol-related permissiveness and parental intoxication. The main analyses were conducted using Poisson regression.

FINDINGS

Parents' education had no statistically significant impact on alcohol use among the 17-18-year-olds, while 13-16-year-olds with low educated parents had an elevated relative risk (RR) of both drinking [RR = 1.21, 95% confidence interval (CI) = 1.13-1.29] and intoxication (RR = 1.32, 95% CI = 1.21-1.44). The RRs became statistically insignificant when including all the parental factors as covariates in the regression models. Among adolescents who had consumed alcohol, low parental education was related to more frequent drinking (RR = 1.24, 95% CI = 1.11-1.38) and intoxication episodes (RR = 1.42, 95% CI = 1.22-1.66). Again, the RRs became statistically insignificant when we accounted for all the parental factors. This pattern was replicated when we applied an alternative indicator for low parental SES.

CONCLUSIONS

Adolescent drinking in Norway appears to be related inversely to parents' social standing. The elevated risk of low socio-economic status vanishes when general parenting, alcohol-related parental permissiveness and parents' drinking are accounted for.

Smoking Initiation Among Mexican Heritage Youth and the Roles of Family Cohesion and Conflict

PURPOSE

High levels of family conflict increase the risk for early smoking initiation and smoking escalation among adolescents, whereas high levels of warmth and cohesion in the family are protective against smoking initiation. However, little is known about the associations between changes in family function during adolescence on subsequent smoking initiation among Mexican heritage adolescents.

METHODS

In 2005-2006, 1,328 Mexican heritage adolescents aged 11-14 years enrolled in a cohort study to examine nongenetic and genetic factors associated with cigarette experimentation. In 2008-2009, 1,154 participants completed a follow-up. Multivariate logistic regression models were computed to prospectively examine associations between smoking behavior assessed in 2008-2009 and changes in family cohesion and family conflict assessed in both 2005-2006 and 2008-2009, controlling for gender, age, and linguistic acculturation, positive outcome expectations associated with smoking, as well as friends and family smoking behavior.

RESULTS

Overall 21% had tried cigarettes by 2008-2009. Consistently low levels of family cohesion (odds ratio [OR] = 3.06; 95% confidence interval [CI], 1.38-6.73) and decreases in family cohesion (OR = 2.36; 95% CI, 1.37-4.07), as well as consistently high levels of family conflict (OR = 1.74; 95% CI, 1.08-2.79) and increases in conflict (OR = 1.87; 95% CI, 1.19-2.94) were independent risk factors for smoking initiation among Mexican heritage youth.

CONCLUSIONS

Our findings suggest that family cohesion protects against adolescent smoking, whereas family conflict increases the risk for smoking. Therefore, intervention programs for adolescents and parents could focus on enhancing family bonding and closeness, which is protective against smoking initiation.

Psychosocial correlates of alcohol use and heavy episodic drinking among Italian adolescents: Data from the second International Self-Reported Delinquency study

BACKGROUND AND OBJECTIVES

To provide a comprehensive picture of the wide spectrum of psychosocial factors potentially associated with alcohol consumption and problematic drinking among Italian adolescents in order to encourage debate on the context-specificity or universality of psychosocial correlates of adolescent alcohol use and misuse across countries and cultures.

METHODS

The International Self-Report Delinquency survey questionnaire was used to assess several variables concerning sociodemographic background, family relationships and problems, school performance and climate, life events, victimization experiences, neighborhood climate, personality traits, and attitudes, delinquent behavior, drug use, and peers behavior in a city-based sample of 6,363 seventh to ninth grade Italian students.

RESULTS

Generalized linear regression models showed that recent alcohol consumption and heavy episodic drinking were associated with multiple factors pertaining to different levels and domains reflecting the adolescent's personality and behavior as well as the different social and cultural contexts in which adolescents spend most of their time. Poor relations with parents, parental divorce, positive attitudes toward violence, and low self-control appeared to precede recent alcohol use and misuse and might be potential risk factors for alcohol use and/or misuse, while the association between problematic drinking and deviant attitudes (i.e., violent behavior, drug use, and affiliation with deviant peers) might be explained through reciprocal influences.

DISCUSSION AND CONCLUSIONS

Some psychosocial correlates of adolescent alcohol use and misuse might be universal across countries and cultures. Additionally, certain family, school, personality, behavioral, and peer-related factors might be more important than other correlates of youth alcohol use.

Alcohol consumption patterns among adolescents are related to family structure and exposure to drunkenness within the family: results from the SEYLE project

There is expedient evidence showing that differences in adolescent alcohol consumption and other risk-behaviour depend on both family structure and family member drunkenness exposure. Data were obtained among adolescents (N = 12,115, mean age 14.9 ± 0.89) in Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy,Romania, Slovenia and Spain within the European Union'ss 7th Framework Programme funded project, 'Saving and Empowering Young Lives in Europe (SEYLE)’. The current study reveals how adolescents' alcohol consumption patterns are related to their family structure and having seen their family member drunk. The results revealed statistically significant differences in adolescent alcohol consumption depending on whether the adolescent lives in a family with both birth parents, in a single-parent family or in a family with one birth parent and one step-parent. The study also revealed that the abstaining from alcohol percentage among adolescents was greater in families with both birth parents compared to other family types. The study also showed that the more often adolescents see their family member drunk the more they drink themselves. There is no difference in adolescent drinking patterns whether they see their family member drunk once a month or once a week. This study gives an insight on which subgroups of adolescents are at heightened risk of alcohol abuse and that decrease of family member drunkenness may have positive effects on the drinking habits of their children.

A pilot feasibility cluster randomised controlled trial of screening and brief alcohol intervention to prevent hazardous drinking in young people aged 14–15 years in a high school setting (SIPS JR-HIGH)

Background

Approximately 33% of 15- to 16-year-olds in England report alcohol intoxication in the past month. This present work builds on the evidence base by focusing on Alcohol Screening and Brief Intervention (ASBI) to reduce hazardous drinking in younger adolescents.

Objectives

To explore the feasibility and acceptability of a future definitive cluster randomised controlled trial (cRCT) of ASBI in a school setting to staff, young people and parents; to explore the fidelity of the interventions as delivered by school learning mentors; to estimate the parameters for the design of a definitive cRCT of brief alcohol intervention, including rates of eligibility, consent, participation and retention at 12 months; and to pilot the collection of cost and resource-use data to inform the cost-effectiveness/utility analysis in a definitive trial.

Setting

Seven schools across one geographical area in North East England.

Methods

Feasibility of trial processes, recruitment and retention and a qualitative evaluation examined facilitators and barriers to the use of ASBI approaches in the school setting in this age group. A three-arm pilot cRCT (with randomisation at the school level) with qualitative evaluation to assess the feasibility of a future definitive cRCT of the effectiveness and cost-effectiveness of ASBI in a school setting, with an integrated qualitative component. The trial ran in parallel with a repeated cross-sectional survey, which facilitated screening for the trial.

Participants

Year 10 school pupils (aged 14–15 years).

Interventions

Young people who screened positive on a single alcohol screening question, and consented to take part, were randomised to one of three groups: (1) feedback that their drinking habits may be risky and provision of an advice leaflet (control condition,n = two schools); (2) feedback as for the control condition plus a 30-minute brief interactive session, which combined structured advice and motivational interviewing techniques, delivered by the school learning mentor (intervention 1,n = two schools); or (3) feedback as for the control condition plus a 30-minute brief interactive session as for intervention 1 plus a 60-minute session involving family members delivered by the school learning mentor (intervention 2,n = three schools). Young people were followed up at 12 months.

Main outcome measures

Feasibility and acceptability.

Randomisation

Randomisation was carried out at the school level. Randomisation achieved balance on two school-level variables (numbers of pupils in school year and proportion receiving free school meals).

Blinding

School staff, young people and researchers were not blind to the intervention allocated.

Results

A total of 229 young people were eligible for the trial; 182 (79.5%) were randomised (control,n = 53; intervention 1,n = 54; intervention 2,n = 75). Of the 75 randomised to intervention 2, 67 received intervention 1 (89%). Eight received both intervention 1 and intervention 2 (11%). In total, 160 out of 182 were successfully followed up at 12 months (88%). Interviews were carried out with six school lead liaisons, 13 learning mentors, 27 young people and seven parents (n = 53). Analysis shows that the school setting is a feasible and acceptable place to carry out ASBI, with learning mentors seen as suitable people to do this. Intervention 2 was not seen as feasible or acceptable by school staff, parents or young people.

Outcomes/conclusions

It is feasible and acceptable to carry out a trial of the effectiveness and cost-effectiveness of single-session ASBI with young people in the school setting, with learning mentors delivering the intervention. Future work should include a definitive study that does not include a parental arm.

Trial registration

Current Controlled Trials ISRCTN07073105.

Funding

The National Institute for Health Research Public Health Research programme.

The relationship between brand-specific alcohol advertising on television and brand-specific consumption among underage youth

BACKGROUND

Being able to investigate the relationship between underage drinkers' preferences for particular brands and their exposure to advertising for those brands would represent a significant advance in alcohol marketing research. However, no previous national study has examined the relationship between underage youth exposure to brand-specific alcohol advertising and consumption of those brands.

METHODS

We conducted a cross-sectional, Internet-based survey of a national sample of 1,031 youth, ages 13-20, who had consumed at least 1 drink of alcohol in the past 30 days. We ascertained all alcohol brands consumed by respondents in the past 30 days. The main outcome measure was brand-specific consumption during the past 30 days, measured as a dichotomous variable. The main predictor variable was exposure to brand-specific alcohol advertising on television. The respondents reported which of 20 television shows popular with youth they had watched during the past 30 days. For each respondent, we calculated a standard measure of potential exposure to the brand-specific alcohol advertising that aired on those shows during the preceding 12 months, based on Nielsen (New York, NY) estimates of the youth audience for each show's telecasts.

RESULTS

Compared to no brand-specific advertising exposure, any exposure was associated with an increased likelihood of brand-specific consumption (adjusted odds ratio 3.02; 95% confidence interval: 2.61-3.49) after controlling for several individual- and brand-level variables. When measured as a continuous variable, the relationship between advertising exposure and brand consumption was nonlinear, with a large association at lower levels of exposure and diminishing incremental effects as the level of exposure increased.

CONCLUSIONS

There is a robust relationship between youth's brand-specific exposure to alcohol advertising on television and their consumption of those same alcohol brands during the past 30 days. This study provides further evidence of a strong association between alcohol advertising and youth drinking behavior.

Can the school context moderate the protective effect of parental support on adolescents' alcohol trajectories in urban Chicago?

BACKGROUND

Research explaining school effects on alcohol use is scare. This study examined the interactive effect between family support and school characteristics (size, poverty, and sector) on adolescents' alcohol use trajectories in Chicago.

METHODS

Longitudinal and multilevel data were from the Project of Human Development in Chicago Neighborhoods and the Common Core of Data (National Center for Educational Statistics). The sample consisted of 2205 adolescents in 558 schools. A three-level hierarchical linear model was used to estimate multilevel growth curve models and school effects on alcohol trajectories.

RESULTS

In addition to the strong relationship between parental support and alcohol trajectories; the results also found school effects on the average baseline of alcohol use and the rates of change across time. Interestingly, high levels of parental support were more effective in preventing alcohol use in public schools, while adolescents attending private schools with low levels of parental support were more likely to consume alcohol. Similarly, students attending public schools with higher rates of poverty who enjoy higher levels of parental support were less likely to consume alcohol compared to students with lower parental support attending lower rates of schools poverty.

CONCLUSION

Key findings highlight the importance of the interaction between parental support and school characteristics meaning that protective factors provided by parents could be reinforced or diminished by the school context.

Socialization to binge drinking: a population-based, longitudinal study with emphasis on parental influences

BACKGROUND

Binge drinking is associated with considerable harm. However, too little is known about socialization to this pattern of alcohol consumption.

AIM

To identify longitudinal predictors of young adult binge drinking, with an emphasis on possible parental influences.

METHODS

A population-based prospective study, in which respondents (N=2558) were surveyed from mid-adolescence until their late 20s. The data set was linked to national registers. Data were collected on parental alcohol consumption, parental binge drinking and parental alcohol problems, as well as on other aspects of the family milieu. The respondents' frequency of alcohol consumption was assessed, as well as a number of binge drinking measures: (i) frequency of intoxication episodes, (ii) frequency of consuming 5+ units, and (iii) "usual" consumption patterns of 5-6+ units, 7-9+ units, and 10+ units.

RESULTS

A surprisingly high proportion of the sample met the criteria for binge drinking. After control for parental, peer and individual characteristics, parental binge drinking predicted respondents' binge drinking, using all definitions, at age 28 years (p<.001). Parental frequency of alcohol consumption predicted frequency of alcohol consumption in their offspring at age 28 (p<.001).

CONCLUSION

The findings suggest a socialization pattern of alcohol role modeling from parents to offspring. The findings are also consistent with genetic research showing alcohol use to have moderate heritability. We may witness new binge drinking cultures in Norway, but binge drinking patterns also seem to echo parental influences.

Communicating Trust Between Parents and Their Children

This article discusses how Danish parents and their children communicate trust. Based on Niklas Luhmann’s sociological theory, the article explores new aspects of communication about alcohol-related rules. The analysis shows how the parents emphasize the importance of communicating trust, while the adolescents, on the other hand, observe the parents’ communication on the basis of their own, more instrumental, logic. Trust becomes a functional solution to the parents’ paradoxical situation, because it enables them to balance between a democratic family ideal, emphasizing the adolescents’ independence, while taking care of risk behavior. The article draws on Danish qualitative data comprising 37 focus group interviews with adolescents (14-16 years of age) and six focus group interviews with parents.

The temporal effects of parental divorce on youth substance use

This article examines how the parental divorce process affects youth substance use at various stages relative to the divorce. With child-fixed-effect models and a baseline period that is long before the divorce, the estimates rely on within-child changes over time. Youth are more likely to use alcohol 2-4 years before a parental divorce. After the divorce, youth have an increased risk of using alcohol and marijuana, with the effect for marijuana being 12.1 percentage points in the two years right after the divorce (p = .010). The magnitudes of the effects persist as time passes from the divorce.

Adaptation of the ESPA29 Parental Socialization Styles Scale to the Basque Language: Evidence of Validity

The aim of this study is to adapt the ESPA29 scale of parental socialization styles in adolescence to the Basque language. The study of its psychometric properties is based on the search for evidence of internal and external validity. The first focuses on the assessment of the dimensionality of the scale by means of exploratory factor analysis. The relationship between the dimensions of parental socialization styles and gender and age guarantee the external validity of the scale. The study of the equivalence of the adapted and original versions is based on the comparisons of the reliability coefficients and on factor congruence. The results allow us to conclude the equivalence of the two scales.

Associations between proximity and density of local alcohol outlets and alcohol use among Scottish adolescents

Associations between different alcohol outcomes and outlet density measures vary between studies and may not be generalisable to adolescents. In a cross-sectional study of 979 15-year old Glaswegians, we investigated the association between alcohol outlet availability (outlet density and proximity), outlet type (on-premise vs. off-premise) and frequent (weekly) alcohol consumption. We adjusted for social background (gender, social class, family structure). Proximity and density of on-premise outlets were not associated with weekly drinking. However, adolescents living close (within 200 m) to an off-sales outlet were more likely to drink frequently (OR 1.97, p=0.004), as were adolescents living in areas with many nearby off-premises outlets (OR 1.60, p=0.016). Our findings suggest that certain alcohol behaviours (e.g. binge drinking) may be linked to the characteristics of alcohol outlets in the vicinity.

The parent-child relationship and adolescent alcohol use: a systematic review of longitudinal studies

BACKGROUND

Alcohol use among adolescents has become a major public health problem in the past decade and has large short- and long-term consequences on their health. The aim of this systematic review was to provide an overview of longitudinal cohort studies that have analyzed the association between the parent-child relationship (PCR) and change in alcohol use during adolescence.

METHODS

A search of the literature from 1985 to July 2011 was conducted in Medline, PsycINFO, and EMBASE in order to identify longitudinal, general population studies regarding the influence of the PCR on alcohol use during adolescence. The studies were screened, and the quality of the relevant studies was assessed. A best-evidence synthesis was used to summarize the results.

RESULTS

Twenty-eight relevant studies were identified. Five studies found that a negative PCR was associated with higher levels of alcohol use. Another seven papers only found this association for certain subgroups such as boys or girls, or a specific age group. The remaining sixteen studies did not find any association.

CONCLUSIONS

We found weak evidence for a prospective association between the PCR and adolescent alcohol use. Further research to the association of the PCR with several types of alcohol use (e.g., initiation or abuse) and to the potential reversed causality of the PCR and alcohol use is required.

Community influences on adolescents' use of home-brewed alcohol in rural South Africa

Background

Alcohol represents a major public health challenge in South Africa, however little is known about the correlates of alcohol use among rural adolescents. This article examines community influences on adolescents’ use of home-brewed alcohol in a rural region of South Africa.

Method

A total of 1600 high school adolescents between 11 and 16 years of age participated in this study. Seven hundred and forty (46.3%) were female and 795 (49.7%) were male. Data on gender were missing for 65 students (4.0% of the sample). The age range was 11–29 years (mean age 16.4 years; Standard deviation = 2.79). A survey questionnaire on adolescent risk behavior that examined adolescents’ use of alcohol and various potential community influences on alcohol use was administered. Factor analysis was used to group community-level variables into factors. Multiple logistic regression techniques were then used to examine associations between these community factors and adolescents’ use of home-brewed alcohol.

Results

The factor analysis yielded five community-level factors that accounted for almost two-thirds of the variance in home-brewed alcohol use. These factors related to subjective adult norms around substance use in the community, negative opinions about one’s neighborhood, perceived levels of adult antisocial behavior in the community, community affirmations of adolescents, and perceived levels of crime and violence in the community (derelict neighborhood). In the logistic regression model, community affirmation was negatively associated with the use of home-brew, whereas higher scores on “derelict neighborhood” and “adult antisocial behavior” were associated with greater odds of drinking home-brew.

Conclusion

Findings highlight community influences on alcohol use among rural adolescents in South Africa. Feeling affirmed and valued by the broader community appears to protect adolescents against early alcohol use. In contrast, perceptions of high levels of adult anti-social behavior and crime and violence in the community are significant risks for early alcohol initiation. Implications of these findings for the prevention of alcohol use among adolescents in rural communities are discussed.

The role of early life experience and species differences in alcohol intake in microtine rodents

Social relationships have important effects on alcohol drinking. There are conflicting reports, however, about whether early-life family structure plays an important role in moderating alcohol use in humans. We have previously modeled social facilitation of alcohol drinking in peers in socially monogamous prairie voles. We have also modeled the effects of family structure on the development of adult social and emotional behaviors. Here we assessed whether alcohol intake would differ in prairie voles reared by both parents compared to those reared by a single mother. We also assessed whether meadow voles, a closely related species that do not form lasting reproductive partnerships, would differ in alcohol drinking or in the effect of social influence on drinking. Prairie voles were reared either bi-parentally (BP) or by a single mother (SM). BP- and SM-reared adult prairie voles and BP-reared adult meadow voles were given limited access to a choice between alcohol (10%) and water over four days and assessed for drinking behavior in social and non-social drinking environments. While alcohol preference was not different between species, meadow voles drank significantly lower doses than prairie voles. Meadow voles also had significantly higher blood ethanol concentrations than prairie voles after receiving the same dose, suggesting differences in ethanol metabolism. Both species, regardless of rearing condition, consumed more alcohol in the social drinking condition than the non-social condition. Early life family structure did not significantly affect any measure. Greater drinking in the social condition indicates that alcohol intake is influenced similarly in both species by the presence of a peer. While the ability of prairie voles to model humans may be limited, the lack of differences in alcohol drinking in BP- and SM-reared prairie voles lends biological support to human studies demonstrating no effect of single-parenting on alcohol abuse.

A telephone survey of parental attitudes and behaviours regarding teenage drinking

BACKGROUND

Irish teenagers demonstrate high rates of drunkenness and there has been a progressive fall in age of first drinking in recent decades. International research indicates that parents exert substantial influence over their teenager's drinking. We sought to determine the attitudes and behaviours of Irish parents towards drinking by their adolescent children.

METHODS

We conducted a telephone survey of a representative sample of of 234 parents who had a teenager aged between 13 and 17 years.

RESULTS

Six per cent reported that they would be unconcerned if their son or daughter was to binge drink once per month. On the issue of introducing children to alcohol in the home, 27% viewed this as a good idea while 63% disagreed with this practice. Eleven per cent of parents reported that they had given a drink to their teenager at home. Parents who drank regularly themselves, who were from higher socio-demographic groups and who lived in the east of Ireland demonstrated more permissive attitudes to teenage drinking.

CONCLUSIONS

We found no evidence of widespread permissive attitudes and behaviours among Irish parents. Given that parental influences have been demonstrated to exert substantial impact on teenage drinking, it may be possible to harness the concerns of Irish parents more effectively to reverse the trends of escalating alcohol related harm in Ireland.

New estimates of the number of children living with substance misusing parents: results from UK national household surveys

BACKGROUND

The existing estimates of there being 250,000 - 350,000 children of problem drug users in the UK (ACMD, 2003) and 780,000 - 1.3 million children of adults with an alcohol problem (AHRSE, 2004) are extrapolations of treatment data alone or estimates from other countries, hence updated, local and broader estimates are needed.

METHODS

The current work identifies profiles where the risk of harm to children could be increased by patterns of parental substance use and generates new estimates following secondary analysis of five UK national household surveys.

RESULTS

The Health Survey for England (HSfE) and General Household Survey (GHS) (both 2004) generated consistent estimates - around 30% of children under-16 years (3.3 - 3.5 million) in the UK lived with at least one binge drinking parent, 8% with at least two binge drinkers and 4% with a lone (binge drinking) parent. The National Psychiatric Morbidity Survey (NPMS) indicated that in 2000, 22% (2.6 million) lived with a hazardous drinker and 6% (705,000) with a dependent drinker. The British Crime Survey (2004) and NPMS (2000) indicated that 8% (up to 978,000) of children lived with an adult who had used illicit drugs within that year, 2% (up to 256,000) with a class A drug user and 7% (up to 873,000) with a class C drug user. Around 335,000 children lived with a drug dependent user, 72,000 with an injecting drug user, 72,000 with a drug user in treatment and 108,000 with an adult who had overdosed. Elevated or cumulative risk of harm may have existed for the 3.6% (around 430,000) children in the UK who lived with a problem drinker who also used drugs and 4% (half a million) where problem drinking co-existed with mental health problems. Stronger indicators of harm emerged from the Scottish Crime Survey (2000), according to which 1% of children (around 12,000 children) had witnessed force being used against an adult in the household by their partner whilst drinking alcohol and 0.6% (almost 6000 children) whilst using drugs.

CONCLUSION

Whilst harm from parental substance use is not inevitable, the number of children living with substance misusing parents exceeds earlier estimates. Widespread patterns of binge drinking and recreational drug use may expose children to sub-optimal care and substance-using role models. Implications for policy, practice and research are discussed.

Racial/ethnic differences in parental concern about their child's drug use in a nationally representative sample in the United States

INTRODUCTION

Parental concern and negative attitudes toward drug use may prevent youth from being involved in drug use. However, few studies have addressed parental concern about children's drug use and its possible variation by race/ethnicity. In this study, we explored the potential racial/ethnic differences in parental concern about their children's drug use with a nationally representative sample.

METHODS

The data were from the 2003 National Survey of Children's Health, a random household telephone survey of parents of children up to age 17 (n = 102353). The analytic sample was restricted to parents of children aged 6 to 17 years (n = 61046). Multivariate logistic regression models, controlling for children's age, gender, family structure, and family poverty level, were fitted, simultaneously accommodating the complex survey design.

RESULTS

Parents of African American and Hispanic children expressed more concern than parents of white children, even after controlling for potential confounders (adjusted odds ratio (AOR), 1.9; 95% CI, 1.8-2.1 and AOR, 1.9; 95% Cl, 1.7-2.1, respectively).

CONCLUSIONS

The level of parental concern about adolescent drug use was different across race/ethnicity groups. The results may have implications for parental participation in school-based adolescent prevention programs.

Psychosocial risk factors in home and community settings and their associations with population health and health inequalities: a systematic meta-review

Background

The effects of psychosocial risk factors on population health and health inequalities has featured prominently in epidemiological research literature as well as public health policy strategies. We have conducted a meta-review (a review of reviews) exploring how psychosocial factors may relate to population health in home and community settings.

Methods

Systematic review (QUORUM) of literature reviews (published in any language or country) on the health associations of psychosocial risk factors in community settings. The literature search included electronic and manual searches. Two reviewers appraised included reviews using criteria for assessing systematic reviews. Data from the more robust reviews were extracted, tabulated and synthesised.

Results

Thirty-one reviews met our inclusion criteria. These explored a variety of psychosocial factors including social support and networks, social capital, social cohesion, collective efficacy, participation in local organisations – and less favourable psychosocial risk factors such as demands, exposure to community violence or anti-social behaviour, exposure to discrimination, and stress related to acculturation to western society. Most of the reviews focused on associations between social networks/support and physical or mental health. We identified some evidence of favourable psychosocial environments associated with better health. Reviews also found evidence of unfavourable psychosocial risk factors linked to poorer health, particularly among socially disadvantaged groups. However, the more robust reviews each identified studies with inconclusive findings, as well as studies finding evidence of associations. We also identified some evidence of apparently favourable psychosocial risk factors associated with poorer health.

Conclusion

From the review literature we have synthesised, where associations have been identified, they generally support the view that favourable psychosocial environments go hand in hand with better health. Poor psychosocial environments may be health damaging and contribute to health inequalities. The evidence that underpins our understanding of these associations is of variable quality and consistency. Future research should seek to improve this evidence base, with more longitudinal analysis (and intervention evaluations) of the effects of apparently under-researched psychosocial factors such as control and participation within communities. Future policy interventions relevant to this field should be developed in partnership with researchers to enable a better understanding of psychosocial mechanisms and the effects of psychosocial interventions.

Alcohol use in families: a 15-year prospective follow-up study

AIMS

To study the prevalence of adolescents' problematic alcohol use and its parental predictors: drinking habits and socio-demographic factors.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS

Questionnaires were sent regularly to the same Finnish families (n = 1132) from the onset of pregnancy (in 1986-87) to the child's age of 15 years (in 2001-02) (n = 1028). There was a total of three follow-up points.

FINDINGS

At 15 years of age, 83% of girls and 79% of boys had used alcohol; 18% of boys and 14% of girls had been drunk more than once a month. The child's permanent separation from at least one biological parent was the strongest socio-demographic predictor of adolescents drinking. Fathers' present heavy drinking and parental early drinking were the best predictors of their children's problematic alcohol use at the age of 15.

CONCLUSIONS

Knowledge of fathers' alcohol use and its time of onset may be used to determine children who are at added risk of problematic alcohol use later in life. Special guidance, support and treatment can be targeted to these families.

The role of the family in preventing and intervening with substance use and misuse: a comprehensive review of family interventions, with a focus on young people

The family plays a key part in both preventing and intervening with substance use and misuse, both through inducing risk, and/or encouraging and promoting protection and resilience. This review examines a number of family processes and structures that have been associated with young people commencing substance use and later misuse, and concludes that there is significant evidence for family involvement in young people's taking up, and later misusing, substances. Given this family involvement, the review explores and appraises interventions aimed at using the family to prevent substance use and misuse amongst young people. The review concludes that there is a dearth of methodologically highly sound research in this area, but the research that has been conducted does suggest strongly that the family can have a central role in preventing substance use and later misuse amongst young people.

Promoting healthy choices: the importance of differentiating between ordinary and high risk cannabis use among high-school students

Education can affect the lives of adolescents by reinforcing healthy choices and promoting a healthy lifestyle. However, difficulties experienced in the school and family environments may interfere with these goals. This may be particularly true for those youth already participating in health-compromising behaviors such as drug use. Of course, patterns of drug use take many forms, and some are more serious than others. Youth using cannabis at more intensive levels have often been overlooked in the literature. This paper, based on 1997 data, addressed this gap by examining the effects of individual and cumulative school and family factors on not only the probability of any cannabis use but also the progression to problem use among 1980 Ontario students. The results suggested that disrupted family structure increased the likelihood of cannabis use in general. However, patterns of problem use were displayed among youth experiencing problems in school and poor family relationships. As anticipated, adolescents experiencing multiple school and family factors were also significantly more likely to engage in cannabis use, and in its more serious form, when controlling for other demographic predictors. The implications for health promotion initiatives in the school are discussed.

Perceptions of the Family Environment and Youth Behaviors: Alcohol-Abusing Runaway Adolescents and Their Primary Caretakers

Research suggests family disturbance is highly correlated to adolescents running away from home. However, given methodological challenges, few studies assess parent report of the family situation and instead, rely primarily on adolescent self-report. This article reports the findings of parents' and runaway adolescents' reports on several behavioral dimensions. Substance-using runaway adolescents completed measures about their family environment and adolescent problem behaviors. Of 119 adolescents, 49 of their parents also completed measures at intake. Adolescents perceived a more negative family environment than did their parents, and parents rated their youth as having more externalizing problems than did the youth themselves. Findings are consonant with prior research showing a relationship between parental distress and child problems. Contrary to prior findings, this sample of parents did not report significant alcohol use, and there was no relationship between their use and their child's use. Implications for future research and family therapy are discussed.

Occupational level of the father and alcohol consumption during adolescence; patterns and predictors

STUDY OBJECTIVE

This paper describes and attempts to explain the association between occupational level of the father and high alcohol consumption among a cohort of New Zealand adolescents from age 11 to 21.

DESIGN

Data were obtained from the longitudinal Dunedin multidisciplinary health and development study. At each measurement wave, those who then belonged to the quartile that reported the highest usual amount of alcohol consumed on a typical drinking occasion were categorised as high alcohol consumers. Potential predictors of high alcohol consumption included environmental factors, individual factors, and educational achievement measured at age 9, 11, or 13. Longitudinal logistic GEE analyses described and explained the relation between father's occupation and adolescent alcohol consumption.

SETTING

Dunedin, New Zealand.

PARTICIPANTS

About 1000 children were followed up from birth in 1972 until adulthood.

MAIN RESULTS

A significant association between fathers' occupation and adolescent alcohol consumption emerged at age 15. Overall adolescents from the lowest occupational group had almost twice the odds of being a large consumer than the highest occupational group. The association between father's occupation and high alcohol consumption during adolescence was explained by the higher prevalence of familial alcohol problems and friends approving of alcohol consumption, lower intelligence scores, and lower parental attachment among adolescents from lower occupational groups.

CONCLUSIONS

Socioeconomic background affects adolescent alcohol consumption substantially. This probably contributes to cumulation of disadvantage. Prevention programmes should focus on adolescents from lower socioeconomic groups and make healthier choices the easier choices by means of environmental change.

Adolescent smoking and family structure in Europe

This paper examines the relationship between family structure and smoking among 15-year-old adolescents in seven European countries. It also investigates the association between family structure and a number of known smoking risk factors including family socio-economic status, the adolescent's disposable income, parental smoking and the presence of other smokers in the adolescent's home. Findings are based on 1998 survey data from a cross-national study of health behaviours among children and adolescents. Family structure was found to be significantly associated with smoking among 15-year-olds in all countries, with smoking prevalence lowest among adolescents in intact families and highest among adolescents in stepfamilies. Multivariate analysis showed that several risk factors were associated with higher smoking prevalences in all countries, but that even after these other factors were taken into account, there was an increased likelihood of smoking among adolescents in stepfamilies. Further research is needed to determine the possible reasons for this association.

Family stressors and adolescent cannabis use: a pathway to problem use

The extent to which the family environment is characterized by stress may have a substantial impact on life-course trajectories of young people. Illicit drug use is a fairly common part of these trajectories. This paper estimates the direct impact of family stressors on the progression to problem cannabis use, as well as their indirect effects via the youth's school experience among adolescents in Ontario. The results suggest that family stressors have direct and indirect effects increasing the probability of cannabis use outcomes. The implications of these more complex associations between factors believed to influence adolescent drug use trajectories are discussed.

Heavy cannabis use among UK teenagers: an exploration

Findings are presented from a survey of a sample of 2641 UK school students aged 15--16 years. This exercise was part of the 30 country European School Survey Project on Alcohol and other Drugs (ESPAD). The 201 students who reported using cannabis (marihuana) 40 times or more were examined using cluster analysis. They were also compared to other students. Three clusters of heavy cannabis users emerged. The smallest was largely distinguished by antisocial behaviour. Another cluster were clearly unhappy, with little support from parents and friends, high levels of depressed mood and low levels of self-esteem. The largest cluster were 'ordinary' and had little to distinguish them apart from a belief that their environment was stable and predictable and that society's rules should be obeyed. Although clear relationships emerged between heavy cannabis use and heavy use of other substances, the 'ordinary' cluster of heavy cannabis users were less likely than the others to have used other illicit drugs. It is therefore concluded that teenage heavy cannabis users have varied motivations and contexts for their usage. They should not be seen as a homogeneous group and many do not appear to use other illicit drugs.