All in the family: parental substance misuse, harsh parenting, and youth substance misuse among juvenile justice-involved youth

Exploring perceptions of genetic risk and the transmission of substance use disorders

BACKGROUND

Substance use disorders (SUDs) have been consistently shown to exhibit moderate intergenerational continuity (1-3). While much research has examined genetic and social influences on addiction, less attention has been paid to clients' and lay persons' perceptions of genetic influences on the heritability of SUD (4) and implications for treatment.

METHODS

For this qualitative study, twenty-six structured Working Model of the Child Interviews (WMCI) were conducted with mothers receiving inpatient SUD treatment. These interviews were thematically analyzed for themes related to maternal perceptions around intergenerational transmission of substance use behaviours.

RESULTS

Findings show that over half of the mothers in this sample were preoccupied with their children's risk factors for addictions. Among this group, 29% spontaneously expressed concerns about their children's genetic risk for addiction, 54% shared worries about their children's propensity for addiction without mentioning the word gene or genetic. Additionally, 37% had challenges in even discussing their children's future when prompted. These concerns mapped onto internal working models of attachment in unexpected ways, with parents who were coded with balanced working models being more likely to discuss intergenerational risk factors and parents with disengaged working models displaying difficulties in discussing their child's future.

CONCLUSION

This research suggests that the dominant discourse around the brain-disease model of addictions, in its effort to reduce stigma and self-blame, may have unintended downstream consequences for parents' mental models about their children's risks for future addiction. Parents receiving SUD treatment, and the staff who deliver it, may benefit from psychoeducation about the intergenerational transmission of SUD as part of treatment.

Addictive behavior and mental health of adolescents aged 11-17 years in Bangladesh in 2014: A cross-sectional study

Background and Aims

This study aimed to evaluate the factors associated with addictive behavior and mental health in adolescents aged 11-17 years in Bangladesh.

Methods

This study analyzed data from the Bangladesh Global School-based Health Survey (GSHS) conducted in 2014. Adolescents aged 11-17 years studying government schools were considered as respondents for this survey. A two-phase group sample design was utilized to deliver illustrative information of all understudies in grades (classes) 7-10 in Bangladesh. Bivariate analyses followed by a weight-adjusted multiple logistic regression was fitted to a sample of size 2989 adolescents.

Results

One in ten and one in four adolescents had different substance addictions and some forms of mental health conditions, respectively. Sex of participants (adjusted odds ratio [AOR]: 4.49; confidence interval [CI]:2.28-8.84), being bullied (AOR: 3.08; CI:1.46-6.49), use of tobacco among parents (AOR: 5.82; CI:3.16-10.75), parental understanding of adolescents' problems (AOR: 0.45; CI:0.23-0.82), and food affordability (AOR: 1.24; CI:1.09-1.42) were associated with addictive behaviors of adolescents. Bullied males with nonempathetic parents were found to be more vulnerable to addictive behaviors and bullied females showed higher tendencies to mental health issues.

Conclusion

Considering the elevated prevalence of reported mental health concerns, identifying vulnerable groups and formulating intervention-oriented policies engaging youths can pave the way towards achieving robust health and well-being for them in Bangladesh.

Trajectories of parental harshness and exposure to community violence differentially predict externalizing and internalizing mental health problems in legal system-involved youth

Youth with legal system involvement are especially likely to experience parental harshness (PH) and exposure to community violence (ETV), two common forms of life stress. However, most studies examine these stressors separately or collapse across them in ways that preclude examination of their co-occurrence. Consequently, it is unclear 1) how PH and ETV simultaneously fluctuate across development and 2) how these fluctuations predict future mental health problems in legal system-involved youth. We used group-based multi-trajectory modeling to estimate simultaneous trajectories of PH and ETV in 1027 legal system-involved youth and regression analyses to understand how trajectory membership predicted mental health problems three years later. Four trajectories of co-occurrence were identified (1: Low; 2: Moderate and Decreasing; 3: Moderate PH/High ETV; 4: High PH/Moderate ETV). Compared to the Low trajectory, all trajectories with PH/ETV elevations predicted violent crime and substance problems; trajectory 3 (Moderate PH/High ETV) predicted nonviolent crime and depression/anxiety symptoms; trajectory 4 (High PH/Moderate ETV) predicted depression diagnosis. These results elucidate how PH and ETV typically co-occur across adolescence for legal system-involved youth. They also reveal important commonalities and dissociations among types of mental health problems.

Tailoring parenting styles and family-based interventions cross-culturally as an effective prevention strategy for youth substance use: a scoping review

Background

The challenge of substance use among youth continues to be a highly concerning public health issue across the globe. The notion that parenting lifestyles and family-based intervention can help in the prevention of adolescent substance use have received robust attention from policy makers, researchers' clinicians and general public, nonetheless, there is scarcity of high quality evidence to support these concepts.

Objective

To review available literature which assessed the effects of parenting styles and family-based interventions on the prevention of adolescent substance use.

Methods

A scoping review of literature to identify studies published in English between 2012 and 2022 was conducted searching Scopus, MEDLINE, PsychInfo, and CINAHL databases focused on effects of parenting styles and family-based interventions in the prevention of adolescent substance use.Keywords of family-based intervention strategies and possible outcomes of parenting styles on youth substance use were coded from the results, discussion, or conclusion. Strategies were inductively categorized into themes according to the focus of the strategy.

Results

A total of 47 studies, published between 2012 and 2022 in English language included. Narrative synthesis illustrated that parental involvement, restriction of mature-rated content, parental monitoring, authoritative parenting styles, and parental support and knowledge can help in the prevention of adolescent substance use. On the contrary, poor parent-child bonding, overprotection, permissive parenting, parental frustrations, authoritarian and harsh parenting styles promoted adolescent substance use disorders. Proximal risk factors like peer influence, previous use of other substances, and risky behaviours had more effect than just parenting styles. Culturally tailored family-based intervention strategies such as "Preventive Parenting", "Parent Training", and "Parent Involvement", with focus on "Technology Assisted Intervention", particularly "SMART "(Substance Misuse among Adolescents in Residential Treatment) are found as effective family-based intervention strategies to mitigate substance use in youth.

Conclusion

Culturally tailored family-based behavioural strategies psychosocial intervention strategies can be considered of the most effective strategies to prevent substance use disorders in youth.

Intervention for marijuana using, court-involved non-incarcerated youth

INTRODUCTION

Justice-involved youth (JIY) are at elevated risk for substance use and for substance use-related harm compared to non-JIY. Marijuana use is of significant concern in this population, as it is tied to reoffending. Motivational enhancement therapy (MET) and electronic interventions show promise in reducing youth substance use; the degree to which these findings extend to JIY requires additional research attention. Thus, the purpose of this study was to test the preliminary feasibility and effectiveness of a combined brief electronic parenting intervention plus a brief MET-based electronic intervention for JIY adolescents, followed by feedback and development of a change plan with a court worker, on marijuana use.

METHODS

Participants were 83 parent-youth dyads recruited from a diversionary family court program who screened positive for past-year marijuana use. At baseline and 3- and 6-month follow-ups, youth self-reported on their substance use, parental monitoring, peer substance use, and dyads completed a discussion task querying parental monitoring, limit setting, and substance use. The study randomized dyads to psychoeducation or the experimental intervention condition post-baseline. The MET-based intervention involved the self-administered e-TOKE (an electronic, marijuana-specific assessment and feedback tool) and a brief follow-up meeting with court staff counselors to review feedback and create a marijuana use change plan. Caregivers completed a computer program aimed at improving parenting and communication with their adolescents. The study administered feasibility and acceptability measures for both conditions.

RESULTS

Feasibility of study procedures was demonstrated through recruitment and retention (∼75 % success). Acceptability ratings from youth, parents, and court staff were high and positive. While levels of parental monitoring, as assessed by an observational task, improved over the course of the study, the intervention did not result in a significant change in any of the outcomes tested.

CONCLUSIONS

Despite high acceptability and feasibility ratings for the use of an electronic plus in-person MET intervention, reduction of marijuana and other substances was limited for most youth. This suggests that a more intensive intervention, such as stepped care, may be necessary for JIY who are not specifically referred for court proceedings due to marijuana use or those with already well-established use patterns.

Parenting, emotion regulation, and externalizing symptomatology as adolescent antecedents to young adult health risk behaviors

This study used longitudinal data to elucidate how trajectories of negative parenting across adolescence are associated with young adult health risk behaviors (HRBs) by testing difficulties with emotion regulation and externalizing symptomatology as sequential underlying mediators. The sample included 167 adolescents (53% males, M_age  = 14 at Time 1 and M_age  = 18 at Time 5) who were assessed five times. Adolescents self-reported on negative parenting, emotion regulation, externalizing symptomatology, and engagement in HRBs. Results suggest that increasingly negative parenting across adolescence has adverse consequences for emotion regulation development and in turn, externalizing symptomatology, which confers risk for young adult HRBs. Results offer insights towards mechanisms for prevention and intervention and public health policy aimed at reducing the prevalence and consequences of engagement in HRBs.

A Two-Way Street? Reciprocal Associations Between Parental Warmth and Hostility with Substance Use Among Justice-Involved Adolescents

Transactional developmental theories propose that poor parenting behaviors contribute to youth substance use, and youth substance use contributes to poor parenting behaviors. However, research aimed at testing these theories has not distinguished: (1) between- and within-person sources of variance; (2) maternal and paternal parenting behaviors; and (3) alcohol, marijuana, and other illicit drug use. This study addressed these limitations by investigating the reciprocal associations between maternal and paternal warmth and hostility with alcohol, marijuana, and other illicit drug use among justice-involved adolescents, an at-risk population for substance use. 1354 justice-involved adolescents (86.4% male; M_age = 16.04 [SD = 0.14], range = 14-17; 41.4% Black, 33.5% Hispanic, 20.2% White, 4.8% other race/ethnicity) completed self-reports assessing parental warmth, parental hostility, and substance use every six months for 36 months. Random-intercept structural equation models disaggregated between- and within-person associations. At the between-person level, maternal and paternal warmth were negatively associated with alcohol, marijuana, and other illicit drug use, whereas maternal and paternal hostility were positively associated with alcohol, marijuana, and other illicit drug use. At the within-person level, maternal and paternal warmth predicted decreases in marijuana and other illicit drug use, and paternal warmth predicted decreases in alcohol use six months later. Maternal hostility predicted increases in subsequent marijuana and other illicit drug use. Marijuana and other illicit drug use predicted decreases in subsequent paternal hostility. The results are partially consistent with transactional developmental models proposing recursive influences between parenting behaviors and youth substance use. Evocative effects were in the opposite direction than expected and specific to fathers, such that youth drug use was related to improvements in the father-youth relationship. The results support the potential utility of family-based interventions for substance use among justice-involved adolescents.

"I Grew Up Amidst Alcohol and Drugs:" a Qualitative Study on the Lived Experiences of Parental Substance Use Among Adults Who Developed Substance Use Disorders Themselves

Experiencing parental substance use (PSU) has been associated with a heightened risk of developing substance use disorders (SUDs) in offspring. The primary goal of this study was to explore perspectives of adult children with lived experience of PSU who also developed SUDs themselves through first-hand experience. This study was conducted in Flanders (Belgium). A qualitative exploratory research design was applied. Seventeen semi-structured interviews were conducted with adult children of parents with SUDs (range: 29-48 years) who themselves had developed SUDs. All interviews were audio-taped and transcribed verbatim. Three overarching themes emerged through thematic analysis: 1) loneliness and neglect in childhood; 2) stigma and the self; and 3) the role of social connection in substance use and recovery. The narratives highlighted the central role of feelings of loneliness, isolation and belonging among children of parents with SUDs in childhood and adulthood. Increasing public awareness on the impact of PSU on children and accessible support is needed to overcome stigma and remove barriers to social inclusion for children of parents with SUDs. Findings may prove valuable in informing policy, program and treatment development aimed at breaking maladaptive intergenerational cycles.

The nexus of family environment with youth street criminal behavior in Khyber Pakhtunkhwa Pakistan

This empirical work focuses on the impact of unsupportive and harsh family practices on youth criminal behaviour. The present study hypothesizes that the harsh practices and low support of a family are the contributing factors for street crimes and that family practices increase the intensity of youth street criminality, particularly in a Pakistani society. While studying youth delinquent behaviour in a Pakistani society, this study employs general strain theory (GST), which has not been employed in any research in Pakistan till date. Thus, the authors examined the variables of the study from the view point of general strain theory (GST). A diverse sample size of 300 street criminals, housed in different jails of Khyber-Pakhtunkhwa (KPK) was selected randomly. However, from each jail, the sample respondents were selected through proportion allocation strategy. Moreover, primary data were collected through structured interviews and analyzed through a series of steps, which involved exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and structure equation modeling (SEM). These analyses helped in determining the relationship between family harsh practices, and low family support, with youth participation in street crimes. Findings of this study offer evidence that family harsh practices and low family support directly trigger youth participation in street crimes. The present study does not only confirm the hypothetical statement of GST regarding positive and negative stimuli but also add up the significant contribution in the existing literature from the context of Pakistani society. Initiating awareness programs and sessions regarding different parental skills by sociologist and psychologist on community level, as well as the need for the sociologists and psychologist to provide assistance while addressing psychological issues of offenders are some of the recommendations based on the study findings.