Country of origin, age of drinking onset, and drinking patterns among Mexican American young adults

Age of onset and alcohol and cannabis use disorders among Mexican American young adults: Robust substance-specific effects of early use as a risk factor

We investigated the substance-specific and cross-substance risk associated with early onset (before age 15) of drunkenness and cannabis use in the subsequent development of alcohol (AUD) and cannabis use disorder (CUD) in Mexican American young adults. Survival analyses employed Cox proportional hazards models for AUD and CUD, separately. In cross-risk analyses, we modeled estimates for those participants reporting lifetime use of both substances. Early onset of drunkenness and early onset of cannabis use were associated with shorter time to AUD and CUD, respectively, even after accounting for psychiatric disorders. While there were no cross-risk associations, adjusting for psychiatric disorders and early onset cannabis use attenuated the association of early drunkenness with AUD.

Age at Immigration and Substance Use and Problems Among Males and Females at the U.S.-Mexico Border

OBJECTIVE

Although substance use and problems among Mexican Americans are associated with both immigration to the United States and living at the U.S.-Mexico border, little is known about relationships between age at immigration and substance use by gender within the border context. The purpose of this study was to analyze the association of age at immigration with heavy alcohol use, alcohol use disorders (AUD), and drug use among Mexicans Americans living both on and off the U.S.-Mexico border.

METHOD

Household surveys were conducted, using area probability sampling of 2,336 Mexican Americans (1,185 female), ages 18-65, living at the Texas-Mexico border in the metropolitan areas of Laredo and McAllen/Brownsville, and in the nonborder location of San Antonio.

RESULTS

Females immigrating before age 12 were less likely to report heavy alcohol use (odds ratio [OR] = 0.309), and those immigrating before age 21 were less likely to report any drug use during the last year compared with their U.S.-born counterparts (OR = 0.473; OR = 0.386, respectively). Males immigrating after age 20 were less likely to report heavy alcohol use (OR = 0.478), and those immigrating between ages 12 and 20 were less likely to report AUD (OR = 0.479) and drug use (OR = 0.255) compared with their U.S.-born counterparts. Early age at immigration (before age 12) was significantly associated with drug use for males living on the border compared with those living off the border.

CONCLUSIONS

Findings suggest that among females, immigrating before age 12 (vs. being born in the United States) is protective against heavy alcohol and drug use, but among males, immigrating before age 12 results in similarly heavy patterns of use as their U.S.-born counterparts, partially supporting previous findings that early immigration is particularly risky in relation to substance use and AUD.

Cultural Correlates of DUI Risk Perceptions Among Documented and Undocumented Recent Latino Immigrants in South Florida

Latinos do not drink and drive more often than non-Latino Whites, yet are disproportionately involved in alcohol-related arrests and fatal crashes. These disparities have been linked to a failure in recognizing the impairing effects of alcohol on driving psychomotor abilities and low risk perceptions of being caught or prosecuted by law enforcement for DUI (driving under the influence). However, little is known about the role that cultural factors play in shaping drinking and driving risk perceptions among Latino immigrants. This study examines associations between cultural factors and DUI risk perceptions in a sample of 467 documented and undocumented recent Latino immigrants. Results revealed cultural risk factors were associated with higher alcohol use and decreased DUI risk perceptions. Cultural protective factors were linked with less drinking behaviors. Undocumented immigrants reported higher rates of alcohol use, lower levels of cultural protective factors, and higher levels of cultural risk factors. Findings contribute to the limited knowledge of drinking and driving among Latino immigrants early in the immigration process and suggest a need for greater attention to cultural factors in developing DUI prevention programs tailored toward Latino immigrants.

Pattern and risk of developing alcohol use disorders, illegal substance use and psychiatric disorders after early onset of alcohol use: Results of the Thai National Mental Health Survey 2013

INTRODUCTION

Although underage drinking is a global concern, little is known about the relationship between age at first drink and development of various psychiatric comorbidities.

METHODS

A secondary data analysis was done among 2928 lifetime drinkers from the Thai National Mental Health Survey 2013. Age at first drink, and onset of related psychiatric outcomes were inquired. Survival analysis using Cox regression was performed to estimate the risk over time for psychiatric problems across age ranges at first drink.

RESULTS

Two-thirds of male and one-third of female drinkers were considered underage at drinking onset. Substance use and abuse developed earlier (<5 years) than alcohol use disorders (AUDs) and other outcomes (mostly >10 years). Those who started drinking before age 15 years were more likely to develop use of cannabis (HR=4.75; 95% CI 2.73, 8.24), club drugs (HR=2.88; 95% CI 1.46, 5.71) and inhalants (HR=6.46; 95% CI% 1.64, 25.37), compared to those who were 20 years or older at drinking onset. Using age as an alternative time-scale, those aged <15years at drinking onset were significantly more likely to experience AUDs, psychotic symptoms, intermittent explosive disorder and panic disorder. However, the early onset drinkers were less likely to develop depression compared to those who started at age 20 years and over.

CONCLUSION

Premature alcohol consumption tends to be a gateway to various serious consequences. Efforts of such drinking age policy and interventions are needed to address vulnerable young populations.

Natural mentors and youth drinking: a qualitative study of Mexican youths

Parental influences on youth drinking are well documented but not the influence of extended family members. This article explores extended family influences on alcohol use among Mexican youths and whether extended family members can be considered natural mentors. We conducted a qualitative study using ethnographic open ended interviews with 117 first year university students in Mexico City. The ethnographic interviews revealed six drinking groups: excessive, heavy, regular, occasional, abstainers and non drinkers. Youths reported close relationships with extended family members who provided counsel and acted as representatives of familial norms and values. The alcohol beliefs and behaviors of these family members, including their alcohol misuse, had a positive influence on youths' alcohol attitudes. The naturally occurring mentoring relationships of Mexican extended family members can positively influence moderate youth drinking. Natural mentoring relationships should be encouraged and facilitated in prevention efforts for Mexican youths, Mexican-American youths and potentially other Hispanic/Latino youths.

Changes in alcohol use among first year university students in Mexico

BACKGROUND

Alcohol use and misuse is widespread among university students in many countries. Specific cultural factors may impact alcohol use after entering university.

OBJECTIVE

This paper considers changes in alcohol use among first year university students in Mexico.

METHODS

A qualitative study using ethnographic interviews with 57 female and 60 male student drinkers in Mexico City from March to June 2011. Each interview was evaluated by a set of thematic codes developed inductively from the interviews. Findings from excessive, heavy, regular, occasional drinkers, abstainers, and non-drinkers were analyzed to explore whether or not linkages existed between and/or among particular themes.

RESULTS

Students reported factors associated with changes in role and status, friendships, and increased autonomy as reasons for increasing or decreasing their alcohol use after entering university. CONCLUSIONS/IMPORTANCE: Understanding the influence of Mexican cultural norms on alcohol use among Mexican and Mexican Americans can be helpful in informing studies and preventive efforts among both Mexican and Mexican American young people.

Drinking patterns and victimization among male and female students in Mexico

AIMS

The purpose of this study is to estimate the prevalence of alcohol use and alcohol-related consequences, identify drinking profiles using latent profile analysis (LPA), and investigate associations between profiles and violent victimization among young people in Mexico.

METHODS

LPA identified profiles of drinking behavior in a survey of entering first year university students. Multinomial and logistic regression examined associations between drinking patterns, socio-demographic variables and violent victimization.

RESULTS

The LPA identified five profiles of behaviors and consequences among the 22,224 current, former and never drinkers: Non/Infrequent-No Consequences, Occasional-Few Consequences, Regular-Some Consequences, Heavy-Many Consequences and Excessive-Many Consequences drinkers. The Occasional-Few Consequences profile comprised the largest, and the Excessive-Many Consequences profile the smallest, group of drinkers. Multinomial regression showed males and older students more likely to be Heavy or Excessive-Many Consequences drinkers. Living alone was associated with higher odds, and higher maternal education with lower odds, of being a Non/Infrequent-No Consequences drinker. Heavier drinking profiles were more likely to experience violent victimization adverse consequences. Logistic regression showed male and female Heavy and Excessive-Many Consequences drinkers had the highest odds, and Non/Infrequent drinkers the lowest odds, of experiencing any victimization.

CONCLUSION

Findings suggest changes in male and female drinking behavior and a continuation of the established pattern of infrequent but high consumption among Mexican youths. Both male and female Heavy and Excessive-Many Consequences drinkers were at elevated risk for experiencing victimization. Identifying cultural gender norms about drinking including drinker expectations and drinking context that contribute to these patterns can inform prevention efforts.

Differences in health behaviours between immigrant and non-immigrant groups: a protocol for a systematic review

BACKGROUND

Health behaviours are important determinants of health and adoption of unhealthy behaviour is considered as one of the mechanisms through which immigrants' health changes over time in the host country. The change in health behaviours over time can contribute either to improving or worsening the overall health status of immigrants. Despite being the important mediators for the change in overall health status and chronic health conditions, no previous review (either general or systematic) has examined differences in key health behaviours simultaneously between immigrants and non-immigrants. This study aims to provide a systematic overview of the current global literature on differences in key health behaviours (that is, tobacco smoking, physical activity and alcohol drinking) between immigrant and non-immigrant groups.

METHODS/DESIGN

Empirical studies in English language reporting quantitative data simultaneously on both immigrant and non-immigrant groups will be considered for this systematic review. Electronic scientific searches will be conducted on seven databases to identify relevant studies of interests: MEDLINE, CINAHL, PsycINFO, EMBASE, Global Health, SocINDEX and ProQuest. In addition, Google/Google Scholar will be used to find the relevant studies and personal contact with experts will also be undertaken. Titles, abstracts and keywords of studies identified in the search strategies will be screened for inclusion criteria. The authors will select the studies following the PRISMA guidelines. The quality of included studies will be appraised using the Critical Appraisal Skills Programme (CASP) checklists. A descriptive summary statistics of included studies will describe the study designs, socio-demographic characteristics, and the exposure (immigrant and non-immigrant groups) and outcome (key health behaviours) measures. P-values and confidence intervals (CIs) for the associations between exposure and key health behaviours will also be reported.

DISCUSSION

This systematic review will facilitate a better understanding of differences in key health behaviours between immigrant and non-immigrant counterparts. It will provide a rigorous and reliable research base for future research and advance information on key health behaviours for a range of immigrant groups compared to non-immigrants in the high-migrant-receiving countries.

SYSTEMATIC REVIEW REGISTRATION

This systematic review protocol has been registered with PROSPERO (registration number: CRD42014008688).

Does age at first treatment episode make a difference in outcomes over 11 years?

This study examines the associations between age at first substance use treatment entry and trajectory of outcomes over 11 years. We found significant differences in individual and treatment characteristics between adult intakes first treated during young adulthood (25 years or younger) and those first treated at an older age. Compared to their first treated older age counterparts matched on demographics and dependence type, those who entered first treatment during young adulthood had on average an earlier onset for substance use but a shorter duration between first substance use and first treatment entry; they also had worse alcohol and other drug outcomes 11 years post treatment entry. While subsequent substance use treatment and 12-step meeting attendance are important for both age groups in maintaining positive outcomes, relationships varied by age group. Findings underline the importance of different continuing care management strategies for those entering first treatment at different developmental stages.

CHRNA5 and CHRNA3 variants and level of neuroticism in young adult Mexican American men and women

A lifetime history of alcohol dependence has been associated with elevations in neuroticism in Mexican American young adults. The identification of genetic markers associated with neuroticism and their influence on the development of alcohol use disorders (AUD) may contribute to our understanding of the relationship between personality traits and the increased risk of AUD in Mexican Americans. The purpose of this study was to investigate associations between neuroticism and 13 single nucleotide polymorphisms (SNPs) in the nicotinic acetylcholine (nAChR) α5-subunit (CHRNA5) and α3-subunit (CHRNA3) genes in young adult Mexican American men and women. Participants were 465 young adult Mexican American men and women who are literate in English and are residing legally in San Diego County. Each participant gave a blood sample and completed a structured diagnostic interview. Neuroticism was assessed using the Maudsley Personality Inventory. The minor alleles of four CHRNA5 polymorphisms (rs588765, rs601079, rs680244 and rs555018) and three CHRNA3 polymorphisms (rs578776, rs6495307 and rs3743078) showed associations with neuroticism. Several of these SNPs also displayed nominal associations with DSM-IV alcohol and nicotine dependence, but tests of mediation suggested that these relations could be partially explained by the presence of co-occurring neuroticism. These findings suggest that genetic variations in nicotinic receptor genes may influence the development of neuroticism, which in turn is involved in the development of AUDs and nicotine dependence in Mexican American young adults.

Substance use, generation and time in the United States: the modifying role of gender for immigrant urban adolescents

Although immigrant youth have lower rates of substance use than US born youth, whether substance use varies by generation and time in the US is unclear. This study examines adolescent alcohol, tobacco and marijuana use by generation/time in US (i.e., first generation, in US ≤4 years; first generation, in US >4 years; second generation; and third generation or higher). Data come from a 2008 survey of Boston, Massachusetts public high school students (n = 1485). Multivariable logistic regression models were used to examine the association between generation/time in the US and risk of past 30-day substance use, adjusting for age and race/ethnicity. To determine whether the associations differed by gender, we fit gender stratified regression models. The prevalence of substance use was lowest among immigrants who had been in the US ≤4 years. Among girls, generation/time in US was not related to alcohol use or to tobacco use. For boys, being an immigrant regardless of number of years in the US, as well as second generation was associated with a significantly lower risk of tobacco use, compared to third generation youth. Additionally, immigrant boys who had been in the US ≤4 years had a significantly lower risk of alcohol use. Among both boys and girls, all first and second generation youth were significantly less likely to report marijuana use compared to third generation youth. Immigrant youth have a lower risk of alcohol, tobacco and marijuana use relative to US born youth; however the protective effect of foreign nativity on alcohol was eroded much more quickly than for tobacco or marijuana. The effects of generation and time in US on substance use differ by gender and the particular substance.

Acculturation stress, anxiety disorders, and alcohol dependence in a select population of young adult Mexican Americans

OBJECTIVES

Mexican Americans comprise one of the most rapidly growing populations in the U.S. and within this population the process of acculturation has been suggested to be associated with some mental health problems. This study sought to ascertain quantitative information indexing acculturation stress and its association with mental health disorders in a select community sample of Mexican Americans.

METHODS

Demographic information, DSM-III-R diagnoses, and information on cultural identity and acculturation stress were obtained from 240 Mexican American young adults that were recruited by fliers and were residing in selected areas of San Diego.

RESULTS

No associations were found between measures of cultural identification and lifetime diagnoses of drug or alcohol dependence, major depressive disorder, anxiety disorders or antisocial personality disorder/conduct disorder in this sample of Mexican American young adults. However, lifetime diagnoses of alcohol dependence, substance dependence, and anxiety disorders were associated with elevations in acculturation stress.

CONCLUSION

Quantitative measures of acculturation stress, but not cultural identity per se, were found to be significantly associated with substance dependence and anxiety disorders in this select population of Mexican American young adults. These data may be helpful in designing prevention and intervention programs for this high risk population.

Sleep quality and alcohol-use disorders in a select population of young-adult Mexican Americans

OBJECTIVE

Adult male Hispanics, particularly those born in the United States, are more likely to drink frequently and to consume larger quantities of alcohol than Whites or Blacks. Because alcohol and other substance-use disorders are frequently associated with disturbances in sleep, this study investigated measures of sleep quality and substance use disorders in a select sample of young-adult Mexican Americans.

METHOD

Diagnoses of alcohol-use disorders and other psychiatric disorders (based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised), results from the Pittsburgh Sleep Quality Index (PSQI), family history of alcohol dependence, and measures of acculturation stress were obtained from 294 Mexican American young adults, ages 18-30, who were literate in English and were residing legally in San Diego County.

RESULTS

Lifetime diagnoses of alcohol-use disorders, family history of alcohol dependence, acculturation stress, and lifetime diagnoses of major depressive disorder were all correlated with significantly poorer quality sleep as indexed by the global score on the PSQI. Regression analyses also revealed that gender was correlated with habitual bedtime, whereas drug dependence (cannabis, stimulants, and/or opiates) was significantly correlated with how long it took to fall asleep, major depressive disorder with the number of hours spent sleeping a night, and anxiety disorders and major depressive disorder with waking up in the early morning or middle of the night.

CONCLUSIONS

These data suggest that alcohol-use disorders are significantly associated with poorer quality of sleep in this population of young adults and that substance-use disorders may affect different aspects of sleep than anxiety and depressive disorders do. These findings may be helpful in designing prevention and intervention programs for alcohol-use disorders in this high-risk population.

Why might adverse childhood experiences lead to underage drinking among US youth? Findings from an emergency department-based qualitative pilot study

Research suggests that adverse childhood experiences (e.g., child abuse, interparental violence) predispose youth to early drinking initiation, but specifics about how and why adolescents progress from these exposures to alcohol use are not well understood. This National Institute on Alcohol Abuse and Alcoholism supported study presents data from semistructured interviews with 22 adolescents who reported both initiating drinking ≤18 years old and ≥2 adverse childhood experiences. Data were collected in 2007 as part of a formative research effort for an emergency department-based intervention to reduce adolescent drinking. Findings suggest that prevention initiatives for youth from challenging environments may need to do more than address conformity and social motivations for underage alcohol initiation. Study limitations are noted and future research is suggested.

The Hispanic Americans Baseline Alcohol Survey (HABLAS): Alcohol consumption and sociodemographic predictors across Hispanic national groups

OBJECTIVE

To examine differences in alcohol consumption among Hispanic national groups in the United States [Puerto Ricans, Mexican, Cuban, and Dominican South Central (D/SC) Americans] and identify sociodemographic predictors of drinking and binge drinking (four drinks for women and five for men in a 2-hr period).

METHOD

The study used a household probability sample of adult Hispanics in five metropolitan areas in the United States. Comprehensive data on alcohol consumption were collected. Analyses included bivariate and multivariate regression techniques.

RESULTS

Puerto Rican and Mexican American men reported higher drinking rates, weekly consumption, and binge drinking than D/SC and Cuban Americans. Women drank significantly less than men. Mexican American women reported the highest abstention rate (61%); Puerto Rican women drank more per week and binged more frequently compared with their counterparts in other groups. Puerto Rican origin, initiating drinking during high school years (<18), and male gender (US- or foreign-born) were significant predictors of weekly alcohol consumption. Being younger, being single, Puerto Rican or D/SC American origin, initiating drinking at <18 years, being a US- or foreign-born male and being a US-born female were significant predictors of binge drinking.

CONCLUSIONS

There are considerable differences in drinking behavior across Hispanic national groups as well as between men and women. Results underscore the need to recognize heterogeneity in drinking practices while designing effective prevention interventions in the community.

Extending the theory of planned behavior to predict alcohol, tobacco, and marijuana use among youth of Mexican heritage

This study examined the applicability of extending the theory of planned behavior to explain the normative processes in substance use among Mexican-heritage youth. The theory identifies norms, attitudes, and perceived behavioral control as predictors of intentions, which in turn, predict behaviors. To date, the theory had a limited conceptualization of norms and had not been extended to youth of Mexican descent, one of the fastest growing segments of the U.S. population and one at particular risk for alcohol, tobacco, and marijuana use. Based on norm focus theory, it was hypothesized that norms are multidimensional, consisting of parental injunctive, peer injunctive, descriptive, and personal substance use norms. Second, it was hypothesized that parental injunctive, peer injunctive, and descriptive norms indirectly affect substance use intentions through attitudes, personal norms, and perceived behavioral control. The third hypothesis postulated that the model would operate differently based on Mexican-heritage youths' country of origin. Mexican-heritage youth (N = 1,499) from 30 elementary schools in Phoenix, AZ completed questionnaires in three waves over 18 months as part of a larger study. The findings supported the first hypothesis, showing the multidimensionality of norms. The second hypothesis was partially supported by findings from a multi-group multilevel path analysis using Mplus. Descriptive norms' association with intentions was partially mediated by attitudes, personal norms, and perceived behavioral control, while parental and peer injunctive norms were fully mediated, partially supporting the second hypothesis. Contrary to the third hypothesis, the mediation model did not differ based on Mexican-heritage youths' country of origin.