1
|
Caetano R, Vaeth PAC, Canino G. Children exposed to alcohol-related problems and DSM-5 alcohol use disorder in San Juan, Puerto Rico. J Ethn Subst Abuse 2017; 18:374-386. [PMID: 29068775 DOI: 10.1080/15332640.2017.1371657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article estimates the proportion of children (17 and younger) exposed to an adult with an alcohol problem or alcohol use disorder (AUD) in San Juan, Puerto Rico. Data are from a household random sample of 1,510 individuals 18-64 years of age. A total of 20.9% of children in sample households were exposed to an adult with an alcohol problem, and 5.7% were exposed to an adult with DSM-5 AUD. These considerable proportions suggest that alcohol treatment and family support programs should include help for adults in the family, and special support for exposed children in the household.
Collapse
Affiliation(s)
- Raul Caetano
- a Pacific Institute for Research and Evaluation , Oakland , California
| | - Patrice A C Vaeth
- a Pacific Institute for Research and Evaluation , Oakland , California
| | | |
Collapse
|
2
|
Caetano R, Vaeth PAC, Canino G. Family cohesion and pride, drinking and alcohol use disorder in Puerto Rico. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 43:87-94. [PMID: 27808561 PMCID: PMC5597303 DOI: 10.1080/00952990.2016.1225073] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 07/26/2016] [Accepted: 08/09/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The extended multigenerational family is a core value of Hispanic culture. Family cohesion/pride can have protective effects on drinking- and drug-use-related behavior among Hispanics. OBJECTIVES To examine the association between family cohesion/pride, drinking, binge drinking, and DSM-5 alcohol use disorder (AUD) in Puerto Rico. METHODS Data are from a household random sample of 1510 individuals 18-64 years of age in San Juan, Puerto Rico. RESULTS Bivariate analyses showed that family cohesion/pride was not associated with the average number of drinks consumed per week but was associated with binge drinking among men. Family cohesion/pride was also associated with DSM-5 AUD. Results of the multivariate analyses were consistent with these bivariate results for DSM-5 AUD. Respondents with low (OR = 2.2, 95CL = 1.21-3.98; p < .01) and medium (OR = 1.88; 95CL = 1.12-3.14; p < .01) family cohesion/pride were more likely than those with high family cohesion/pride to have a positive diagnosis of DSM-5 AUD. More liberal drinking norms and positive attitudes toward drinking were also strong predictors of the average number of drinks consumed per week. More liberal drinking norms also predicted binge drinking, and DSM-5 AUD. CONCLUSIONS Higher family cohesion/pride may have a protective effect against DSM-5 AUD. This may have practical implications for clinical and prevention programs. As long as high cohesion is not enabling drinking, these programs can enhance and support family cohesion/pride to help clients in treatment and recovery and prevent drinking problems.
Collapse
Affiliation(s)
- Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation 180 Grand Avenue, Suite 1200, Oakland, California 94612, USA
| | - Patrice A. C. Vaeth
- Prevention Research Center, Pacific Institute for Research and Evaluation 180 Grand Avenue, Suite 1200, Oakland, California 94612, USA
- Medical Sciences Campus, University of Puerto Rico P.O. Box 365067, San Juan, PR 00936-5067, USA
| | - Glorisa Canino
- Medical Sciences Campus, University of Puerto Rico P.O. Box 365067, San Juan, PR 00936-5067, USA
| |
Collapse
|
3
|
Caetano R, Vaeth PAC, Santiago K, Canino G. The dimensionality of DSM5 alcohol use disorder in Puerto Rico. Addict Behav 2016; 62:20-4. [PMID: 27305100 PMCID: PMC4955770 DOI: 10.1016/j.addbeh.2016.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 06/01/2016] [Accepted: 06/06/2016] [Indexed: 01/05/2023]
Abstract
AIMS TO Test the dimensionality and measurement properties of lifetime DSM-5 AUD criteria in a sample of adults from the metropolitan area of San Juan, Puerto Rico. DESIGN Cross-sectional study with survey data collected in 2013-2014. SETTING General population. PARTICIPANTS Random household sample of the adult population 18 to 64years of age in San Juan, Puerto Rico (N=1510; lifetime drinker N=1107). MEASUREMENT DSM-5 alcohol use disorder (2 or more criteria present in 12months). RESULTS Lifetime reports of AUD criteria were consistent with a one-dimensional model. Scalar measurement invariance was observed across gender, but measurement parameters for tolerance varied across age, with younger ages showing a lower threshold and steeper loading. CONCLUSIONS Results provide support for a unidimensional DSM-5 AUD construct in a sample from a Latin American country.
Collapse
Affiliation(s)
- Raul Caetano
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA 94612, USA.
| | - Patrice A C Vaeth
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA 94612, USA
| | - Katyana Santiago
- University of Puerto Rico, Behavioral Sciences Research Institute, Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| | - Glorisa Canino
- University of Puerto Rico, Behavioral Sciences Research Institute, Medical Sciences Campus, P.O. Box 365067, San Juan 00936-5067, Puerto Rico
| |
Collapse
|
4
|
Gayman MD, Cislo AM, Hansard S. Time-Clustered Deaths and Substance Use Disorder among Young Adults *. Stress Health 2016; 32:2-11. [PMID: 24639323 PMCID: PMC4167986 DOI: 10.1002/smi.2569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 02/12/2014] [Accepted: 02/17/2014] [Indexed: 11/11/2022]
Abstract
This study assesses whether experiencing multiple deaths of loved ones clustered in time increases risk for substance use problems. Using survey data from a community sample of young adults in Miami, Florida (N = 1747), time-clustered deaths were categorized based on the age of the respondent at the time of each death, with less time between deaths representing greater time-clustering. Results indicate that young adults experiencing multiple deaths that are highly time clustered are at increased risk for substance use disorder and alcohol use. This study provides an alternative way of thinking about how young people may be affected by major life events. It suggests that the increased risk for substance use disorder associated with multiple deaths may be more likely to materialize when the deaths are highly clustered in time.
Collapse
|
5
|
Mancha BE, Hulbert A, Latimer WW. A latent class analysis of alcohol abuse and dependence symptoms among Puerto Rican youth. Subst Use Misuse 2012; 47:429-41. [PMID: 22216959 PMCID: PMC6413868 DOI: 10.3109/10826084.2011.643525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study aim was to classify youths into homogenous groups based on their symptoms of Alcohol Abuse and Dependence. An NIDA-funded cross-sectional survey was administered to 622 middle and high school students in San Juan, Puerto Rico in 2000. Latent class analysis (LCA) examined the Alcohol Abuse and Dependence symptoms. Three distinct classes of drinkers were found: low (86.0% of sample), moderate (11.7% of sample), and high (2.3% of sample) severity classes which were distinguished by differing estimated probabilities of symptom reporting. The study has implications for the diagnosis of Alcohol Abuse and Dependence among Puerto Rican youths. Limitations are also noted.
Collapse
Affiliation(s)
- Brent Edward Mancha
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
| | | | | |
Collapse
|
6
|
Gayman MD, Cuddeback GS, Morrissey JP. Help-seeking behaviors in a community sample of young adults with substance use disorders. J Behav Health Serv Res 2012; 38:464-77. [PMID: 21523514 DOI: 10.1007/s11414-011-9243-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Despite the high prevalence of substance use disorders (SUDs) in the U.S., many with a SUD go untreated and/or report lengthy delays to help-seeking initiation. From a public health standpoint, because SUDs often emerge in early adulthood, information on help-seeking behaviors among young adults is important. Using data from young adults ages 18-23 years with a history of a SUD (n = 672) in Miami-Dade County, Florida, this study estimates the prevalence of lifetime help-seeking initiation and examines factors related to help seeking and delays to help-seeking initiation. The majority (68%) of young adults with a history of a SUD reported never having sought help, and those who reported help seeking experienced relatively lengthy delays (1-7 years) to help-seeking initiation. These findings underscore the need for both timely substance abuse treatment and for accelerated research on successful outreach strategies for young adults with SUDs.
Collapse
Affiliation(s)
- Mathew D Gayman
- Department of Sociology, Affiliated Faculty, Partnership for Urban Health Research, Georgia State University, 1080-A, PO Box 5020, Atlanta, GA 30302-5020, USA.
| | | | | |
Collapse
|
7
|
Borges G, Breslau J, Orozco R, Tancredi DJ, Anderson H, Aguilar-Gaxiola S, Mora MEM. A cross-national study on Mexico-US migration, substance use and substance use disorders. Drug Alcohol Depend 2011; 117:16-23. [PMID: 21296509 PMCID: PMC3110586 DOI: 10.1016/j.drugalcdep.2010.12.022] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 12/21/2010] [Accepted: 12/22/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Epidemiologic research has consistently found lower prevalence of alcohol and drug use disorders among Hispanic immigrants to the US than among US-born Hispanics. Recent research has begun to examine how this change occurs in the process of assimilation in the US. We aimed to study immigration, US nativity, and return migration as risk factors for alcohol and drug use among people of Mexican origin in both the US and Mexico. METHODS Data come from nationally representative surveys in the United States (2001-2003; n=1208) and Mexico (2001-2002; n=5782). We used discrete time event history models to account for time-varying and time-invariant characteristics. RESULTS We found no evidence that current Mexican immigrants in the US have higher risk for alcohol or alcohol use disorders than Mexicans living in Mexico, but current immigrants were at higher risk for drug use and drug use disorders. Current Mexican immigrants were at lower risk for drug use and drug disorders than US-born Mexican-Americans. US nativity, regardless of parent nativity, is the main factor associated with increasing use of alcohol and drugs. Among families of migrants and among return migrants we found increased risk for alcohol use, drug use and alcohol and drug use disorders. Evidence of selective migration and return of immigrants with disorders was found regarding alcohol use disorders only. CONCLUSIONS Research efforts that combine populations from sending and receiving countries are needed. This effort will require much more complex research designs that will call for true international collaboration.
Collapse
Affiliation(s)
- Guilherme Borges
- National Institute of Psychiatry, Calzada México Xochimilco No. 101-Col. San Lorenzo Huipulco, México DF, CP 14370 Mexico City, Mexico.
| | | | | | | | | | | | | |
Collapse
|
8
|
Merikangas KR, Conway KP, Swendsen J, Febo V, Dierker L, Brunetto W, Stolar M, Canino G. Substance use and behaviour disorders in Puerto Rican youth: a migrant family study. J Epidemiol Community Health 2009; 63:310-6. [PMID: 19147633 DOI: 10.1136/jech.2008.078048] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Hispanics in the USA have higher rates of substance use disorders than similar ethnic groups residing in Latin American nations, and recent evidence suggests an increase in substance use among US Hispanic youth. This investigation examines the familial and societal correlates of this increase by comparing Puerto Rican families residing in the mainland USA and Puerto Rico. METHODS Using migrant and controlled family study methods, 279 probands in San Juan and 236 probands in New Haven were recruited from treatment clinics and the general community to compose four diagnostic groups: drug abuse/dependence; alcohol abuse/dependence; psychiatric controls; unaffected controls. 806 biological offspring aged 12-17 were then directly interviewed. RESULTS Total rates for alcohol use were greater among San Juan youth than their migrant counterparts. By contrast, US migrant adolescents were more likely to use cannabis. A strong association was observed between parental and child substance use at both sites, particularly for boys, and offspring of probands with drug use disorders were at greatest risk for substance use and related disorders. Familial aggregation patterns did not vary substantially by site. CONCLUSIONS Despite societal influences on the magnitude and patterns of substance use in migrant youth, the consistent influence of parental disorders across sites reveals that the cross-generational transmission of substance use disorders in prior studies extends to Hispanic families and is an important factor to consider in the development of prevention strategies.
Collapse
Affiliation(s)
- K R Merikangas
- Intramural Research Programme, National Institute of Mental Health/NIH, Bethesda, Maryland, USA
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Latimer WW, Rojas VC, Mancha BE. Severity of alcohol use and problem behaviors among school-based youths in Puerto Rico. Rev Panam Salud Publica 2008; 23:325-32. [PMID: 18510792 DOI: 10.1590/s1020-49892008000500004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The present study sought to: (a) categorize youths into groups based on their level of alcohol use and number of symptoms of alcohol abuse and dependence defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and (b) examine whether these categories were associated with other problem behaviors in which youths engage (marijuana use, sexual intercourse, and having been arrested or having trouble with the law). METHODS The study is based on a cross-sectional survey administered to 972 school-based youths from one middle school and one high school in San Juan, Puerto Rico. Youths were categorized based on their alcohol use and alcohol problems. These categories were then examined for associations with lifetime marijuana use, lifetime sexual intercourse, and having been arrested or having had trouble with the law in the past year. The original eight categories of alcohol use were collapsed into six categories based on the results. RESULTS For virtually every group characterized by higher severity of alcohol use and alcohol problems, researchers found an increasing prevalence of marijuana use in their lifetimes, increasing odds of sexual intercourse in their lifetimes, and having had trouble with the law in the past year. CONCLUSIONS Knowing about variations in alcohol use and alcohol problems may be instrumental in measuring the degree to which youths may also be engaging in a range of other elevated risk behaviors and a progression to more serious forms of alcohol and drug use.
Collapse
Affiliation(s)
- William W Latimer
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore 21205, Maryland, USA.
| | | | | |
Collapse
|
10
|
Lloyd DA, Turner RJ. Cumulative lifetime adversities and alcohol dependence in adolescence and young adulthood. Drug Alcohol Depend 2008; 93:217-26. [PMID: 17980975 PMCID: PMC2254520 DOI: 10.1016/j.drugalcdep.2007.09.012] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 08/31/2007] [Accepted: 09/14/2007] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Negative life events have been implicated in the development of alcohol dependence. This paper tests whether cumulative exposure to such stressors significantly predicts risk of DSM-IV alcohol dependence disorder in young adults. We also provide descriptive data that characterizes the patterns of cumulative exposure to such events and rates of alcohol dependence across gender, race/ethnic, and socioeconomic groups. METHOD Members of a representative urban community sample of 1786 young adults in South Florida were interviewed retrospectively using the Composite International Diagnostic Interview, and a lifetime checklist of 41 major adverse life events. The conditional risk of first onset of alcohol dependence disorder was estimated in relationship to a measure of lifetime cumulative adversity using discrete-time event history analysis. RESULTS Event history analysis suggested that lifetime stress exposure exhibits a pattern of association with alcohol dependence that is consistent with a cumulative impact interpretation. Both recent events and events more distant in time were significantly and independently associated with such risk. Although these results contribute toward an understanding of variations in alcohol dependence across individuals, they do not assist in the understanding of observed ethnic group differences in such dependence.
Collapse
Affiliation(s)
- Donald A Lloyd
- Center for Demography and Population Health, Department of Sociology, 616 Bellamy, Florida State University, Tallahassee, FL 32306-2240, USA.
| | | |
Collapse
|
11
|
Thompson MP, Sims L, Kingree JB, Windle M. Longitudinal associations between problem alcohol use and violent victimization in a national sample of adolescents. J Adolesc Health 2008; 42:21-7. [PMID: 18155026 DOI: 10.1016/j.jadohealth.2007.07.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Revised: 06/29/2007] [Accepted: 07/02/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE Research indicates that alcohol use is both a risk factor for and a consequence of violent victimization. This study investigated the longitudinal associations between problem alcohol use and victimization, and whether these associations varied by gender. METHODS Data from the National Longitudinal Study on Adolescent Health (Add Health) were used to investigate the prospective associations between alcohol use and victimization over three time points spanning 7 years. Because adolescence is a time of rapid growth, we used latent growth modeling (LGM) in addition to traditional cross-lagged structural equation modeling (SEM). RESULTS For boys, both SEM and LGM indicated that problem alcohol use was a risk factor for subsequent violent victimization. For girls, the SEM suggested a bi-directional association, although the LGM provided stronger support for problem alcohol use as a risk factor for, rather than a consequence of, violent victimization. CONCLUSIONS Findings across the two statistical approaches suggest that interventions that reduce the likelihood of problem alcohol use among adolescents can minimize the short-term risk of victimization and the long-term risk of problem alcohol use in young adulthood.
Collapse
Affiliation(s)
- Martie P Thompson
- Department of Public Health Sciences, Clemson University, Clemson, South Carolina 29634, USA.
| | | | | | | |
Collapse
|
12
|
Canino G, Vega WA, Sribney WM, Warner LA, Alegría M. Social Relationships, Social Assimilation, and Substance-Use Disorders among Adult Latinos in the U.S. JOURNAL OF DRUG ISSUES 2008; 38:69-101. [PMID: 20011228 DOI: 10.1177/002204260803800104] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Based on social control perspectives and results from prior studies we test hypotheses about the extent to which characteristics of family and social networks are associated with substance use disorders (SUD), and whether these associations vary by sex. In this study SUD is alcohol or illicit drug abuse or dependence as defined by criteria of the Diagnostic and Statistical Manual of the American Psychiatric Association. With nationally representative data of adult Latinos from the National Latino and Asian American Survey (NLAAS), we found that respondents' language use with family, rather than language proficiency, appears to be a more efficient proxy for social assimilation to represent differential levels of risk of SUD. SUD was positively associated with problematic family relations for men but not women, and SUD was positively associated with more frequent interactions with friends for women but not men. The results suggest that the salient features of social assimilation associated with SUD include the context of language use and transformations in family and social network relationships that differ in important ways between Latino men and women.
Collapse
Affiliation(s)
- Glorisa Canino
- Behavioral Sciences Research Institute and the Department of Pediatrics, University of Puerto Rico
| | | | | | | | | |
Collapse
|
13
|
Torres LR, Peña JB, Westhoff WW, Zayas LH. A Cross-National Comparison of Adolescent Alcohol and Drug Use Behaviors: U. S. Hispanics and Youth in the Dominican Republic. JOURNAL OF DRUG ISSUES 2008. [DOI: 10.1177/002204260803800107] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of substance use behaviors during adolescence is an important concern in the United States and internationally. Of particular importance to the U.S. is our ability to compare prevalence estimates and trends with those of neighboring countries, particularly those that feed our immigrant population and have a circulatory migration pattern with us. One of the fastest-growing Hispanic groups is Dominicans, who are also a young group, with a third of Dominicans in the United States under age 18. However, cross-national comparisons of the substance use rates of youth in the U. S. and the Dominican Republic have not been done. Our study represents, to our knowledge, the first such comparison. We conducted a secondary data analysis comparing data from the U.S. Center for Disease Control and Prevention's (CDC) 1997 Youth Risk Behavior Survey (YRBS), a biennial survey in the U.S., to data from a survey conducted by the Ministry of Education of the Dominican Republic in 1997. The Dominican Republic survey used a similar sampling methodology and the Spanish version of the YRBS, piloted and modified to ensure linguistic and cultural appropriateness. Youth in the United States in general, and U.S. Hispanic youth in particular, consistently reported higher lifetime and recent use of alcohol, marijuana, and cocaine than youth in the Dominican Republic. Our study supports other cross-national comparisons that have found rates of substance use for youth in Latin America lower than those for youth in the United States. Cross-national comparisons of this nature help each individual country inform its social policies around prevention. They may also allow us to examine the impact of immigration, acculturation, and return migration processes on adolescent substance use in both countries.
Collapse
|
14
|
Maldonado-Molina MM, Collins LM, Lanza ST, Prado G, Ramírez R, Canino G. Patterns of substance use onset among Hispanics in Puerto Rico and the United States. Addict Behav 2007; 32:2432-7. [PMID: 17493764 PMCID: PMC3001340 DOI: 10.1016/j.addbeh.2007.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Revised: 02/19/2007] [Accepted: 04/09/2007] [Indexed: 11/18/2022]
Abstract
PURPOSE Examine patterns of progression in substance use among Hispanic youth 13 to 17 years of age from two longitudinally representative studies. METHOD Patterns of substance use among youth in Puerto Rico were examined using a longitudinal study (n=663) of adolescents living on the island. The National Longitudinal Study of Youth was used to examine patterns of substance use among Hispanics living in the United States (n=1,445). Latent transition analysis was used to estimate the probability of membership in each stage of substance use and incidence of transitions between different substance use stages over time. RESULTS Six stages best described the heterogeneity in substance use among youth in Puerto Rico. Five stages were sufficient to describe patterns of substance use among youth in the United States. Youth living in Puerto Rico reported lower rates of smoking and illicit drug use, but higher rates of alcohol use, when compared with rates among Hispanics in the United States. DISCUSSION Similar patterns of substance use were identified for Hispanic youth living in the United States and youth living in Puerto Rico.
Collapse
Affiliation(s)
- Mildred M Maldonado-Molina
- University of Florida, College of Medicine, Department of Epidemiology and Health Policy Research, 1329 SW 16th St, Room 5130, Box 100177, Gainesville, FL 32610-0177, USA.
| | | | | | | | | | | |
Collapse
|
15
|
Springer A, Kelder S, Orpinas P, Baumler E. A cross-national comparison of youth risk behaviors in Latino secondary school students living in El Salvador and the USA. ETHNICITY & HEALTH 2007; 12:69-88. [PMID: 17132585 DOI: 10.1080/13557850601002155] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES As Latin Americans' exposure to the USA increases through migration patterns and US political and economic ties to their countries of origin, they become susceptible to adopting not only the cultural expressions of the USA such as fashion, but also the health-related behaviors of the US population. In assessing potential health risks for Salvadoran youth that may result from the connection between Latin Americans and the USA, this study compared the prevalence of health risk behaviors from four behavior domains (aggression and victimization, depression and suicidal ideation, substance use, and sexual behavior) between Salvadoran and US Latino secondary school students aged 14-17 years. DESIGN A secondary analysis was performed on two 1999 cross-sectional survey data. In the USA, results were based on 1,063 Latino high school students who answered the nationally representative Youth Risk Behavior Survey (YRBS) conducted by the Centers for Disease Control and Prevention. In El Salvador, results were based on 793 public secondary school students who answered a local YRBS survey conducted in coordination with the Ministry of Education of El Salvador. RESULTS The prevalence rates for aggression/victimization and for depression and suicidal ideation behaviors were similar between Salvadoran and US Latino adolescents. Substance use prevalence, however, was 10-40% higher for US Latino adolescents. While the prevalence of sexual intercourse was higher among US Latino youth (between 13 and 27% higher, depending on age), the prevalence of condom use was lower among sexually active Salvadoran youth (between 11 and 42% lower, depending on age). CONCLUSIONS In the context of the transnationalization of the Salvadoran population, with potential for increased influence of the USA in Salvadoran culture, these differences in risk behavior are important for targeting effective interventions for Latino adolescents in El Salvador and in the USA.
Collapse
Affiliation(s)
- Andrew Springer
- The University of Texas School of Public Health, Center for Health Promotion and Prevention Research, Houston, TX 77030, USA.
| | | | | | | |
Collapse
|
16
|
Warner LA, Valdez A, Vega WA, de la Rosa M, Turner RJ, Canino G. Hispanic drug abuse in an evolving cultural context: an agenda for research. Drug Alcohol Depend 2006; 84 Suppl 1:S8-16. [PMID: 16750335 DOI: 10.1016/j.drugalcdep.2006.05.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Drug abuse in the U.S. Hispanic population appears to be in a dynamic state of acceleration, although there are differences in drug use patterns between U.S.-born and foreign-born Hispanics, and across Hispanic subgroups (i.e., Mexican, Cuban, Puerto Rican, and Central or South American). An understanding of the consequences of cultural adjustments for drug use is needed to effectively anticipate the scope and dimensions of illicit drug use in the largest, rapidly growing, minority group in the U.S. This paper provides an epidemiologic overview of current Hispanic drug use, summarizes research on the relationship between culture change and drug use, organized according to individual, social (i.e., family and peer group), and community level influences on drug use, and offers a systematic agenda for future research.
Collapse
Affiliation(s)
- Lynn A Warner
- School of Social Welfare, University at Albany, State University of New York, 135 Western Avenue, Albany, NY 12222, USA.
| | | | | | | | | | | |
Collapse
|
17
|
Wu LT, Ringwalt CL. Use of alcohol treatment and mental health services among adolescents with alcohol use disorders. Psychiatr Serv 2006; 57:84-92. [PMID: 16399967 PMCID: PMC1361354 DOI: 10.1176/appi.ps.57.1.84] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study examined the use of and perceived need for alcohol treatment services among adolescents (aged 12 to 17 years) who received mental health services in the previous year compared with same-aged adolescents who did not receive such services. METHODS Study data were drawn from the 2000 and 2001 National Household Surveys on Drug Abuse. The authors conducted logistic regression analyses to identify the characteristics associated with the receipt of and perceived need for alcohol services among adolescents with alcohol use disorders. RESULTS Adolescents who received mental health services were much more likely than those who did not to meet criteria for alcohol use disorders in the previous year (10 percent compared with 4 percent). Among adolescents with alcohol use disorders, 15 percent of those who received mental health services used any alcohol services, compared with only 6 percent of those who did not receive mental health services. Of adolescents with alcohol use disorders who did not receive any alcohol services, only 3 percent reported a need for alcohol treatment. Among adolescents with alcohol use disorders who received mental health services, Hispanics were significantly less likely than whites to receive any alcohol services. CONCLUSIONS These findings from a nationally representative sample of adolescents reveal a largely unrecognized and underserved population at risk. Factors related to the underutilization of alcohol services by adolescents with alcohol use disorders deserve greater research attention.
Collapse
Affiliation(s)
- Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | | |
Collapse
|
18
|
Perkonigg A, Pfister H, Hofler M, Frohlich C, Zimmermann P, Lieb R, Wittchen HU. Substance use and substance use disorders in a community sample of adolescents and young adults: incidence, age effects and patterns of use. Eur Addict Res 2006; 12:187-96. [PMID: 16968994 DOI: 10.1159/000094421] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We present the prevalence and incidence rates of alcohol, nicotine, and illicit substance use, abuse, and dependence in a sample of German adolescents and young adults. Patterns of onset, cohort trends, and use of various substance classes are also analyzed. METHOD A prospective longitudinal epidemiological study with a representative sample of adolescents and young adults (n = 3,021; baseline age range = 14-24 years) was conducted in Munich, Germany. Participants were assessed between 1995 and 1999 with the Munich-Composite International Diagnostic Interview. RESULTS Cumulative lifetime incidence (up to age 28) of any substance abuse or dependence was 43.8%, and 12-month prevalence of any substance abuse or dependence was 24.4%. The lifetime incidence of nicotine dependence was most frequent (24.8%), followed by alcohol abuse (19.3%) and alcohol dependence (9.2%); 61.7% endorsed the regular use of a substance for at least one circumscribed period during their lifetime. Age-specific incidence rates and age at onset of substance use disorders differed by age cohorts. Furthermore, nicotine dependence was significantly associated with illicit substance use disorders (HR = 2.6, 95% CI 1.7-4.0). An interactive relationship between age, age at onset of nicotine dependence, and subsequent onset of illicit substance use disorders was found. CONCLUSIONS Since the baseline investigation in 1995, high incidence rates of substance use disorders and substance use have been observed in this young German sample. Especially younger cohorts report significantly earlier ages at onset of abuse and dependence. There also seems to be a trend towards a secondary age at onset peak of nicotine dependence after the onset of illicit drug use disorders. Further investigations are needed to study these patterns in younger samples. However, results emphasize the need for a combined prevention of illicit drugs and nicotine dependence.
Collapse
Affiliation(s)
- Axel Perkonigg
- Department of Clinical Psychology and Psychotherapy, Dresden University of Technology, Dresden, Germany.
| | | | | | | | | | | | | |
Collapse
|
19
|
Dierker LC, Ramirez RR, Chavez LM, Canino G. Association between psychiatric disorders and smoking stages among Latino adolescents. Drug Alcohol Depend 2005; 80:361-8. [PMID: 15964715 DOI: 10.1016/j.drugalcdep.2005.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2004] [Revised: 05/06/2005] [Accepted: 05/11/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We examined the prevalence of smoking behaviors and their association with psychiatric disorders within a representative sample of youth from Puerto Rico. METHOD A complex sampling design was used and analyses were conducted to account for the unequal selection probability, stratification and clustering. All analyses were weighted back to the population from which they were drawn. Psychiatric and substance use disorders were assessed using the parent and youth versions of the Diagnostic Interview Schedule for Children, Version 4.0 (DISC-IV). RESULTS After controlling for other comorbidity, major depression and oppositional defiant disorder were significantly associated with nicotine dependence, rather than with lower levels of use. In contrast, conduct disorder was generally associated with lower levels of use rather than with nicotine dependence. As expected, the alcohol and drug use disorders demonstrated some of the strongest associations with individual smoking stages. CONCLUSIONS By examining psychiatric correlates of smoking stages within an island-wide sample of adolescents, the present study highlights those disorders that may play a role in the development and/or persistence of smoking behavior in Puerto Rico and further clarifies the appropriate targets for smoking intervention conducted in community settings.
Collapse
Affiliation(s)
- Lisa C Dierker
- Wesleyan University, Psychology Department, 207 High Street, Middletown, CT 06459, USA.
| | | | | | | |
Collapse
|
20
|
Diamond GM, Izzard MC, Kedar T, Hutlzer A, Mell H. Psychological symptoms and drug use severity among Israeli adolescents presenting for outpatient drug abuse treatment. J Adolesc 2005; 28:495-505. [PMID: 16022884 DOI: 10.1016/j.adolescence.2004.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2003] [Revised: 06/10/2004] [Accepted: 10/16/2004] [Indexed: 11/19/2022]
Abstract
The objective of this study was to assess the rates of externalizing and internalizing symptoms, and the relation between psychological symptoms and drug use severity, among 117 Israeli adolescents presenting for outpatient drug abuse treatment. Psychological symptoms were assessed via both adolescent self-report and parent report. Drug use was assessed using both adolescent self-report and urinalysis. Results showed that 58% of the sample evidenced clinical levels of psychological symptoms, with girls evidencing higher rates of externalizing and mixed symptomatology than boys. Parents' report of adolescents' internalizing symptoms predicted severity of drug use. These findings suggest that treatment for this population should be multidimensional, and address not only drug use per se, but also psychological risk factors.
Collapse
Affiliation(s)
- Gary M Diamond
- Department of Behavioral Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, Israel.
| | | | | | | | | |
Collapse
|
21
|
Abstract
This study was designed to examine clusters of problem behaviors in a sample from the National Longitudinal Study of Adolescent Health at two time points. The technique employed was a person-oriented approach, cluster analysis. Three clusters were identified, a normal behaviors cluster, a problem behaviors cluster, and a deviant behaviors cluster. The clusters were tested for stability and for their relationships to the demographic variables gender, race, age, and socioeconomic status. The mean values for most of the problem behaviors in the problem behaviors cluster were higher than for those in the normal behaviors cluster and lower than for those in the deviant behaviors cluster. Selling drugs and weapon use distinguished the deviant behaviors cluster from the other two. Different interventions probably will be required to address the needs of those in each of the different clusters.
Collapse
Affiliation(s)
- Robin Bartlett
- School of Nursing, University of North Carolina at Greensboro, Greensboro, NC 27412-6170, USA
| | | | | |
Collapse
|
22
|
Chung T, Martin CS, Winters KC. Diagnosis, course, and assessment of alcohol abuse and dependence in adolescents. RECENT DEVELOPMENTS IN ALCOHOLISM : AN OFFICIAL PUBLICATION OF THE AMERICAN MEDICAL SOCIETY ON ALCOHOLISM, THE RESEARCH SOCIETY ON ALCOHOLISM, AND THE NATIONAL COUNCIL ON ALCOHOLISM 2005; 17:5-27. [PMID: 15789857 DOI: 10.1007/0-306-48626-1_1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Risk for the onset of an alcohol use disorder (AUD) peaks during adolescence and the transition to young adulthood, highlighting the public health significance of alcohol use by adolescents. This chapter summarizes recent research on the diagnosis, course, and assessment of adolescent AUDs. This review focuses on developmental considerations in assessment of AUD criteria, the prevalence of DSM-IV AUDs among adolescents, typical alcohol symptom profiles in youth, and limitations of DSM-IV AUD criteria when applied to adolescents. In addition, studies of AUD course in adolescents, as well as factors influencing the course of AUDs are summarized. The chapter also provides an overview of brief alcohol screening instruments and other measures used in more comprehensive assessment of AUDs in adolescents.
Collapse
Affiliation(s)
- Tammy Chung
- University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA
| | | | | |
Collapse
|
23
|
Latimer WW, Floyd LJ, Vasquez M, O'Brien M, Arzola A, Rivera N. Substance use among school-based youths in Puerto Rico: differences between gender and grade levels. Addict Behav 2004; 29:1659-64. [PMID: 15451134 DOI: 10.1016/j.addbeh.2004.02.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The present study examined substance use rates among adolescents in Grades 7-12 in Puerto Rico. Nine hundred eighty-nine students completed the Spanish version of the International Survey of Adolescent Health. More than 50% of middle school youths and 75% of high-school youths reported lifetime alcohol use. Female gender was associated with tobacco use in middle school while male gender was associated with marijuana use in high school. High-school females reported lower rates of tobacco use and marijuana use than middle-school females. High-school males exhibited substantially higher drug-use rates than middle-school males for each substance. These findings may suggest that universal drug prevention interventions may be needed for females in Puerto Rico before they enter middle school, while targeted interventions aimed at high-risk females who continue to smoke tobacco or marijuana may be more effective during high school. In contrast, targeted drug prevention interventions for males probably need to begin in middle school and be maintained if not increased in intensity throughout the high-school years.
Collapse
Affiliation(s)
- William W Latimer
- Johns Hopkins University, School of Hygiene and Public Health, 624 N Broadway, Suite 794, PO Box 775, Baltimore, MD 21205, USA.
| | | | | | | | | | | |
Collapse
|
24
|
Bartlett TR. Letters to the Editor. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2004; 17:46. [PMID: 15366309 DOI: 10.1111/j.1744-6171.2004.00046.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Warner LA, White HR. Longitudinal effects of age at onset and first drinking situations on problem drinking. Subst Use Misuse 2003; 38:1983-2016. [PMID: 14677779 DOI: 10.1081/ja-120025123] [Citation(s) in RCA: 182] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The purpose of this study was to describe aspects of the first alcohol-use experience, and examine the predictive relations among age of first use, context of alcohol use initiation, and problem drinking with and without controls for psychosocial risk factors. Data were from the Rutgers Health and Human Development Project, a five-wave, prospective study of substance-use behaviors in a community sample. Respondents, who were first interviewed at age 12 (1979-81) and most recently at age 30 or 31 (1999-2000) (N=371), reported on their first drinking experience, and on a range of known risk factors for alcohol abuse. Most alcohol initiation occurred during a family gathering. Regardless of initiation context, youth who drank at an early age were more likely than youth who initiated later to become problem drinkers, although the risk was relatively greater for the youth who first drank outside a family gathering. Based on multivariate logistic regressions, feeling drunk at initiation was the only onset-related variable significantly associated with problem drinking; other significant risks factors included male gender, delinquency, and family history of alcoholism. Because most initiation occurs at a family gathering, alcoholism prevention research may benefit from examining the role that drinking in family contexts could play with regard to socializing young drinkers to less risky drinking behaviors in adulthood. In particular, further research focusing on the subjective effects experienced by youth when they first drink may be merited.
Collapse
Affiliation(s)
- Lynn A Warner
- School of Social Work, Rutgers University, New Brunswick, New Jersey 08901, USA.
| | | |
Collapse
|
26
|
Abstract
Alcohol misuse among women is an important and growing problem. There is epidemiological and metabolic evidence that risk factors for and consequences of alcohol misuse are significantly different for women than for men. Understanding these differences is imperative if effective preventative and treatment interventions are to be undertaken. This article reviews the epidemiology of alcohol misuse by women, effects of alcohol misuse on women, fetuses, and relationships, and assessment and treatment strategies. We then suggest directions for future research in this field.
Collapse
Affiliation(s)
- G W Redgrave
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
| | | | | |
Collapse
|
27
|
Young SE, Corley RP, Stallings MC, Rhee SH, Crowley TJ, Hewitt JK. Substance use, abuse and dependence in adolescence: prevalence, symptom profiles and correlates. Drug Alcohol Depend 2002; 68:309-22. [PMID: 12393225 DOI: 10.1016/s0376-8716(02)00225-9] [Citation(s) in RCA: 206] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We present data on the lifetime prevalence of substance use, abuse and dependence in adolescents obtained through structured psychiatric interviews and self-report questionnaires. Most notably, we evaluate symptom profiles based on DSM-IV abuse and dependence criteria for tobacco, alcohol and marijuana, including a gender comparison. Participants are 3,072 adolescents (12-18 years) drawn from three community-based family samples in Colorado. Age trends suggest that substance use is a developmental phenomenon, which increases almost linearly from early to late adolescence. Substance use disorders are less common than experimentation in adolescence, but approximately 1 in 4 adolescents in the oldest cohorts meets criteria for abuse for at least one substance, and 1 in 5 meets criteria for substance dependence. By age 18 nearly 1 in 3 adolescents report daily smoking and 8.6% meet criteria for tobacco dependence. Although alcohol is the most commonly abused substance (10%), a slightly larger proportion of adolescents meet criteria for dependence on marijuana (4.3%) than alcohol (3.5%). Gender differences in prevalence of use more often show greater use in males than females. Males more frequently meet criteria for dependence on alcohol and marijuana in late adolescence, while females are more often nicotine dependent. A comparison of abuse and dependence symptom profiles shows some interesting variability across substances, and suggests that manifestations of a subset of symptoms are gender specific.
Collapse
Affiliation(s)
- S E Young
- Institute for Behavioral Genetics, University of Colorado, Campus Box 447, Boulder, CO 80309, USA.
| | | | | | | | | | | |
Collapse
|