Sibling influences on adolescent substance use: the role of modeling, collusion, and conflict

Tribal Reservation Adolescent Connections Study: A study protocol using mixed methods for examining social networks and associated outcomes among American Indian youth on a Northern Plains reservation

BACKGROUND

Rich cultural and traditional practices make interpersonal relationships vital for American Indian (AI) youth. Social relations and multigenerational networks (i.e., peer, family, kinship, and community) remain a salient fixture of AI culture, survival and thriving in reservation communities. Research in other populations has demonstrated how social networks impact youth risk and resilience, but data are lacking on AI adolescent networks. Intergenerational trauma from settler colonialism leads some AI youth to early initiation of substance use and subsequent substance misuse, along with disproportionately high risk for suicide and vulnerability to witnessing and experiencing violence. Using network data to develop prevention strategies among this population is a promising new avenue of research. In this study protocol paper, we describe the rationale and methodology of an exploratory study to be conducted with American Indian 9th and 10th graders at three schools on a Northern Plains reservation.

METHODS

This mixed methods study will collect quantitative social network surveys (N = 300) and qualitative interviews (n = 30). The study will examine the extent to which existing social network theories and data metrics adequately characterize AI youth networks or how they may need to be expanded for this population. Associations of network characteristics with risk and protective factors for substance use, exposure to violence, and suicide will also be examined.

DISCUSSION

This innovative methodological approach holds promise for informing the development of effective preventive approaches to address co-occurring risks for substance use, violence and suicide among AI adolescents. Understanding processes that impact social networks among AI adolescents can promote culturally resonant social relationships that may support better outcomes for youth.

Prevalence of probable substance use disorders among children in Ugandan health facilities

BACKGROUND

Globally, there is a concerning surge in the prevalence of substance use among adolescents and children, creating a substantial public health problem. Despite the magnitude of this issue, accessing healthcare explicitly for substance use remains challenging, even though many substance users frequently visit healthcare institutions for other health-related issues. To address this gap, proactive screening for substance use disorders has emerged as a critical strategy for identifying and engaging patients at risk of substance use. The purpose of this study was to investigate the prevalence of probable alcohol and other substance use disorders, and associated factors, among children aged 6 to 17 years old attending health facilities in Mbale, Uganda.

METHODS

We conducted a health facility cross-sectional study, involving 854 children aged 6-17 years. The prevalence of probable alcohol and other substance use disorders was assessed using a validated Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) screening tool. Univariable and multivariable modified Poisson regression analyses were performed using STATA 15 software.

RESULTS

The overall prevalence of probable alcohol use disorders (AUD) and other substance use disorders (SUD) was 27.8% (95% CI 1.24-1.31) while that of probable AUD alone was 25.3% (95% CI 1.22-1.28). Peer substance use (APR = 1.24, 95% CI 1.10-1.32), sibling substance use (APR = 1.14, 95% CI 1.06-1.23), catholic caregiver religion (APR = 1.07 95% CI 1.01-1.13), caregiver income of more than $128 (APR = 0.90, 95% CI 0.82-0.98), having no parental reprimand for substance use (APR = 1.05, 95% CI 1.01-1.10) and having no knowledge of how to decline an offer to use substances (APR = 1.06, 95% CI 1.01-1.12) were found to be significantly associated with probable AUD/SUD.

CONCLUSIONS

Our findings suggest a high prevalence of probable AUD and SUD among children and adolescents visiting healthcare facilities for other conditions, along with a strong link between AUD and SUD prevalence and social factors. The implication for our healthcare system is to actively screen for and treat these conditions at primary healthcare facilities.

Sibling influences on adolescent alcohol use during the spring 2020 COVID-19 pandemic shutdown

OBJECTIVE

To examine the bidirectional associations between adolescent siblings' alcohol use before and during the onset of the COVID-19 pandemic in Spring 2020 and whether youths' stress about missed social connections (i.e., social disruption stress) moderated these associations.

METHOD

The sample consisted of 682 families (2,046 participants) with two adolescent siblings (older siblings: Mage = 15.67 years, 51% female; younger siblings: Mage = 13.14 years, 48% female) and one parent (Mage = 45.15 years; 85% female) from five Midwestern U.S. states. Siblings reported on their own drinking and social disruption stress before and during the onset of the pandemic via online surveys.

RESULTS

Accounting for younger siblings' earlier drinking and other confounders, older siblings' prepandemic drinking predicted a greater likelihood of younger siblings' drinking during the Spring 2020 pandemic shutdown. This association was not moderated by younger siblings' social disruption stress. The association between younger siblings' prepandemic drinking and older siblings' drinking during the shutdown was moderated by older siblings' social disruption stress. Specifically, younger siblings' earlier drinking was more strongly related to older siblings' drinking during the shutdown if older siblings reported more social disruption stress.

CONCLUSIONS

Siblings are important socialization agents of alcohol use during adolescence. Sibling interventions may be particularly salient during times of stress and isolation when youths' social interactions with peers may be limited. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sibling Spillovers: Having an Academically Successful Older Sibling May be More Important for Children in Disadvantaged Families

This paper examines causal sibling spillover effects among students from different family backgrounds in elementary and middle school. Family backgrounds are captured by race, household structure, mothers' educational attainment, and school poverty. Exploiting discontinuities in school starting age created by North Carolina school-entry laws, we adopt a quasi-experimental approach and compare test scores of public school students whose older siblings were born shortly before and after the school-entry cutoff date. We find that individuals whose older siblings were born shortly after the school-entry cutoff date have significantly higher test scores in middle school, and that this positive spillover effect is particularly strong in disadvantaged families. We estimate that the spillover effect accounts for approximately one third of observed statistical associations in test scores between siblings, and the magnitude is much larger for disadvantaged families. Our results suggest that spillover effects from older to younger siblings may lead to greater divergence in academic outcomes and economic inequality between families.

Associations between older siblings' substance use and younger siblings' substance use intentions: Indirect effects via substance use expectations

OBJECTIVE

We examined the direct and indirect effects of older siblings' substance use behaviors (i.e., cannabis and e-cigarettes) on younger siblings' later substance use intentions via their substance use expectations.

MATERIAL AND METHODS

Data were collected from 682 families (N = 2,046) with two adolescent siblings (older siblings: M age = 15.67 years, 51% female; younger siblings: M age = 13.14 years, 48% female) and one parent (M age = 45.15 years; 85% female). Participants completed annual online surveys at two occasions. Older siblings reported on their cannabis and e-cigarette use frequencies (Time 1) and younger siblings reported on their substance use expectations (Time 1) and intentions (Time 1 and 2); parents reported on adolescents' sociodemographic characteristics and their own substance use (Time 2).

RESULTS

Structural equation modeling results suggested that older siblings' cannabis and e-cigarette use was indirectly related to younger siblings' later intentions to use these substances through their positive expectations about substances, after accounting for younger siblings' earlier intentions to use substances and control variables including parents' and friends' use. There were no significant direct relations between older siblings' cannabis or e-cigarette use and younger siblings' intentions to use them.

CONCLUSIONS

Findings indicate that older siblings are critical and unique socialization agents of younger siblings' expectations and intentions to use substances. Intervention and prevention programs that target adolescents' substance use should consider the ways in which siblings shape each other's substance use.

Adolescent Sibling Associations among Alcohol, Cannabis, and Sexual Risk Behavior: A Test of Interdependence

BACKGROUND

Although siblings are conceptualized as a salient social influence during adolescence, few studies have examined how adolescent siblings influence each other's substance use and risky sexual behavior. Objectives: In this study, we investigated the influence of alcohol use days, cannabis use days, and cannabis and alcohol co-use days on the sexual risk behavior of siblings while accounting for dyadic influence.

METHODS

At the baseline visit for a randomized controlled trial for adolescents referred due to parents' concerns about their substance use ("referred adolescents"; n = 99; M_age=15.95; 38.38% female), we assessed alcohol and cannabis use days as well as sexual risk behavior of the referred adolescents and their sibling (M_age=15.03; 51.52% female). We computed the number of days in the 30 days prior to the baseline that alcohol and cannabis use occurred on the same day. Using a cross-sectional actor partner interdependence model, we tested two models of how adolescents' substance use is associated with their own ("actor effect") and their siblings' ("partner effect") sexual risk behavior-one model for alcohol and cannabis use, and one model for daily co-use.

RESULTS

For referred adolescents and their siblings, within an individual, greater alcohol, cannabis, and daily co-use was significantly associated with sexual risk behavior (actor effects). Furthermore, more sibling co-use days was positively associated with referred adolescent sexual risk behavior (partner effect), representing interdependence.

CONCLUSION

These findings confirm the influence siblings have on one another's risky behavior in adolescence and have implications for prevention and intervention efforts for adolescent substance use.

Alcohol and Cannabis Use Milestones in Diverse Urban Adolescents: Associations with Demographics, Parental Rule Setting, Sibling and Peer Deviancy, and Outcome Expectancies

Objective: Alcohol and cannabis use progression milestones in adolescence (such as ages at first use, first intoxication and at onset of regular use) may inform the development of alcohol and cannabis use disorders. Although parent, sibling, and peer behavior and alcohol-related cognitions have been shown to be associated with alcohol milestone attainment, findings have been mixed; further, those factors' associations with cannabis use milestones are unknown. This study examined whether progression through such milestones differed as a function of perceived peer/sibling deviancy, parental rule-setting, and substance use outcome expectancies in a racially diverse adolescent sample.Methods: Data were drawn from a two-wave longitudinal health survey study of 9-11^th graders (n = 355 for the current analyses; M_age=15.94 [SD = 1.07]; 44% male; 43% Black; 22% White; 18% Asian; 17% Multiracial; 10% Hispanic/Latinx ethnicity) at an urban high school. A series of logistic and proportional hazards regressions examined associations of peer/sibling deviancy, parental rule-setting, and outcome expectancies with age and attainment of alcohol/cannabis use milestones.Results: For both alcohol and cannabis, greater peer deviancy and positive expectancies were associated with higher odds of milestone attainment, while negative expectancies were associated with slower progression through milestones. For cannabis, but not alcohol, greater perceived sibling deviancy was positively associated with milestone attainment, while negative expectancies were associated with lower odds of milestone attainment.Conclusions: Perceived deviant behavior by peers and siblings, in addition to adolescents' expectancies for either alcohol or cannabis use, is associated with attainment and progression through key adolescent substance use milestones.

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

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

The development of effortful control from late childhood to young adulthood

The present study investigated the developmental precursors of effortful control, a temperament trait that involves the propensity to regulate one's impulses and behaviors, to motivate the self toward a goal when there are conflicting desires, and to focus and shift attention easily. Data came from the California Families Project, a multimethod longitudinal study of 674 Mexican-origin youth (and their parents), who were assessed at ages 10, 12, 14, 16, and 19. Effortful control (measured via self- and parent-reports) was moderately stable over time (r = .47 from age 10 to 19), and its developmental trajectory followed a u-shaped pattern (decreasing from age 10 to 14, before increasing from age 14 to 19). Findings from latent growth curve models showed that youth who experience more hostility from their parents, associate more with deviant peers, attend more violent schools, live in more violent neighborhoods, and experience more ethnic discrimination tend to exhibit an exacerbated dip in effortful control. In contrast, youth with parents who closely monitor their behavior and whereabouts exhibited a shallower dip in effortful control. Analyses of the facets of effortful control revealed important disparities in their trajectories; specifically inhibitory control showed linear increases, attention control showed linear decreases, and activation control showed the same u-shaped trajectory as overall effortful control. Moreover, most of the precursors of effortful control replicated for inhibitory control and attention control, but not for activation control. We discuss the broader implications of the findings for adolescent personality development and self-regulation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sibling bullying at 12 years and high-risk behavior in early adulthood: A prospective cohort study

Emerging evidence suggests that sibling aggression is associated with the development of high-risk behavior. This study investigated the relationship between sibling bullying perpetration and victimization in early adolescence and high-risk behavior in early adulthood. Sibling bullying was assessed at 12 years in 6,988 individuals from the Avon Longitudinal Study of Parents and Children, a birth cohort based in the UK and high-risk behavioral outcomes were assessed at 18-20 years. Frequent sibling bullying perpetration predicted antisocial behavior (OR = 1.74; 95%CI, 1.38-2.20), while frequent sibling bullying victimization increased the odds of nicotine dependence (OR = 2.87; 95%CI, 1.55-5.29), even after accounting for peer bullying and parent maltreatment. Categorical analysis revealed that particularly bullies and bully-victims were at risk of developing high-risk behavior. Finally, this study found that adolescents who were involved in bullying perpetration across multiple contexts (home and school) had the highest odds of reporting antisocial behavior (OR = 3.05; 95%CI, 2.09-4.44), criminal involvement (OR = 2.12; 95%CI, 1.23-3.66), and illicit drug use (OR = 2.11; 95%CI, 1.44-3.08). Findings from this study suggest that sibling bullying perpetration may be a marker of or a contributory factor along the developmental trajectory to antisocial behavior problems. Intervention studies are needed in order to test whether reducing sibling bullying can alleviate long-term adverse social and behavioral outcomes.

Sibling Influences on Risky Behaviors from Adolescence to Young Adulthood: Vertical Socialization or Bidirectional Effects?

This study built on research on sibling influences to assess potential bidirectional effects of older and younger siblings' risky behaviors on one another's risky behaviors; our longitudinal design allowed us to test these effects when siblings were at about the same chronological age, at different points in time. We also tested whether the strength and/or direction of effects of siblings' risky behaviors changed from middle adolescence to young adulthood. Reports of risky behaviors (i.e., deviant behaviors and excessive alcohol use) were provided by firstborn and secondborn siblings from up to 201 families on five occasions spanning 10 years. In general, accounting for known covariates, multilevel models revealed bidirectional sibling effects and some evidence that secondborns' risky behaviors were stronger and more consistent predictors of firstborns' behaviors than the reverse. Sibling influence generally declined with age and sibling effects were not moderated by gender constellation. Findings indicate that both older and younger siblings are important socializers of risk behaviors across adolescence and continue to shape each other's alcohol use into early adulthood.

The Developmental Unfolding of Sibling Influences on Alcohol Use over Time

Research has long demonstrated that siblings are similar in their alcohol use, however much of this work relies on cross-sectional samples or samples of adolescents alone and/or exclusive focus on older siblings' impact on younger siblings. Using a three time-point design from early adolescence to early adulthood (M ages = 14.9, 18.3, and 22.4 years, respectively; 55% female; 54% European ancestry, 38% Asian ancestry), we evaluated the prospective older and younger sibling influences on alcohol use across time (N = 613 sibling pairs; 35% sisters, 26% brothers, 39% mixed-gender; average age difference = 2.34 years; 34% full-biological siblings, 46% genetically-unrelated adopted siblings, 20% pairs where one child was the biological offspring of parents and the other was adopted). The results from both the traditional and random-intercept cross-lagged panel analyses showed that older siblings' alcohol use predicted younger siblings' alcohol use across each developmental transition and across a variety of sibling contexts (e.g., gender composition, age difference, genetic relatedness). On the other hand, younger siblings' alcohol use only predicted older siblings' alcohol use when siblings were close in age (1.5 years or less) and under conditions of high sibling companionship. These results add to a body of literature illustrating how both older and younger siblings are important socializing agents of adolescent and early adult alcohol use. Assessing or co-treating siblings for alcohol problems may be an important add-on to existing adolescent and early adult alcohol prevention and intervention programs.

Family, Peer, and Pubertal Determinants of Dating Involvement Among Adolescents

This study examines the influence of family, peer, and biological contributors to dating involvement among early adolescents (11-14 years of age; n = 244). Further, we assess how parental monitoring may be modified by pubertal maturation and older sibling risky behavior. Data on delinquent peer affiliation, pubertal maturation, parental monitoring, older sibling risky behavior, and dating involvement were gathered through observations and surveys from adolescents, mothers, older siblings, and teachers. Results indicate that lower levels of parental monitoring and higher levels of older sibling risky behavior were related to adolescents' dating involvement through delinquent peer affiliation. Pubertal maturation was directly related to dating involvement for early daters. Findings emphasize the value of examining social and biological factors, in concert, over time.

Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China

Given the prevalence of Internet use among youth, there is concern that a subset of Internet-using youth may exhibit problematic or addictive patterns of Internet use. The present study examines the association between problematic Internet use (PIU), demographic variables, and health-related measures among Chinese adolescents. Survey data from 1552 adolescents (male=653, mean age=15.43years) from Jilin Province, China, were collected. According to the Young Diagnostic Questionnaire for Internet Addiction (YDQ), 77.8% (n=1207), 16.8% (n=260), and 5.5% (n=85) showed adaptive, maladaptive, and problematic Internet use, respectively. Multinomial logistic regression analysis revealed that gender and family income per month differed between youth showing problematic and adaptive patterns of Internet use. Well-being, self-esteem, and self-control were related to severity of problematic Internet use, with greater severity typically associated with poorer measures in each domain. The findings that severity of problematic Internet use is associated with specific socio-demographic features and temperamental and well-being measures suggest that specific groups of youth may be particularly vulnerable to developing problematic Internet use. Early prevention/intervention programs targeting at-risk groups may help improve public health.

Understanding sibling influence on adolescents' alcohol use: Social and cognitive pathways

Research indicates that older siblings uniquely influence their younger brothers' and sisters' substance use behaviors during adolescence; however, the underlying mechanisms of socialization are rarely examined. The present study investigated whether social and/or cognitive pathways mediated the association between adolescent siblings' alcohol use and whether these pathways were moderated by the gender composition of the sibling dyad. Participants included one parent and two adolescent siblings (M age=14.52 and 17.17years) from 326 families. Data were collected via telephone interviews. Path analysis demonstrated that the association between older and younger siblings' alcohol use was mediated via social and cognitive pathways. Specifically, older siblings' drinking was positively related to the frequency of siblings' co-use as well as more positive expectations about alcohol, which in turn were positively associated with younger siblings' alcohol use. Identifying the ways in which siblings influence each other's substance use and health is critical because they are emerging and effective targets of intervention and prevention.

Sibling Facilitation Mediates the Association Between Older and Younger Sibling Alcohol Use in Late Adolescence

Previous research has shown adolescent siblings are similar in their alcohol use and that this similarity is largely due to their shared environment. Using a genetically-informed sibling sample (196 full-biological pairs, 384 genetically unrelated pairs), we confirmed that the extent to which older siblings facilitate younger siblings' alcohol use (i.e., help them get alcohol) was one factor contributing to this shared environmental association. All analyses controlled for parent and peer influences. Findings were not moderated by sibling differences in genetic relatedness, gender, or ethnicity. Proximity in sibling age strengthened these associations, somewhat. Results were especially strong for sibling pairs where the older sibling was of legal drinking age. Implications for prevention and intervention are discussed.

Perceptions of Family Alcohol Use in a Young Adult Sample

Perceptions of family alcohol use have been linked to adolescent alcohol use behaviors, yet there have been no studies that have assessed this relationship in young adults. This study examined perceptions of family alcohol use and their association with participants' self-reported alcohol use. Participants included 171 undergraduate students (mean age = 21.67, 71.9 percent female, 75.4 percent Caucasian). Participants completed measures assessing quantity and frequency of alcohol use, negative consequences of use, and sibling relationship quality. They also reported their perceptions of alcohol use for siblings and parents during a typical week. Perceptions of siblings' quantity of weekly alcohol use were significantly associated with participants' quantity of alcohol use (r = .21, p = .006) and frequency of alcohol use (r = .23, p = .002). Perceptions of parental alcohol use were not related to the participants' alcohol use patterns.

Predicting steep escalations in alcohol use over the teenage years: age-related variations in key social influences

AIMS

This study examined how family, peer and school factors are related to different trajectories of adolescent alcohol use at key developmental periods.

DESIGN

Latent class growth analysis was used to identify trajectories based on five waves of data (from grade 6, age 12 to grade 11, age 17), with predictors at grades 5, 7 and 9 included as covariates.

SETTING

Adolescents completed surveys during school hours.

PARTICIPANTS

A total of 808 students in Victoria, Australia.

MEASUREMENTS

Alcohol use trajectories were based on self-reports of 30-day frequency of alcohol use. Predictors included sibling alcohol use, attachment to parents, parental supervision, parental attitudes favourable to adolescent alcohol use, peer alcohol use and school commitment.

FINDINGS

A total of 8.2% showed steep escalation in alcohol use. Relative to non-users, steep escalators were predicted by age-specific effects for low school commitment at grade 7 (P = 0.031) and parental attitudes at grade 5 (P = 0.003), and age-generalized effects for sibling alcohol use (Ps = 0.001, 0.012, 0.033 at grades 5, 7 and 9, respectively) and peer alcohol use (Ps = 0.041, < 0.001, < 0.001 at grades 5, 7 and 9, respectively). Poor parental supervision was associated with steep escalators at grade 9 (P < 0.001) but not the other grades. Attachment to parents was unrelated to alcohol trajectories.

CONCLUSIONS

Parental disapproval of alcohol use before transition to high school, low school commitment at transition to high school, and sibling and peer alcohol use during adolescence are associated with a higher risk of steep escalations in alcohol use.

Similarities and differences in adolescent siblings' alcohol-related attitudes, use, and delinquency: evidence for convergent and divergent influence processes

A growing body of research indicates that siblings influence each other's risky and deviant behaviors during adolescence. Guided by research and theory on sibling similarities and differences, this study examined the operation and implications of three different influence processes--social learning, shared friends, and sibling differentiation--during adolescence. Participants included one parent and two adolescent siblings (earlier born age: M = 17.17 years, SD = 0.94; later born age: M = 14.52 years, SD = 1.27) from 326 families. Data were collected via telephone interviews. Using reports from both older and younger siblings, two-stage cluster analyses revealed three influence profiles: mutual modeling and shared friends, younger sibling admiration, and differentiation. Additional analyses revealed that mutual modeling and shared friends as well as younger sibling admiration were linked to similarities in brothers' and sisters' health-risk behaviors and attitudes, whereas differentiation processes were associated with divergence in siblings' characteristics. The discussion focuses on refining the study of sibling influence, with particular attention paid to the operation and implications of both convergent and divergent influence processes.

The role of economic strain on adolescent delinquency: a microsocial process model

The current study examines the role of economic strain as a moderator of the microsocial processes influencing younger siblings' delinquency (externalizing behavior and substance use) in a longitudinal design. The younger siblings (122 younger brothers and 122 younger sisters) were from 244 families with same-sex biological siblings. Structural equation modeling was utilized to examine a process model whereby mothers' harsh/inconsistent parenting and older sibling delinquency influence younger siblings' delinquent behavior via sibling aggression and delinquent peer affiliation. Findings suggest that indirect mechanisms vary as a function of economic strain, with sibling aggression having a stronger, more detrimental effect on adolescent delinquency in economically strained families. Data suggest that familial economic conditions contextualize the relative roles of parenting, sibling, and peer processes in the transmission of risk to adolescent delinquency.