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Abstract
Early alcohol use places youth at risk for adverse health, academic, and legal consequences. We examined the content of the total array of self-cognitions in urban youth to determine whether specific self-concept profiles were associated with early drinking, drinking-related self-cognitions, and conduct problems. We conducted a secondary analysis of data from a cross-sectional study with 9- to 12-year-old predominantly Black and Hispanic youth (N = 79) who attended urban school and summer youth programs. Measures included an open-ended self-description task and questionnaires to measure presence/absence of a drinking-related self-cognition, alcohol use, and conduct problems. We content analyzed 677 self-descriptors; cluster analysis revealed six unique self-concept profile groups. In a cluster group distinguished by negative self-content, 37% drank alcohol and 42% had a drinking-related self-cognition. Youth in this group also had conduct problems. School nurses are in prime positions to identify and intervene with youth who have at-risk self-concept profiles.
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Affiliation(s)
| | - Colleen Corte
- College of Nursing, University of Illinois at Chicago, IL, USA
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Lee CK, Corte C, Stein KF, Feng JY, Liao LL. Alcohol-related cognitive mechanisms underlying adolescent alcohol use and alcohol problems: Outcome expectancy, self-schema, and self-efficacy. Addict Behav 2020; 105:106349. [PMID: 32078890 DOI: 10.1016/j.addbeh.2020.106349] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 02/07/2020] [Accepted: 02/07/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE The objective of this study was to empirically test a theoretical model to determine the cognitive mechanisms that are associated with adolescent alcohol use and alcohol problems. We posited that alcohol outcome expectancies would affect alcohol-refusal self-efficacy through the drinker self-schema. We also posited that alcohol outcome expectancies and the drinker self-schema would affect alcohol use and problems through alcohol-refusal self-efficacy. METHODS A survey was administered to 225 adolescents in a public junior high school in Taiwan at two-time points, six months apart. Path analysis was used to determine the mechanisms underlying the alcohol-related cognitive constructs on the alcohol use and alcohol problems separately, controlling for appropriate alcohol-related personal and environmental factors. Indirect effects were estimated using the bootstrapping method. RESULTS Higher positive alcohol outcome expectancies and lower negative alcohol outcome expectancies predicted higher drinker self-schema scores. Higher positive alcohol outcome expectancies and drinker self-schema scores predicted lower alcohol-refusal self-efficacy. Lower alcohol-refusal self-efficacy was associated with a history of drinking and alcohol problems in the past six months. Effects of alcohol outcome expectancies on alcohol use and alcohol problems were partially mediated through the drinker self-schema and alcohol-refusal self-efficacy. CONCLUSIONS Findings support the proposed theoretical cognitive mechanisms underlying alcohol use and alcohol problems in a sample of Taiwanese adolescents. Given that alcohol-related cognitive constructs are modifiable, the findings also provide a foundation to suggest that interventions to reduce positive alcohol outcome expectations and prevent the formation of a drinker self-schema may facilitate alcohol-refusal self-efficacy and mitigate drinking behaviors in this adolescent population.
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Walker SC, Duong M, Hayes C, Berliner L, Leve LD, Atkins DC, Herting JR, Bishop AS, Valencia E. A tailored cognitive behavioral program for juvenile justice-referred females at risk of substance use and delinquency: A pilot quasi-experimental trial. PLoS One 2019; 14:e0224363. [PMID: 31697698 PMCID: PMC6837457 DOI: 10.1371/journal.pone.0224363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/13/2019] [Indexed: 01/20/2023] Open
Abstract
This pilot quasi-experimental trial tested a gender-responsive cognitive behavioral group intervention with 87 court-involved female adolescents (5 juvenile courts) who were at indicated risk for substance use disorder. Participants in the intervention (n = 57) received twice weekly group sessions for 10 weeks (20 sessions) focused on building emotional, thought and behavior regulation skills and generalizing these skills to relationally-based scenarios (GOAL: Girls Only Active Learning). Youth in the control condition (n = 30) received services as usual, which included non-gender-specific aggression management training, individual counseling and no services. The GOAL program was found to be acceptable to youth and parents and feasible to implement within a juvenile court setting using skilled facilitators. Compared to services as usual, the program significantly and meaningfully reduced self-reported delinquent behavior (β = 0.84, p < 0.05) over 6 months, and exhibited trend level effects for reduced substance use (β = 0.40, p = 0.07). The program had mixed or no effects on family conflict and emotion regulation skills. These findings are discussed in light of treatment mechanisms and gender-responsive services.
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Affiliation(s)
- Sarah C. Walker
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| | - Mylien Duong
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
| | - Christopher Hayes
- Snohomish County Juvenile Court, Everett, Washington, United States of America
| | - Lucy Berliner
- Harborview Center for Sexual Assault and Trauma, Seattle, Washington, United States of America
| | - Leslie D. Leve
- College of Education, University of Oregon, Eugene, Oregon, United States of America
| | - David C. Atkins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
| | - Jerald R. Herting
- Department of Sociology, University of Washington, Seattle, Washington, United States of America
| | - Asia S. Bishop
- Department of Social Work, University of Washington, Seattle, Washington, United States of America
| | - Esteban Valencia
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
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Vidourek RA, King KA, Patel P. Recent alcohol use among African American adolescents based on school experiences and individual perceptions toward school. J Ethn Subst Abuse 2019; 20:60-76. [PMID: 30829561 DOI: 10.1080/15332640.2019.1571977] [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: 10/27/2022]
Abstract
This study examined whether recent alcohol use among African American adolescents differed based on school experiences and perceptions toward school. A secondary analysis of the 2012 National Survey on Drug Use and Health was performed to answer research questions. Results from the multivariable logistic regression models revealed that male and female students at highest risk for recent alcohol use were those who hated/did not like going to school, never/seldom felt that the schoolwork they were assigned was meaningful and important, thought that the things they learned in school would be very/somewhat unimportant, got mostly grades C, D, and F the past semester, and felt that all/most of the students in their grade smoked cigarettes, used marijuana, drank alcohol, and got drunk weekly. Recommendations for future studies are included.
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Affiliation(s)
- Rebecca A Vidourek
- Health Promotion and Education, University of Cincinnati, Cincinnati, Ohio
| | - Keith A King
- Health Promotion and Education, University of Cincinnati, Cincinnati, Ohio
| | - Pooja Patel
- Health Promotion and Education, University of Cincinnati, Cincinnati, Ohio
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Lee CK, Corte C, Stein KF. Drinker Identity: Key Risk Factor for Adolescent Alcohol Use. THE JOURNAL OF SCHOOL HEALTH 2018; 88:253-260. [PMID: 29399840 DOI: 10.1111/josh.12603] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/13/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Adolescent alcohol use continues to be a critical public health problem with both short- and long-term negative health consequences. Defining oneself in terms of alcohol, a drinking-related identity, has been shown to predict high levels of alcohol use. Because adolescence is the developmental period during which identity development is most salient, preventing the development of the drinker identity and early identification of youth who have a developing drinker identity may be important for prevention and early intervention. METHODS We review the theory- and evidence-based literature about identity development and the effects of a drinker identity on alcohol use behaviors in adolescents, discuss potential determinants of the drinker identity, and discuss future implications for practice and research. RESULTS There is some evidence that the drinker identity forms in early adolescence and becomes more well-developed during adolescence. The drinker identity predicts alcohol use behaviors both concurrently and over time in adolescence and young adulthood. There is also some evidence that early exposure to alcohol may contribute to formation of the drinker identity. CONCLUSIONS Identity-based approaches may be promising strategies to identify adolescents who are at risk for alcohol use and to intervene with early prevention or treatment within the school setting.
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Affiliation(s)
- Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan
| | - Colleen Corte
- College of Nursing, University of Illinois at Chicago, 845 South Damen Avenue, Chicago, IL 60612
| | - Karen F Stein
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642
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Vidourek RA, King KA, Merianos AL. Where do adolescent recent drinkers obtain and use alcohol? JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1378734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rebecca A. Vidourek
- Health Promotion and Education, University of Cincinnati, Cincinnati, OH, USA
| | - Keith A. King
- Health Promotion and Education, University of Cincinnati, Cincinnati, OH, USA
| | - Ashley L. Merianos
- Health Promotion and Education, University of Cincinnati, Cincinnati, OH, USA
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Bartsch LA, King KA, Vidourek RA, Merianos AL. Self-Esteem and Alcohol Use Among Youths. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2017. [DOI: 10.1080/1067828x.2017.1322018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Nesi J, Rothenberg WA, Hussong AM, Jackson KM. Friends' Alcohol-Related Social Networking Site Activity Predicts Escalations in Adolescent Drinking: Mediation by Peer Norms. J Adolesc Health 2017; 60:641-647. [PMID: 28325545 PMCID: PMC6402495 DOI: 10.1016/j.jadohealth.2017.01.009] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/07/2016] [Accepted: 01/13/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Adolescents' increased use of social networking sites (SNS) coincides with a developmental period of heightened risk for alcohol use initiation. However, little is known regarding associations between adolescents' SNS use and drinking initiation nor the mechanisms of this association. This study examined longitudinal associations among adolescents' exposure to friends' alcohol-related SNS postings, alcohol-favorable peer injunctive norms, and initiation of drinking behaviors. METHODS Participants were 658 high-school students who reported on posting of alcohol-related SNS content by self and friends, alcohol-related injunctive norms, and other developmental risk factors for alcohol use at two time points, 1 year apart. Participants also reported on initiation of three drinking behaviors: consuming a full drink, becoming drunk, and heavy episodic drinking (three or more drinks per occasion). Probit regression analyses were used to predict initiation of drinking behaviors from exposure to alcohol-related SNS content. Path analyses examined mediation of this association by peer injunctive norms. RESULTS Exposure to friends' alcohol-related SNS content predicted adolescents' initiation of drinking and heavy episodic drinking 1 year later, controlling for demographic and known developmental risk factors for alcohol use (i.e., parental monitoring and peer orientation). In addition, alcohol-favorable peer injunctive norms statistically mediated the relationship between alcohol-related SNS exposure and each drinking milestone. CONCLUSIONS Results suggest that social media plays a unique role in contributing to peer influence processes surrounding alcohol use and highlight the need for future investigative and preventive efforts to account for adolescents' changing social environments.
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Affiliation(s)
- Jacqueline Nesi
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - William A. Rothenberg
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Chapel Hill, NC 27599
| | - Andrea M. Hussong
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Chapel Hill, NC 27599
| | - Kristina M. Jackson
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI 02912
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Prince DM, Epstein M, Nurius PS, Gorman-Smith D, Henry DB. Reciprocal Effects of Positive Future Expectations, Threats to Safety, and Risk Behavior Across Adolescence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 48:54-67. [PMID: 27617781 DOI: 10.1080/15374416.2016.1197835] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We examined the reciprocal relationships among positive future expectations, expected threats to future safety, depression, and individual substance use and delinquency using 4 waves of data (N = 248-338) from African American and Latino adolescent male participants in the Chicago Youth Development Study. Individual positive future expectations and expected threats to safety were assessed at each wave and modeled as latent constructs. Individual substance use and delinquency were assessed at each wave and represented as ordinal variables ranging from low to high. Categorical autoregressive cross-lagged structural models were used to examine the hypothesized reciprocal relationships between both aspects of future expectations construct and risk behavior across adolescence. Analyses show that future expectations has important effects on youth substance use and involvement in delinquency, both of which in turn decrease positive expectations and increase expectation of threats to future safety across adolescence. Similarly, low positive expectations for the future continued to predict increased substance use and involvement in delinquency. The expected threats to safety construct was significantly correlated with delinquency within time. These effects are observed across adolescence after controlling for youth depression and race. Findings support the reciprocal effects hypothesis of a negative reinforcing cycle in the relationships between future expectations and both substance use and involvement in delinquent behavior across adolescence. The enduring nature of these relationships underscores the importance of future expectation as a potential change mechanism for intervention and prevention efforts to promote healthy development; vulnerable racial and ethnic minority male adolescents may especially benefit from such intervention.
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Affiliation(s)
- Dana M Prince
- a Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University
| | - Marina Epstein
- b Social Development Research Group , University of Washington
| | | | | | - David B Henry
- e Institute for Health Research and Policy , University of Illinois at Chicago
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King KA, Vidourek RA, Merianos AL, Bartsch LA. Psychosocial Factors Associated with Alcohol Use Among Hispanic Youth. J Immigr Minor Health 2016; 19:1035-1041. [PMID: 27557680 DOI: 10.1007/s10903-016-0485-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined whether authoritarian parenting, school experiences, depression, legal involvement and social norms predicted recent alcohol use and binge drinking among a national sample of Hispanic youth. A secondary data analysis of the National Survey on Drug Use and Health was performed (N = 3457). Unadjusted odds ratios were computed via univariate logistic regression analyses and significant variables were retained and included in the multivariable logistic regression analyses. Results indicated that in the past 30 days, 13.8 % of Hispanic youth drank alcohol and 8.0 % binge drank. Hispanic youth at highest risk for alcohol use were 16-17 years of age, experienced authoritarian parenting, lacked positive school experiences, had legal problems, and felt that most students at their school drank alcohol. Results should be considered when developing and implementing alcohol prevention efforts for Hispanic youth. Multiple approaches integrating family, school, and peers are needed to reduce use.
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Affiliation(s)
- Keith A King
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
| | - Rebecca A Vidourek
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
| | - Ashley L Merianos
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA
| | - Lauren A Bartsch
- Health Promotion and Education, University of Cincinnati, PO Box 210068, Cincinnati, OH, 45221-0068, USA.
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Rathbone CJ, Salgado S, Akan M, Havelka J, Berntsen D. Imagining the future: A cross-cultural perspective on possible selves. Conscious Cogn 2016; 42:113-124. [DOI: 10.1016/j.concog.2016.03.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 02/24/2016] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
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Lee CK, Corte C, Stein KF, Finnegan L, McCreary LL, Park CG. Expected Problem Drinker Possible Self: Predictor of Alcohol Problems and Tobacco Use in Adolescents. Subst Abus 2015; 36:434-9. [PMID: 25551683 DOI: 10.1080/08897077.2014.988323] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Alcohol and tobacco use commonly co-occur in adolescents. According to the cross-substance facilitation of information processing hypothesis, cognitive structures related to one substance increase use of another related substance through enhanced cognitive processing. In this study, the authors test this hypothesis by determining whether a problem drinker "possible self" in 8th grade predicts alcohol and tobacco use in 9th grade. METHODS A secondary data analysis of a 12-month longitudinal dataset was conducted. The outcome variables were alcohol consumption, alcohol problems, and tobacco use in 9th grade. The main predictor of interest was presence of an expected problem drinker possible self in 8th grade. Zero-inflated gamma regression, zero-inflated negative binomial regression, and logistic regression were used. RESULTS Among 137 adolescents, controlling for known family, parent, and peer determinants, and corresponding 8th grade behavior, having an expected problem drinker possible self in 8th grade predicted alcohol problems, but not level of alcohol consumption in 9th grade. Moreover, the expected problem drinker possible self in 8th grade predicted tobacco use in 9th grade, controlling for known determinants and concurrent alcohol problems. CONCLUSIONS Findings provide support for the cross-substance facilitation hypothesis, suggesting that interventions designed to modify the expected problem drinker possible self may reduce not only adolescent alcohol use but also tobacco use. Further studies are needed to determine whether smoking content is embedded in a drinking cognition or 2 separate but related drinking and smoking cognitions account for the association between alcohol and tobacco use.
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Affiliation(s)
- Chia-Kuei Lee
- a College of Nursing , University of Illinois at Chicago , Chicago , Illinois , USA.,b School of Nursing , University of Rochester , Rochester , New York , USA
| | - Colleen Corte
- a College of Nursing , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Karen F Stein
- b School of Nursing , University of Rochester , Rochester , New York , USA
| | - Lorna Finnegan
- a College of Nursing , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Linda L McCreary
- a College of Nursing , University of Illinois at Chicago , Chicago , Illinois , USA
| | - Chang G Park
- a College of Nursing , University of Illinois at Chicago , Chicago , Illinois , USA
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Lee CK, Corte C, Stein KF, Park CG, Finnegan L, McCreary LL. Prospective effects of possible selves on alcohol consumption in adolescents. Res Nurs Health 2014; 38:71-81. [PMID: 25545451 DOI: 10.1002/nur.21641] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2014] [Indexed: 11/11/2022]
Abstract
Possible selves, cognitions about the self that reflect hopes, fears, and expectations for the future, are reliable predictors of health risk behaviors but have not been explored as predictors of adolescents' alcohol use. In a secondary analysis of data from 137 adolescents, we examined the influence of possible selves assessed in eighth grade on alcohol consumption (yes/no and level of use) in ninth grade. Having a most important feared possible self related to academics in eighth grade predicted alcohol abstinence in ninth grade. Among those who reported alcohol use, having many hoped-for possible selves and a most important hoped-for possible self related to academics in eighth grade predicted lower level of alcohol consumption in ninth grade. Interventions that foster the personal relevance and importance of academics and lead to the development of hoped-for possible selves may reduce adolescents' alcohol consumption.
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Affiliation(s)
- Chia-Kuei Lee
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Box SON, Rochester, NY, 14642
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Dudovitz RN, Li N, Chung PJ. Behavioral self-concept as predictor of teen drinking behaviors. Acad Pediatr 2013; 13:316-21. [PMID: 23707688 DOI: 10.1016/j.acap.2013.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 03/06/2013] [Accepted: 03/10/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Adolescence is a critical developmental period for self-concept (role identity). Cross-sectional studies link self-concept's behavioral conduct domain (whether teens perceive themselves as delinquent) with adolescent substance use. If self-concept actually drives substance use, then it may be an important target for intervention. In this study, we used longitudinal data from 1 school year to examine whether behavioral self-concept predicts teen drinking behaviors or vice versa. METHODS A total of 291 students from a large, predominantly Latino public high school completed a confidential computerized survey in the fall and spring of their 9th grade year. Survey measures included the frequency of alcohol use, binge drinking and at-school alcohol use in the previous 30 days; and the Harter Self-Perception Profile for Adolescents behavioral conduct subscale. Multiple regressions were performed to test whether fall self-concept predicted the frequency and type of spring drinking behavior, and whether the frequency and type of fall drinking predicted spring self-concept. RESULTS Fall behavioral self-concept predicted both the frequency and type of spring drinking. Students with low versus high fall self-concept had a predicted probability of 31% versus 20% for any drinking, 20% versus 8% for binge drinking and 14% versus 4% for at-school drinking in the spring. However, neither the frequency nor the type of fall drinking significantly predicted spring self-concept. CONCLUSIONS Low behavioral self-concept may precede or perhaps even drive adolescent drinking. If these results are confirmed, then prevention efforts might be enhanced by targeting high-risk teens for interventions that help develop a healthy behavioral self-concept.
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Affiliation(s)
- Rebecca N Dudovitz
- Department of Pediatrics, University of California, Los Angeles, CA 90095, USA.
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