Alcohol use and patterns of delinquent behaviour in male and female adolescents

Externalising pathways to alcohol-related problems in emerging adulthood

BACKGROUND

Both 'early-onset persistent' and 'adolescent-onset' conduct problems (CPs) are associated with alcohol-related problems in emerging adulthood. The escalation of early CPs into criminal behaviour and heavy alcohol consumption prior to emerging adulthood are both likely to be important pathways.

METHODS

Data were analysed from 3,038 young people in a UK birth cohort, the Avon Longitudinal Study of Parents and Children. The exposure was developmental trajectories of CPs ('low', 'childhood-limited', 'adolescent-onset' and 'early-onset persistent') between ages 4 and 13 years. The mediator was latent classes representing heavy alcohol consumption and/ or criminal behaviour at age 15 years. For the outcome, a quadratic latent growth curve was estimated to capture nonlinear change in alcohol-related problems between ages 18 and 23 years.

RESULTS

Those with 'early-onset persistent' [b(95% CI) = 1.16 (0.17, 2.14)] and 'adolescent-onset' CPs [b(95% CI) = 1.31 (0.17, 2.45)] had higher levels of alcohol-related problems at age 18 years compared to those with 'low' CPs', but there was little evidence of an association with alcohol-related problems after age 19 years. There was evidence for an indirect effect of 'early-onset persistent' CPs [b(95% CI) = 1.12 (0.52, 1.72)] on alcohol-related problems at age 18 years via the latent classes of alcohol and criminal behaviour in adolescence. This was not found for 'adolescent-onset' CPs [b(95% CI) = 0.35 (-0.36, 1.07)].

CONCLUSIONS

Strong associations exist between early CPs, adolescent alcohol consumption and criminal behaviour and alcohol-related problems at age 18 years. Associations between early CPs and alcohol-related problems weakened considerably across emerging adulthood.

Adolescent alcohol use before and after the high school transition

BACKGROUND

An important question is whether the high school (HS) entry is a critical developmental event associated with escalation of alcohol use. This study examined trajectories of adolescent alcohol use as a function of a normative developmental event-the HS entry. In addition, given that at-risk youth may be particularly vulnerable to the stress associated with this transition, we examined how these alcohol use trajectories may be shaped by a measure of early behavioral risk, early adolescent delinquency.

METHODS

Participants included 891 twelve-year-olds from the prospective National Longitudinal Survey of Youth 1997 for whom relevant longitudinal school data were available (51.2% boys; 61.4% White).

RESULTS

Alcohol use after HS entry increased at a significantly greater rate than did use during the middle school years, even after accounting for students' age at transition. In addition, early delinquency emerged as a risk factor such that differences in alcohol use existed prior to the transition. That is, children with early delinquency characteristics displayed more rapid progression in alcohol use, but this effect was evident only during middle school.

CONCLUSIONS

HS entry appears to be a critical developmental event associated with increased social risk for greater alcohol use that goes beyond the simple maturational (i.e., aging) factors. Youth with behavioral problems appears to be at greater risk in middle school, in contrast to lower risk youth for whom HS entry may be a more critical event, in part because HS may be a less restrictive environment and/or because alcohol use becomes more normative at that time. Adolescent substance use may be described as a series of distinct developmental stages that closely correspond to school transitions and suggest a critical period for targeted intervention that may differ as a function of preexisting risk.

Hope as a Moderator of the Associations between Common Risk Factors and Frequency of Substance Use among Latino Adolescents

Ample research suggests that delinquency, depressive symptoms, and peer substance use are common risk factors associated with adolescent substance use. However, the factors that may help to buffer the deleterious effects of these risk factors on adolescent substance use, such as hope, have yet to be examined. The current study evaluated hope as a moderator of the associations between these common risk factors and frequency of substance use (alcohol, tobacco, and marijuana) in a sample of Latino high school students (Mage = 16.14years, SD = 1.30; 55% female). Findings indicated that the influence of delinquency on frequency of tobacco and marijuana use depended on levels of hope, with delinquency only positively associated with frequency of use when levels of hope were low. Additionally, hope moderated the association between depressive symptoms and alcohol use, such that depressive symptoms were only positively associated with frequency of alcohol use when levels of hope were low. Results and their implications for intervention are reviewed.

Higher rates of adolescent substance use in child welfare versus community populations in the United States

OBJECTIVE

Youth substance use exacts costly consequences for a variety of important health outcomes. We examined and compared prevalence rates and a common set of psychosocial factors of lifetime and current substance use among child welfare-involved youths and community youths from two nationally representative data sets.

METHOD

Using the National Survey of Child and Adolescent Well-Being and the National Longitudinal Study of Adolescent Health, we compared prevalence rates and conducted logistic regression models for eight binary outcome measures of substance use: lifetime and current use of alcohol, inhalant, marijuana, and other illicit drugs to examine predictors of substance involvement in the two samples.

RESULTS

Substance use prevalence was higher among child welfare-involved youths than community youths for lifetime marijuana use, lifetime and current inhalant use, and lifetime and current other illicit drug use. Among both child welfare-involved and community youths, delinquency was the factor most strongly associated with all lifetime substance use outcomes. Notably, family structure and parental closeness were important protective factors against current substance use among child welfare-involved youths. For community youths, poorer emotional health was the strongest indicator of current substance use.

CONCLUSIONS

Substance use among all adolescents is a critical public health concern. Given the heightened vulnerability of child welfare-involved youths, it is particularly important to focus prevention and early intervention efforts on this population. Further research should explore additional factors associated with substance use among these youths so that child welfare and behavioral health systems may jointly target prevention and intervention efforts.

Predictors of binge drinking in adolescents: ultimate and distal factors - a representative study

BACKGROUND

As epidemiological surveys have shown, binge drinking is a constant and wide-spread problem behavior in adolescents. It is not rare to find that more than half of all adolescents engage in this behavior when assessing only the last 4 weeks of time independent of the urbanity of the region they live in. There have been several reviews on predictors of substance consumption in adolescents in general, but there has been less high quality research on predictors of binge drinking, and most studies have not been theoretically based. The current study aimed to analyze the ultimate and distal factors predicting substance consumption according to Petraitis' theory of triadic influence. We assessed the predictive value of these factors with respect to binge drinking in German adolescents, including the identification of influence direction.

METHODS

In the years 2007/2008, a representative written survey of N = 44,610 students in the 9th grade of different school types in Germany was carried out (net sample). The return rate of questionnaires was 88% regarding all students whose teachers or school directors had agreed to participate in the study. In this survey, prevalence of binge drinking was investigated as well as potential predictors from the social/interpersonal, the attitudinal/environmental, and the intrapersonal fields (3 factors of Petraitis). In a multivariate logistic regression analysis, these variables were included after testing for multicollinearity in order to assess their ability to predict binge drinking.

RESULTS

Prevalence of binge drinking in the last 30 days was 52.3% for the surveyed adolescents with a higher prevalence for boys (56.9%) than for girls (47.5%). The two most influential factors found to protect against binge drinking with p < .001 were low economic status and importance of religion. The four most relevant risk factors for binge drinking (p < .001) were life-time prevalence of school absenteeism/truancy, academic failure, suicidal thoughts, and violence at school in the form of aggressive behavior of teachers. The model of Petraitis was partly confirmed for Binge Drinking in German adolescents and the direction of influence factors was clarified.

CONCLUSIONS

Whereas some of the risk and protective factors for binge drinking are not surprising since they are known for substance abuse in general, there are two points that could be targeted in interventions that do not focus on adolescents alone: (a) training teachers in positive, reassuring behavior and constructive criticism and (b) a focus on high risk adolescents either because they have a lack of coping strategies when in a negative mood or because of their low academic achievement in combination with absenteeism from school.

Characterization of South African adolescents with alcohol use disorders but without psychiatric or polysubstance comorbidity

BACKGROUND

Individuals who begin drinking during early adolescence and exhibit externalizing pathology and disinhibitory/dysregulatory tendencies are more vulnerable to developing alcohol use disorders (AUDs) in adulthood. Previous research has focused on in-treatment populations with substantial comorbid psychopathology and polysubstance use. Here, we characterize a unique sample of treatment-naïve adolescents without such comorbidity to help identify vulnerable youth who may benefit from early intervention.

METHODS

We compared externalizing propensity, disinhibitory characteristics, and school performance in adolescents with AUDs (but without comorbid psychopathology or other substance use; n = 70) to those of demographically matched controls (n = 70). Within the AUD group, we compared measures of substance use and the disinhibitory syndrome between boys and girls with differing severity of externalizing propensity.

RESULTS

Adolescents with AUDs demonstrated more externalizing propensity and disinhibitory personality traits (impulsivity, novelty seeking, and excitement seeking), poorer self-monitoring and response inhibition, more bullying and sexual risk-taking behavior, poorer first-language performance, and greater use of alcohol, cannabis, and nicotine (p < 0.05). Within the AUD group, participants with higher externalizing propensity began drinking earlier, more frequently, and for a longer duration than those with lower externalizing symptoms (p < 0.05). Disinhibitory features (personality, cognition, and behavior) were, however, not stronger in those with higher externalizing propensity.

CONCLUSIONS

We suggest that the constructs of externalizing propensity and disinhibitory syndrome are useful in characterizing treatment-naïve adolescents with AUDs but without comorbid psychopathology or polysubstance use. These results support the importance of these constructs in understanding adolescent AUDs, even when the frank externalizing diagnoses of childhood (oppositional defiant disorder and conduct disorder) are excluded.

Alcohol consumption and binge drinking in adolescents: comparison of different migration backgrounds and rural vs. urban residence--a representative study

Background

Binge drinking is a constant problem behavior in adolescents across Europe. Epidemiological investigations have been reported. However, epidemiological data on alcohol consumption of adolescents with different migration backgrounds are rare. Furthermore representative data on rural-urban comparison concerning alcohol consumption and binge drinking are lacking. The aims of the study are the investigation of alcohol consumption patterns with respect to a) urban-rural differences and b) differences according to migration background.

Methods

In the years 2007/2008, a representative written survey of N = 44,610 students in the 9^th. grade of different school types in Germany was carried out (net sample). The return rate of questionnaires was 88% regarding all students whose teachers respectively school directors had agreed to participate in the study. Weighting factors were specified and used to make up for regional and school-type specific differences in return rates. 27.4% of the adolescents surveyed have a migration background, whereby the Turkish culture is the largest group followed by adolescents who emigrated from former Soviet Union states. The sample includes seven large cities (over 500,000 inhabitants) (12.2%), independent smaller cities ("urban districts") (19.0%) and rural areas ("rural districts") (68.8%).

Results

Life-time prevalence for alcohol consumption differs significantly between rural (93.7%) and urban areas (86.6% large cities; 89.1% smaller cities) with a higher prevalence in rural areas. The same accounts for 12-month prevalence for alcohol consumption. 57.3% of the rural, re-spectively 45.9% of the urban adolescents engaged in binge drinking in the 4 weeks prior to the survey. Students with migration background of the former Soviet Union showed mainly drinking behavior similar to that of German adolescents. Adolescents with Turkish roots had engaged in binge drinking in the last four weeks less frequently than adolescents of German descent (23.6% vs. 57.4%). However, in those adolescents who consumed alcohol in the last 4 weeks, binge drinking is very prominent across the cultural backgrounds.

Conclusions

Binge drinking is a common problem behavior in German adolescents. Obviously adolescents with rural residence have fewer alternatives for engaging in interesting leisure activities than adolescents living in cities. This might be one reason for the more problematic consumption patterns there. Common expectations concerning drinking behavior of adolescents of certain cultural backgrounds ('migrants with Russian background drink more'/'migrants from Arabic respectively Oriental-Islamic countries drink less') are only partly affirmed. Possibly, the degree of acculturation to the permissive German alcohol culture plays a role here.

The Role of Attitudes, Family, Peer and School on Alcohol Use, Rule Breaking and Aggressive Behavior in Hispanic Delinquent Adolescents

OBJECTIVE: The purpose of this study was to examine ecodevelopmental risk factors associated with alcohol uses, rule breaking and aggressive behaviors among Hispanic delinquent adolescents. Specifically, this study tests the effect of attitudes, family, peer, and school bonding on alcohol use, rule breaking and aggressive behaviors in Hispanic delinquent youth. METHODS: A sample of 235 heterogeneous Hispanic delinquent adolescents was recruited through referrals from the Miami-Dade County's Department of Juvenile Services and from the Miami-Dade County Public School system. Logistic regression methods were utilized to examine the independent effect of each risk factor (attitudes, family, peer, school) and to determine the extent to which these factors are associated with alcohol use, rule breaking and aggressive behaviors. RESULTS: Family functioning was inversely and significantly related to past 90-day alcohol use in univariate regression (β = -.24, p = .035) but was not significant in multiple regression (β = -0.09, p = .556). Peer alcohol use (β = 2.02, p<0.001) and poor alcohol attitudes (β =0.59, p=0.006) were positively and significantly related to past 90-day alcohol use in the final model. Poor alcohol attitudes, family functioning, peer alcohol use, and school bonding were all significantly related to both rule breaking and aggressive behaviors in the final model. CONCLUSIONS: Findings highlight the importance of identifying risk factors at multiple levels to prevent/reduce alcohol use, rule breaking and aggressive behaviors among Hispanic delinquent youth.