Predictors of Substance Use Initiation by Early Adolescence

OBJECTIVE

Substance use initiation during early adolescence is associated with later development of substance use and mental health disorders. This study used various domains to predict substance use initiation, defined as trying any nonprescribed substance (e.g., alcohol, tobacco, cannabis), by age 12, using a large longitudinal data set.

METHODS

Substance-naive youths from the Adolescent Brain Cognitive Development Study (ages 9-10; N=6,829) were followed for 3 years. A total of 420 variables were examined as predictors of substance use initiation, using a penalized logistic regression with elastic net; domains spanned demographic characteristics, self and peer involvement with substance use, parenting behaviors, mental and physical health, culture and environment, hormones, neurocognitive functioning, and structural neuroimaging.

RESULTS

By age 12, 982 (14.4%) children reported substance initiation, with alcohol being the most common. Models with only self-report predictors had similar prediction performance to models adding hormones, neurocognitive factors, and neuroimaging predictors (AUCtest=0.66). Sociodemographic factors were the most robust predictors, followed by cultural and environmental factors, physical health factors, and parenting behaviors. The top predictor was a religious preference of Mormon (coefficient=-0.87), followed by a religious preference for Jewish (coefficient=0.32), and by Black youths (coefficient=-0.32).

CONCLUSIONS

Sociodemographic variables were the most robust predictors of substance use initiation. Adding resource-intensive measures, including hormones, neurocognitive assessment, and structural neuroimaging, did not improve prediction of substance use initiation. The application of these large-scale findings in clinical settings could help to streamline and tailor prevention and early intervention efforts.

The interaction between Greek affiliation and religiosity on problem drinking in college students

Objective: Greek affiliation is associated with increased problem drinking in college, while religiosity typically offers protective benefits. The current study examined the interaction between Greek status and religiosity-both public (e.g., religious attendance) and private (e.g., prayer frequency)-on problem drinking. Participants and Methods: Undergraduates (N = 477) completed an online survey battery in late spring 2019, at the end of their freshman year. Results: Analyses focused on prayer frequency were not significant; however, the two-way interaction between Greek affiliation and religious attendance was significant. There was no difference in problem drinking across Greek and non-Greek students when religious attendance was low. As frequency of religious attendance increased, Greek students engaged in increased problem drinking compared to non-Greek students. Conclusions: Greek involvement may undermine the protective authority of religious practices on problem drinking, in part through moral licensing, whereby morally sound behaviors (i.e., religious attendance) may justify past or future problem drinking.

Chronic disease multimorbidity and substance use among African American men: veteran-non-veteran differences

OBJECTIVES

The purpose of the study was to explore the extent to which prior military service may moderate the relationship between chronic disease multimorbidity and substance use among African American men in the United States.

DESIGN

Data for this cross-sectional study was downloaded from the 2016 -2019 United States (US) National Survey on Drug Use and Health. We estimated three survey-weighted multivariable logistic regression models, where use of each of the following substances served as the dependent variables: illicit drugs, opioids, and tobacco. Differences in these outcomes were examined along two primary independent variables: veteran status and multimorbidity (and an interaction term for these variables). We also controlled for the following covariates: age, education, income, rurality, criminal behavior, and religiosity.

RESULTS

From the 37,203,237 (weighted N) African American men in the sample, approximately 17% reported prior military service. Veterans with ≥ 2 chronic diseases had higher rates of illicit drug use (aOR = 1.37, 95% CI = 1.01, 1.87; 32% vs. 28%) than non-veterans with ≥ 2 chronic diseases. Non-veterans with one chronic disease had higher rates of tobacco use (aOR = 0.80, 95% CI = 0.69, 0.93; 29% vs. 26%) and opioid misuse (aOR = 0.49, 95% CI = 0.36, 0.67; 29% vs. 18%) than veterans with one chronic disease.

DISCUSSION

Chronic disease multi-morbidity appears to be a context in which African American veterans may be at greater risk for certain undesirable health behaviors than African American non-veterans and at lower risk for others. This may be due to exposure to trauma, difficulty accessing care, socio-environmental factors, and co-occurring mental health conditions. These complex interactions may contribute to higher rates of SUDs among African American veterans compared to African American non-veterans.

The Relationship between Religion, Substance Misuse, and Mental Health among Black Youth

Studies suggest that religion is a protective factor for substance misuse and mental health concerns among Black/African American youth despite reported declines in their religious involvement. However, few studies have investigated the associations among religion, substance misuse, and mental health among Black youth. Informed by Critical Race Theory, we evaluated the correlations between gender, depression, substance misuse, and unprotected sex on mental health. Using multiple linear regression, we assessed self-reported measures of drug use and sex, condom use, belief in God, and religiosity on mental health among a sample of Black youth (N = 638) living in a large midwestern city. Results indicated drug use, and sex while on drugs and alcohol, were significant and positively associated with mental health symptoms. Belief in God was negatively associated with having sex while on drugs and alcohol. The study's findings suggest that despite the many structural inequalities that Black youth face, religion continues to be protective for Black youth against a myriad of prevalent problem behaviors.

A Systematic Review on Alcohol Consumption among Non-Religious and Religious Adults

Background: Research has suggested that religiosity is a protective factor in alcohol use, but this is an area that could be further explored. Objective: To undertake a systematic review of the literature on drinking patterns and their relationship with religiosity and non-religiosity in adult populations. Methods: We searched for relevant studies using the PubMed, LILACS, Web of Science, Scopus, and Psych-INFO databases. This review included only studies of people aged 18 and over which had a non-religious group as a comparison measure. Results: Fifty-one studies met the inclusion criteria. The present review showed that religious people tend to have lower alcohol consumption compared to those with no religion. However, this difference appears only when religions are analyzed together without differentiating between religious affiliations (Catholicism, Buddhism, Evangelicalism, etc.). Some religious affiliations, such as Buddhism, Catholicism and Lutheranism, appear to be risk factors for alcohol consumption. Definitions of risk consumption showed high heterogeneity, ranging from eight to 21 or more doses per week, a difference of 13 doses of alcohol between studies. Conclusions: The present review showed that religious people tend to have lower alcohol consumption compared to non-religious people. However, the results are contradictory when religious affiliations are analyzed separately and compared with non-religious participants. Adequately understanding which dimensions of religiosity and non-religiosity (e.g., group processes, engagement, meaning, rules of behavior) are protective in adulthood is fundamental to the construction of more effective interventions in this age group.

The Relationship between Christian Religiosity and Adolescent Substance Use in China

Abundant research has shown that Christian religiosity inhibits adolescent substance use, especially in communities where most of the population shares the same religious values and beliefs. Due to the lack of empirical research, it is unclear if Christian religiosity has the same inhibitory influence in predominantly secular and religiously diverse societies. This study aims to bridge this gap and thereby improve our understanding of the relationship between Christian religiosity and delinquent behavior in different cultural contexts. Through the analysis of survey data collected from a large probability sample of adolescents in China's special administrative region of Macau, this study found a strong inverse relationship between Christian religiosity and adolescent substance use, despite the predominantly secular nature of Macau society. In contrast, religious commitment among non-Christian youths showed no relationship with substance use. The theoretical and practical implications of the findings are discussed.

Associations between religiosity, aggression and crime: results from the National Survey on Drug Use and Health

PURPOSE

To explore the association between religiosity, aggression (self- and other-directed) and law-breaking behaviors.

METHODS

We used data from the National Survey on Drug Use and Health (NSDUH) in the United States of America across 2008-2014, with a pooled sample of 270,227 adult respondents. We categorized respondents as religious if they considered religious beliefs to be important parts of their lives and/or to be influential in making decisions and/or if they considered it important that friends share their beliefs and/or if they reported attending at least one service over the past 12 months. We used regression models to calculate the odds ratio for committing different forms of aggression and for breaking the law when measuring positively on religiosity and its parameters.

RESULTS

More than 85% of our sample qualified as religious. A positive religiosity was correlated with a statistically significant lower risk of self-directed aggression [aOR = 0.83, 95% CI (0.69-0.99)]. Importance of religious beliefs and influence of religious beliefs were inversely correlated to perpetration of self-directed aggression [aOR = 0.81, 95% CI (0.70-0.95)] and [aOR = 0.82, 95% CI (0.70-0.96)], respectively. Positive religiosity was not significantly correlated to lower odds of other-directed aggression. All religiosity parameters were associated with significantly reduced odds of breaking the law, except for infrequent service attendance which was associated with a significantly higher risk of breaking the law [aOR = 1.07, 95% CI (1.03-1.12)].

CONCLUSION

Religiosity has components with a differential impact on aggressive and law-breaking behaviors. Future longitudinal studies are needed to analyze whether religiosity protects against suicidality and promotes pro-social actions.

Religiosity and Substance Use Among Youth in Southeast Europe: The Importance of God as the Strongest Protective Religious Dimension

Using a large sample of youth ( N = 10,398) from 10 countries of Southeast Europe, the present study analyzed the effects of different dimensions of religiosity on various types of substance use across three different religions. The results, based on risk ratios and binary logistic regression, indicated that belief in the importance of God is generally a much stronger protective factor against substance use than church attendance or personal prayer. At the level of the entire sample, risk ratios revealed that finding God to be highly important reduced the likelihood of using hard drugs by as much as 69% and the likelihood of using soft drugs by 74%. In the case of alcohol use, the effect was weaker and less robust. Overall, the results of this study results point to the high relative importance of belief in God as a factor strengthening an individual’s ability to refrain from substance use.

Sexual minority status, religiosity, and suicidal behaviors among college students in the United States

BACKGROUND

Religiosity has been protective against suicidal behaviors, though it is unclear whether the protective effects extend to the high-risk group of sexual minorities.

METHODS

We analyzed data from the Healthy Minds Study, which was administered to college students enrolled in one of 140 campuses across the United States (N = 104,463) from September through December 2020, and from January to June 2021. We limited the sample to emerging adulthood (i.e., ages 18-30). We calculated the prevalence of suicidal behaviors and the mean of importance of religion, stratifying by sexual minority status. We used multivariable logistic regression to examine the associations between predictors (sexual minority status, importance of religion) and outcomes (suicidal ideation, suicide plan, and suicide attempt), adjusting for age, gender, and race/ethnicity. We then tested to see whether the association between importance of religion and suicidal behaviors was conditional on sexual minority status.

RESULTS

Significantly larger proportions of sexual minority students reported suicidal behaviors than heterosexual students. A larger proportion of heterosexual students viewed religion to be very important in their lives when compared with sexual minority students. Being a sexual minority was associated with greater odds of all suicidal behaviors, and greater importance of religion was associated with lower odds. The importance of religion was significantly associated with lower odds of suicidal behaviors for heterosexual students when compared with sexual minority students.

CONCLUSION

The association between importance of religion and suicidal behaviors was conditional on sexual minority status.

The Influence of Religious Involvement on Intimate Partner Violence Victimization via Routine Activities Theory

Routine activities theory attempts to explain victimization by examining how one's behavior, or routine activities, increases or decreases their likelihood of victimization. It has been postulated that religious individuals are less likely to associate with motivated offenders, less likely to reduce their target suitability, and more likely to enhance their guardianship, in turn reducing victimization. How, if at all, this theoretical framework can predict protection from a specific form of victimization, such as intimate partner violence (IPV), remains unexplored. Using the American subsample of the International Dating Violence Study (n = 4,162), this article attempts to determine whether religious involvement can serve as a factor that reduces IPV victimization indirectly through the three elements of routine activities theory: motivated offenders, target suitability, and capable guardianship. To test this research question, a series of logistic regression models are conducted. Results of these models indicate that religiosity does have a negative and significant impact on victims of IPV, net of variables derived from routine activities theory. This study is among the first to suggest that perhaps this theoretical framework may not be applicable to all forms of victimization. The major practical implication of this finding is that IPV victimization could be reduced using faith-based strategies. For example, religious counseling or preventive and intervention programs that increase prosocial bonds between partners are viable options in helping to reduce IPV victimization among couples. Nevertheless, it is imperative to determine other non-religious programs or methods to protect from IPV for individuals who are not religious.

Saving Grace? Religious ecology and deaths of despair

Since the late 1990s, deaths related to drug and alcohol abuse and suicide have increased substantially in the United States. Religious ecology is an important community attribute with theoretical links to these "deaths of despair." This study uses spatial autoregressive models to explore the relationship between religious ecology and deaths of despair, analyzing 2,992 US counties. Analyses focus on the effects of four American religious traditions (Mainline Protestant, Evangelical Protestant, Black Protestant, and Catholic), and how religious ecological effects interact with structural community disadvantage. Mainline Protestantism is protective in communities of low to medium disadvantage, while Black Protestantism is protective at high levels of disadvantage. Catholicism is positively associated with death rate at high levels of disadvantage. These denominational differences are likely linked to social processes of organizational support and norms about alcohol, which vary in efficacy and salience by community disadvantage. Overall, findings highlight the importance of religious ecology to understanding community health and mortality, as well as nuance in where and how religious ecology matters.

Religion and Recovery Among Individuals Experiencing Homelessness

Faith-based organizations provide essential recovery services to individuals experiencing homelessness. Research suggests that religion and spirituality aid recovery from alcohol and drug addiction, although less is known about these factors in homeless populations. This study used qualitative interviews to explore the role of religion in recovery from addiction in a sample of 14 adults with a history of homelessness. Analysis of emergent themes revealed that religion provided participants with a range of personal and social benefits, many which addressed personal, social, and tangible losses and crises associated with substance use and homelessness. Understanding the specific benefits religion may provide during recovery can guide research and help providers improve programs for this vulnerable population.

Religious service attendance typologies and African American substance use: a longitudinal study of the protective effects among young adult men and women

PURPOSE

This study sought to identify variation by gender in the associations between religious service attendance from adolescence to young adulthood and seven measures of lifetime and short-term substance use.

METHODS

To conduct this nationally representative study, data from the Add Health Surveys was abstracted from Waves I and IV (N = 3,223) to construct four types of service attendance (non-attenders, attenders only as adolescents, attenders only in young adulthood, and consistent attenders). A series of logistic regressions were conducted to identify the independent effects of each pattern of service attendance on each substance among all black young adults, as well as male and female sub-samples.

RESULTS

Analysis revealed consistent attenders were generally less likely to use substances, with the effects being strongest among females. Among young adult only attenders, males recorded lower odds across all three short-term measures whereas females reported lower odds only for monthly cigarette use.

CONCLUSION

The protective effects of religious service attendance are more robust for African Americans who consistently attend in adolescence and young adulthood, especially among females.

Spirituality, religiousness, and mental health: A review of the current scientific evidence

Research in the field of “Spirituality and Health” has been growing, with spirituality/religiousness (S/R) being consistently related to both physical and mental health. The objective of this article is to provide an updated review of the current scientific evidence on the relationship between S/R and mental health, highlighting the most important studies. As a secondary objective, the mechanisms that explain this relationship and the interventions that utilize this information in treating mental disorders will be discussed. The findings reveal a large body of evidence across numerous psychiatric disorders. Although solid evidence is now available for depression, suicidality, and substance use, other diagnosis, such as post-traumatic stress disorder, psychosis, and anxiety, have also shown promising results. The effects of S/R on mental health are likely bidirectional, and the manner in which religious beliefs are used to cope with distress (i.e. negative and positive), may affect mental health outcomes. Despite these findings, the mechanisms that explain these associations and the role of S/R interventions need further study. Concerning clinical practice, mental health providers should ask patients about S/R that are important in their lives to provide holistic and patient-centered care.

Predicting Substance Use from Religiosity/Spirituality in Individuals with Cystic Fibrosis

Religiosity and spirituality predict lower alcohol and other substance use in community samples of adolescents and adults. However, the roles of religiosity and spirituality in substance use have not been examined in individuals with cystic fibrosis (CF). Adults with CF (n = 123) completed measures of spirituality, religiosity, and substance use. Clinical measures of illness severity (e.g., BMI and  %FEV₁) were obtained from participants' medical records. Substance use rates for alcohol, tobacco, and marijuana were lower in this sample than those seen in the general population. Of the measured BMMRS subscales, spiritual experiences and religious commitment were significant predictors of lower alcohol use. These results suggest that personal factors of religiosity and spirituality are more important for substance use in adults with CF than participation in religious service and events or adoption of religious practices.

Risk, compensatory, and protective factors in problem gambling: The role of positive mental health characteristics

There is a limited evidence base from which to draw conclusions about compensatory and protective factors for problem gambling. The aim of this study was to explore the potential for positive mental health characteristics (general coping, emotional support, spirituality, interpersonal skills, personal growth and autonomy, and global affect) to play a compensatory role and protective role in problem gambling in a convenience sample of 499 Australian university students. Hazardous alcohol use, past-year substance use, gambling-related cognitions (interpretive bias, illusion of control, predictive control, gambling-related expectancies, and perceived inability to stop gambling), gambling high-risk situations (negative and positive reinforcement situations), and gambling motives (money, positive feelings, regulate internal state, and challenge) positively predicted problem gambling severity. None of the positive mental health characteristics negatively predicted problem gambling severity, suggesting that these factors did not play a compensatory role. However, emotional support, personal growth and autonomy, and global affect buffered the influence of gambling motives and high-risk situations, suggesting that these factors played a protective role. In contrast, spirituality displayed a direct positive predictive relationship with problem gambling severity, suggesting that it served to act as a risk factor in this sample. The identification of these modifiable risk and protective factors has implications for the development of effective prevention and intervention initiatives. Further longitudinal research employing population-representative samples is required to replicate these results and investigate relationship-, community-, and societal-level risk, compensatory and protective factors associated with the development of problem gambling.

Recovery capital among migrants and ethnic minorities: A qualitative systematic review of first-person perspectives

This systematic review of 15 qualitative studies explores recovery capital among migrants and ethnic minorities (MEM). The results of the framework analysis indicate that addressing barriers to recovery and (often minority-related) root causes of problem substance use is vital to recovery among MEM, as well as building recovery capital on personal, social and community level. The review unpacks the importance of "cultural" and "spiritual" elements of recovery capital both inside and outside treatment, the interconnectedness of the different dimensions of recovery capital, as well as their intertwinement with root causes of substance use and barriers to recovery. The results point out the importance of offering culturally and trauma-sensitive relational support and building recovery capital through recovery-oriented systems of care. Moreover, this study highlights the need for further research concerning recovery in MEM populations.

Maternal Comfort with Lesbian, Gay, and Bisexual People and Their Children's Drinking, Smoking, and Disordered Weight Control Behaviors as Adults

Purpose: We investigated associations between maternal comfort with lesbian, gay, and bisexual (LGB) people during the participant's adolescence and their health indicators in adulthood. Methods: Data came from a prospective cohort, Growing Up Today Study (N = 7476), limited to men and women who provided information during their adulthood about recent binge drinking, cigarette smoking, or disordered weight control behaviors (DWCB) and whose mothers provided information during the participant's adolescence about her comfort with LGB people. Results: Increased maternal comfort with LGB people was associated with increased engagement in health indicators for heterosexual but not sexual minority adults (binge drinking, cigarette smoking, and DWCB for women; binge drinking for men). No association existed between maternal comfort with LGB people and binge drinking or cigarette smoking for sexual minority women, and binge drinking for sexual minority men. This resulted in statistically smaller differences across sexual orientation in cigarette smoking for women when their mothers were highly comfortable with LGB people compared with those whose mothers were uncomfortable with LGB people. There were no differences in binge drinking (women and men) and DWCB (women only) across sexual orientation when mothers were highly comfortable with LGB people. Conclusion: Maternal comfort with LGB people is associated with certain sexual orientation-related disparities in health indicators through adulthood, due to increased engagement in health indicators by heterosexual adults. Exposure to sexual orientation stigma in adolescence, measured as maternal comfort with LGB people, possibly drives well-known differences in drinking, smoking, and DWCB during adulthood between heterosexual and sexual minority adults.

Religious Social Support Protects against Social Risks for Adolescent Substance Use

We used a social developmental perspective to identify how prominent social contexts influence substance use during adolescence. Longitudinal data were collected annually from 167 parent-adolescent dyads over four years. We investigated whether parent substance use was related to adolescent substance use directly and indirectly via peer substance use and whether these associations were moderated by religious social support. Structural equation modeling (SEM) analysis indicated significant moderated mediation: Greater parent substance use predicted increases in adolescent substance use indirectly via increased peer substance use when adolescent religious social support was low or average, but not high. These results suggest religious social support may protect adolescents against prominent social risks for intergenerational substance use.

Problematic alcohol use among fathers in Kenya: Poverty, people, and practices as barriers and facilitators to help acceptance

BACKGROUND

In Kenya, the prevalence of alcohol use disorder (AUD) is close to 6%, but a notable treatment gap persists. AUD is especially pronounced among men, leading to negative consequences at both individual and family levels. This study examines the experiences of problem-drinking fathers in Kenya regarding previous treatment-seeking related to alcohol use. Experiences and dynamics of the family are also explored as they pertain to treatment-seeking experiences.

METHODS

In Eldoret, Kenya, semi-structured qualitative interviews were conducted with 11 families with a male exhibiting problem drinking, his spouse, and one child. Thematic content analysis was used to examine themes related to barriers and facilitators to treatment.

RESULTS

Participants only reported informal help received from family and community members; they exhibited little awareness of available formal treatments. Families were both deeply affected by alcohol use and actively involved in help-seeking. Indeed, fathers' experiences are described as help-accepting rather than help-seeking. Three overarching themes emerged from the results: poverty, people, and practices. Poverty could be a motivator to accept help to support one's family financially, but stress from lack of work also drove drinking behaviours. People were also crucial as both barriers and facilitators of help-accepting. Negative help strategies or peer influence deterred fathers from accepting help to quit. Positive motivation, social support, and stigma against drinking were motivators. Practices that were culturally salient, such as religiosity and gender roles, facilitated help acceptance. Overall, most help efforts were short-term and only lead to very short-term behaviour change.

CONCLUSION

Families and communities are active in help provision for problem-drinking men in Kenya, though results confirm remaining need for effective interventions. Future interventions could benefit from recognizing the role of family to aid in treatment-engagement and attending to the importance of poverty, people, and practices in designing treatment strategies.

Smoking and Religion: Untangling Associations Using English Survey Data

While factors affecting smoking are well documented, the role of religion has received little attention. This national study aims to assess the extent to which religious affiliation is associated with current-smoking and ever-smoking, controlling for age, sex, ethnicity and socio-economic status. Variations between adult and youth populations are examined using secondary analysis of individual-level data from 5 years of the Health Survey for England for adult (aged >20, n = 39,837) and youth (aged 16-20, n = 2355) samples. Crude prevalence statistics are contrasted with binary logistic models for current-smoking and ever-smoking in the adult and youth samples. Analyses suggest that Muslims smoke substantially less than Christians. Highest levels of smoking characterise people not professing any religion. Associations between smoking and the Muslim religion attenuate to statistical insignificance in the face of ethnic and socio-economic factors. An association between smoking and the absence of a religious affiliation is sustained. An understanding of the association between smoking and religion is essential to the development of tobacco control programmes.

The efficacy of spiritual/religious interventions for substance use problems: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Spiritual/religious (S/R) interventions are commonly used to treat substance use problems, but this is the first systematic review and meta-analysis to examine their efficacy for these problems.

METHODS

Ten electronic databases were searched to identify eligible studies (i.e., randomized controlled trials) published between January 1990 and February 2018 that examined S/R interventions' efficacy for substance use or psycho-social-spiritual outcomes. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Robust variance estimation in meta-regression was used to estimate effect sizes and conduct moderator analysis.

RESULTS

Twenty studies comprising 3700 participants met inclusion criteria. Four studies used inactive controls, 14 used active controls, and two used both inactive and active controls and were therefore included in estimating both absolute and relative effect sizes. The absolute effect of S/R interventions (compared with inactive controls such as no treatment) was moderate but non-significant (six studies, d = .537, 95% confidence interval [CI] = -.316, 1.390), possibly due to low power. The relative effect of S/R interventions (compared with other interventions) was statistically significant (16 studies, d = .176, 95% CI = .001, .358). Because only 12-step-oriented interventions were compared with other interventions, this finding does not apply to the relative effect of non-12-step-oriented S/R interventions. Moderator analysis showed that relative effect sizes differ significantly by country.

CONCLUSION

We found evidence of S/R interventions' efficacy in helping people with substance use problems. More high-quality efficacy studies of non-12-step-oriented S/R interventions for substance use problems are needed.

“Create in Me a Clean Heart”: The Role of Spirituality in Desistance From Substance Use

Although the impact of religion on behavior is robust and well-examined in many areas, the role spirituality plays in changes in drug use over time has received relatively little attention. Using a life-course theoretical framework, this relationship is examined through growth curve modeling techniques. Specifically, multilevel analyses are estimated testing within-person relationships between substance use desistance and spirituality. The Pathways to Desistance longitudinal data are analyzed and leading criminological predictors are included, to determine if spirituality has a unique impact on substance use net of these criminological factors, and if these impacts vary across gender. Results from these analyses suggest that the impact of spirituality on desistance varies by gender, with spirituality significantly increasing the odds of desistance from marijuana use for females, but not males.

Spiritual belief and its link with potentially addictive behaviors in a youth sample in Switzerland

BACKGROUND

Earlier studies suggested a positive impact of spirituality on addictive disorders, but this effect has rarely been studied in a large adolescent and young adult population.

AIM

To examine the association between spiritual beliefs (general belief, the supporting role of spiritual belief, the critical role of spiritual belief) and potentially addictive behaviors (tobacco, alcohol, cannabis and other illegal drugs, excessive Internet use and gambling).

METHODS

Data were collected using online self-report questionnaires among a sample of 5179 adolescents and young adults aged 15-24 years in post-mandatory education in Switzerland. Statistical analysis at bivariate and multivariate level was performed.

RESULTS

At the bivariate level, spiritual beliefs were linked to a lower risk of tobacco smoking, alcohol misuse and cannabis use as well as an increased risk of Internet overuse and gambling. However, at the multivariate level, controlling for age, gender, language and place of birth, significant associations were found only for alcohol misuse, Internet overuse and gambling.

CONCLUSION

The study provides evidence that spiritual belief could protect youth from the risk of alcohol misuse but could also increase the risk of excessive Internet use and gambling. The role of spiritual beliefs in preventing or motivating these problematic behaviors is of great interest for adolescent health care providers and should be considered in the light of the separation-individuation process and transition from adolescence to adulthood.

Patterns of cancer-related health behaviors among middle-aged and older adults: Individual- and area-level socioeconomic disparities

Multiple health behaviors could have greater impact on chronic diseases than single behaviors, but correlates of behavioral clusters are relatively understudied. Using data from NIH-AARP Diet and Health Study (initiated in 1995) for 324,522 participants from the U.S. (age 50-71), we conducted exploratory factor analysis to identify clusters of adherence to eight cancer prevention behaviors. Poisson regressions examined associations between cluster scores and neighborhood socioeconomic deprivation, measured with census block group (1) poverty and (2) low education. Four clusters emerged: Movement (adequate physical activity/less TV); Abstinence (never smoked/less alcohol); Weight control (healthy body mass index/high fruits and vegetables); and Other (adequate sleep/receiving cancer screenings). Scores on all clusters were lower for participants in neighborhoods with the highest poverty (most deprived quintile versus least deprived: relative risk [RR] = 0.95 (95% confidence interval [CI] = 0.94-0.96) for Movement, 0.98 (95% CI = 0.97-0.99) for Abstinence, 0.94 (95% CI = 0.92-0.95) for Weight control, and 0.94 (95% CI = 0.93-0.95) for Other; all p < 0.001). Scores on three clusters were lower for participants in neighborhoods with the lowest education (RR = 0.88 (95% CI = 0.87-0.89) for Movement, 0.89 (95% CI = 0.88-0.90) for Weight control, and 0.90 (95% CI = 0.89-0.91) for Other; all p < .001). Health behaviors among older adults demonstrated four clusters. Neighborhood deprivation was associated with lower scores on clusters, suggesting that interventions to reduce concentrated deprivation may be an efficient approach for improving multiple behaviors simultaneously.

Religiosity, Crime, and Drug Use Among Juvenile Offenders: A Test of Reciprocal Relationships Over Time

This article examines whether an individual's religiosity has reciprocal relationships with crime and drug use among juvenile offenders. Structural equation modeling is applied to analyze 11-wave panel data from a study of juveniles adjudicated or found guilty of a serious offense in two states. Offenders' religiosity is measured both objectively (participation in religious activities) and subjectively (religious salience, experiences, and efficacy). While holding constant an offender's exposure time (the proportion of time on the street), previous levels of crime and drug use, and sociodemographic controls, this study found the relationship between religiosity and crime (i.e., nondrug offending) to be either bidirectional or unidirectional. The relationship between religiosity and drug use (binge drinking, marijuana use, and hard drug use) is, however, unidirectional over time. When unidirectional relationship is found, it is religiosity that decreases crime and drug use, not the other way around. Implications of findings are discussed.

Rural and Urban Differences in Nebraskans’ Access to Marijuana, Methamphetamine, Heroin, and Prescription Pills

The ability of a user to access a given type of drug is related to the configuration of the market for that drug, and a range of economic and criminal justice concerns. This study focuses on Nebraskan’s “ready access” to four types of drugs (marijuana, methamphetamine, heroin, and prescription pills) in 2016, using a statewide survey of housed Nebraskan adults. Ready access is defined as a participant knowing at least one person from whom they could obtain a given type of drug if they wanted to. We found that 35% of adult Nebraskans knew at least one person from whom they could obtain marijuana, 8.9% for methamphetamine, 4.5% for heroin, and 17.8% knew at least one source for prescription pills. Relationships between knowing a source for each type of drug and rurality, sex, race, religious attendance, mental health symptoms, and education are explored.

Religious Involvement and Marijuana Use for Medical and Recreational Purposes

In this article, we use data from the 2016 National Survey on Drug Use and Health (NSDUH) to examine the association between religious involvement and marijuana use for medical and recreational purposes in U.S. adults (N = 41,517). We also consider whether the association between religious involvement and marijuana use varies according to personal health status. Our results show that adults who attend religious services more frequently and hold more salient religious beliefs tend to exhibit lower rates of medical and recreational marijuana use. We also find that these “protective effects” are less pronounced for adults in poor health. Although our findings confirm previous studies of recreational marijuana use, we are the first to examine the association between religious involvement and medical marijuana use. Our moderation analyses suggest that the morality and social control functions of religious involvement may be offset under the conditions of poor health.

Applying the Problem Behavior Theory to Adolescent Drug Use Among a Cross-Sectional Sample of Boys Participating in a Community-Based Youth Organization

BACKGROUND

Drug use remains an important public health concern in the United States, and understanding drug use among young adolescents is vital towards improving the health of the population.

OBJECTIVE

This study applied the Problem Behavior Theory (PBT) to lifetime drug use among a cross-sectional sample of Boy Scouts (N = 770). The PBT provides a conceptual framework for identifying risk and protective factors for adolescent problem behaviors, including drug use.

METHODS

Scouts reported their drug use and socio-demographics, and were assessed on several risk and protective factors. For analyses, sociodemographic and risk and protective factors were selected according to the framework provided by PBT, and use of each drug was regressed logistically on these selected factors. Final logistic models were assessed for goodness of fit and discriminatory power.

RESULTS

The PBT demonstrated discriminatory power for all drugs (Tjur's R² values ≥.29), but fell sharply for illicit drug use (Tjur's R² =.20). There were no consistent correlates of drug use. Conclusions/Importance: The PBT had less explanatory power for illicit drug use compared to tobacco, alcohol, and marijuana, which suggests different risk and protective factors were associated with illicit drug use.

Profiles of adolescent religiousness using latent profile analysis: Implications for psychopathology

Prior research has documented robust associations between adolescent religiousness/spirituality (R/S) and psychopathology outcomes including externalizing and internalizing symptomatology, yet no previous studies have examined these associations with adolescent R/S profiles using a person-centred approach. We examined whether there are identifiable subgroups characterized by unique multidimensional patterns of R/S experiences and how these experiences may be related to externalizing and internalizing symptomatology. The sample consisted of 220 Appalachian adolescents between 12 and 18 years old who were primarily White and primarily Christian. Latent profile analysis revealed three profiles of adolescent R/S: high religiousness (28.4%), introjectors (47.6%), and low religiousness (24.0%). These profiles were differentially related to internalizing and externalizing symptomatology such that the high religiousness group was significantly lower than the introjectors with respect to internalizing and externalizing symptomatology and lower than the low religiousness group in externalizing symptomatology. Implications and suggestions for future research using person-centred approaches to better understand differential developmental trajectories of religious development are provided. Statement of contribution What is already known Prior research has demonstrated a negative relationship between adolescent religiousness and spirituality (R/S) and psychopathology. Numerous studies document the differential relationships between aspects of R/S and psychopathology; however, few have done so from a person-centred perspective. There are several theories that outline how R/S to study R/S when paying specific attention to culture. Saroglou's Big Four dimensions of religion (believing, bonding, behaving, and belonging) posits that these four dimensions (1) are able to delimit religion from proximal constructs; (2) translate major distinct dimensions of religiousness; (3) can be seen across cultural contexts; and (4) are good candidates to study cultural variability in religion due to their diversity; however, to the authors' knowledge there has been no attempt to synthesize the Big Four dimensions and person-centred work. What the present study adds The present study found three profiles of adolescent R/S: high religiousness, low religiousness, and of particular interest, the introjectors. Those high in introjection seem to have a partial internalization of religiousness due to their low score in private practices but moderate to high scores on other aspects of religiousness. This group would not have been found through the use of traditional data analysis techniques or even through structural equation models. Importantly, those in the introjector group were also significantly higher in internalizing symptomatology than those in the high religiousness group, and higher in externalizing symptomatology than both the high religiousness and low religiousness. This 'u-shaped' pattern in which those in the middle-range of R/S were the worst off would also not have been found using traditional data analysis techniques.

Religion, Alcohol Use and Risk Drinking Among Canadian Adults Living in Ontario

This research examines (1) the association between risk drinking and religious affiliation and (2) differences between religions for risk drinking among adults living in Ontario, Canada, for Christians, Buddhists, Sikhs, Muslims, Hindus, Jews, other religious groups and the non-religious. Data are based on telephone interviews with 16,596 respondents and are derived from multiple cycles (2005-2011) of the Centre for Addiction and Mental Health's (CAMH) Monitor survey, an ongoing cross-sectional survey of adults in Ontario, Canada, aged 18 years and older. Data were analysed using bivariate cross-tabulations, Mann-Whitney U nonparametric test and logistic regression. Alcohol use and risk drinking occur among members of all religious groups; however, the rate of drinking ranges widely. Risk drinking is significantly associated with religion. When compared to the No religion/Atheist group, several religious groups (Baptist, Christian, Hindu, Jehovah's Witness, Jewish, Muslim/Islam, Non-denominational, Pentecostal, Sikh and Other religion) in our sample have significantly lower odds of risk drinking. Risk drinkers also attended significantly fewer services among several religions. Results suggest that there are differences in the risk drinking rates among Canadian adults, living in Ontario, by religion. It appears that religious traditions of prohibition and abstention do hold sway among Canadian adults for some religious groups.

Relationship of Religiosity and Spirituality to Hazardous Drinking, Drug Use, and Depression Among Sexual Minority Women

Using data from Wave 3 of the Chicago Health and Life Experiences of Women (CHLEW) study (N = 699), we explored whether religiosity and spirituality were associated with risk of hazardous drinking, drug use, and depression among sexual minority women (SMW; i.e., lesbian, bisexual) and possible differences by race/ethnicity. Participants were more likely to endorse spirituality than religiosity, and endorsement of each was highest among African American SMW. We found no protective effect of religiosity or spirituality for hazardous drinking or drug use. An association initially found between identifying as very spiritual and past-year depression disappeared when controlling for help-seeking. Among SMW with high religiosity, African American SMW were more likely than White SMW to report hazardous drinking. Latina SMW with higher spirituality were more likely than White SMW to report drug use. Results suggest that religiosity and spirituality affect subgroups differently, which should be considered in future research on resiliency among SMW.

Statistical Effects of Religious Participation and Marriage on Substance Use and Abuse in Racial and Ethnic Minorities

Substance use and abuse, which includes alcohol use, alcohol dependence, drug use, and drug dependence, inflicts a substantial toll on Americans. Although studies have demonstrated the protective effect of social support, such as religious participation and via marriage, understanding their influence on racial and ethnic minorities is limited. Thus, the aim of this study is to assess the impact of social support on substance use and abuse in racial and ethnic minorities. The Collaborative Psychiatric Epidemiology Surveys, sponsored by the National Institute of Mental Health, a repository of race, ethnicity, and mental health data, was leveraged to develop four models using multivariate analysis, specifically logistic regression to estimate the probability of meeting the criteria for substance use and abuse. Racial and ethnic minorities were found to have lower rates of substance use and abuse compared to Whites, and foreign-born individuals were consistently less likely to use or abuse substances compared to American-born minorities. Mental health conditions were highly associated with substance use and abuse, and social support by way of religious participation and marriage was protective against substance use and abuse. In racial and ethnic minorities, nativity and social support were protective against substance use and abuse; however, these protective factors did not completely eliminate risk. Thus, although race and ethnicity are important to understanding health outcomes and health behaviors, such as substance use and abuse, it is the intersection of multiple factors, representing internal and external forces, which may be more informative and offer a more comprehensive picture of the landscape influencing drug and alcohol use and dependence. Targeted interventions should consider leveraging religious spaces and bilingual materials when attempting to reach racial and ethnic minorities.

What could keep young people away from alcohol and cigarettes? Findings from the UK Household Longitudinal Study

Background

Adolescents are vulnerable to risky behaviours that are likely to co-occur. We examined whether happiness, awareness of alcohol- or smoking-related harm or the size of friendship networks would be longitudinally associated with young people’s risky behaviours.

Methods

We used available cases (N=1,729) from adolescents aged between 10 and 15 who participated in waves 2 and 3 of the UK Longitudinal Household Study that has annually collected population representative data from 40,000 UK households. The outcome variable was patterns of cigarette and alcohol use among adolescents (1= persistent non-use; 2= ex-use; 3= initiation; 4= persistent use) that we derived by tabulating current alcohol or cigarette use at waves 2 and 3. Explanatory variables were scores on participants’ perception of overall happiness, awareness of harm due to alcohol and cigarette use, and supportive friendship network size, collected at wave 2. Covariates were participants’ sex, age, base level of self-reported health status, reported religious affiliation, and household social position. All estimates were corrected for the complex survey design and non-response. Multinomial logistic regression was used to test assumed associations by taking persistent cigarette and alcohol use as the reference category.

Results

Findings showed higher happiness scores were longitudinally associated with adolescents’ persistent non-use (RRR=1.06, 95% CI=1.01-1.13). Awareness of alcohol or cigarette use-related harm was longitudinally associated with persistent non-use (RRR=1.24, 95% CI 1.15-1.35) as well as initiation of alcohol or cigarette use (RRR=1.21, 95% CI=1.11-1.32).

Conclusion

Joint interventions to promote happiness and harm awareness could help young adolescents from engaging with drinking alcohol or smoking cigarettes.

Social Support, Religious Involvement and Alcohol Use among Students at a Conservative Religious University

The misuse of alcohol among college students remains a significant public health concern in the United States. Excessive drinking among college students has been linked to numerous negative consequences, including rape, impaired academic performance, absenteeism from work and school and damaged social relations. This study examined whether religious involvement and social support played a role in reducing the frequency of alcohol use. A non-random convenience sample of 364 students from a larger study of 760 college students-18 years old and older-were recruited over a 2 month period. The survey used in this study consisted of 124 items and collected information on areas such as substance misuse, sexual activity, use of pornography, relationships, personal religious practices, and social support. A descriptive analysis and chi-square were performed to determine if there was a relationship between frequency of alcohol use and gender, marital status, student class, GPA, religion, ethnicity and age. Linear regression was conducted to determine if social support and religious involvement were predictors of frequency of alcohol misuse. Multivariate regression analysis was used for predicting religious involvement when including social support while controlling for gender, age, ethnicity and grade. The present study revealed that religious involvement was a predictor for reduced frequency of alcohol use, while social support was not a predictor of lower frequency of alcohol use.

Religious involvement and marijuana use among a sample of African American young adults

Is religiosity associated with African American drug use? Despite the increased research attention that has been devoted to the topic, findings to date have been inconclusive. To address this issue, we analyze data from a sample of 434 young adults residing in Miami-Dade County Florida. We find that, of the four dimensions of religiosity considered here, only religious attendance is inversely related to marijuana use for men and women. The implications of these findings are discussed.

Religious Coping and Substance Use: The Moderating Role of Sex

The objectives of this study were to ascertain whether positive and negative religious coping are associated with substance use and to determine whether sex moderates this association. This study utilized a cross-sectional design and examined 349 undergraduate students (103 males and 246 females) at a midsize southeastern university. Participants completed a demographic questionnaire, the Brief RCOPE, and the Drinking and Drug Habits Questionnaire. Results revealed a positive association between negative religious coping and substance use only for males. While positive religious coping was significantly negatively associated with substance use, sex did not moderate this association. These results suggest that males may be especially vulnerable to engaging in substance use when utilizing negative religious coping. It may be important for university counseling centers to be cognizant of the types of religious coping used by students, as well as sex differences regarding the association between negative religious coping and substance use.

Predictors of Religiosity in a Cohort of African Americans

Few studies have considered life course predictors of religiosity. We use the Woodlawn Study of a cohort of 1242 first grade African American children followed over four time periods to age 42 to observe how early school behaviors, family characteristics and neighborhood and social resources relate to later religiosity. Past literature suggested several domains of religiosity and exploratory factor analyses supported four measures of religiosity: religiosity as a resource, youth religiosity, divine struggle, and young adult religiosity. In multivariate analyses, males rated by teachers as shy in first grade, those with more than a high school education, and females who reported higher social ties in young adulthood were more likely to report religiosity as a resource at age 42. Males with both shy and aggressive behavior in first grade and females with lower math grades in first grade reported more youth religiosity. Those who obtained more education were less likely to report divine struggle. In terms of religiosity as a young adult, females who had been rated as both shy and aggressive in first grade, those living in neighborhoods with a higher proportion of African Americans, those with higher social ties in young adulthood and those living in neighborhoods with a higher proportion of African Americans reported higher adult religiosity. Longitudinal studies offer an opportunity to examine how patterns of religiosity vary over the life course and how early family, school, and social adaptation influence later religiosity in adulthood.

Self-Perceived Strengths Among Adolescents With and Without Substance Abuse Problems

The importance of examining positive aspects of youth development has been emphasized across disciplines involved in the care of youth with substance abuse problems. However, little is known about the strengths of adolescents with substance abuse problems, especially youth entering residential treatment. Utilizing the Strengths Assessment Inventory, a measure assessing psychological and social strengths, we examined patterns of strengths across groups of age- and gender-matched youth who reported no substance use, frequent substance use, and those entering treatment for severe substance use. Each group consisted of 43 participants ranging in age from 14 to 18 years. Results indicated that, on average, individuals entering treatment scored lower on personal strengths. However, through the use of more sophisticated statistical approaches, it was found that certain strengths were predictive of individuals belonging to the treatment group. Results are discussed in terms of their relevance to the treatment of adolescent substance abuse problems.