Is the Effect of Parenting on Substance Use among Adolescents and Young Adults Context Dependent? Evidence from Ten Countries of Southeastern Europe

Related to some inconsistent evidence in the literature, the current study tested the links between three parenting styles and four measures of substance use in samples of adolescents and young adults from ten, socio-economically diverse countries in Southeastern Europe (N = 10,909, 50.3% males, Mage = 21.70, SD = 4.5); it also tested whether these links were moderated by a measure of social progress. Results indicated that only authoritative parenting style was negatively associated with substance use; both authoritarian and permissive parenting styles were positively associated with substance use. The country-level effect on substance use was modest, yet significant; it explained between 1% and 4% of the total variance. Findings also provided some evidence of a moderation effects by social progress. Exploratory follow-up HLM analyses also provided evidence of significant country level social progress effects on alcohol use, soft drug use, and hard drug use; however, no significant cross-level interactions effects were found. Key study implications include positive effects by both authoritarian and permissive parenting on young adult substance use, but importantly, negative ones by authoritative parenting. Findings have important implications for potential intervention and prevention efforts, in addition to addressing potential country-level differences.

Family-based prevention in youth's substance misuse in low- and middle-income countries: A review from Turkey and cultural adaptation of family based interventions

Family-based interventions have been recognized and practised more in high-income countries than in low- and middle-income countries. However, the threats posed by substance misuse to the youth do not change for the latter. The development of appropriate preventive programs is an area of interest for addiction prevention in low- and middle-income countries by recognizing the risk factors for substance misuse among young individuals. This study aims to present the risk factors primarily in family-based conditions for substance use among young people in low- and middle-income countries and to provide information on family-based interventions that can be developed in line with these factors. It is aimed to discuss how family-based studies can be adapted to samples such as Turkey in the light of three programs originating in the USA. Fifty-six publications gathered from the literature between 1989-2021 by using keywords were included in the study. Adolescence and young adulthood are the riskiest developmental periods for substance misuse worldwide. Economic, cultural and family-based factors involving the youth are of considerable importance. Families' consciousness of youth's substance use is worthful to prevent youth's addictions in the future. Studies show that family-based preventions are promising interventions in this regard.

Parents Are Unaware of Their Youths' Tobacco Use: Results from the Population Assessment of Tobacco and Health Study

BACKGROUND

In this study, we determined the prevalence of and factors associated with parent unawareness of youth tobacco use.

METHODS

We used data from waves 1, 2, and 3 (2013-2016) of the Population Assessment of Tobacco and Health study, a nationally representative study of 13,650 US youth ages 12 to 17 and their parents. We conducted weighted multivariate analyses comparing parent unawareness of youth-reported ever use and associations between parents' unawareness of youth use and covariates.

RESULTS

Youth ever tobacco use ranged from 21.8% in 2013-2014, to 24.1% in 2014-2015, to 23.4% in 2015-2016. Parent unawareness ranged from 57.6% in 2013-2014, to 61.9% in 2014-2015, and 64.5% in 2015-2016. Factors associated with higher parent unawareness of youth tobacco use in 2015-2016 were youth being female, black, or Hispanic (adjusted odds ratio [AOR] = 1.24-2.61; all ps < .05). Youth with lower academic performance, relatives who used tobacco, tobacco available in the home, or past 30-day use, were less likely to have parents unaware of their use (AORs 0.33-0.56; all ps < .05).

CONCLUSIONS

Among youth who reported ever using tobacco, most had parents who were unaware of their use. School-based efforts targeting specific sociodemographic factors could increase parent awareness of youth tobacco use.

The correspondence of parent-reported measures of adolescent alcohol and cannabis use with adolescent-reported measures: A systematic review

BACKGROUND

Valid assessment of adolescent substance use is important in both research and clinical applications. However, the optimal approach to assessing adolescent use remains controversial, particularly with regard to the use of parent-reported measures. Methods: Using a systematic review of existing literature, we sought to evaluate the utility of parent measures of adolescent alcohol and cannabis use by examining their correspondence with self-report measures. Furthermore, we investigated study-related variables that may be associated with differing levels of parent-child correspondence. Relevant articles were identified using a systematic search across multiple databases. Results: The review revealed generally poor agreement between parent and adolescent reports of alcohol and cannabis use. Parents consistently underestimated use and problems associated with use when compared with adolescents. Community-based (versus clinical) samples, reporting regarding alcohol (versus cannabis), and reporting problems associated with use (versus reports of use/nonuse) were each associated with lower levels of parent-child agreement. Conclusions: Recommendations for the optimal use of parent measures of adolescent substance use are provided.

Parental belief and adolescent smoking and drinking behaviors: A propensity score matching study

This research examines the effects of parental belief on adolescent later smoking and drinking behaviors. Previous studies show that parental belief may have detrimental or beneficial influences on adolescents' behaviors. Analysis is based on Wave 1 and 2 data from the National Longitudinal Study of Adolescent Health (Add Health), N = 3232, and is conducted using an OLS regression estimation and propensity score matching (PSM; nearest-neighbor and kernel matching). Results show that, of adolescents who used cigarettes and alcohol at Wave 1, they are more likely to continue the activity if their parents were aware of it. Adolescents are also more likely to use cigarettes if their parents believed they smoked when in fact they did not. Of adolescents who did not use alcohol, no significant association is found between parental belief and their later alcohol use. Self-fulfilling prophecy is proposed to explain the effects of parental belief. Results obtained from PSM show weaker effects of parental belief, suggesting that part of the effects is explained by shared factors which are responsible for the belief and adolescent substance use. Adolescent concealment is proposed as an important unobserved confounder that influences the association between parental belief and adolescent substance use. The study suggests that research on parent-adolescent communication affected by the self-fulfilling prophecy needs to consider adolescents' intentional concealment, which may help avoid conflicts elicited by discussing topics that adolescents feel uncomfortable confiding in.

Parental Identification and Response to Adolescent Substance Use and Substance Use Disorders

Previous research showing that parents tend to underestimate adolescent substance use is consistent with concerns that adolescent substance use may develop because parents delay in reacting to it. However, little research has examined parental decisions regarding how and when to intervene on adolescent substance use. This study examines the actions that parents report they would take after a) discovering substance use to intoxication and b) when they believe their child has a substance use problem. Internet surveys were conducted asking parents (N = 975) how they would respond to a) evidence of their child's use to intoxication and b) their child's significant problem with either alcohol, cannabis, prescription opioids, or illicit drugs. While parental response to alcohol and cannabis intoxication focused on talking with their children (34% and 45% respectively) and punishment (30% and 18% respectively), parents were significantly more likely to report help-seeking behaviors when responding to prescription opioid or illicit drug use intoxication (37% and 30% respectively). More effective public health initiatives are needed to provide parents with practical strategies to address adolescent substance use and to increase parental engagement in the services offered by addiction specialists.

Biomedical ethics and clinical oversight in multisite observational neuroimaging studies with children and adolescents: The ABCD experience

Observational neuroimaging studies with children and adolescents may identify neurological anomalies and other clinically relevant findings. Planning for the management of this information involves ethical considerations that may influence informed consent, confidentiality, and communication with participants about assessment results. Biomedical ethics principles include respect for autonomy, beneficence, non-maleficence, and justice. Each project presents unique challenges. The Adolescent Brain and Cognitive Development study (ABCD) collaborators have systematically developed recommendations with written guidelines for identifying and responding to potential risks that adhere to biomedical ethics principles. To illustrate, we will review the ABCD approach to three areas: (1) hazardous substance use; (2) neurological anomalies; and (3) imminent potential for self-harm or harm to others. Each ABCD site is responsible for implementing procedures consistent with these guidelines in accordance with their Institutional Review Board approved protocols, state regulations, and local resources. To assure that each site has related plans and resources in place, site emergency procedures manuals have been developed, documented and reviewed for adherence to ABCD guidelines. This article will describe the principles and process used to develop these ABCD bioethics and medical oversight guidelines, the concerns and options considered, and the resulting approaches advised to sites.