Prevalence and predictors of substance use: a comparison between adolescents with and without learning disabilities

Consumo de alcohol

Se busca conocer cómo es el consumo de alcohol entre los adolescentes. Es un estudio descriptivo y transversal sobre una muestra de 1.128 sujetos. El análisis estadístico se realiza con el SPSS.20 para Windows. El 46% bebe alcohol los fines de semana, el 46.4% comenzó entre los 16 y 18 años, el 56.2% consume mezclas, el 79.97% lo hace en compañía y el 24.6% tuvo una o dos borracheras en el último mes. El consumo de alcohol es una conducta presente en un alto porcentaje de adolescentes con inicio muy temprano. Es necesario educar para la prevención.  

Alcohol, tobacco and cannabis use: Do students with mild-intellectual disability mimic students in the general population?

Education policies encourage inclusion of students with mild-intellectual disability (mild-ID) in community/school life. However, such policies potentially increase exposure to substance use. This article examines tobacco, alcohol and cannabis use among French students enrolled in special units for students with disabilities (ULIS) at mainstream junior high schools compared to those of general population of the equivalent age; and explores factors associated with substance use among ULIS students, known to present mostly mild-ID. In 2014, a questionnaire adapted from the international HBSC/WHO study was administered to 700 ULIS students (mean-age 14.2). Comparative data were gathered from 7023 junior high-school students (mean-age 13.6) in the general population. Among students <14 years-old, tobacco and alcohol use rates were similar between ULIS and general population. For students ≥14, alcohol use remained comparable, while tobacco and cannabis use were higher in general population. Among ULIS students, low perceived health/life satisfaction, divorced/separated parents and high perceived academic demands were associated with tobacco use. Bullying, not liking school very much and attending schools outside a deprived area were associated with alcohol use. Having had sexual intercourse and not perceiving one's health as excellent were associated with cannabis use. Having dated was associated with using all three substances.

Detecting initiation or risk for initiation of substance use before high school during pediatric well-child check-ups

BACKGROUND

Youth substance use (SU) is prevalent and costly, affecting mental and physical health. American Academy of Pediatrics and Affordable Care Act call for SU screening and prevention. The Youth Risk Index(©) (YRI) was tested as a screening tool for having initiated and propensity to initiate SU before high school (which forecasts SU disorder). YRI was hypothesized to have good to excellent psychometrics, feasibility and stakeholder acceptability for use during well-child check-ups.

DESIGN

A high-risk longitudinal design with two cross-sectional replication samples, ages 9-13 was used. Analyses included receiver operating characteristics and regression analyses.

PARTICIPANTS

A one-year longitudinal sample (N=640) was used for YRI derivation. Replication samples were a cross-sectional sample (N=345) and well-child check-up patients (N=105) for testing feasibility, validity and acceptability as a screening tool.

RESULTS

YRI has excellent test-retest reliability and good sensitivity and specificity for concurrent and one-year-later SU (odds ratios=7.44, CI=4.3-13.0) and conduct problems (odds ratios=7.33, CI=3.9-13.7). Results were replicated in both cross-sectional samples. Well-child patients, parents and pediatric staff rated YRI screening as important, acceptable, and a needed service.

CONCLUSIONS

Identifying at-risk youth prior to age 13 could reap years of opportunity to intervene before onset of SU disorder. Most results pertained to YRI's association with concurrent or recent past risky behaviors; further replication ought to specify its predictive validity, especially adolescent-onset risky behaviors. YRI well identifies youth at risk for SU and conduct problems prior to high school, is feasible and valid for screening during well-child check-ups, and is acceptable to stakeholders.

Self-reported adolescent health status of extremely low birth weight children born 1992-1995

OBJECTIVES

To compare the self-reported health of extremely low birth weight (ELBW, <1 kg) adolescents with that of normal birth weight (NBW) controls and the children's assessments of their general health at ages 8 versus 14 years.

METHODS

One hundred sixty-eight ELBW children and 115 NBW controls of similar gender and sociodemographic status completed the Child Health and Illness Profile-Adolescent Edition at age 14 years. It includes 6 domains: Satisfaction, Comfort, Resilience, Risk Avoidance, Achievement, and Disorders. At age 8 years, the children had completed the Child Health and Illness Profile-Child Edition. Results were compared between ELBW and NBW subjects adjusting for gender and sociodemographic status.

RESULTS

ELBW adolescents rated their health similar to that of NBW adolescents in the domains of Satisfaction, Comfort, Resilience, Achievement and Disorders but reported more Risk Avoidance (effect size [ES] 0.6, P < .001). In the subdomain of Resilience, they also noted less physical activity (ES -0.58, P < .001), and in the subdomain of Disorders, more long-term surgical (ES -0.49) and psychosocial disorders (ES -0.49; both P < .01). Both ELBW and NBW children reported a decrease in general health between ages 8 and 14 years, which did not differ significantly between groups.

CONCLUSIONS

ELBW adolescents report similar health and well-being compared with NBW controls but greater risk avoidance. Both ELBW and NBW children rate their general health to be poorer at age 14 than at age 8 years, possibly due to age-related developmental changes.

Differences in drinking expectancies and motives for regular education and special education high school students with emotional/behavioral disorders

Alcohol expectancies and drinking motives were compared for regular education students (n=159) and students with emotional/behavioral disorders (EBD) receiving special education services (n=51). Differences existed between groups with respect to expected negative social consequences and emotional and physical outcomes associated with drinking. Across groups, drinkers reported more positive alcohol expectancies than non-drinkers, while non-drinkers reported more negative alcohol expectancies than drinkers. Differences also existed between the regular education and EBD students who drank with respect to coping, conformity, and social motives. Accounting for sample sizes differences, the relationship between alcohol use and negative physical effect was stronger for regular education students, while the relationship between alcohol use and conformity motives was stronger for the EBD group.

Associations among sleep problems, learning difficulties and substance use in adolescence

This study investigated the relationships among sleep problems, learning difficulties and substance use in adolescence. Previous research suggests that these variables share an association with executive functioning deficits, and are intertwined. The sample comprised 427 adolescents (M age = 16 years) attending remedial schools and 276 adolescents (M age = 15 years) attending a mainstream school in Cape Town, South Africa. Participants completed anonymous self-report questionnaires. Results indicated that adolescents without learning difficulties were more likely to use tobacco, methamphetamine and cannabis, whereas those with learning difficulties engaged in more inhalant use. Adolescents who had more sleep problems were more likely to use tobacco, alcohol, methamphetamine, cannabis, inhalants, cocaine, ecstasy and any other illegal drug. Adolescents with learning difficulties had more sleep problems than those without learning difficulties. However, sleep problems remained independently associated with tobacco, cannabis and inhalant use when learning difficulties were taken into account.

Learning disabilities and risk-taking behavior in adolescents: a comparison of those with and without comorbid attention-deficit/hyperactivity disorder

Risk-taking behavior includes alcohol and drug use, delinquency, acts of aggression, sexual activity, and so on. Many studies have explored the relationship between adolescents and risk-taking behavior; however, only a few studies have examined this link in adolescents with learning disabilities (LD) or attention-deficit/hyperactivity disorder (ADHD). The purpose of the present study was to address that limitation by comparing the risk-taking behavior of adolescents with LD (n=230), with comorbid LD/ADHD (n=92), and without LD or ADHD (n=322) on their substance use, engagement in major and minor delinquency, acts of aggression, sexual activity, and gambling activities. The study also investigated whether psychosocial variables (e.g., well-being) may act as mediating variables that help explain between-group differences. Results suggest that it is a combination of the LD and the secondary psychosocial characteristics that explains why adolescents with LD and comorbid LD/ADHD more frequently engage in some risk-taking behavior.

Prevalence and influences on self-reported smoking among adolescents with mild learning disabilities, attention deficit hyperactivity disorder, and their typically developing peers

Many adolescents take up the smoking habit despite its well-documented adverse health effects. This study explores the prevalence and influences on smoking among 89 adolescents with mild learning disabilities, 108 with attention deficit hyperactivity disorder (ADHD), and 124 typically developing peers aged 12-16 years. All the participants were attending mainstream secondary schools and they were asked to complete a self-report questionnaire on smoking. It was found that adolescents with ADHD smoked more than adolescents with mild learning disabilities, who in turned smoked more than adolescents not diagnosed with any disability. More adolescents with ADHD reported that the majority of their friends smoked and they were less well informed about the health effects of smoking. No differences were identified between the three groups in terms of the smoking behaviour of their parents and the perceived attitudes of their parents and friends towards smoking. Findings are discussed and suggestions are made for further research.

Relationship of substance use by students with disabilities to long-term educational, employment, and social outcomes

The study is based on data from the National Education Longitudinal Study of 1988-2000 (NELS: 88). The results indicate that adolescents with disabilities who used either cigarettes or marijuana or who engaged in binge drinking had significantly higher dropout rates, lower high school graduation status, lower college attendance, and lower high school grade point averages, and fewer earned core credit units in English, science, and mathematics than nonusers. In addition, adolescents with disabilities who used either cigarettes, alcohol, or drugs were significantly more likely to engage in sexual activity at a younger age. The findings support the need for improved substance use prevention programming targeting the needs of youth with disabilities.

Risk and resilience for substance abuse among adolescents and adults with LD

Substance abuse is a major problem affecting the health and well-being of many people in our society. Although anecdotal evidence concerning linkages between learning disabilities (LD) and substance abuse has been common, this association is not well documented or understood. This article reviews the current research on substance abuse for adolescents and adults with LD, interpreting findings within a risk and resilience framework. Integrating these studies with the broader literatures on substance abuse and the needs of individuals with LD, the author develops hypotheses regarding specific risk and protective factors that could affect the occurrence of substance abuse for adolescents and adults with LD. Potential risk factors include a poor understanding of one's disability, a lack of skills for developing peer relationships, and the need for prolonged family support. Future directions for research in relation to prevention of and intervention regarding substance abuse among individuals with LD are discussed.

Substance use disorders in young adults with and without LD: predictive and concurrent relationships

This article reports on young people with and without learning disabilities (LD) and substance use disorders (SUD). Participants were assessed for LD at ages 12 and 19 and for SUD and psychiatric disorders at age 19. Participants with LD at ages 12 and 19 were more likely to develop an SUD or a psychiatric disorder compared to participants without consistent LD. Participants with LD at age 19 were more likely to have a concurrent SUD or psychiatric disorder compared to those without LD at age 19, while participants with LD at age 12 showed only a trend toward increased rates of SUD at age 19 when compared to participants without LD at age 12. Participants with and without LD did not differ in substance use, consumption levels, or onset history. In a multivariate model, adolescent LD was associated with a three-fold increased risk for SUD after behavioral problems and family structure had entered the model. Although these results provide some support for the notion that adolescents with LD are at increased risk for SUD, LD also appears to confer a general risk for adverse outcomes.

Health-risk behaviors and protective factors among adolescents with mobility impairments and learning and emotional disabilities

PURPOSE

To identify the risk involvement of three groups of young people with disabilities relative to a comparison group: mobility impairments, learning disabilities, and emotional disabilities. Protective factors are explored to identify which individual, family, and school factors are associated with diminished risk.

METHODS

Analyses are based on the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of 20,780 seventh- through 12(th)-grade youth in the United States. Five negative health outcomes were studied: suicide attempts, sexual abuse, regular cigarette smoker, alcohol use, and marijuana use. For bivariate analyses Student's t-test and Chi-square were used, and logistic regressions were performed on all dichotomized dependent variables.

RESULTS

For most risk behaviors studied, youth with disabilities were more involved than peers. Factors that predisposed to risk varied little between those with and without disabilities. Likewise, there was substantial consistency between groups as to protective factors. What distinguished each group of young people with disabilities from peers is that they reported significantly more exposure to risk factors and significantly fewer protective factors.

A review of methods and instruments for assessing externalizing disorders: theoretical and practical considerations in rendering a diagnosis

This review addresses the most current and widely used methods of assessing childhood and adolescent externalizing disorders. Interviews, rating scales, and self-report instruments are described, and their strengths and weaknesses are discussed. Direct observational techniques in naturalistic and analogue settings are also reviewed. Throughout the article, commentary is offered regarding the psychometric adequacy and clinical validity of these instruments. It is suggested that, although the instruments presently used to assist in diagnosing externalizing disorders generally possess adequate reliability and representational validity, evidence of elaborative validity is lacking. Clinicians and researchers are encouraged to adopt a broader conceptualization of the diagnostic process, to question existing standards for establishing validity, and to consider alternative means of demonstrating diagnostic utility.

Longitudinal research in learning disabilities: report on an international symposium

In June of 1995 an international symposium on longitudinal research in learning disabilities (LD) was held in Missillac, France. The purpose of the symposium was to bring together an international panel of experts in this area to promote international dialogue on longitudinal research in LD, define and develop guidelines for conducting such research, identify problems inherent in this type of research and methods to alleviate them, and establish research priorities. This article synthesizes and highlights the information that emerged from individual presentations and ensuing discussions. Generic considerations regarding longitudinal research are presented; however, particular emphasis is given to the confluence of longitudinal research and learning disabilities.

Alcohol and drug use among young persons with traumatic brain injury

The pre- and postinjury patterns of alcohol and illicit drug use of 87 persons with traumatic brain injury ages 16 to 20 were examined. Follow-up data were collected at two time intervals averaging 8 and 28 months postinjury. A comparison with large-sample studies revealed that patients had preinjury drinking patterns similar to those in the general population. A review of data provided evidence of a decline in alcohol use at initial follow-up; however, preinjury and second follow-up alcohol use patterns were similar. Analyses suggested that drinking quantity and frequency increased over time, perhaps eventually returning to postinjury levels. A review of the literature and the findings of the present investigation indicate that men and persons with a history of preinjury heavy drinking are at greatest risk for long-term alcohol abuse postinjury. Postinjury illicit drug use rates remained relatively low, falling below 10% at both follow-up intervals. Among persons taking prescribed medications, 17% reported moderate or heavy drinking at second follow-up.

Risk factors for substance use by Mexican American youth with and without learning disabilities

This survey study was designed to (a) investigate the prevalence of minor and major substance use among low socioeconomic status elementary and middle school Mexican American students identified with learning disabilities (LD; n = 150) and without LD (n = 150), and (b) identify psychosocial and environmental risk factors that may lead to the use of various substances among both non-learning disabled (non-LD) students and students with LD in an all-Mexican American sample. No differences were found in the use of substances between the two groups. Risk factors that were found to influence the use of minor substances for students identified as learning disabled, as opposed to the non-LD students, included use of substances by close friends and susceptibility to peer influence. Risk factors that were found to affect the use of major substances for students identified as learning disabled, as opposed to the non-LD students, included the number of minor substances used and stressful life events. Findings are discussed in the context of differing pathways leading to the use of substances for non-LD students and students with LD within an intraethnic group study.