[Alcoholic father, adolescent drug abuse and protective factors]

Famille et traitement de la toxicomanie chez les adolescents : étude de cas

L’importance d’impliquer la famille dans le traitement de réadaptation en toxicomanie chez les adolescents fait consensus, mais la nature de son influence demeure peu documentée. Objectifs. Le but de cette étude de cas est de mieux comprendre la contribution de l’implication familiale dans ce processus de réadaptation. Méthode. Des entrevues individuelles semi-structurées ont été menées auprès de deux jeunes en traitement de la toxicomanie, leurs parents et les cliniciens les ayant suivis. Des données quantitatives complémentaires pré et post-traitement sur la gravité des problèmes familiaux et de consommation auprès de deux jeunes ont été recueillies. Résultats. Les récits de ces différents acteurs soulignent les bienfaits d’une implication parentale constante à travers les différentes étapes du traitement.

Preventing disruptive boys from becoming heavy substance users during adolescence: a longitudinal study of familial and peer-related protective factors

Childhood disruptiveness is one of the most important antecedents of heavy substance use in adolescence, especially among boys. The first aim of the present study is to verify whether parental monitoring and friend conventionality protect disruptive boys from engaging in heavy substance-use in adolescence. The second purpose is to examine whether these protective effects are strengthened by attachment to parents or friends respectively. Finally, the third objective is to verify whether the expected protective effect of parental monitoring could be mediated through exposure to conventional friends. A sample of 1037 boys from low socioeconomic neighbourhoods was followed from childhood (age 6) to adolescence (age 15). Parent, teacher, and self-reported measures were used to measure disruptiveness, parental monitoring, family attachment, friend conventionality, and attachment to friends. Results suggest that parental monitoring and friends' conventionality mitigated the relationship between childhood disruptiveness and adolescence heavy substance use. Exposure to conventional friends further mediated the protective effect of parent monitoring. The postulated enhancement of attachment quality on the protective effect of parents or peer behaviors was not confirmed, but low attachment was related to heavier substance use in highly monitored disruptive boys. Parental monitoring, family attachment, and peer conventionality are factors amenable to intervention, and thus represent promising targets for future prevention strategies aimed at-risk boys. Our results underscore the importance of simultaneously addressing the behavioral and the affective dimensions in interventions with parents.

[Links between stress factors, mental health and initial consumption of tobacco and alcohol during pre-adolescence]

BACKGROUND

We know the effects of stress hassles and life events on mental health at pre-adolescence and the impact of the first experiences with alcoholic beverages and tobacco, where the precocity of the initiation tends to encourage abuse and later dependence on these substances. The goal of this study was to look into the related effect of environmental factors (daily hassles, life events, and social support) on perceived mental health and on the initiation and consumption of tobacco and alcohol by preadolescents.

METHODS

POPULATION

The study was carried out in 12 institutions in a French department ("Indre-et-Loire") in the "Région Centre", including students from the last year of primary school (fifth grade) and the first two years of middle school (sixth and seventh grades): all nine elementary schools in Joué-lès-Tours, the second largest city of the department, and three middle schools in Tours and surrounding areas (urban, semi-rural and inner city). The sample was made up of 476 preadolescents attending school, 234 girls (49%) and 242 boys (51%), 267 primary school and 209 middle school students, with an average age of 11 years and 7 months.

MATERIAL

Standardized questionnaires, specific to this population: with a scale of daily hassles, life events, mental health, and social support, were used. They proved to be adapted to each of them (Cronbach alpha coefficient>0.70) and the types of hassles and life events corresponded to the psycho developmental knowledge specific of this period. For the middle school students, dependence on tobacco was defined according to the "Hooked on nicotine checklist".

PROCEDURE

In April 2004 in class (anonymity guaranteed).

RESULTS

The results show that the hassles (considered in terms of occurrence or intensity, that is, the perceived stress) and life events (occurrence and negative perception) have a negative effect on mental health. In particular, pressure due to family problems has the greatest influence on mental health. For primary school students, this is followed by problems linked to self-perception; for middle school students, those linked to school. The consequences of hassles and life events on mental health allowed us to verify the solidity of the model used in previous studies [the Lausanne pediatric psychiatry team ], even with a younger preadolescent population. The effect of daily hassles is greater than that of life events, but they are not independent of one another (mediational model). Social support plays a modulating and protective role in mental health and the effects of daily hassles and life events. The prevalence of preadolescent smokers (simple experimentation or more or less regular use) is 5.7% (n=26). The prevalence of alcohol use is greater, encompassing more than one-third of subjects (33.4%; n=153). The influence of daily hassles can be seen both on the age of initiation to alcoholic beverages and to use of alcohol and intoxications. It is also observed on the age of initiation to tobacco and nicotine dependence (only taken into account for middle school students). That is to say that they promote precocity in the consumption of these products and increase their use. The absence of links with tobacco consumption may be due to the low number of preadolescent tobacco users. Life events also show an effect on tobacco and alcohol consumption, but it is lesser and should be moderated. Mental health is also correlated (but weakly) to the use of alcoholic beverages and intoxications. This applies more specifically to middle school students. Finally, the role of social support cannot be distinguished.

CONCLUSIONS

This study shows the degree that daily hassles impact mental health and the recourse to psychoactive substances during preadolescence. Precocious use of tobacco and alcohol, the abuse of these substances and occasionally the beginning of dependence should be considered, at the very least, as warning signs for states of tension on individual, familial and environmental levels, or even as signs of established problems which could be revealed through a thorough clinical.

Alcohol use in adolescents whose fathers abuse drugs

This study examined the interrelation of several domains, including father attributes, father-child relations, peer influences, environmental factors, and youth personality, as they related to adolescent alcohol use. Several aspects of the father-child relationship were also examined as possible protective factors against adolescent drinking. Subjects consisted of 204 HIV-positive and HIV-negative drug-abusing fathers and their adolescent children between the ages of 12-20. Data were collected via individual structured interviews of both the fathers and the youth. Results indicated that several items from each domain were related to adolescent drinking, and that an affectionate father-child bond had a protective effect. Moreover, hierarchical regression analyses demonstrated that the youth's personality mediated between all other domains and adolescent alcohol use. There was also a direct effect of peer influences on adolescent drinking. Findings extend the literature on the specific mechanisms which link parental substance use with adolescent alcohol use in a high-risk population.