The role of psychosocial factors and biological sex on rural Thai adolescents' drinking intention and behaviours: A structural equation model

AIMS

To examine the contributions of psychosocial factors (attitude towards drinking, perceived drinking norms [PDNs], perceived behavioural control [PBC]), and biological sex on drinking intention and behaviours among rural Thai adolescents.

DESIGN

A cross-sectional study design.

METHODS

In 2022, stratified by sex and grade, we randomly selected 474 rural Thai adolescents (Mage  = 14.5 years; SD = 0.92; 50.6% male) from eight public district schools in Chiang Mai Province, Thailand, to complete a self-administered questionnaire. Structural equation modelling with the weighted least square mean and variance adjusted was used for data analysis.

RESULTS

All adolescents' psychosocial factors contributed significantly to the prediction of drinking intention, which subsequently influenced their drinking onset, current drinking and binge drinking pattern in the past 30 days. PDNs emerged as the strongest psychosocial predictor of drinking intention, followed by PBC. Rural adolescents' drinking intention significantly mediated the relationship between all psychosocial factors and drinking behaviours either fully or partially. The path coefficient between drinking attitude and drinking intention was significantly different between males and females.

CONCLUSION

Different from previous studies focus on adolescents' drinking attitude, rural Thai adolescents' PDNs play a significant role on their drinking intention and subsequently their drinking onset and patterns. This nuanced understanding supports a paradigm shift to target adolescents' perceived drinking norms as a means to delay their drinking onset and problematic drinking behaviours.

IMPACT

Higher levels of perceived drinking norms significantly led to the increase in drinking intention among adolescents. Minimizing adolescents' perceptions of favourable drinking norms and promoting their capacity to resist drinking, especially due to peer pressure, are recommended for nursing roles as essential components of health education campaigns and future efforts to prevent underage drinking.

PATIENT OR PUBLIC CONTRIBUTION

In this study, there was no public or patient involvement.

Progression through early drinking milestones in an adolescent treatment sample

AIMS

Research using nationally representative and community samples demonstrates a robust association between early onset of drinking and increased likelihood of numerous adverse outcomes. However, little is known about the subsequent drinking that occurs early in the drinking career. The present study dissects the transition from any alcohol use to treatment entry by taking a fine-grained approach to examining the attainment and progression of drinking events in a sample of adolescents in substance use treatment.

DESIGN/SETTING

Data were taken from the Drug Abuse Treatment Outcome Study for Adolescents (DATOS-A), a multi-site, community-based study of adolescents entering treatment.

PARTICIPANTS

Respondents included 3331 youth aged 12-18 years (mean = 15.75) admitted to treatment in 1993-95 (74% male, 52% white, 24% African American, 20% Hispanic).

MEASUREMENTS

Age of attainment was obtained for five drinking-related milestones, including first drink of alcohol, first time drunk, first monthly drinking, first drank five or more drinks/day on a weekly basis and first drank five or more drinks/day on a daily basis.

FINDINGS

Most milestones were attained at a very early age, and average progression through adjacent drinking events was relatively swift, Movement through early drinking milestones was accelerated in girls and white youth. Youth who reported their first drink at an early age (age 10 or younger) showed slower progression, suggesting the existence of distinct processes underlying early use and drinking transitions within an individual.

CONCLUSIONS

This study provides data relevant to understanding drinking progression/natural history in a large clinical sample, especially for differences by gender and ethnicity. The findings have implications for the identification of intermediate stages that might benefit from selected intervention programs.