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CORK Bibliography: Protective Factors

50 citations. January 2011 to present

Prepared: March 2012

Abadi MH; Shamblen SR; Thompson K; Collins DA; Johnson K. Influence of risk and protective factors on substance use outcomes across developmental periods: A comparison of youth and young adults. Substance Use & Misuse 46(13): 1604-1612, 2011. (47 refs.)

Data were collected from samples of youth (ages 11-18; N = 38,268) and young 10 adults (ages 18-24; N = 602) across 30 Tennessee counties using surveys and telephone interviews conducted in 2006-2008. Data were analyzed using hierarchical nonlinear modeling to determine: (1) which risk and protective factors predicted alcohol and marijuana use, and (2) whether predictors differed as a function of developmental period. Findings provide preliminary evidence that prevention efforts need to take into consideration the changing environment and related influences as youth age, especially as they move from a more protected community environment to one where they live somewhat independently. Implications and limitations are discussed.

Ahmed SH. Toward an evolutionary basis for resilience to drug addiction. (editorial). Behavioral and Brain Sciences 34(6): 310-311, 2011. (0 refs.)

According to Muller & Schumann (M&S), people would have evolved adaptations for learning to use psychoactive plants and drugs as instruments that reveal particularly advantageous in modern urban environments. Here I "instrumentalize" this framework to propose an evolutionary basis for the existence of a biological resilience to drug addiction in people.

Amodeo M; Griffin M; Paris R. Women's reports of negative, neutral, and positive effects of growing up with alcoholic parents. Families in Society 92(1): 69-76, 2011. (55 refs.)

Parental alcoholism does not necessarily result in negative outcomes for the offspring; we examined whether it would result in negative perceptions of the experience. Black women and White women with alcoholic parents (N = 126) rated and described the effect of parental alcoholism on them: 65% reported a negative effect, 26% reported a positive effect, and 7% reported a neutral effect. We examined these ratings in relation to the women's overall adult adjustment. More positive ratings were associated with being Black and with variables such as social support, experiencing lower family conflict, and having no alcohol problem oneself. Human service providers need greater access to research findings to see that children from these families will be diverse in their psychological and social functioning.

Baldwin JA; Brown BG; Wayment HA; Nez RA; Brelsford KM. Culture and context: Buffering the relationship between stressful life events and risky behaviors in American Indian youth. Substance Use & Misuse 46(11): 1380-1394, 2011. (78 refs.)

The Sacred Mountain Youth Project was conducted to investigate risk and protective factors related to alcohol and drug use among American Indian youth. Findings indicated that stressful life events were positively associated with depressed mood, substance use, and risky behavior; cultural identity had no direct effects, but a secondary model showed that social support and protective family and peer influences were related to cultural identity. These findings suggest that the relationships between stressors and their negative sequelae are complex. Emphasis on protective processes that are culturally specific to American Indian youth may lead to effective alcohol and drug use prevention programs.

Baler RD; Volkow ND. Addiction as a systems failure: Focus on adolescence and smoking. (review). Journal of the American Academy of Child and Adolescent Psychiatry 50(4): 329-339, 2011. (115 refs.)

Objective: Scientific advances in the field of addiction have forever debunked the notion that addiction reflects a character flaw under voluntary control, demonstrating instead that it is a bona fide disease of the brain. The aim of this review is to go beyond this consensus understanding and explore the most current evidence regarding the vast number of genetic, developmental, and environmental factors whose complex interactions modulate addiction risk and trajectory. Method: Focusing on childhood and adolescent smoking as a paradigm, we review the important risk factors for the development of addictions, starting at the level of genetics and closing with a focus on sociocultural and policy factors. Results: A critical review of the pertinent literature provides a detailed view of the cumulative power of risk and protection factors across different phenomenological levels to modulate the risk of undesirable outcomes, particularly for young people. The result represents a compelling argument for the need to engage in comprehensive, multilevel approaches to promoting health. Conclusions: Today, the field of medicine understands more about disease than about health; however it need not be that way. The view of drug addiction as a systems failure should help refocus our general approach to developing dynamic models and early comprehensive interventions that optimize the ways in which we prevent and treat a complex, developmental disorder such as drug addiction.

Becerra D; Castillo J. Culturally protective parenting practices against substance use among adolescents in Mexico. Journal of Substance Use 16(2): 136-149, 2011. (59 refs.)

The results of this study indicated that parental support and parental monitoring were significant predictors of lower lifetime and recent substance use for males and females. Parental support significantly predicted lower lifetime and recent cigarette use among males and lower recent marijuana use among females. Parental monitoring, however, was a stronger predictor of lower recent alcohol, cigarette and marijuana use among adolescent females in the study. Because substance use in Mexico tends to be higher in cities that border the United States, understanding protective factors against adolescent substance use is important in the development of culturally appropriate substance abuse prevention programmes in Mexico. Implications for research and practice are discussed.

Brassai L; Piko BF; Steger MF. Meaning in life: Is it a protective factor for adolescents' psychological health? International Journal of Behavioral Medicine 18(1): 44- 51, 2011. (43 refs.)

Background: Searching for a coherent meaning in life has long been proposed to be a protective factor in adolescent development. Purpose: The present study aimed to examine meaning in life as a protective factor in a largely unstudied population: Romanian adolescents. Additionally, we sought to provide a novel, multidimensional assessment of several health-related variables (substance abuse, health risk behaviors, psychological health). Potential gender differences were explored regarding the role of life meaning in adolescent health. Method Data were collected in 2006 from students enrolled in the secondary schools of the Middle Transylvanian Region, Romania (n=1,977). Self-administered questionnaires were used as a method of data collection including items of life meaning and psychological health. Results: Meaning in life played a protective role with regard to health risk behaviors except smoking and binge drinking. Among males, meaning in life was found to be correlated only to illicit drug and sedative use, whereas among females, meaning in life was associated with binge drinking, unsafe sex, and lack of exercise and diet control. Psychological health was strongly related to meaning in life. Conclusion: In Romanian adolescents, meaning in life is a protective factor against health risk behaviors and poor psychological health.

Brook JS; Lee JY; Finch SJ; Koppel J; Brook DW. Psychosocial factors related to cannabis use disorders. Substance Abuse 32(4): 242-251, 2011. (24 refs.)

The objective of this study was to explore the association between psychosocial risk and protective factors and cannabis use disorders (CUDs) in a cohort of African American and Puerto Rican young adults. A representative sample (N = 838) from the East Harlem area of New York City was assessed at 4 points in time (at mean ages 14.1, 19.2, 24.5, and 29.2). The psychosocial measures came from 6 domains: personality attributes, family, peer, work, neighborhood, and substance use. The psychosocial measures were assessed at each of the first 3 waves of the study, and CUDs were assessed at the fourth and final wave of the study. Multivariate logistic regression and a cumulative risk analysis were conducted. Increased psychological symptoms (odds ratio [OR] = 1.21; 95% confidence interval [CI], 1.05-1.39; P < .01), problems resulting from cannabis use (OR = 2.69; 95% CI, 1.33-5.46; P < .01), frequent arguments with one's partner (OR = 1.84; 95% CI, 1.09-3.10; P < .05), high levels of deviance (OR = 1.81; 95% CI, 1.21-2.71; P < .01), and frequent acts of violence directed toward the participant (OR = 1.19; 95% CI, 1.01-1.42; P < .05) were all associated with an increased risk for CUDs. An increase in the number of risks was associated with an increase in the probability of having CUDs at the fourth wave (again, at a mean age of 29.2). A decrease in the number of risk factors may lead to a decrease in CUDs.

Burris JL; Sauer SE; Carlson CR. A test of religious commitment and spiritual transcendence as independent predictors of underage alcohol use and alcohol-related problems. Psychology of Religion and Spirituality 3(3): 231-240, 2011. (58 refs.)

Religiousness exerts a protective effect against underage alcohol use, but it is largely unknown whether its protective quality extends equally to alcohol-related problems. It is also unclear to what extent spirituality, which is related to religiousness, exerts a similar protective effect. The current study examined whether facets of religiousness and spirituality-religious commitment and spiritual transcendence-were differentially related to alcohol use and alcohol-related problems among an underage sample of young adults. Despite being underage, most participants (n = 344; 61% female) reported having an alcoholic drink at least once a month and having at least two to three drinks per occasion. Results of hierarchical linear regression analyses that controlled for demographics, positive alcohol expectancies, and impulsivity found unique associations between religious commitment and spiritual transcendence and alcohol use. Specifically, religious commitment operated as a protective factor, while spiritual transcendence operated as a risk factor for alcohol use. Neither religious commitment nor spiritual transcendence predicted alcohol-related problems. Results of this study inform future research by highlighting the importance of studying religiousness and spirituality as unique constructs with the potential for differential predictive utility.

Carlo G; Crockett LJ; Wilkinson JL; Beal SJ. The longitudinal relationships between rural adolescents' prosocial behaviors and young adult substance use. Journal of Youth and Adolescence 40(9): 1192-1202, 2011. (58 refs.)

While many adolescents and young adults experiment with substances (e.g., alcohol, cigarette smoking, marijuana), recent research suggests that rural youth and young adults may be more at risk for substance use than their urban counterparts. This study was designed to examine the longitudinal relationships between rural adolescents' prosocial behaviors and substance use in young adulthood. Furthermore, we examined the potential mediating effects of adolescent substance use, academic investment, and delinquency. Rural youth (N = 531; 263 girls) were surveyed in grades 10-12 (Time 1; M age = 16.17; SD = .91) and again in early adulthood (Time 2). Measures of prosocial behaviors, substance use, academic investment, and deviant activities were assessed at Time 1. At Time 2, measures of marijuana use, cigarette smoking, and getting drunk were administered. Overall, the findings showed that rural adolescents who frequently exhibit prosocial behaviors are less likely to engage in substance use in young adulthood than those who exhibit relatively low levels of prosocial behaviors. These findings indicate that prosocial behaviors may have positive health consequences, establishing behavioral trajectories that lead to lower levels of risky health behaviors in adulthood in rural populations.

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Administration. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-41. Rockville MD: Substance Abuse and Mental Health Administration, 2011. (57 refs.)

This report presents the first information from the 2010 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco. In respect to illicit drug use, in 2010, an estimated 22.6 million Americans aged 12 or older were current (past month) illicit drug users. This estimate represents 8.9 percent of the population aged 12 or older. The rise in drug use is largely the result of the increasing use of marijuana. Following an introduction, the first chapters deal with illicit drugs, alcohol use, tobacco use, providing information on use patterns by demographics. The next three chapters examine the initiation of substance use, measures related to prevention (risk and protective factors), and substance dependence and abuse and their treatment. The concluding chapter deals with trends in substance use among adolescents and young adults. Data is summarized in 56 figures and 9 tables.

Public Domain

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Administration. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-41. Rockville MD: Substance Abuse and Mental Health Administration, 2011. (57 refs.)

Public Domain

Cheng TC; Lo CC. A longitudinal analysis of some risk and protective factors in marijuana use by adolescents receiving child welfare services. Children and Youth Services Review 33(9): 1667-1672, 2011. (32 refs.)

The present study sought to identify risk and protective factors in marijuana use by adolescents involved in child welfare services. Longitudinal records of 1797 adolescents were extracted from the National Survey of Child and Adolescent Well-Being data set. The obtained multivariate results from generalized estimating equations showed that an adolescent's likelihood of being a current marijuana user rose with prior lifetime use of the drug and was also associated with out-of-home child welfare services, perceived parental monitoring, perceived closeness to parent, engagement with school environment, and age. Implications for child welfare services are discussed.

Danielsson AK; Romelsjo A; Tengstrom A. Heavy episodic drinking in early adolescence: Gender-specific risk and protective factors. Substance Use & Misuse 46(5): 633-643, 2011. (54 refs.)

This longitudinal study examined possible gender differences regarding risk and protective factors for heavy episodic drinking among 1,222 seventh-grade students (aged 13) in the City of Stockholm, Sweden, with follow-up 2 years later. Logistic regression analyses showed that several factors predicted heavy episodic drinking. The strongest predictors for boys' heavy episodic drinking in the ninth grade were heavy episodic drinking (odds ratio [OR] = 5.30) and smoking in the seventh grade (OR = 5.80). Drinking peers (OR = 2.47) and smoking (OR = 2.44) in the seventh grade showed the strongest association for girls. Furthermore, high parental monitoring and having a secure attachment to parents may have a protective effect when risk factors are present. Our results lend support to prevention initiatives to strengthen the parent-child relation and focus on adolescents' ability to resist peer pressure and of limiting parental provision of alcohol. The study's limitations are noted.

Donovan E; Wood M; Frayjo K; Black RA; Surette DA. A randomized, controlled trial to test the efficacy of an online, parent-based intervention for reducing the risks associated with college-student alcohol use. Addictive Behaviors 37(1): 25-35, 2012. (37 refs.)

Alcohol consumption among college students remains a major public health concern. Universal, Web-based interventions to reduce risks associated with student alcohol consumption have been found to be effective in changing their alcohol-related behavior. Recent studies also indicate that parent-based interventions, delivered in booklet form, are effective. A parent-based intervention that is also Web-based may be well suited to a dispersed parent population; however, no such tool is currently available. The purpose of this study was to test the efficacy of an online parent-based intervention designed to (1) increase communication between parents and students about alcohol and (2) reduce risks associated with alcohol use to students. A total of 558 participants, comprising 279 parent-teen dyads, were enrolled in the study. The findings suggested that parents who participated in the online intervention were more likely to discuss protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, with their teens, as compared with parents in an e-newsletter control group. Moreover, students whose parents received the intervention were more likely to use a range of protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, as compared with students whose parents did not receive the intervention. A universal, online, parent-based intervention to reduce risks associated with student alcohol consumption may be an efficient and effective component of a college's overall prevention strategy.

Eliason MJ; Burke A; van Olphen J; Howell R. Complex interactions of sexual identity, sex/gender, and religious/spiritual identity on substance use among college students. Sexuality Research and Social Policy 8(2): 117- 125, 2011. (32 refs.)

Alcohol, tobacco, and other drug use pose serious health problems on college campuses. A significant body of research shows student religiosity to be a protective factor, but a very little research has examined influences of sexual identities on alcohol and other drug use among college students, and its associations with religious or spiritual identity. This study examined the relationships of sex/gender, sexual identity, and religious/spiritual identity on current alcohol use, drug use, and smoking via an online survey of 2,204 college students. We found a three-way interaction between sex/gender, sexual identity, and religious/spiritual identity, with religion showing protective value for nonheterosexual women, but not nonheterosexual men, related to alcohol use. Nonheterosexual students also showed different patterns of risk and protective factors. A subset of the sample that indicated that they did not use sexual identity labels showed very high rates of alcohol, tobacco, and drug use, often exceeding the lesbian, gay, and bisexual group on these measures. These findings provide new information on nonheterosexual student drug and alcohol use and indicate the need for additional research in this area of study.

Guo H; Reeder AI; McGee R; Darling H. Adolescents' leisure activities, parental monitoring and cigarette smoking: A cross-sectional study. Substance Abuse Treatment, Prevention and Policy 6(e-article 12), 2011. (30 refs.)

Background: Adolescent participation in leisure activities is developmentally beneficial, but certain activities may increase health compromising behaviours, such as tobacco smoking. A limited range of leisure activities has been studied, with little research on out-of-school settings where parental supervision is a potential protective factor. Tobacco smoking is an important, potentially modifiable health determinant, so understanding associations between adolescent leisure activities, parental monitoring, demographic factors and daily smoking may inform preventive strategies. These associations are reported for a New Zealand adolescent sample. Methods: Randomly selected schools (n = 145) participated in the 2006 Youth In-depth Survey, a national, biennial study of Year 10 students (predominantly 14-15 years). School classes were randomly selected and students completed a self-report questionnaire in class time. Adjustment for clustering at the school level was included in all analyses. Since parental monitoring and demographic variables potentially confound relations between adolescent leisure activities and smoking, variables were screened before multivariable modelling. Given prior indications of demographic differences, gender and ethnic specific regression models were built. Results. and Discussion: Overall, 8.5% of the 3,161 students were daily smokers, including more females (10.5%) than males (6.5%). In gender and ethnic specific multivariate analysis of associations with daily smoking (adjusted for age, school socioeconomic decile rating, leisure activities and ethnicity or gender, respectively), parental monitoring exhibited a consistently protective, dose response effect, although less strongly among Maori. Attending a place of worship and going to the movies were protective for non-Maori, as was watching sports, whereas playing team sport was protective for all, except males. Attending a skate park was a risk factor for females and Maori which demonstrated a strong dose response effect. Conclusions: There were significant differences in the risk of daily smoking across leisure activities by gender and ethnicity. This reinforces the need to be alert for, and respond to, gender and ethnic differences in the pattern of risk and protective factors. However, given the consistently protective, dose response effect of parental monitoring, our findings confirm that assisting oversight of adolescent leisure activities may be a key component in public health policy and prevention programmes.

Havnen KS; Breivik K; Stormark KM; Jakobsen R. Why do children placed out-of-home because of parental substance abuse have less mental health problems than children placed for other reasons? Children and Youth Services Review 33(10): 2010-2017, 2011. (51 refs.)

The purpose of this paper was to compare children placed out-of-home because of parental substance abuse (PSA) with children placed for other reasons (NPSA), and to explore the association between PSA and mental health problems in a Norwegian sample of 6- to 12-year-old children in out-of-home care (N=109). Several group differences were found related to the children themselves, their families and the Child Welfare case. The PSA children had less total difficulties, conduct problems and emotional problems than the NPSA children assessed by the teachers on the Revised Rutter Scale. However, both groups had far more mental health problems than children in general. The most important variable explaining the group difference in all subgroups of mental health problems was the extent of prosocial behavior in the children, but being placed for behavioral problems also explained a significant part of total difficulties and conduct problems. Variables like gender, discipline problems and socioeconomic conditions did not have a significant effect. The conclusion of the study was that prosocial behavior might be regarded as an important protective factor against mental health problems, which is an argument for investing in programs focusing on enhancing the placed children's mastering strategies.

Hayer T; Meyer G. Self-exclusion as a harm minimization strategy: Evidence for the casino sector from selected European countries. Journal of Gambling Studies 27(4): 685-700, 2011. (28 refs.)

As the international gambling market continues to expand, determining effective approaches to prevent gambling-related problems becomes increasingly important. Despite a lack of in-depth research into its benefits, self-exclusion is one such measure already in use around the world in various sectors of the gambling industry. The present study is the first of its kind to examine the effectiveness of self-exclusion schemes in the casino sector in selected European countries. A written survey yielded a sample of N = 152 (self)-excluded gamblers. In addition to this cross-section analysis, a small sub-group (n = 31) was monitored over time by means of follow-up surveys carried out 1, 6, and 12 month(s) after the exclusion agreement came into force. The results reveal that the self-excluded individuals are typically under a great deal of strain and show a relatively pronounced willingness to change. However, this largely reaches its peak at the time the decision to self-exclude is made. From a longitudinal perspective, various parameters indicate a clear improvement in psychosocial functioning; a favorable effect that also starts directly after the exclusion agreement was signed. Finally, considering theoretical and empirical findings, possibilities for optimizing (self-)exclusion schemes will be discussed.

Hemphill SA; Heerde JA; Herrenkohl TI; Patton GC; Toumbourou JW; Catalano RF. Risk and protective factors for adolescent substance use in Washington State, the United States and Victoria, Australia: A longitudinal study. Journal of Adolescent Health 49(3): 312-320, 2011. (40 refs.)

Purpose: To compare the levels of risk and protective factors and the predictive influence of these factors on alcohol, tobacco, and cannabis use over a 12-month follow-up period in Washington State in the United States and in Victoria, Australia. Method: The study involved a longitudinal school-based survey of students drawn as a two-stage cluster sample recruited through schools, and administered in the years 2002 and 2003 in both states. The study used statewide representative samples of students in the seventh and ninth grades (n = 3,876) in Washington State and Victoria. Results: Washington State students, relative to Victorian students, had higher rates of cannabis use but lower rates of alcohol and tobacco use at time 1. Levels of risk and protective factors showed few but important differences that contribute to the explanation of differences in substance use; Washington State students, relative to Victorian students, reported higher religiosity (odds ratio, .96 vs. .79) and availability of handguns (odds ratio, 1.23 vs. 1.18), but less favorable peer, community, and parental attitudes to substance use. The associations with substance use at follow-up are generally comparable, but in many instances were weaker in Washington State. Conclusions: Levels of risk and protective factors and their associations with substance use at follow-up were mostly similar in the two states. Further high-quality longitudinal studies to establish invariance in the relations between risk and protective factors and substance use in adolescence across diverse countries are warranted.

Hill EM; Maggi S. Emotional intelligence and smoking: Protective and risk factors among Canadian young adults. Personality and Individual Differences 51(1): 45- 50, 2011. (43 refs.)

A sample of 20 and 21 year old participants (n = 2699) of the Canadian National Longitudinal Survey of Children and Youth (NLSCY) was used to investigate the association between emotional intelligence and smoking in young adulthood. Emotional intelligence was measured with a short-form of the original EQ-i (Statistics Canada, 2008), which assessed overall emotional intelligence and five dimensions: interpersonal competencies, intrapersonal competencies, stress management competencies, adaptability competencies and general mood. Using self-reported smoking behaviors, participants were classified as daily, occasional or non-smokers. Multinomial logistic regression analyses were conducted to test the association between emotional intelligence (and its dimensions) with daily and occasional smoking (compared to non-smoking - the reference category). Analyses were conducted on the total sample and were also stratified across gender. Stress management emerged as a protective factor against occasional and daily smoking among both males and females. Unexpectedly, a higher score on interpersonal competencies was associated with occasional smoking (compared to non-smoking) among males, suggesting that this group may consist of several social smokers. Our results suggest that emotional intelligence may comprise gender-specific protective and risk factors for occasional and daily smoking, which in turn should be considered in the development of smoking prevention programs.

Hodder RK; Daly J; Freund M; Bowman J; Hazell T; Wiggers J. A school-based resilience intervention to decrease tobacco, alcohol and marijuana use in high school students. BMC Public Health 11: 722, 2011. (77 refs.)

Background: Despite schools theoretically being an ideal setting for accessing adolescents and preventing initiation of substance use, there is limited evidence of effective interventions in this setting. Resilience theory provides one approach to achieving such an outcome through improving adolescent mental well-being and resilience. A study was undertaken to examine the potential effectiveness of such an intervention approach in improving adolescent resilience and protective factor scores; and reducing the prevalence of adolescent tobacco, alcohol and marijuana use in three high schools. Methods: A non-controlled before and after study was undertaken. Data regarding student resilience and protective factors, and measures of tobacco, alcohol and marijuana use were collected from grade 7 to 10 students at baseline (n = 1449) and one year following a three year intervention (n = 1205). Results: Significantly higher resilience and protective factors scores, and significantly lower prevalence of substance use were evident at follow up. Conclusions: The results suggest that the intervention has the potential to increase resilience and protective factors, and to decrease the use of tobacco, alcohol and marijuana by adolescents. Further more rigorous research is required to confirm this potential.

Hodge DR; Marsiglia FF; Nieri T. Religion and substance use among youths of Mexican heritage: A social capital perspective. Social Work Research 35(3): 137-146, 2011. (50 refs.)

Despite elevated levels of substance use among many Latino youths, there has been little research on protective factors against such use. In keeping with federal commitments to address health disparities, this prospective study examined the protective influence of religion on substance use among a school-based sample (N = 804) of youths of Mexican heritage in the American Southwest. Drawing from the social capital literature, the authors posited that both integration into religious networks and trust in religious values at time 1 (T1) would predict less likelihood of using substances at time 2 (T2) but that exposure to religious norms at T1 would not predict subsequent substance use at T2. The hypotheses regarding religious networks and religious norms were largely confirmed, whereas little support emerged for the hypothesis regarding religious values. The results are discussed in light of the various pathways through which religion may exhibit a protective influence.

Jang SJ; Johnson BR. The effects of childhood exposure to drug users and religion on drug use in adolescence and young adulthood. Youth & Society 43(4): 1220-1245, 2011. (27 refs.)

Previous research finds drug-using peers and religiosity to be key predictors of drug use among youth, but the effects of childhood exposure to drug users and religion on later drug use have been understudied. The authors hypothesize a child's exposure to parental drug use and religious upbringing have a causal influence on drug use in youth primarily through drug-using peer association and religiosity during adolescence and young adulthood. To test this hypothesis, the authors analyze nationally representative three-wave panel data spanning ages 6 to 22. Results from estimating a structural equation model provide empirical support for the hypothesis, as the causal influence was found to be indirect via the proximate predictors of drug use among youths; that is, childhood risk and protective factors were positively associated with their adolescent and young adulthood counterparts, which in turn had a causal effect on drug use by youth.

Johnson S; Koh WP; Wang RW; Govindarajan S; Yu MC; Yuan JM. Coffee consumption and reduced risk of hepatocellular carcinoma: Findings from the Singapore Chinese Health Study. Cancer Causes & Control 22(3): 503-510, 2011. (39 refs.)

Background: Coffee consumption has been associated with reduced markers of hepatic cell damage, reduced risk of chronic liver disease, and cirrhosis across a variety of populations. Data on the association between coffee consumption and risk of hepatocellular carcinoma (HCC), especially in high-risk populations, are sparse. Methods: This study examines the relationship between coffee and caffeine consumption, and the risk of developing HCC within the Singapore Chinese Health Study, a prospective cohort of 63,257 middle-aged and older Chinese men and women, a relatively high-risk population for HCC. Baseline data on coffee consumption and other dietary and lifestyle factors were collected through in-person interviews at enrollment between 1993 and 1998. Results: As of 31 December 2006, 362 cohort participants had developed HCC. High levels of coffee or caffeine consumption were associated with reduced risk of HCC (p for trend < 0.05). Compared with non-drinkers of coffee, individuals who consumed three or more cups of coffee per day experienced a statistically significant 44% reduction in risk of HCC (hazard ratio 0.56, 95% confidence interval, 0.31-1.00, p = .049) after adjustment for potential confounders and tea consumption. Conclusion: These data suggest that coffee consumption may reduce the risk of developing HCC in Chinese in Singapore.

Jones L. The first three years after foster care: A longitudinal look at the adaptation of 16 youth to emerging adulthood. Children and Youth Services Review 33(10): 1919-1929, 2011. (34 refs.)

Sixteen former foster youth were followed for 3 years to examine their adaptation to emerging adulthood. Youth were classified on their adaptation according to 2 concepts, Connectedness and Risks. Connectedness refers to engagement with the adult world through work, schooling, marriage, and parenthood. Risks refer to problems with substance abuse, financial difficulties, and mental health problems that would hinder engagement with the adult world. All of the youth maintained at least one adult connection, but only 6 youth did not have a risk at the final interview. Three years after discharge 50% of the respondents had a drug and/or alcohol problem, and had neither savings nor health insurance. Despite many problems the post foster care period was marked by much resilience as most struggled to remain independent, and continue their schooling. Factors which facilitated successful adaptations were: a period of transitional residence after foster care, good support systems including family and former social workers, and a commitment to further education.

Koenig LB; Haber JR; Jacob T. Childhood religious affiliation and alcohol use and abuse across the lifespan in alcohol-dependent men. Psychology of Addictive Behaviors 25(3): 381-389, 2011. (36 refs.)

The current study examined the relationship between childhood religious affiliation and alcohol use across the life span. A sample of 931 men (average age of 51) from the Vietnam Era Twin Registry, which includes an overrepresentation of alcohol-dependent men, completed the Lifetime Drinking History interview, which assessed drinking across the life span. Childhood religious affiliation was obtained from the men's spouse/partner. Affiliations were subdivided into four categories: nonreligious, accommodating (religions that are relatively more accepting of the larger culture), differentiating (religions that set themselves apart from the larger culture), and Catholic. Differences in a variety of alcohol use variables by religious affiliation were examined, as well as the protective effect of childhood religious affiliation on three alcohol use variables at 5-year intervals from age 20 to age 50. Significant differences were found for abstinence, regular drinking, and current quantity-frequency (QFI) scores, with individuals in differentiating religions having the highest rates of abstinence/nonregular drinking and the lowest consumption levels. When examining QFI and alcohol dependence symptoms and diagnoses over time, the nonreligious group had more alcohol use than the religious groups, with the differentiating affiliations showing the least alcohol use. The differences between affiliations were not always significant, but the consistent pattern suggests that childhood religious affiliation may continue to affect alcohol use even into adulthood.

Lietz CA. Empathic action and family resilience: A narrative examination of the benefits of helping others. Journal of Social Service Research 37(3): 254- 265, 2011. (41 refs.)

Empathy is identified as a protective factor that has been helpful for children considered at high risk for poor mental health and social functioning due to experiencing stressful circumstances such as family violence, substance abuse of a parent, or poverty. Yet, little is known about its relevance to a family's ability to overcome adversity. This study examined the narratives of 20 resilient families who maintained family functioning despite experiencing a multitude of risk factors including poverty, death of a child, significant health problems, or substance abuse problems. Narrative analysis was used to identify the ways families situated empathic actions within their stories of resilience. Findings suggest families developed increased compassion for others as a result of their own experiences with loss, trauma, or stress and discussed how helping others increased their ability to cope with the challenges they faced. Future research and practice implications are outlined and support the usefulness of strengths-based concepts and interventions.

Luczak SE; Pandika D; Shea SH; Eng MY; Liang TB; Wall TL. ALDH2 and ADH1B interactions in retrospective reports of low-dose reactions and initial sensitivity to alcohol in Asian American college students. Alcoholism: Clinical and Experimental Research 35(7): 1238-1245, 2011. (52 refs.)

Background: A mechanistic model has been proposed for how alcohol-metabolizing gene variants protect individuals from the development of alcohol use disorders, with heightened sensitivity to alcohol being an early step (endophenotype) in this model. This study was designed to determine whether possession of 2 alcohol-metabolizing genes variations, the aldehyde dehydrogenase ALDH2*2 allele and the alcohol dehydrogenase ADH1B*2 allele, was associated with self-reported sensitivity to alcohol at low doses and at initial use. Methods: Asian-American college students (N = 784) of Chinese and Korean descent were genotyped at the ALDH2 and ADH1B loci and assessed for lifetime alcohol symptoms following 1 or 2 drinks and level of response to alcohol during the first 5 lifetime drinking episodes. Results: Participants who had an ALDH2*2 allele were more likely to report experiencing all 6 low-dose symptoms and having heightened initial response to alcohol. An interaction was found between ALDH2*2 and ADH1B*2, with ADH1B*2 being associated with heightened self-reported sensitivity to alcohol only in individuals who also possessed 1 ALDH2*2 allele. Conclusions: These findings suggest the effects of ADH1B*2 may be felt more strongly in Asians who already have some heightened sensitivity to alcohol from possessing 1 ALDH2*2 allele, but who are not too sensitized to alcohol from possessing 2 ALDH2*2 alleles. These results offer additional insight into the discrepant findings that have been reported in the literature for the role of ADH1B*2 in response to alcohol and the development of alcohol-related problems.

Marsiglia FF; Yabiku ST; Kulis S; Nieri T; Parsai M; Becerra D. The influence of linguistic acculturation and gender on the initiation of substance use among Mexican heritage preadolescents in the borderlands. Journal of Early Adolescence 31(2): 271-299, 2011. (93 refs.)

This article examined the impact of linguistic acculturation and gender on the substance use initiation of a sample of 1,473 Mexican heritage preadolescents attending 30 public schools in Phoenix, Arizona. It was hypothesized that linguistic acculturation operates differently as a risk or protective factor for young children than for older youth. The study used discrete-time event history methods to model the rate at which nonusing children initiate substance use. Alcohol, cigarettes, marijuana, and inhalants were studied separately while inhalant use was examined more closely. Results suggested that while linguistic acculturation is a risk factor for Mexican heritage preadolescents, this association depended on the type of substance. For inhalants, higher linguistic acculturation with friends was inversely associated with drug initiation both for boys and girls. Implications for preventive science and future intervention research are discussed.

Martens MP; Martin JL; Littlefield AK; Murphy JG; Cimini MD. Changes in protective behavioral strategies and alcohol use among college students. Drug and Alcohol Dependence 118(2-3): 504-507, 2011. (20 refs.)

Background: Protective behavioral strategies (PBS) are specific cognitive-behavioral strategies designed to reduce alcohol consumption and resulting negative consequences:A host of studies have examined the cross-sectional relationship between such strategies and alcohol use in the high-risk population of United States college students, but prospective studies on the construct are lacking. The primary purposes of this study were to determine if PBS use prospectively predicted subsequent alcohol use/alcohol-related problems and if changes in PBS use were associated with less alcohol use and fewer problems. Methods: Data were examined from 521 heavy drinking college students (60% male, 84% White, mean age = 18.9 years). Participants completed questionnaires assessing alcohol use, alcohol-related problems, and PBS use at baseline, 6-month, and 12-month follow-ups. Results: Analysis of residualized change scores indicated that increases in some PBS across time were associated with less alcohol use and fewer alcohol-related problems at follow-up. Findings regarding the prospective relationship between PBS use and subsequent alcohol use/problems were equivocal. Discussion: Results from the study suggest that PBS may have value in alcohol-related interventions among college students. Clinicians who help clients increase their use of PBS may help those clients increase the probability of drinking less and experiencing fewer alcohol-related problems in the future.

McFadden D; Croghan IT; Piderman KM; Lundstrom C; Schroeder DR; Hays JT. Spirituality in tobacco dependence: A Mayo Clinic survey. Explore: The Journal of Science and Healing 7(3): 162- 167, 2011. (23 refs.)

Context: With widespread interest in natural remedies and "wholistic" treatments, there has been a renewed focus on the impact of spirituality related alternative therapy for many current chronic diseases. Objective: To assess the potential impact of spiritual beliefs on lifestyle choices such as tobacco use, we conducted a patient survey. Design:/Setting: This cross-section study was conducted using a 27-question survey of patients seen at the Mayo Clinic over a 14-week period. Patients: We invited all patients (smokers and nonsmokers) seen in several Mayo Clinic divisions to participate in this voluntary survey. Interventions: The survey included demographic information, history of tobacco use or nonuse, and assessment of spirituality. Main Outcome Measure: Among the 501 patients who participated, 370 were nonsmokers and 131 were smokers. Compared with smokers, nonsmokers more often participated in religious activities such as regular weekly church attendance (48% vs. 24%), daily prayer, and Bible study (49% vs. 24%; P < .001). Current smoking was negatively correlated with religious activities. However, after adjustment for demographic facdtors, there was no significant difference in intrinsic spirituality (importance of religion) between the two groups (P < .130). Result: Nonsmokers are more likely to engage in religious activities such as prayer, Bible study, and regular church attendance. Further studies may be helpful to clearly define the potential impact of spirituality on smoking cessation.

Mohatt NV; Fok CCT; Burket R; Henry D; Allen J. Assessment of awareness of connectedness as a culturally-based protective factor for Alaska native youth. Cultural Diversity & Ethnic Minority Psychology 17(4): 444-455, 2011. (47 refs.)

Research with Native Americans has identified connectedness as a culturally based protective factor against substance abuse and suicide. Connectedness refers to the interrelated welfare of the individual, one's family, one's community, and the natural environment. We developed an 18-item quantitative assessment of awareness of connectedness and tested it with 284 Alaska Native youth. Evaluation with confirmatory factor analysis and item response theory identified a 12-item subset that functions satisfactorily in a second-order four-factor model. The proposed Awareness of Connectedness Scale (ACS) displays good convergent and discriminant validity, and correlates positively with hypothesized protective factors such as reasons for living and communal mastery. The measure has utility in the study of culture-specific protective factors and as an outcomes measure for behavioral health programs with Native American youth.

Nagoshi JL; Marsiglia FF; Parsai M; Castro FG. The moderating effects of ethnic identification on the relationship between parental monitoring and substance use in Mexican heritage adolescents in the southwest united states. Journal of Community Psychology 39(5): 520-533, 2011. (48 refs.)

The purpose of this study was to assess the combined effects of ethnic identification and perceived parental monitoring on the substance use of a sample of 162 male and 192 female Mexican heritage seventh grade adolescents. Parental monitoring predicted lower risk for substance use. An interaction of ethnic identification by parental monitoring was observed with parental monitoring exhibiting stronger effects in decreasing use of alcohol use among boys who scored low on ethnic identification. For girls, decreased substance use was predicted by stronger parental monitoring coupled with high ethnic identification. Results. are discussed in terms of how the youth's ethnic identification is a distinct process from acculturation, and how ethnic identification may operate as an added protective factor in conjunction with parental monitoring, as protective factors against adolescent substance abuse.

Nguyen N; Walters ST; Wyatt TM; DeJong W. Use and correlates of protective drinking behaviors during the transition to college: Analysis of a national sample. Addictive Behaviors 36(10): 1008-1014, 2011. (31 refs.)

Objective: This study examined patterns and correlates of protective drinking behaviors among incoming first-year college students. Method: Incoming first-year students (n = 76,882) from 258 colleges across the U.S. provided baseline data on demographics, drinking practices, and protective behaviors as part of a web-based alcohol education program. Across the several colleges, responses to protective behavior questions were collected from seven weeks before the start of the school year to five weeks after. Results: Factor analysis identified three protective behavior sub-factors: Limit Drinking, Avoid Drinking and Driving, and Intent to Get Drunk. Both Limit Drinking and Avoid Drinking and Driving generally declined over the course of the data collection period while Intent to Get Drunk and peak blood alcohol concentration increased immediately after the start of school. In multiple regression analyses, the number of heavy drinking episodes in the past two weeks had a strong negative association with a Total Protective Behavior Score and the Limit Drinking Score, and a positive association with the Intent to Get Drunk Score. With the exception of the Intent to Get Drunk Score, women were more likely to use protective behaviors than men. Underage drinkers used protective behaviors less often than their of-age peers, though the effect was small. Race/ethnicity, time to matriculation, and intent to join/membership in a fraternity/sorority had negligible effects on protective behavior scores. Conclusions: College students increase risky drinking after the start of school while progressively using fewer behaviors that might mitigate the consequences of drinking.

Oesterle S; Hawkins JD; Hill KG. Men's and women's pathways to adulthood and associated substance misuse. Journal of Studies on Alcohol and Drugs 72(5): 763-773, 2011. (62 refs.)

Objective: Social role transitions have been linked to changes in substance use and misuse during young adulthood. This study examined how commonly observed pathways to adulthood, defined by education, employment, marriage, and parenthood, were associated with alcohol, tobacco, and marijuana misuse from ages 18 to 33. Method: Data came from a longitudinal panel of 412 men and 396 women recruited when they were in fifth grade in Seattle public schools in 1985. Participants were followed through age 33 in 2008, with 92% retention. Results: Young adults who had little postsecondary education and remained unmarried through age 30 generally had the highest rates of substance misuse. Those who were involved in postsecondary education and postponed family formation had the lowest rates, particularly with respect to daily smoking and nicotine dependence. Parenting during the young adult years was associated with lower rates of substance misuse for both men and women. However, taking on parenting responsibilities early, during the late teen years and early 20s (observed mostly for women), was associated with higher rates of tobacco misuse. Differences in substance misuse by pathways to adulthood were fairly constant across the young adulthood years and were already observed at age 18, suggesting that substance misuse patterns are established early. Conclusions: Young adults may change their substance use only partially in response to new freedoms and responsibilities in young adulthood. Preventive efforts should include a focus on early initiation of substance use and educational experiences that move people into life trajectories and associated substance misuse patterns.

Puleo CM; Conner BT; Benjamin CL; Kendall PC. CBT for childhood anxiety and substance use at 7.4-year follow-up: A reassessment controlling for known predictors. Journal of Anxiety Disorders 25(5): 690- 696, 2011. (36 refs.)

A previous report suggested that successful cognitive behavioral therapy (CBT) for child anxiety reduced substance use problems at 7.4-year follow-up, but that report did not include predictors of: (a) substance use disorder (SUD: e.g., attention deficit-hyperactivity disorder symptoms, negative life events, family substance abuse, additional treatment), or (b) treatment outcome (e.g., severity of internalizing pathology, age). Analyses incorporating these factors tested previously reported findings in 72 participants (ages 15-22 at follow-up: 84% of the 7.4-year follow-up sample), using parent and youth diagnostic interviews and report measures. The majority of previously reported associations between less successful treatment and later substance use problems remained significant after controlling for known predictors of SUD and treatment outcome. Our findings bolster previous conclusions that effective CBT for child anxiety may have ameliorative effects on the target disorder and later substance use problems.

Rasic D; Kisely S; Langille DB. Protective associations of importance of religion and frequency of service attendance with depression risk, suicidal behaviours and substance use in adolescents in Nova Scotia, Canada. Journal of Affective Disorders 132(3): 389-395, 2011. (58 refs.)

Purpose: We examined relationships of measures of personal importance of religion and frequency of attendance at religious services with risk of depression and risk behaviours in high school students in Cape Breton, Canada. We examined the impact of confounding and explanatory factors on these relationships. Methods: Data were drawn from self-report surveys of adolescents aged 15-19 (N=1615) at three high schools in May, 2006. We used logistic regression to assess associations of religious importance and religious service attendance with risk of depression, suicidal behaviour, binge drinking and frequent marijuana use, controlling in multivariate models for sociodemographic factors, family structure and social capital. Results: Among females, higher personal importance of religion was associated with decreased odds of depression, suicidal ideation, drinking and marijuana use, while more religious attendance was protective for substance use behaviours and suicidal ideation. In males, both measures of religiosity were associated with decreased substance use. In multivariate models, religious importance had weak protective effects for depression and suicidal thinking in females, which were respectively modified by social trust and substance use. Attendance was protective for suicidal thinking in females, and was modified by depression. These associations were not seen in males. Attendance was consistently associated with less substance use in females, while importance was not. Importance was consistently protective for marijuana use and attendance was protective for binge drinking in males. Limitations: This was a cross-sectional self-report survey and causality cannot be inferred. Conclusion: Protective associations of measures of religiosity are seen in Canadian adolescents, as they are elsewhere.

Reisen CA; Bianchi FT; Cohen-Blair H; Liappis AP; Poppen PJ; Zea MC et al. Present and past influences on current smoking among Hiv-positive male veterans. Nicotine & Tobacco Research 13(8): 638-645, 2011. (52 refs.)

Introduction: Cigarette smoking has become an important influence of morbidity and mortality for HIV-positive individuals in the era of highly active antiretroviral therapy. Although smoking is common among military personnel and veterans, the lasting impact of military service on smoking at a later stage of life has not been examined. The current study investigated present and past influences on current smoking among HIV-positive male veterans. Methods: Participants were 200 HIV-positive men served by the Veterans Affairs Medical Center. A survey was administered via audio-enhanced computer-assisted self-interview, and additional information was extracted from the computerized patient record system. Results: Logistic regression was performed to test hypotheses concerning the participants' current situations as well as characteristics of their past military service. Having smokers in one's environment, being more depressed, and having used alcohol or drugs were associated with having smoked in the previous 30 days, whereas stronger endorsement of attitudes stating adverse effects of smoking was linked to lower likelihood of smoking. Neither having been in a military conflict nor the length of the military service was significantly related to current smoking. Conclusions: Remote experiences in the military did not have a sustained effect on smoking behavior years later. Implications of this study for the development of smoking cessation programs targeting HIV-positive veterans include the importance of altering attitudes about tobacco, treating underlying depression, addressing social influence, decreasing substance use, and increasing awareness of the heightened vulnerability to a variety of negative consequences of smoking among infected individuals.

Rockloff MJ; Greer N. Audience influence on EGM gambling: The protective effects of having others watch you play. Journal of Gambling Studies 27(3): 443-451, 2011. (7 refs.)

One component of social facilitation on gambling is the potential for an audience of people to observe the play of Electronic Gaming Machine (EGM) gamblers and influence their behaviour without participating directly in gambling themselves. An experiment was conducted with an audience of onlookers, purported to be students of research methods, taking notes while watching the participants play an EGM. Forty-three male and 82 female participants (N = 125), aged 18-79 (M = 49.2, SD = 15.6), played a laptop simulated 3-reel EGM using a $20 stake in three conditions: (1) alone, (2) watched by a simulated audience of six persons, or (3) watched by an audience of 26. Outcomes on the poker machine were rigged with a fixed sequence of five wins in the first 20 spins and indefinite losses thereafter. The results found smaller bet-sizes associated with larger audiences of onlookers, and this outcome is consistent with a hypothesized motivation to display more wins to the audience. Moreover, final payouts were greater in the audience conditions compared to the control, further suggesting that an audience may be a protective factor limiting player losses.

Ronel N; Levy-Cahana M. Growing-up with a substance-dependent parent: Development of subjective risk and protective factors. Substance Use & Misuse 46(5): 608-619, 2011. (68 refs.)

A qualitative phenomenological study of high-risk adolescents, who are children of substance-dependent parents, explored the presence of subjective risk and protective factors. Nineteen adolescents were interviewed, all of whom had a father or both parents either actively dependent on psychoactive substances or recovering from substance dependence. The participants were assigned to one of two groups, based on the degree to which they maintained normative lives or had misused substances themselves. It was found that certain perceptions of the participants, concerning themselves and their parents, served as either subjective risk or protective factors, respectively. Implications for the treatment of this population are outlined.

Roy A; Carli V; Sarchiapone M. Resilience mitigates the suicide risk associated with childhood trauma. Journal of Affective Disorders 133(3): 591-594, 2011. (26 refs.)

Objective: We wished to examine whether resilience might be a protective factor in relation to suicidal behavior. Method: To do this resilience was examined in relation to childhood trauma, a well established risk factor for suicidal behavior, in two samples. In a preliminary sample 20 abstinent substance abuse patients who had attempted suicide were matched for age and their score on the Childhood Trauma Questionnaire (CTQ) with 20 substance abuse patients who had never attempted suicide. The two age and CTQ matched attempter (N =20) and non-attempter (N= 20) groups were then compared for their scores on the Connor-Davidson Researchilience Scale (CD-RISC). In the second sample 166 prisoners who had attempted suicide were matched for age and their scores on the CTQ with 166 prisoners who had never attempted suicide. These two age and CTQ matched attempter (N= 166)and non-attempter (N= 166) groups were similarly compared for their CD-RISC resilience scores. Results: In the preliminary substance abuse sample, patients who had never attempted suicide (N = 20) had significantly higher mean CD-RISC resilience scores than the age and CTQ matched patients who had attempted suicide (N= 20). Similarly in the prisoner sample, those who had never attempted suicide (N= 166) had significantly higher CD-RISC resilience scores than the age and CTQ matched prisoners who had attempted suicide (N= 166). Conclusions: The results from these two studies suggest that resilience may be a protective factor mitigating the risk of suicidal behavior associated with childhood trauma.

Sanchez ZM; Opaleye ES; Chaves TV; Noto AR; Nappo SA. God forbids or mom disapproves? Religious beliefs that prevent drug use among youth. Journal of Adolescent Research 26(5): 591-616, 2011. (37 refs.)

Researches have emphasized religiosity as a protective factor against drug use although the mechanism through which it occurs is still unknown. This article aims to explore religious beliefs that could prevent drug use among youth. Three sources of qualitative data were used: participant observation in 21 religious institutions, semistructured interviews of 37 religious leaders, and 6 focus groups comprised of 55 religious drug-naive youths. The young people's discourses and the sermons of religious leaders revealed that conceptions about drugs were based on media content, with little religious or scientific context. Catholics and Spiritists considered the consumption of licit drugs less harmful than that of illicit ones and were especially tolerant of the use of alcohol. Protestants were more emphatic when describing all drugs as being harmful to one's health. Findings suggest that young people who practice a religion invoke several religious concepts to justify their choice for not using drugs, and they attribute this position more to the family legacy than to their own religiosity. Thus youths' antidrug position was more reflective of family values than religious beliefs.

Sheridan K; Haight WL; Cleeland L. The role of grandparents in preventing aggressive and other externalizing behavior problems in children from rural, methamphetamine-involved families. Children and Youth Services Review 33(9): 1583-1591, 2011. (71 refs.)

Preventive interventions are urgently needed for children from rural, methamphetamine-involved families, who are at risk for the development of aggressive and other externalizing behavioral problems. This mixed method study explored naturally occurring sources of protection and considers the implications for targeted interventions. Participants were 41 children aged six to 14 years from rural families involved with methamphetamine and the public child welfare system, their primary caregivers, and 19 parents recovering from methamphetamine addiction. When invited during semi-structured interviews to talk about their families, 48% of children spontaneously described socially and emotionally supportive relationships with healthy grandparents. Children's reports of support from grandparents were associated with lower scores on CBCL Social Problems, [t(37) = 2.23, p<.05]; externalizing behaviors, [t(37) = 2.07, p<.05]; and aggressive behaviors, [t(37) = 2.75. p<.01]. When asked to talk about their families, 58% of parents spontaneously described the support their children received from grandparents, and 26% also described the support that they had received from their own grandparents. Children's and parents' descriptions of grandparent support suggest how grandparents may protect children from the development of aggressive and other externalizing behavior problems. First, grandparents may prevent obstacles to healthy development by providing their grandchildren with safe shelter and basic child care when parents are incapacitated from substance misuse. Second, they may promote their grandchildren's positive social-emotional development through supportive relationships. Third, they may promote social competence through enjoyable leisure activities with healthy adults and non-delinquent peers. Understanding naturally occurring sources of protection for children can inform the development of interventions by identifying strengths on which to build, and suggesting culturally sensitive approaches when children are struggling.

Staton-Tindall M; Frisman L; Lin HJ; Leukefeld C; Oser C; Havens JR et al. Relationship influence and health risk behavior among re-entering women offenders. Womens Health Issues 21(3): 230- 238, 2011. (41 refs.)

Background: Studies have shown that relationships can influence health risk behaviors such as drug use among women offenders. This study takes an exploratory look at the positive and negative influences of parents, peers, and partners for women prisoners to better understand their health risk behavior for HIV, including risky sex and drug use. Methods: The current study includes secondary analysis of cross-sectional data from women offenders enrolled in three protocols of the National Institute on Drug Abuse-funded Criminal Justice Drug Abuse Treatment Studies cooperative agreement. Baseline interviews were completed with incarcerated women preparing for community re-entry and focused on behaviors during the 6 months before incarceration. Relationship influences during the 6 months before prison were categorized as "positive" or "negative" for the women offenders. Findings: Multivariate regression models suggested that positive parental influence was significantly associated with reduced HIV risk and reduced drug use in the 6 months before incarceration. However, negative peer influence increased drug use including both risky needle behavior and any drug use in the 6 months before incarceration. Conclusion: These data suggest that, although relationships are generally important to women, particular types of relationship influences may be related to risky behavior. Implications for targeting re-entry interventions for women offenders are discussed.

Stock ML; Gibbons FX; Walsh LA; Gerrard M. Racial identification, racial discrimination, and substance use vulnerability among African American young adults. Personality and Social Psychology Bulletin 37(10): 1349-1361, 2011. (66 refs.)

Two studies examined racial identity (RI) as a protective factor against substance use cognitions among African American young adults who either envisioned or experienced racial discrimination. In Study 1, participants envisioned a discrimination or nondiscrimination scenario, and then their willingness to use drugs and an indirect measure of substance use were assessed. Discrimination was associated with higher levels of use cognitions among participants with low levels of RI. In Study 2, participants were excluded or included in an online game (Cyberball) by White peers and then engaged in an RI-affirmation or control writing task. Participants attributed this exclusion to racial discrimination. Excluded participants who did not affirm their RI reported the highest levels of substance use cognitions, especially if they had engaged in higher levels of previous substance use. These findings highlight the importance of RI among Black young adults and the impact of discrimination on health behaviors.

Tebes JK; Cook EC; Vanderploeg JJ; Feinn R; Chinman MJ; Shepard JK et al. Parental knowledge and substance use among African American adolescents: Influence of gender and grade level. Journal of Child and Family Studies 20(4): 406-413, 2011. (42 refs.)

Parental knowledge is defined as parental awareness and information about a child's activities, whereabouts, and associations that is obtained through parental monitoring, parental solicitation, or self-disclosure. Increased parental knowledge is generally associated with lower adolescent substance use; however, the influence of various contextual factors, such as adolescent gender and grade level is not well understood, particularly for different racial or ethnic groups. In the present study, we used Hierarchical Generalized Linear Modeling analyses to examine the longitudinal relationship of parental knowledge to adolescent substance use in the context of adolescent gender and grade level among 207 urban African American adolescents in grades 6-11. Results indicated that increased parental knowledge is associated with a concurrent lower likelihood of substance use across all types of substances examined (alcohol, tobacco, marijuana, other drug use, and any drug use), but it did not predict changes in substance use 1 year later for the entire sample. However, analyses by gender and grade level showed that for boys and middle school youth, parental knowledge was a protective factor for increases in substance use across 1 year. Findings are discussed in terms of their implications for prevention and health promotion interventions for adolescent substance use among African American youth.

Tenorio KA; Lo CC. Social location, social integration, and the co-occurrence of substance abuse and psychological distress. American Journal of Drug and Alcohol Abuse 37(4): 218-223, 2011. (37 refs.)

Background: In the United States, social stratification has generally led individuals occupying lower social locations to have more health problems than other individuals, even acknowledging that social groups are distinguished by their particular manifestations of health problems. Objectives: This study examined whether two social integration factors, marriage and religiosity, mediate the relationship between social location and co-occurrence of substance abuse and psychological distress and the nature of this relationship. Methods: Multinomial logistic regression was conducted on data from a national sample of 34,650 adults mostly between the ages of 18 to 35, collected through the 2007 National Survey on Drug Use and Health. Results: White males who were lesser educated and living in poverty were more likely to exhibit co-occuring substance abuse and psychological distress than their demographically similar counterparts. Additionally, being married and religious appeared to be protective factors within the overall study cohort with fewer co-occurring behaviors reported. Conclusion: The data generally confirm the hypothesis concerning mediating roles for religiosity and marriage. Scientific Significance: Confirmation that marriage and religiosity can protect adults against co-occurring substance abuse and psychological distress potentially provides the information necessary to better target health policy and interventions that serve to further enhance the population's mental health.

Wan X; Shin SS; Wang Q; Raymond HF; Liu HL; Ding D et al. Smoking among young rural to urban migrant women in China: A cross-sectional survey. PLoS ONE 6(8): e23028, 2011. (23 refs.)

Background: Rural-to-urban migrant women may be vulnerable to smoking initiation as they are newly exposed to risk factors in the urban environment. We sought to identify correlates of smoking among rural-to-urban migrant women in China. Methods/Principal Findings: A cross-sectional survey of rural-to-urban migrant women working in restaurants and hotels (RHW) and those working as commercial sex workers (CSW) was conducted in ten provincial capital cities in China. Multiple logistic regression was conducted to identify correlates of smoking. We enrolled 2229 rural-to-urban migrant women (1697 RHWs aged 18-24 years and 532 CSWs aged 18-30 years). Of these, 18.4% RHWs and 58.3% CSWs reported ever tried smoking and 3.2% RHWs and 41.9% CSWs reported current smoking. Participants who first tried smoking after moving to the city were more likely to be current smokers compared to participants who first tried smoking before moving to the city (25.3% vs. 13.8% among RHWs, p = 0.02; 83.6% vs. 58.6% among CSWs, p = < 0.01). Adjusting for other factors, "tried female cigarette brands'' had the strongest association with current smoking (OR 5.69, 95% CI 3.44 to 9.41) among participants who had ever tried smoking. Conclusions/Significance: Exposure to female cigarette brands may increase the susceptibility to smoking among rural-to-urban migrant women. Smoke-free policies and increased taxes may be effective in preventing rural-to-urban migrant women from smoking initiation.

White J; Halliwell E. Family meal frequency and alcohol and tobacco use in adolescence: Testing reciprocal effects. Journal of Early Adolescence 31(5): 735-749, 2011. (37 refs.)

This longitudinal study tested the direction of associations between family meals and alcohol and tobacco consumption during early adolescence. We examined family meal frequency, family connectedness, alcohol (binge drinking, drunkenness), and tobacco consumption (past year, daily frequency) in 671 adolescents (51% women; mean age, Wave 1 = 14.05 years). Structural equation modeling (SEM) was employed to estimate the associations between meal frequency and increases in alcohol and tobacco consumption, and alcohol and tobacco consumption on increases in meal frequency over a year, while adjusting for family connectedness, social class, and age. Family meals were associated with reductions in alcohol and tobacco consumption in girls but not boys. Alcohol consumption was also associated with reductions in the frequency of meals among girls, but not boys. Results supported the assertion that family meals protect some girls from substance abuse but suggest meals may have little impact on existing users.