Library Watch - On Adolescents

Serving Substance Abuse Professionals Since 1993

Last Update: 04.06.09

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...on Adolescents

www.ProjectCork.org

Summer 2009

What do adolescents exposed to Alcoholics Anonymous think about 12-step groups?

Kelly JF; Myers MG; Rodolico J. Substance Abuse 29(2): 53-62, 2008
OBJECTIVES: Referral to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) is a common continuing care recommendation. Evidence suggests some youth benefit, yet, despite referrals, youth participation is low. Little is known about adolescents' experiences of AA/NA. Greater knowledge would inform and help tailor aftercare recommendations. METHOD: Two clinical samples of youth (N = 74 and N= 377) were asked about their perceptions of, and experiences with, AA/NA with responses categorized by content into domains assessed for face validity and reliability. RESULTS: The aspects of AA/NA youth liked best were general group dynamic processes related to universality, support, and instillation of hope. The most common reason for discontinuing was boredom/lack of fit. CONCLUSIONS: General group-therapeutic, and not 12-step-specific, factors are most valued by youth during early stages of recovery and/or degree of AA/NA exposure. Many youth discontinue due to a perceived lack of fit, suggesting a mismatch between some youth and aspects of AA/NA.

Adolescent-only substance abuse treatment: Availability and adoption of components of quality.

Knudsen HK. Journal of Substance Abuse Treatment 36(2): 195-204, 2009. (44 refs.)
There are few studies of the availability and quality of adolescent-only treatment programs. Drawing upon existing samples of publicly and privately funded treatment programs, this research considers whether organizational characteristics are associated with the availability of adolescent-only programming and measures components of quality within these programs. Significant organizational correlates of adolescent-only services included organizational size, location within a hospital setting, center accreditation, adherence to a 12-step treatment model, and reliance on public sources of funding. In-depth interviews were then conducted with 154 managers of adolescent-only treatment programs regarding levels of care offered and service quality. The most prevalent levels of care were standard outpatient and intensive outpatient. Analysis of nine domains of treatment quality revealed a medium level of quality. Treatment quality was significantly greater in programs offering more intensive levels of care. These results are largely consistent with other recent research and suggest a need for continued quality improvement efforts in this treatment sector.

Alcohol-related victimization among young adult Canadian drinkers: The explanatory roles of hazardous drinking and illicit drug use

Wells SL; Thompson JM. Canadian Journal of Public Health 100(1): 55-59, 2009. (50 refs.)
Objectives: Consistent evidence has shown that young people are significantly overrepresented among victims of violence due to another person's drinking. Yet little research has examined factors that explain alcohol-related victimization among young adults, particularly in Canada. The present study examines the influence of hazardous drinking and illicit drug use on the likelihood of experiencing alcohol-related physical victimization among young adult drinkers in a Canadian general population sample and determines whether gender differences exist in the roles of these explanatory variables. Methods: A secondary analysis of the 2004 Canadian Addiction Survey (CAS) was conducted, restricting analyses to young adult (ages 18 to 25) drinkers (785 females, 745 males). Logistic regression analyses were conducted to examine associations between explanatory variables and victimization. To assess gender differences in effects, interaction effects of gender by hazardous drinking and illicit drug use were tested. Results: Alcohol-related victimization was more likely among men than among women, hazardous drinkers than non-hazardous drinkers, and illicit drug users than non-users. Multivariate analyses indicated that, among women, illicit drug use was associated with victimization whereas, among men, hazardous drinking was significant. An interaction effect between gender and hazardous drinking indicated that hazardous drinking was more strongly associated with victimization among men than among women. Conclusion: These results highlight the important role of substance use in explaining alcohol-related victimization among young adult Canadian drinkers and suggest that gender-specific prevention programs may be needed.

High school drinking mediates the relationship between parental monitoring and college drinking: A longitudinal analysis.

Arria AM; Kuhn V; Caldeira KM; O'Grady KE; Vincent KB; Wish ED. Substance Abuse Treatment, Prevention and Policy 3: e-article 6, 2008. (58 refs.)
Background: College drinking is a significant public health problem. Although parental monitoring and supervision reduces the risk for alcohol consumption among younger adolescents, few studies have investigated the impact of earlier parental monitoring on later college drinking. This study examined whether parental monitoring indirectly exerts a protective effect on college drinking by reducing high school alcohol consumption. Methods: A longitudinal cohort of 1,253 male and female students, ages 17 to 19, attending a large, public, mid-Atlantic university was studied at two time points. First, data on high school parental monitoring and alcohol consumption were gathered via questionnaire during the summer prior to college entry. Second, during the first year of college, past-year alcohol consumption was measured via a personal interview. Multiple regression models tested the relationship between parental monitoring and past year alcohol use (i.e., number of drinks per drinking day). Results: Holding constant demographics, SAT score, and religiosity, parental monitoring had a significant protective effect on both high school and college drinking level. However, the association between parental monitoring and college drinking level became non-significant once high school drinking level was held constant. Conclusion: While parental monitoring did not directly influence college alcohol consumption, evidence for mediation was observed, whereby parental monitoring had an indirect influence on college drinking through reductions in high school drinking. Initiatives that promote effective parenting might be an important strategy to curb high-risk drinking among older adolescents. More research is needed to understand the nature and degree of parent-child communication that is necessary to extend the protective influence of parents into the college years.

Learning to become an alcohol user: Adolescents taking risks and parents living with uncertainty

Ostergaard J. Addiction Research & Theory 17(1): 30-53, 2009. (80 refs.)
This article investigates how adolescents learn to become alcohol users in a country like Denmark, characterised by extensive drunkenness among young people and a low number of abstainers among adults. Inspired by Howard Becker's study (1953) on marijuana use, the article reveals that just as a road to 'becoming a marijuana user' exists, so does a road to becoming an alcohol user. Integrating Becker's three learning steps with modern socio-cultural theories of risk and the notion of 'controlled loss of control' leads to findings that crucial for becoming an alcohol user is the demystification of the risk experience associated with alcohol intoxication and the learning to find pleasure in losing control. Both the adolescents and the parents of adolescents share this perception although for different reasons. The analyses are based on quantitative and qualitative material: A survey of 2000 adolescents aged 15-16 years, 28 focus group interviews with adolescents, and 8 focus group interviews with parents.

Pathways from adolescent parent-child conflict to substance use disorders in the fourth decade of life.

Brook JS; Brook DW; Zhang CS; Cohen P. American Journal on Addictions 18(3): 235-242, 2009. (63 refs.)
This 24-year community longitudinal study provides important information regarding parent-child conflict in adolescence (mean ages 14-16), vulnerable personality attributes and peer deviance in the twenties (mean age 22), and marital conflict and partner's illicit drug use in the late twenties and early thirties (mean ages 27-32) as related to a later diagnosis of substance use disorders (SUDs) in the thirties (mean ages 32-37). A community-based sample was interviewed between 1975 and 2007. Results based in structural equation modeling indicated that a weak parent-child bond was related to the development of drug-conducive personality traits, which was associated with the selection of drug-using peers and partners, which in turn, predicted SUDs. Both peer deviance and partner's illicit drug use had the greatest effects on SUDs. The findings should aid in formulating prevention and treatment programs targeting specific risk factors in adolescents, young adults, and adults.

Perceived accessibility of cigarettes among youth: A prospective cohort study.

Doubeni CA; Li WJ; Fouayzi H; DiFranza JR. American Journal of Preventive Medicine 36(3): 239-242, 2009. (28 refs.)
Background: The accessibility of tobacco for youth is difficult to measure, partly because of the varied sources of cigarettes. Perceptions about the accessibility of cigarettes assesses availability from all potential sources and has been found to predict future smoking. This study examines the determinants of perceived accessibility from the perspective of a longitudinal study. Methods: Data were derived from the second Development and Assessment of Nicotine Dependence in Youth study, a 4-year longitudinal study of 1246 sixth-grade students who underwent up to 11 in-person interviews from 2002 to 2006. Perceived accessibility was assessed prospectively by asking students whether they agreed or disagreed with the statement It would be easy for me to get a cigarette. Results: At baseline, the average age was 12 years; 85% had never before smoked; more than 21% perceived that cigarettes were easy to obtain. Perceived accessibility increased over the 4 years among the cohort. Youth with friends who smoked or whose parents allowed the watching of R-rated movies were more likely to perceive easy accessibility of cigarettes. Among nonsmokers, there was a dose-response relationship between perceived accessibility and exposure to smoking in the family environment. Nonsmokers who knew commercial sources of cigarettes also had higher perceived accessibility. Conclusions: Several potentially preventable exposures to tobacco in the family and social environment contribute to confidence among some youth that cigarettes are easy to obtain. Further studies are needed to determine if modifying these factors (e.g., through programs to reduce the exposure of youth to tobacco products in the home) might reduce perceived accessibility.

Misuse of over-the-counter cough or cold medications among adolescents: Prevalence and correlates in a national sample.

Ford JA. Journal of Adolescent Health 44(5): 505-507, 2009. (10 refs.)
The current research examines the misuse of over-the-counter cough/cold medications among adolescents with data from the 2006 National Survey on Drug Use and Health. Findings indicate that age, gender, family income, physical and mental health, and the use of alcohol and other drugs are correlates of the misuse of over-the-counter cough/cold medications.

Prevalence and correlates of drug/alcohol-facilitated and incapacitated sexual assault in a nationally representative sample of adolescent girls.

McCauley JL; Conoscenti LM; Ruggiero KJ; Resnick HS; Saunders BE; Kilpatrick DG. Journal of Clinical Child and Adolescent Psychology 38(2): 295-300, 2009. (21 refs.)
Incapacitated/drug-alcohol facilitated sexual assault (IS/DAFS) is rapidly gaining recognition as a distinct form of assault with unique public health implications. This study reports the prevalence, case characteristics, and associated health risks of IS/DAFS using a large, nationally representative sample of 1,763 adolescent girls. Results indicate that 11.8% of girls experienced at least one form of sexual assault; 2.1% of the total sample experienced IS/DAFS. Thus IS/DAFS accounted for 18% of all reported sexual assaults, with a prevalence of 4.0% among girls 15 to 17 years of age and 0.7% among girls 12 to 14 years of age. Girls with a history of IS/DAFS were significantly more likely than girls with other sexual assault histories to report past-year substance abuse but not significantly more likely than girls with other sexual assault histories to report past-year depression or posttraumatic stress disorder.

Family-based treatment for adolescent substance abuse: Controlled trials and new horizons in services research. (review).

Hogue A; Liddle HA. Journal of Family Therapy 31(2): 126-154, 2009. (140 refs.)
This article provides an overview of controlled trials research on treatment processes and outcomes in family-based approaches for adolescent substance abuse. Outcome research on engagement and retention in therapy, clinical impacts in multiple domains of adolescent and family functioning, and durability and moderators of treatment effects is reviewed. Treatment process research on therapeutic alliance, treatment fidelity and core family therapy techniques, and change in family processes is described. Several important research issues are presented for the next generation of family-based treatment studies focusing on delivery of evidence-based treatments in routine practice settings.

Relationship between multiple forms of maltreatment by a parent or guardian and adolescent alcohol use

Shin SH; Edwards E; Heeren T; Amodeo M. American Journal on Addictions 18(3): 226-234, 2009. (52 refs.)
This study examined the effect of the co-occurrence of multiple categories of maltreatment on adolescent alcohol use. Data were from the National Longitudinal Study of Adolescent Health which used a nationally representative sample of adolescents (n = 14,078). Among those reporting any maltreatment, over one-third had experienced more than one type of maltreatment. Logistic regression models found that all types or combinations of types of maltreatment except physical-abuse-only were strongly associated with adolescent alcohol use, controlling for age, gender, race, and parental alcoholism. These results add to accumulating evidence that child maltreatment has a deleterious impact on adolescent alcohol use.

The earlier the more? Differences in the links between age at first drink and adolescent alcohol use and related problems according to quality of parent-child relationships

Kuntsche E; van der Vorst H; Engels R. Journal of Studies on Alcohol and Drugs 70(3): 346-354, 2009. (58 refs.)
Objective: Various studies reported associations between age at first drink (AFD) and later problem behaviors. However, the nature and strength of these associations are less clear. The present study investigates differences in the links between AFD and later alcohol use and the ones between alcohol use and later drinking problems, based on quality of parent-child relationships. Method: Structural equation models were estimated based on a three-wave, 2-year prospective study of 364 adolescents. Results: AFD measured at Time I was related to drinking quantity at Time 2, which was related to alcohol-related problems at Time 3. However, the significant links between AFD and later alcohol use existed solely among adolescents who reported high-quality relationships with their parents. More specifically, compared with all other adolescents, only those who had a late AFD and a high-quality relationship with their parents were found to have low levels of alcohol use at Time 2 and low levels of alcohol-related problems at Time 3. Conclusions: By promoting a high-quality relation-ship, prevention efforts might trigger a spiral of healthy developments during adolescence, including family well-being in early adolescence, late AFDs, lower alcohol-use levels, and eventually fewer alcohol-related problems in late adolescence.

The soundtrack of substance use: Music preference and adolescent smoking and drinking.

Mulder J; Bogt TFM; Raaijmakers QAW; Gabhainn SN; Monshouwer K; Vollebergh WAM. Substance Use & Misuse 44(4): 514-531, 2009. (49 refs.)
A connection between preferences for heavy metal, rap, reggae, electronic dance music, and substance use has previously been established. However, evidence as to the gender-specific links between substance use and a wider range of music genres in a nationally representative sample of adolescents has to date been missing. In 2003, the Dutch government funded the Dutch National School Survey on Substance Use (DNSSSU), a self-report questionnaire among a representative school-based sample of 7,324 adolescents aged 12 to 16 years, assessed music preference, tobacco, and alcohol use and a set of relevant covariates related to both substance use and music preference. Overall, when all other factors were controlled, punk/hardcore, techno/hardhouse, and reggae were associated with more substance use, while pop and classical music marked less substance use. While prior research showed that liking heavy metal and rap predicts substance use, in this study a preference for rap/hip-hop only indicated elevated smoking among girls, whereas heavy metal was associated with less smoking among boys and less drinking among girls. The types of music that mark increased substance use may vary historically and cross-culturally, but, in general, preferences for nonmainstream music are associated positively with substance use, and preferences for mainstream pop and types of music preferred by adults (classical music) mark less substance use among adolescents. As this is a correlational study no valid conclusions in the direction of causation of the music-substance use link can be drawn.

The steroids/sports supplements connection: Pragmatism and sensation-seeking in the attitudes and behaviour of JHS and HS students on Long Island.

Rees CR; Zarco EPT; Lewis DK. Journal of Drug Education 38(4): 329-349, 2008. (35 refs.)
In this article we examine the importance of sensation seeking and pragmatism in the steroids and sports supplements behavior and attitudes of high school and junior high school students on Long Island, New York. Steroid use is much less acceptable than sports supplement use, although the reasons for use are similar. Respondents use supplements more than steroids, have a greater variety of attitudes toward their use, and have a high acceptance of their "energy" potential. There is a significant effect of current sports supplements use on future steroid use. Independent of measurement format (fixed choice questions and hypothetical situations), the steroids-sports supplement connection seems to exist within a pragmatic approach to cosmetic fitness, where the goal is improving physical ability and appearance.

Young people in coerced drug treatment: Does the UK Drug Intervention Programme provide a useful and effective service to young offenders?

Greaves A; Best D; Day E; Foster A.Addiction Research & Theory 17(1): 17-29, 2009. (31 refs.)
Although clear relationships have been identified between dependent drug use and crime, the relationship is less evident in young offenders, particularly for less physically dependent users. This study investigated a sample of young drug-using offenders (aged 18-24; n = 36) accessing drug treatment through the criminal justice system in Birmingham, UK, using structured interviews for the collection of both qualitative and quantitative data. It identified high levels of heroin dependence, with frequency of use linked to both acquisitive crime and willingness to engage in treatment. The relationship between crack cocaine use and offending was less clear with more client ambivalence regarding desire to stop using the drug. Whilst most praised their treatment, and their workers, substitute prescribing was less positively endorsed. The study offers some support for diverting young dependent opiate users from criminal justice services into drug treatment, but presents a less positive prognosis for primary stimulant users.