Assessment of Risk and Protection in Native American Youth: Steps Toward Conducting Culturally Relevant, Sustainable Prevention in Indian Country.

Background: This study constitutes a building block in the cultural adaptation of Communities That Care (CTC), a community-based prevention system that has been found to be effective in reducing youth problem behaviors. Methods: Using the data from the CTC normative survey dataset that consists of more than quarter million youth nationwide, this study examines the reliability and validity of scores derived from the Communities That Care Youth Survey (CTC-YS), one of the primary assessment tools for gathering community data on risk and protective factors related to problem behaviors including substance use. The reliability and criterion validity analyses are conducted overall for the nationwide sample of youth as well as for the student subsample of Native American youth. Results: The results of this study indicate that the existing CTC-YS assessments of risk and protective factors in the domains of community, family, school, and peer groups as well as within individuals yield scores that are reliable and valid within the Native American sample of youth. Conclusions: This study informs the third step in the CTC prevention planning process, which involves the assessment of risk and protective factors to be targeted in preventive interventions. The question of how the assessment of risk and protective factors among Native American youth might be further improved and a description of efforts related to the cultural adaptation of the CTC program currently underway are also addressed in the discussion.

Assessing Variations in Developmental Outcomes Among Teenage Offspring of Teen Mothers: Maternal Life Course Correlates.

This study investigated potential heterogeneity in development among offspring (age 17) of teen mothers and maternal life course as correlates of variation. Using latent class analysis, subgroups of developmental outcomes were identified. Maternal standing in two life course realms (i.e., socioeconomic and domestic) was considered as a potential explanation for heterogeneity in offspring's development. Offspring reported on measures assessing their psychological, academic, and behavioral development. Teen mothers reported on measures of life course realms. Three subgroups of developmental outcomes were identified: on track (52%), at risk (37%), and troubled (11%). Findings suggest that economic hardship and number of pregnancies among teen mothers distinguish developmental patterns among teenage offspring, whereas teen mothers' educational attainment and marital status do not.

Unemployment and substance use problems among young adults: Does childhood low socioeconomic status exacerbate the effect?

The current study tested whether unemployment predicted young adults' heavy episodic drinking, cigarette smoking, and cannabis use after taking into account individual development in substance use. Furthermore, building on the life course perspective, this study examined whether the link between unemployment and substance use among young adults differed for those who experienced low childhood SES compared to those who did not. Data for the present study came from the Seattle Social Development Project (SSDP), a panel study examining a broad range of developmental outcomes from ages 10 to 33. A life history calendar (LHC) was administered to assess substance use and unemployment status during young adulthood. Covariates included baseline symptoms of psychopathology, baseline substance use, gender, ethnicity, and adult educational attainment. Results suggest that unemployment is associated with young adults' heavy episodic drinking and possibly cigarette use, but not cannabis use. Moreover, for all three substances, the detrimental impact of unemployment on substance use seems to be exacerbated among young adults who spent their childhood and adolescence in a lower SES household. Public health efforts that provide other viable and affordable options to cope with unemployment among young adults from low SES backgrounds are needed to address this disproportionate concentration of adverse impacts of unemployment on behavioral health.

Childhood and adolescent predictors of heavy episodic drinking and alcohol use disorder at ages 21 and 33: a domain-specific cumulative risk model.

OBJECTIVE: Guided by a domain-specific cumulative risk model and an emerging notion of general and alcohol-specific influences, this study examined whether general and alcohol-specific influences from family, peer, and school contexts in childhood and adolescence differentially predict heavy episodic drinking and alcohol use disorder at two developmental periods: the transition to adulthood (age 21) and later in adulthood (age 33). METHOD: Data are from a longitudinal panel study (n = 808) examining the etiology of substance use problems and associated behavior problems from age 10 to age 33 in a Northwest United States urban community sample. The sample is ethnically diverse and evenly distributed by gender (51% male). RESULTS: At age 21, alcohol problems were most consistently predicted by adolescent family alcohol and peer alcohol environments and by peer general environment, but not by general family functioning. Conversely, by age 33, alcohol problems were more consistently predicted by general poor family functioning in adolescence and not by family alcohol or any of the peer environment measures. CONCLUSIONS: Adolescent family and peer alcohol environment influenced alcohol problems at the transition to adulthood. However, alcohol problems later in adulthood were more strongly associated with general poor family functioning in adolescence. These results suggest that alcohol prevention efforts should involve both components designed to reduce alcohol-specific risk and components to improve general family and peer environments during childhood and adolescence.

Examining explanatory mechanisms of the effects of early alcohol use on young adult alcohol dependence.

OBJECTIVE: This study examined potential explanatory mechanisms linking childhood alcohol use onset and chronicity of adult alcohol dependence by testing the following three competing hypotheses: (1) a marker hypothesis, where early onset of alcohol use may be simply a marker for other factors that have been linked to both age at initiation and adult alcohol problems; (2) a compromised development hypothesis, where early alcohol initiation may interfere with adolescent development, which can lead to later alcohol problems; and (3) an increased substance use hypothesis, where early onset of alcohol use may lead to increased substance use in adolescence and, in turn, chronic alcohol dependence. METHOD: Data came from a longitudinal community sample of 808 participants recruited at age 10 in 1985. Participants were followed through age 33 in 2008 with 92% retention. RESULTS: Childhood onset of alcohol use (before age 11), when compared with initiation during adolescence, predicted an increased chronicity of adult alcohol dependence, even after accounting for the hypothesized confounds from the marker hypothesis. In addition, adolescent compromised functioning did not mediate this relationship between early alcohol use and chronicity of adult dependence (Hypothesis 2), nor did adolescent substance use (Hypothesis 3). However, compromised functioning and substance use in adolescence predicted increased chronicity of alcohol dependence in young adulthood. CONCLUSIONS: Prevention efforts as early as the elementary grades should focus on delaying the onset of alcohol use and reducing substance use in adolescence as well as improving school functioning, reducing adolescent problem behaviors, and targeting adolescent peer networks.

The effects of general and alcohol-specific peer factors in adolescence on trajectories of alcohol abuse disorder symptoms from 21 to 33 years.

BACKGROUND: The present study examines whether general and alcohol-specific peer risk factors from age 10 to 18 are associated with longitudinal patterns of adult alcohol abuse disorder symptoms from age 21 to 33. METHODS: Using growth mixture modeling, trajectory groups of alcohol abuse disorder symptoms from age 21 to 33 were identified. We then examined the relationships between the identified trajectory groups of alcohol abuse disorder symptoms and respondents' own adolescent binge drinking, a general negative peer factor, and an alcohol-specific peer factor (having drinking peers) in adolescence using pseudo-class Wald Chi-square tests, and multinomial logistic regressions. RESULTS: Four different trajectory groups of alcohol abuse disorder symptoms were identified: persistor group (3%), decreaser group (23%), escalator group (3%), and a no-disorder group (71%). Bivariate Wald Chi-square tests indicated that adolescent binge drinking behavior and general and alcohol-specific peer factors differentiated the adult alcohol abuse trajectory groups. Multivariate multinomial logistic regression showed that the general negative peer factors distinguished those who later persisted in alcohol abuse from those who desisted (i.e., persistor group vs. decreaser group) during young adulthood, even after adjusting for respondents' adolescent binge drinking. On the other hand, associating with drinking peers did not distinguish these trajectories. CONCLUSION: Alcohol-specific peer influences appear to influence alcohol abuse disorder symptoms in the early 20s, while general negative peer exposure in adolescence increases in importance as a risk factor for alcohol abuse disorder symptom persistence in the late 20s and the early 30s.