HIV-RISK BEHAVIORS AMONG PSYCHIATRICALLY HOSPITALIZED ADOLESCENTS WITH AND WITHOUT COMORBID SUD.

OBJECTIVE: The purpose of this study was to examine HIV-risk behaviors among a sample of psychiatric inpatient adolescents with and without comorbid SUD. METHOD: 239 adolescents (60.7% female; mean age=15.3) were interviewed while hospitalized in a psychiatric inpatient treatment facility. Adolescents with and without substance use disorder (SUD) were compared on a number of HIV-risk behaviors and the association between HIV-risk behaviors and other types of mental health problems were examined. RESULTS: Compared to those without SUD, adolescents with SUD, after controlling for age, gender, and other psychiatric disorders, were at an increased risk for being currently sexually active (AOR=2.01, CI=1.00-4.04, p<.05) and for having used alcohol or drugs prior to last sexual intercourse (AOR=5.48, CI=1.91-15.72, p<.01). HIV-risk behaviors were more evident among adolescents with externalizing disorders and those with higher levels of self-reported distress. CONCULSION: Adolescents in psychiatric settings, especially those with substance use disorders and/or externalizing problems, are an important population for whom prevention efforts are needed to reduce the risk of HIV infection.

Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control.

OBJECTIVE: Adolescence is an important period of risk for the development of lifelong smoking behaviors. Compelling, although inconsistent, evidence suggests a relationship between parental smoking and the risk of smoking initiation during adolescence. This study investigates unresolved issues concerning the strength and nature of the association between parent smoking and offspring smoking initiation. METHODS: We enrolled 564 adolescents aged 12 to 17, along with 1 of their parents, into the New England Family Study between 2001 and 2004. Lifetime smoking histories were obtained from parents and their adolescent offspring. Discrete-time survival analysis was used to investigate the influence of parental smoking histories on the risk of adolescent smoking initiation. RESULTS: Parental smoking was associated with a significantly higher risk of smoking initiation in adolescent offspring. In addition, the likelihood of offspring smoking initiation increased with the number of smoking parents and the duration of exposure to parental smoking, suggesting a dose-response relationship between parental smoking and offspring smoking. Offspring of parents who had quit smoking were no more likely to smoke than offspring of parents who had never smoked. The effects of parental smoking on offspring initiation differed by sex (with a stronger effect of fathers' smoking on boys than girls), developmental period (with a stronger effect of parental smoking before the adolescent was age 13 than afterward), and residence of parents (with effects of fathers' smoking being dependent on living in the same household as the adolescent). Parental smoking was also associated with stronger negative reactions to adolescents' first cigarette, a potential marker of the risk of progression to higher levels of use. CONCLUSIONS: Parental smoking is an important source of vulnerability to smoking initiation among adolescents, and parental smoking cessation might attenuate this vulnerability.

Family and peer influences on tobacco use among adolescents with psychiatric disorders.

The purpose of this study was to examine family and peer influences on smoking behaviors among 239 (191 smokers; 48 nonsmokers) psychiatrically hospitalized adolescents. Participants were queried using scales to measure parental supervision and monitoring, parenting style, adolescent-parent communication, family conflict and relations with parents, and the importance placed on life goals. The results of this study are consistent with previous findings from general population studies. Psychiatrically hospitalized adolescents' smoking status were also correlated with their siblings', peers', and girlfriends'/boyfriends' smoking status. In addition, we found that parental monitoring, closeness to parents, and ambitious life goals were protective factors against smoking. As a result, peer and family influences strongly impact the initiation and maintenance of adolescent smoking and should be considered when designing smoking cessation interventions for adolescents with psychiatric disorders.