Origins and Pathways to Drug Abuse

Research Findings from May, 2003 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the origins and pathways to drug abuse. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Personal Competence Skills, Distress, and Well-Being as Determinants of Substance Use in a Predominantly Minority Urban Adolescent Sample

Several previous studies have investigated the relationship between psychological distress and substance use among youth. However, less research has investigated the potentially protective role of psychological well-being on adolescent substance use, and the extent to which personal competence skills may promote well-being. The present study examined personal competence skills, psychological distress and well-being, and adolescent substance use over a three-year period in a predominantly minority sample of urban students (N = 1,184) attending 13 junior high schools in New York City. Structural equation modeling indicated that greater competence skills predicted less distress and greater well-being over time. While psychological well-being was associated with less subsequent substance use, distress did not predict later substance use. Findings indicate that competence skills promote resilience against early stage substance use in part by enhancing psychological well-being, and suggest that school-based prevention programs should include competence enhancement components in order to promote resilience. Griffin, K.W., Botvin, G.J., Scheier, L M., Epstein, J.A., and Diaz, T. Prevention Science, 3, pp. 23-33, 2002.

Positive Impact of Competence Skills and Psychological Wellness in Protecting Inner-city Adolescents from Alcohol Use

Research has shown that competence enhancement prevention programs for substance use are effective in reducing alcohol use and other problem behaviors. However, less is known about the mechanisms by which high competence helps youth avoid negative outcomes. This study explored whether greater competence is associated with increased levels of psychological wellness that in turn deters subsequent alcohol use. Specifically, 1,459 students attending 22 middle and junior high schools in New York City completed surveys that included measures of competence (decision making, self-efficacy), psychological wellness, and alcohol use. Students completed surveys at baseline, 1-year follow-up, and 2-year follow-up. Data collectors administered the questionnaire following a standardized protocol during a regular 40-min class period. On the basis of a longitudinal structural equation model, adolescents who were highly competent reported greater psychological wellness, which was then associated with less drinking. These findings highlight the potential of alcohol prevention programs designed to enhance competence and psychological wellness. Epstein, J.A., Griffin, K.W. and Botvin, G.J. Positive Impact of Competence Skills and Psychological Wellness in Protecting Inner-city Adolescents from Alcohol Use. Prevention Science, 3, pp. 95-104, 2002.

Marijuana Use Among the Adolescent Children of High-Risk Drug-Abusing Fathers

This study examines marijuana use among children of male drug abusers. Subjects were 83 African-American and European-American male drug abusers (the majority of whom were injection drug users) and their children. Thirty-one of the fathers were HIV-positive and 52 were HIV-negative. Using logistic regression analyses, the authors explored cross-sectionally the relationship between four psychosocial domains (i.e., paternal attributes, adolescent problem behaviors, father-adolescent relations, and the environment) and adolescent marijuana use. The father's use of illegal drugs and his failure to cope adaptively predicted adolescent marijuana use, while a close father-child bond predicted less adolescent marijuana use. Adolescent problem behaviors predicted an increased likelihood of marijuana use. Furthermore, hierarchical regression analysis demonstrated that the adolescent's problem behavior mediated the associations between the father-adolescent relationship as well as environmental factors with adolescent marijuana use. Reducing the risk factors and enhancing the protective factors within each of the domains could help reduce marijuana use among the adolescent children of drug-abusing fathers. Moreover, if a father is a drug abuser, it is important to help him establish a close bond with his child in order to help attenuate the influence of his drug use on the child's marijuana use. Brook, D.W., Brook, J.S., Richter, L., Whiteman, M. and Arencibia-Mireles, O. Marijuana Use Among the Adolescent Children of High-Risk Drug-Abusing Fathers. The American Journal on Addictions, 11, pp. 95-110, 2002.

Early and Mid-adolescence Risk Factors for Later Substance Abuse by African Americans and European Americans

This study examined the relationship between risk factors experienced during adolescence by African Americans and European Americans and DSM-IV alcohol dependence and marijuana abuse or dependence in early adulthood. The authors followed a cohort of adolescents from 1990-91 (grades 6 and 7) to 1998-2000 (ages 19-21), evaluating risk factors during early adolescence as predictors of DSM-IV alcohol dependence and marijuana abuse and dependence. African Americans had higher exposure to school, family structure, delinquency, and psychosocial factors. School factors and drug-use modeling of peers and family were the most important risk factors for marijuana abuse or dependence for both European and African Americans. Personal, familial, and social context factors during early adolescence affect adult drug-use problems, particularly for African Americans. Levels of drug use are lower among African Americans, but exposure to risks is higher and there are clear differences in the long-range impact of risk factors. These findings highlight the importance of developing and timing appropriate prevention efforts. Gil, A., Vega, W., and Turner, R.J. Public Health Reports, 117, Supplement 1:S15-S29, 2002.

Coping in Adolescent Children of HIV-Positive and HIV-Negative Substance Abusing Fathers

This study examines the coping techniques of adolescents whose fathers are at risk for contacting the HIV virus or have the HIV virus. Adolescent coping is an important aspect of the adolescent's vulnerability or resilience to drug use and abuse and associated problems. The data for this study was taken from an epidemiological study of fathers who are substance abusers and their adolescent offspring. Adolescents were asked questions regarding their ability to cope with the knowledge that their fathers have AIDS or may contract it. Adolescent adaptive coping was found to be positively related to the adolescents' conventionality, intrapersonal and interpersonal adjustment, and infrequent or no use of marijuana. Adolescent adaptive coping was also associated with paternal adaptive coping, a close father-child bond, and under some conditions, less paternal drug use. Furthermore, for every additional psychosocial risk factor beyond a minimal number, there is a doubling in the odds ratio of the adolescent using maladaptive techniques of coping. Knowledge of such relationships helps guide intervention and policy procedures for adolescents who are at risk because their fathers are HIV-positive or may contract HIV. Brook, D.W., Brook, J.S., Arencibia-Mireles, O., Whiteman, M., Pressman, M. and Rubenstone, E. Coping in Adolescent Children of HIV-Positive and HIV-Negative Substance Abusing Fathers. The Journal of Genetic Psychology, 163 (1), pp. 5-23, 2002.

Alcohol Use in Adolescents Whose Fathers Abuse Drugs

This study examined the interrelation of several domains, including father attributes, father-child relations, peer influences, environmental factors, and youth personality, as they related to adolescent alcohol use. Several aspects of the father-child relationship were also examined as possible protective factors against adolescent drinking. Subjects consisted of 204 HIV-positive and HIV-negative drug-abusing fathers and their adolescent children between the ages of 12 and 20. Data were collected via individual structured interviews of both the fathers and the youth. Results indicated that several items from each domain were related to adolescent drinking, and that an affectionate father-child bond had a protective effect. Moreover, hierarchical regression analyses demonstrated that the youth's personality mediated between all other domains and adolescent alcohol use. There was also a direct effect of peer influences on adolescent drinking. Findings extend the literature on the specific mechanisms which link parental substance use with adolescent alcohol use in a high-risk population. Brook, D.W., Brook, J.S., Rubenstone, E. and Zhang, C. Alcohol Use in Adolescents Whose Fathers Abuse Drugs. Journal of Addictive Diseases, 22, pp. 11-33, 2003.

Maladaptive Parenting and the Association Between Parental and Offspring Psychiatric Disorders

A longitudinal study was conducted to investigate the role of maladaptive parental behavior and the association between parent and offspring psychiatric disorders. Psychosocial and psychiatric interviews were carried out in a representative community sample of 593 biological parents and their offspring from two counties in the state of New York in 1975, 1983, 1985-86, and 1991-93. In 1975, the mean age of offspring was 6 years. Maladaptive parental behavior was assessed in 1975, 1983, and 1985-86. Parent and offspring psychiatric symptoms were assessed in 1983, 1985-86, and 1991-93. Maladaptive parental behavior substantially mediated a significant association between parental and offspring psychiatric symptoms. Parents with psychiatric disorders had higher levels of maladaptive behavior in the household than did parents without psychiatric disorders. Maladaptive parental behavior, in turn, was associated with increased offspring risk for psychiatric disorders during adolescence and early adulthood. Most of the youths that experienced high levels of maladaptive parental behavior during childhood had psychiatric disorders during adolescence or early adulthood, independent of whether or not their parents had psychiatric disorders. In contrast, the offspring of parents with psychiatric disorders were not at increased risk for psychiatric disorders unless there was a history of maladaptive parental behavior. Maladaptive parental behavior is associated with increased risk for the development of psychiatric disorders among the offspring of parents with and without psychiatric disorders. Maladaptive parental behavior appears to be an important mediator of the association between parental and offspring psychiatric symptoms. Johnson, J.G., Cohen, P., Kasen, S., Smailes, E. and Brook, J.S. Maladaptive Parenting and the Association Between Parental and Offspring Psychiatric Disorders. Zeitschrift fÙr Psychosomatische Medizin und Psychotherapie, 48, pp. 396-410, 2002.

Peers Continue to Influence Substance Use in Young Adulthood

This study included data from 294 young adults, ages 19-25, and both a same- and an opposite-gender best friend or mate collected across three annual assessments. The similarity to and influence of the peer on the young adult's substance use were explored. The authors found a similarity across time between both peers and the young adult in cigarette use, alcohol use, binge drinking and, in most cases, marijuana use. In prospective analyses, peer use predicted young adult cigarette use, binge drinking and problem use by the young adults. Results were generally consistent across gender and for both same- and opposite-gender peers. Andrews, J.A., Tildesley, E. Hops, H. and Li, F. The Influence of Peers on Young Adult Substance Use. Health Psychology, 21(4), pp. 349-357, 2002.

Academic Beliefs and Behaviors Related to Increased Cigarette and Marijuana Use

This study examined substance use between 10th and 12th grades in a predominantly African American sample of 785 adolescents from an urban environment. Psychological distress, academic factors, and perceptions of parents and peers were used to examine 10th-grade substance use and changes in use. Results indicated that low achievement and motivation, high truancy, and perceptions of peer substance use were associated with higher 10th-grade substance use. Growth curve analyses revealed that adolescents who perceived negative school attitudes among peers were more likely to increase their cigarette and marijuana use. Among high-achieving students, low motivation was a risk factor for increased cigarette use. Bryant, A.L., and Zimmerman, M.A. Examining the Effects of Academic Beliefs and Behaviors on Changes in Substance Use Among Urban Adolescents. J. of Educational Psychology, 94 (3), pp. 621-637, 2002.

High School Failure Predicted by Deviance, Academic Competence and Tobacco Use

This study explored whether general (vs. specific) deviance and academic competence mediated the relationships between structural strain factors (gender, ethnicity and socioeconomic status (SES)) and 12th grade high school failure. Independent variables of structural strain and mediational variables of drug use, sexual involvement, school trouble, delinquency, and academic performance were assessed in a sample of 754 8th graders and used to predict 12th-grade high school dropout and number of missed months of school in 12th grade (reflecting a latent construct of High School Failure). High school failure was directly predicted by earlier General Deviance, poor Academic Competence, low Family SES, and tobacco use. All ethnic and gender differences in high school failure were mediated by deviance and academic ability or accounted for by Family SES discrepancies. Newcomb, M.D., Abbott, R. D., Catalano, R. F., Hawkins, J. D., Battin-Pearson, S. and Hill, K. Mediational and Deviance Theories of Late High School Failure: Process Roles of Structural Strains, Academic Competence, and General Versus Specific Problem Behaviors. J. of Counseling Psychology, 49(2), pp. 172-186, 2002.

Negative Affectivity and Drug Use in Adolescent Boys: Moderating and Mediating Mechanisms

Using data from the Center on Education and Drug Abuse Research, this investigation examined the relation between negative affectivity and drug use in adolescent boys. In Study 1, 311 boys (15-17 years old) completed inventories of negative affectivity, positive affectivity, constraint, delinquency, peer delinquency, and drug use. Negative affectivity was positively related to drug use, but only for individuals exhibiting high peer delinquency or low constraint. Study 2 examined mechanisms for this relation by following up 143 of the participants at ages 17-20 years. Delinquency and peer delinquency mediated the relation between negative affectivity and later drug use. These findings suggest that the relation between negative affectivity and drug use is best understood within the context of other drug use risk factors. Shoal, G.D. and Giancola, P.R. Negative Affectivity and Drug Use in Adolescent Boys: Moderating and Mediating Mechanisms. Journal of Personality and Social Psychology, 84(1), pp. 221-233, 2003.

Positive Support for the Theoretical Model in the Coping Power Program

This study tests the contextual social-cognitive model, which has served as the basis for the Coping Power program. That program involves an indicated preventive intervention with at-risk preadolescent boys at the time of transition from elementary to middle school. The contextual social-cognitive (CSC) model assumes that (a) aggressive children have distortions in their social-cognitive appraisals and deficiencies in their social problem solving skills and (2) their parents have deficiencies in parenting behaviors. To test this model, particularly the assumption that changes in CSC processes can impact later adolescent outcomes and that these outcomes are mediated through intervention-produced changes at one-year post-intervention follow up, 183 boys were identified as being at risk on the basis of fourth grade and fifth grade teachers' ratings of children's aggressive and disruptive behaviors. Subsequently, the interventions were delivered at the end of elementary school and the beginning of middle school. The intervention effect on delinquency, substance use, and school behavior outcomes was at least partially mediated through intervention-produced changes in the child and parent variables that were targets for the intervention. These analyses testing the model at one-year follow up assessment provided unique support for the assumptions in the CSC model. Changes in the mediating processes, even among high-risk boys, have a meaningful impact on later negative outcomes. Lochman, J.E., and Wells, K.C. Contextual Social-Cognitive Mediators and Child Outcome: A Test of the Theoretical Model in the Coping Power Program. Development and Psychopathology, 14(4), pp. 945-967, 2002.

Peer Influence and Prevention of Problem Behavior

Research shows that deviant peer influence is related to the escalation of various problem behaviors such as substance use, delinquent behavior and violence. The goal of this research was to examine the effects of a family-centered prevention strategy on deviant peer affiliation. The investigators hypothesized that the Adolescent Transitions Program (ATP) would significantly reduce growth in deviant peer affiliation from the beginning of sixth grade to the beginning of ninth grade and that the reduced growth in deviant peer involvement would be correlated with the intensity of the parents' contact with the intervention. The Adolescent Transitions Program involves a 6-week classroom curriculum for all intervention youth, a Family Check-Up component to improve the family management in families identified by a teacher as potentially at-risk, and additional preventive strategies, such as family therapy and brief consultations, for families with motivation and need for assistance. This intervention was administered through a "Family Resource Center" at the school. Six hundred seventy-one youth and their families were recruited to participate from a diverse metropolitan community. Using latent growth analysis, the growth in deviant peer involvement for intervention youth was reliably less than that of the control group. In addition, the results showed that the extent to which parents accessed the family resource center mediated growth in deviant peer affiliation. Dishion, T.J., Bullock, B.M., and Granic, I. Pragmatism in Modeling Peer Influence: Dynamics, Outcomes, and Change Processes. Development and Psychopathology, 14, pp. 969-981, 2002.

Generalizability of the Social Development Model

The social development model is a theory of behavior that has proven useful in explaining the etiology of delinquency, violence, and substance use among adolescents as well as early antisocial behavior among preadolescents. To test the model's generalizability across gender and income groups, a section of the model representing prosocial influences in the etiology of problem behavior was compared for girls and boys and for children from low-income families and non low-income families. Using a sample of 851 elementary school-aged youth from the Raising Healthy Children study, multiple group structural equation modeling was used to assess differences across groups in both measurement of model constructs and hypothesized structural paths between constructs. For both sets of comparisons, overall similarity was found in both measurement and structural models, indicating the robustness of the social development model for different groups. While some studies of differences in the effects of social/interactional variables on problem behavior in adolescence have shown differences by gender and ethnicity, these findings indicate that generally the protective paths from early social skills and family socialization to problem behavior in the elementary school period appear to operate in much the same way in different gender and income groups. Fleming, C.B., Catalano, R.F., Oxford, M.L., and Harachi, T.W. A Test of Generalizability of the Social Development Model Across Gender and Income Groups with Longitudinal Data from the Elementary School Development Period. Journal of Quantitative Criminology, 18(4), pp. 423-439, 2002.

Protective Aspects of American Indian Culture

American Indian youth have notably high rates of use of alcohol and certain illicit substances, yet prevention efforts for this population have been limited. This study examines whether and in what ways differences in ethnic and cultural identities among American Indian youth relate to their drug use norms. Four hundred thirty-four seventh graders from a large southwestern U.S. city who self-identified as American Indian provided self-reports of their norms in use of alcohol, tobacco, marijuana, and other drugs as well as the strength of their ethnic self-identities. Regression analysis indicated that ethnic pride was predictive of some anti-drug norms. For example, students who had a more intense sense of ethnic pride were more likely to report that it was not OK for someone their age to use alcohol, cigarettes, or marijuana. Intragroup ethnic diversity and speaking English only at home and with friends were unrelated to drug norms when other predictors were controlled, and there were few differences by gender, socioeconomic status, or age. Kulis, S., Napoli, M., and Marsiglia, F.F. Ethnic Pride, Biculturalism, and Drug Use Norms of Urban American Indian Adolescents. Social Work Research, 26(2), pp. 101-112, 2002.

Parent Figure Transitions, Delinquency, and Drug Abuse

Children of substance abusing parents have an elevated risk for experiencing disruptions in household composition, including changes in primary caretakers. This study investigated whether changes in caretakers, also called "parent figure transitions" predicted the likelihood of delinquency and drug use among a sample of youth with parents receiving methadone treatment for opiate addiction. A sample of 67 youth was derived from the Focus on Families program, a family-based intervention study to prevent substance abuse in children of opiate-addicted parents. For this analysis, 67 children ages 9-14 were interviewed (mean age=11.4 years at baseline; 13.8 years at final interview). Controlling for baseline delinquency, child characteristics, family conflict, parental depression, and parent criminal history, a greater number of parenting disruptions during the longitudinal study period was associated with a higher probability of delinquent behavior. Gender moderated the effect of parent figure transitions in a parallel analysis for drug use. After accounting for baseline drug use and other confounders, only adolescent females had a higher likelihood of drug use as the number of family disruptions increased. A subgroup of youth who experienced tremendous family instability and had no single consistent parent figure during the study were at extreme risk for delinquent behavior. Keller, T.E., Catalano, R.F., Haggerty, K.P., and Fleming, C.B. Parent Figure Transitions and Delinquency and Drug Use Among Early Adolescent Children of Substance Abusers. American Journal of Drug and Alcohol Abuse, 28(3), pp. 399-427, 2002.