Family, school, peer and individual influences on early adolescent alcohol use: first-year impact of the Resilient Families programme

Introduction and Aims:  This study aimed to examine: (a) the influence of family factors relative to school, peer and individual influences on the development of adolescent alcohol use during the first year of secondary school; and (b) the feasibility of preventing adolescent alcohol use by modifying family factors. Design and Methods:  Twenty-four schools in Melbourne, Australia were randomly assigned to either the 'Resilient Families' intervention or a control condition. A baseline cohort of 2315 grade 7 students (mean age 12.3 years) were followed-up one year later (n = 2128 for longitudinal analyses). A sub-set of parents (n = 1166) also returned baseline surveys. Results: The prevalence of lifetime alcohol use in year 7 was 33% and rose to 47% by year 8. Student-reported predictors of year 8 alcohol use included baseline alcohol [Odds Ratio (OR) 3.64] and tobacco use (2.68), and school friend's alcohol (1.41) and tobacco use (1.64). After adjusting for other influences, student-reported family factors were not maintained as significant predictors of year 8 alcohol use. Parent-report predictors of student-reported alcohol use included allowing alcohol use in the home (2.55), parental alcohol use (1.88) and child hyperactivity (1.85). Protective factors included attendance at brief parent education (0.60) and parent involvement in school education (0.65). Discussion and Conclusions: The intervention appeared to benefit education-related outcomes, but no overall effect in reducing student alcohol use was found in year 8. Intervention effects on alcohol misuse may become significant in later secondary school once the entire program has been implemented. Considerable alcohol use was detected in early secondary school,   suggesting that interventions to reduce alcohol use may be usefully implemented prior to this period.

The importance of family management, closeness with father and family structure in early adolescent alcohol use

Aims To examine the importance of family management, family structure and father–adolescent relationships on early adolescent alcohol use.

Design Cross-sectional data was collected across 30 randomly selected Australian communities stratified to represent a range of socio-economic and regional variation.

Setting Data were collected during school time from adolescents attending a broad range of schools.

Participants The sample consisted of a combined 8256 students (aged 10–14 years).

Measurements Students completed a web-based survey as part of the Healthy Neighbourhoods project.

Findings Family management—which included practices such as parental monitoring and family rules about alcohol use—had the strongest and most consistent relationship with alcohol use in early adolescence. Adolescents reporting higher family management were less likely to have drunk alcohol in their life-time, less likely to drink alcohol in the preceding 30 days and less likely to have had an alcohol binge. Adolescents reporting emotionally close relationships with their fathers were less likely to have drunk alcohol in their life-time and less likely to have had an alcohol binge in the preceding fortnight.

Conclusions Findings indicate that family management practices may contribute to alcohol abstinence in adolescents. Furthermore, emotionally close father–adolescent relationships may also foster abstinence; however, fathers’ drinking behaviours need to be considered.

The influence of families on early adolescent school connectedness : evidence that this association varies with adolescent involvement in peer drinking networks

School connectedness is central to the long term well-being of adolescents, and high quality parent–child relationships facilitate school connectedness. This study examined the extent to which family relationship quality is associated with the school connectedness of pre- and early teenagers, and how this association varies with adolescent involvement in peer drinking networks. The sample consisted of 7,372 10–14 year olds recruited from 231 schools in 30 Australian communities. Participants completed the Communities that Care youth survey. A multi-level model of school connectedness was used, with a random term for school-level variation. Key independent variables included family relationship quality, peer drinking networks, and school grade. Control variables included child gender, sensation seeking, depression, child alcohol use, parent education, and language spoken at home. For grade 6 students, the association of family relationship quality and school connectedness was lower when peer drinking networks were present, and this effect was nonsignificant for older (grade 8) students. Post hoc analyses indicated that the effect for family relationship quality on school connectedness was nonsignificant when adolescents in grade 6 reported that the majority of friends consumed alcohol. The results point to the importance of family-school partnerships in early intervention and prevention.

Effects of early adolescent alcohol use on mid-adolescent school performance and connection: a longitudinal study of students in Victoria, Australia and Washington State, United States

This article examines the effect of early adolescent alcohol use on mid-adolescent school suspension, truancy, commitment, and academic failure in Washington State, United States, and Victoria, Australia. Also of interest was whether associations remain after statistically controlling for other factors known to predict school outcomes.

Reassessing the Effects of Early Adolescent Alcohol Use on Later Antisocial Behavior : A Longitudinal Study of Students in Victoria, Australia and Washington State, United States

The effect of early adolescent alcohol use on antisocial behavior was examined at one- and two-year follow-up in Washington, United States and Victoria, Australia. Each state used the same methods to survey statewide representative samples of students (N = 1,858, 52% female) in 2002 (Grade 7 [G7]), 2003 (Grade 8 [G8]), and 2004 (Grade 9 [G9]). Rates of lifetime, current, frequent, and heavy episodic alcohol use were higher in Victoria than Washington State, whereas rates of five antisocial behaviors were generally comparable across states. After controlling for established risk factors, few associations between alcohol use and antisocial behavior remained, except that G7 current use predicted G8 police arrests and stealing and G9 carrying a weapon and stealing; G7 heavy episodic use predicted G8 and G9 police arrests; and G7 lifetime use predicted G9 carrying a weapon. Hence, risk factors other than alcohol were stronger predictors of antisocial behaviors.

A longitudinal evaluation of the resilient families randomized trial to prevent early adolescent depressive symptoms

This study aimed to evaluate whether an intervention prevented the development of depressive symptoms through the early years of secondary school (Grades 7 to 9 - mean ages 12.3 to 14.5 years) in Victoria, Australia. Twelve schools were randomized to a universal preventative intervention (including a student social relationship/emotional health curriculum, and parent/caregiver parenting education); 12 were randomized as control schools. Multivariate regression analyses used student self-report to predict depressive symptoms at 26-month follow-up (13-months after intervention completion) from baseline measures and intervention status (N = 2027). There was no overall intervention effect on depressive symptoms. However, intervention students with moderate symptoms whose parents attended parent education events had a significantly reduced risk of depressive symptoms at follow-up. Future evaluations of interventions of this type should investigate: therapeutic processes; methods to increase recruitment into effective parent education events; and the potential to target assistance to students with high depressive symptoms.

Longitudinal prediction of mid-adolescent psychosocial outcomes from early adolescent family help seeking and family support

This study examined whether family help seeking and family support represented the same or distinct constructs and prospective associations between emergent constructs and psychosocial outcomes. Data were from 1,713 school-based adolescents participating in a randomized controlled trial, in Victoria, Australia. Family help seeking emerged as a single factor, distinct from family support, and was prospectively associated with improved psychosocial outcomes. Father closeness predicted lower depressive symptoms. Family help seeking predicted higher help seeking for peers. Interactions between family help seeking and family support on psychosocial outcomes were not apparent. Findings highlight the importance of examining family help seeking and family support separately in future studies of adolescents' help-seeking behavior.

Parenting style as a moderator of the effect of temperament on adolescent externalising and internatlising behaviour problems

The direct and interactive effects of temperament and parenting were examined in the prediction of early adolescent externalising behaviour problems (conduct disorder and hyperactivity), internalising problems (depression and anxiety), and substance use, using data on 1,402 13- and 14-year-olds. Significant direct effects were found for four temperament factors (negative reactivity, task persistence, activity, and approach), and four parenting factors (warmth, power assertion, physical punishment, and monitoring). For those high in persistence, low in negative reactivity, or low in activity, problem outcomes were generally very rare, regardless of parenting. Prevalence of behaviour problems was generally elevated among those low in persistence, high in negative reactivity, or high in activity, even in cases where parenting was high in positive qualities such as warmth and monitoring. Prevalence of certain behaviour problems was substantially elevated when low persistence, high negative reactivity, or high activity occurred in combination with lower parental warmth or lower monitoring. The results suggest that parenting can play an important moderating role in the relationship of particular temperament characteristics to behavioural problems. [Author abstract]

Rural adolescent alcohol, tobacco, and illicit drug use: a comparison of students in Victoria, Australia, and Washington State, United States

Purpose: There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit
drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the United States and Victoria (VIC) in Australia.
Participants: The International Youth Development Study (IYDS) recruited representative samples of students from Grade 7 (aged 12 to 13 years) and Grade 9 (aged 14 to 15) in both states. A total of 3,729 students responded to questions about alcohol, tobacco, cannabis, and other illicit substance use (n_VIC = 1,852; n_WA = 1,877). In each state, males and females were equally represented and ages ranged from 12 to 15 years.
Methods: Data were analyzed to compare lifetime and current (past 30 days) substance use for students located in census areas classified as urban, large or small town, and rural. Findings were adjusted for school clustering and
weighted to compare prevalence at median age 14 years.
Findings: Rates of lifetime and current alcohol, tobacco, and cannabis use were significantly higher in rural compared to urban students in both states (odds ratio for current substance use = 1.31).
Conclusions: In both Washington State and Victoria, early adolescent rural students use substances more frequently than their urban counterparts. Future studies should examine factors that place rural adolescents at risk for alcohol, tobacco, and illicit drug use.

Family relationship quality and early alcohol use : evidence for gender-specific risk processes

Objective: Family characteristics (relationship quality, parental behaviors, and attitudes relating to alcohol use) are known to influence alcohol use in the mid-teen years, and there is evidence that family characteristics have different influences on mid-teen girls versus boys. This study examined child gender differences in the association of family relationship quality, parental disapproval of children's alcohol use, and parental alcohol use with early adolescent alcohol use.

Method: Grade 6 and 8 students (modal age 11 and 13, respectively; N = 6,837; 52.6% female) were recruited from 231 schools across three Australian states. Hypotheses were tested using two-level ordinal logistic regression (individuals nested within schools). The main dependent measure was lifetime frequency of early adolescent alcohol consumption. Independent variables included mother's/father's alcohol use, closeness, conflict, and disapproval of adolescent alcohol use. Control variables included sensation seeking, peer alcohol use, and socioeconomic disadvantage.

Results: The key findings were that for the young age group (Grade 6), emotional closeness to the parent of the opposite sex was protective. Family conflict was associated with females' drinking in both age groups but not males' drinking.

Conclusions: There was evidence of gender differences in the epidemiology of family relationship quality and early alcohol use. Social developmental models may need revision to account for these child gender differences. Gender-specific family dynamics may be an important consideration for family-oriented prevention strategy.

Temporal patterns and psychosocial consequences of adolescent help-seeking behaviour

This doctoral thesis presented an investigation of adolescent help-seeking behaviour that is likely to inform future studies examining adolescent psychology. Few prior studies have examined the factor structures of typical social support measures to examine whether family help-seeking and family support are single constructs or can be conceptualised as separate constructs. This three-year longitudinal study investigated the temporal characteristics and psychosocial consequences of early adolescent help-seeking behaviour. Findings highlighted that family help-seeking can be measured separately from family support, and discussed the role of family help-seeking and support in reducing adverse outcomes (e.g. mental health problems, school disengagement) for adolescents. The discussion contends there is interplay between family help-seeking and family support; however, the two constructs represent separate components within an over-arching adaptive process, and should be conceptualised and measured in this manner.

Peer group patterns of adolescent alcohol using behaviours in Victoria, Australia and Washington State, US

 The goal of this study was to examine and cross-nationally compare the peer group patterns of alcohol-drinking behaviors among cohorts of early adolescents (ages 11–14 years) in Victoria, Australia, and Washington State, United States. Latent transition analysis revealed that after 1 year, transitions congruent with peer influence (whereby non-drinking adolescents initiated alcohol use in the presence of drinking peers) and reverse peer influence were observed in both states; however, transitions congruent with peer selection (whereby drinking adolescents self-selected into drinking peer groups) were only observed among Victorian early adolescents. Findings were interpreted to suggest that Australian family and cultural norms that more commonly allow early adolescent alcohol use lead to a higher rate of peer selection.

Negative reactivity and parental warmth in early adolescence, and depressive symptoms in emerging adulthood

ObjectiveCross-sectional research suggests that relationships between temperamental negative reactivity and adolescent depressive symptoms may be moderated by parental warmth. The primary purpose of this study was to conduct the first prospective analysis of this relationship.MethodData from 1,147 families in an Australian population-based longitudinal study were used to examine: (1) temporal relationships between negative reactivity in early adolescence (13–14 years) and depressive symptoms in emerging adulthood (19–20 years); (2) the moderating role of parent-reported warmth in early adolescence (13–14 years); and (3) the moderating role of child gender. Hierarchical multiple regression was conducted to test the hypothesis that parental warmth would moderate the relationship between early adolescent negative reactivity and depressive symptoms in emerging adulthood.ResultsAfter accounting for previous depressive symptoms at age 13–14 years, negative reactivity was positively associated with later depressive symptoms. By contrast, parental warmth at 13–14 years was negatively associated with later depressive symptoms for females but not males. Parental warmth did not moderate the association between early adolescent negative reactivity and subsequent depressive symptoms.ConclusionsThis study was the first to use prospective data to assess the protective effects of early adolescent parental warmth on the association between negative reactive temperaments and early adult depressive symptoms. Findings suggest that parental warmth for negatively reactive children provides only concurrent protection against subsequent depressive risk. This study did not examine parent–child transactional models, which may, in future longitudinal research, improve understanding of how trajectories of parent–child goodness-of-fit contribute to depressive symptoms.

Puberty and the onset of substance use and abuse

Objective: Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use.

Methods: The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of Washington, United States, and Victoria, Australia. Participants were 5769 students in grades 5, 7, and 9, drawn as a 2-stage cluster sample in each state, and the questionnaire was completed in the school classrooms. The main outcomes of the study were lifetime substance use (tobacco use, having been drunk, or cannabis use), recent substance use (tobacco, alcohol, or cannabis use in the previous month), and substance abuse (daily smoking, any binge drinking, drinking at least weekly, or cannabis use at least weekly).

Results: The odds of lifetime substance use were almost twofold higher (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.4–2.1) in midpuberty (Tanner stage III) and were threefold higher (OR: 3.1; 95% CI: 2.4–4.2) in late puberty (Tanner stage IV/V), after adjustment for age and school grade level. Recent substance use was moderately higher (OR: 1.4; 95% CI: 1.0–1.9) in midpuberty and more than twofold higher (OR: 2.3; 95% CI: 1.7–3.3) in late puberty. The odds of substance abuse were twofold higher (OR: 2.0; 95% CI: 1.2–3.2) in midpuberty and more than threefold higher (OR: 3.5; 95% CI: 2.2–5.4) in late puberty. Reporting most friends as substance users was more likely in the later stages of pubertal development, a relationship that accounted in part for the association found between later pubertal stage and substance abuse.

Conclusions: Pubertal stage was associated with higher rates of substance use and abuse independent of age and school grade level. Early maturers had higher levels of substance use because they entered the risk period at an earlier point than did late maturers. The study findings support prevention strategies and policies that decrease recreational substance use within the peer social group in the early teens.

Body dissatisfaction and body change strategies among adolescents : a longitudinal investigation

This thesis examined body dissatisfaction and body change behaviors among adolescent girls and boys from a biopsychosocial framework. The contribution of biological, psychological and sociocultural factors were examined in relation to body dissatisfaction, weight loss, weight gain and increased muscle tone behaviors among early adolescent girls and boys. In particular, pubertal maturation, body mass index (BMI), perception of body shape and size and psychological factors, such as depression, anxiety, ineffectiveness, self-esteem and perfectionism, were examined as possible factors that may precipitate or maintain body dissatisfaction and engagement in body change strategies. The sociocultural factors evaluated were the quality of family and peer relationships, as well as the influence of family and peers in predicting the adoption of specific body change strategies. The specific mechanisms by which these influences were transmitted were also examined. These included perceived discussion, encouragement and modelling of various body change strategies, as well as perceived teasing about body shape and size. A number of separate cross-sectional and longitudinal studies were conducted to examine the above relationships and identify the factors that contribute to weight loss, weight gain and increased muscle tone behaviors in adolescents. Study 1 examined the psychometric properties and principal components structure of the Bulimia Test Revised (BULIT-R; Thelen, Farmer, Wonderlich, & Smith, 1991) to assess its applicability to adolescent samples. Study 2 investigated the nature of body dissatisfaction and weight loss behaviors among 603 adolescents (306 girls and 297 boys) using a standardised questionnaire. This preliminary study was conducted to ascertain whether variables previously found to be relevant to adolescent girls, could also be related to the development of body dissatisfaction and weight loss behaviors among adolescent boys. Studies 3 and 4 described the development and validation of a body modification scale that measured weight loss, weight gain and increased muscle tone behaviors. Studies 5 and 6 were designed to modify an Excessive Exercise Scale developed by Long, Smith, Midgley, and Cassidy (1993) into a shorter form, and validate this scale with an adolescent sample. Study 7 investigated the factors that contribute to weight loss, weight gain and increased muscle among adolescent girls and boys both cross-sectionally and longitudinally (over one year). Structural equation modelling was used to examine associations among self-reported body dissatisfaction, body change strategies and a range of biological, psychological and sociocultural variables both cross-sectionally and longitudinally. Overall, the results suggested that both girls and boys experience body dissatisfaction and engage in a number of different body change strategies in order to achieve an ideal size. A number of gender similarities and differences were identified in the expression of body dissatisfaction and the adoption of body change strategies for both girls and boys. Girls were more likely than boys to report body dissatisfaction and engage in weight loss behaviors, while boys were more likely than girls to engage in weight gain and increased muscle tone behaviors. Generally, the same factors were found to contribute to weight loss, and more specifically, bulimic symptomatology, ad weight gain in both adolescent girls and boys. While a combination of biological, psychological and sociocultural factors contributed to bulimic symptomatology, only biological and psychological factors were found to contribute to weight gain in adolescents. The most notable gender differences were found in the model of increased muscle tone. Sociocultural and biological factors contributed to increased muscle tone behaviors in girls, while sociocultural and psychological factors were implicated in these behaviors in adolescent boys. With the exception of the model of increased muscle tone for boys, body dissatisfaction was a consistent factor in the adoption of body change behaviors. Consistent with previous investigations, the present thesis provides empirical support for the need to examine the etiology and maintenance of such concerns and behaviors from a multifaceted perspective.