psychosocial factors in adolescent substance use

  • substance use typically initiated during adolescence

    • 10-18 years old

    • relatively common

  • lower cigarette use and higher electronic cigarette use

  • short term negative consequences: emotional (depression), interpersonal (relationship strain), physical (accidental injuries), occupational (academic problems)

  • long term: developing substance use disorder

— THEORETICAL UNDERPINNINGS OF ADOLESCENT SUBSTANCE USE—

  • prior research focused disproportionately on the individual factors in comparison to social factors

~1.1 bioecological model of development~

  • Brofenbrenner’s bioecological model (1979)

    • organizes socialization factors

      • contributes to etiology of adolescent substance use

    • contextual factors/systems: peers, families, schools, neighborhoods

      • shape behavior and development

  • mesosystem: interaction between microsystems (peers and parents)

  • exosystem: larger social system (operates indirectly)

    • neighborhoods

  • macrosystem: cultural values, politics, religion and law, etc

  • some contexts have more direct impacts and some are indirect

  • biological: the degree adolescents are susceptible to socialization contexts

~1.2 relevant models encompassing genes and neurobiology~

  • genes and environment interactive → diathesis-stress framework

    • some individuals are more vulnerable and have a higher risk for developing psychopathology

      • problematic substance use

    • certain risk genotype

  • increased sensitivity to wider range of environmental exposures (certain genetic variant)

    • adaptive socialization contexts

  • environmental and social factors play a stronger role

    • peer pressure

    • family monitoring

    • twin studies show environment explained around 65% of alcohol initiation variance

  • genetic effects grow stronger as individuals gain autonomy

    • ~35% for genetics, environment dropped ~47%

  • possible interpretation:

    • adolescence: parental supervision restricts opportunities for genetic tendencies to develop

    • more freedom- genetic vulnerabilities become more expressed

~1.3 Social learning theory~

  • adolescence learn substance use through observing parents, siblings, peers

    • influential figure uses/approves → adolescents more likely to imitate

  • Reinforced: role model is rewarded for substance use, model is similar to adolescent, and model has high social status

~ 1.4 Social control theory ~

  • strong bonds to family, school, community discourages substance use (and deviant acts)

  • attachment, support, belonging → reduce the likelihood of using substances

  • weak connections/low commitment to conventional norms → increased vulnerability

~1.5 social development model~

  • social learning + social control theories

  • youth form bonds across 4 domains- family, school, peers, community

    • based on perceived rewards for pro/antisocial behavior

      • prosocial acts rewards→ healthy behavior

      • antisocial → promore risk behavior (substance use)

  • socialization agents shift with age

    • parents: dominant early adolescence

    • peers: later adolescents

—PARENT SOCIALIZATION CONTEXT—

  • parents are influential→ affects both adolescent substance use behavior directly and friendship tie choices

    • parental control: supervision, rule-setting

    • parental warmth: affection, emotional support

      • high control and warmth → protect against substance use

        • parenting syles:

          • authoritative (high control + high warmth): most protective

          • authoritarian (high cont., low warm.)

          • permissive (low, high)

          • neglectful (low, low)

~2.1 parental monitoring and knowledge~

  • parental knowledge is the strongest predictor of lower substance use

    • how they get knowledge: active monitoring/solicitation and youth disclosure

  • maternal knowledge predicts lower initiation and less favorable attitudes

  • network effect: high parental knowledge and low inconsistent discipline amongst teen’s friend group’s parents → predicts lower substance use

  • knowledge → reduces exposure to deviant peers → esp. important for girls in certain contexts

  • bidirectional

    • less parental knowledge → more use

    • teen use → reduce disclosure and parent engagement

~2.2 aspects of parental warmth~

  • warmth/cohesion/support → lower adolescent substance use

    • seek guidance, internalize rules, endorse anti-use norms

    • directly reduces initiation

    • indirectly shape peer choices

  • high conflict relationships → greater risk

~2.3 parental substance use and permission in the home~

  • parental use → higher teen use

  • both mom and dad use matters parental permission to taste alcohol in childhood → earlier first full drink → higher frequency in adolescence

~2.4 varying effects across age and biological sex~

  • sex differences

  • girls: more monitored

    • low monitoring + deviant peers → stronger risk in some studies

  • mother-daughter quality esp. protective

  • knowledge effects stronger for boys (mixed overall)

  • knowledge/monitoring: strongest in early adolescence

  • relationship quality: mid/late adolescence

  • effects fate by early adulthood in some studies

  • risk from parental use: dec. with age

  • can persist into early adulthood

  • late adolescence: communication and self-disclosure>strict monitoring

—PEER SOCIALIZATION—

  • adolescence: less family time, more peer time, higher social reward sensitivity

    • peers → more influential

      • effects operate directly (pressure) and indirectly (norms)

~3.1 peer selection and peer socialization~

  • socialization: peer use/approval→ teen use

  • selection: teens choose friends who use

  • shared-report bias: teens project their own use onto peers

    • overestimate peer use

  • socialization and/or selectron stronger → depends

~3.2 descriptive and subjective peer terms~

  • believing peers approve/use substances is enough to influence them

    • doesn’t have to see them

  • descriptive norms: what teens think peers do

  • subjective norms: what teens think peers approve of

  • teens overestimate peer substance use

    • underestimate healthy behavior

  • misperceptions increase substance use

  • campaigns to correct these beliefs work only slightly

~3.3 positive peer effects~

  • influence good behavior

    • supportive, academically engaged, religious friend groups → lower risk for substance use

  • positive friendships: protection (not pressure)

~3.4 varying effects across age and sex~

  • peer influence peaks 14-16 years old

    • weakens with age

  • early teens most likely to be affected by peers smoking/drinking

  • results of which genders are more influenced are mixed

  • peer effects remain in adulthood

  • `weaker

  • limited to partners and friends with similar habits

—SCHOOL SOCIALIZATION CONTEXT—

  • school climate matters too

    • supportive teachers + positive atmosphere → lower use

    • school connectedness (valued + engaged) → lower use

  • truancy and disengagement→ higher risk/earlier use

    • disengagement predicts later drug/alcohol problems

  • fits social control theory

—ANIMAL MODELS—

  • tests how social environment, stress, peer presence affect drug use

    • more risk taking, peer driven behavior, sensitivity to stress

    • peer presence increases drug intake, esp. under stress

  • males: social/reward reasons

  • females: stress/anxiety reliefs

3 STATEMENTS

  1. the environments that punish substance use are the same ones who encouraged them through stress and pressure

  2. parent surveillance doesn’t always prevent substance use, it just makes kids sneakier

  3. School connectedness can offer better protection than drug policies but it’s easier to police than care.

midterm question: How far does an individual’s liberties extend in terms of drug use? 

  • religious 

  • medical 

  • recreational