Insufficient attention to protective and risk factors of particular salience for Black youth (e.g., racial identity and racial discrimination) in population-based substance use studies has left gaps ...in our understanding of alcohol and tobacco use development in Black adolescents. The current study aimed to capture the clustering of such understudied factors and their collective influence on alcohol and tobacco use initiation among Black adolescents. Data were drawn from The National Survey of American Life (n = 1,170; age range = 13-17; 6.9% Afro Caribbean, 93.1% African American; 50.0% female). Latent profile analysis applied to 11 indicators representing family, community, and individual level protective and risk factors revealed (1) High Vulnerability (high risk, low protective factors; 17.5%), (2) Moderate Vulnerability (moderate on both; 63.2%), and (3) Low Vulnerability (high protective, low risk factors; 19.3%) classes. Classes differed significantly by religious community support, school bonding, quality of relationship with mother, religious involvement, and interpersonal trauma. Relative to Class 2, Class 1 had higher odds of alcohol (OR = 1.518, CI:1.092-2.109) and tobacco use (OR = 1.998, CI:1.401-2.848); Class 3 had lower odds of alcohol (OR = 0.659, CI:0.449-0.968) but not tobacco use (OR = 0.965, CI:0.611-1.523). Findings suggest that alcohol and tobacco use initiation among Black adolescents is shaped by the collective influence of community and family level support, with commonly experienced risk factors such as non-interpersonal trauma distinguishing liability to a lesser degree. The equally modest prevalence of tobacco use among low and moderate vulnerability classes further indicates that fostering these connections may be especially effective in reducing tobacco use risk.
Objective: The present study aimed to characterize the association of perceived gender discrimination and illicit drug use among a sample of African American (AA) and European American (EA) ...adolescent girls and young women. Method: Data were drawn from a high-risk family study of alcohol use disorder of mothers and their offspring (N = 735). Multinomial regressions were used to examine whether experience of offspring and maternal gender discrimination were associated with offspring illicit drug use (cannabis, cocaine, ecstasy, PCP, opiates, hallucinogens, solvents, sedatives, or inhalants). Outcomes included offspring age of drug use initiation (age ≤ 14) and lifetime heavy drug use (≥ 50 times) of 1 or more illicit substances. Interactions between race and offspring gender discrimination were modeled to assess for race differences. Results: Results revealed that gender discrimination was associated with a greater likelihood of offspring early initiation (relative risk ratio RRR = 2.57, 95% CI 1.31, 5.03) versus later initiation (RRR = 1.33, 95% CI 0.80, 2.24). Offspring gender discrimination was associated with offspring heavy drug use (RRR = 2.09, 95% CI 1.07, 4.06) and not associated with moderate/light use (RRR = 1.44, 95% CI 0.86, 2.42), but post hoc tests revealed no significant group differences. Conclusions: Findings suggest that perceived offspring gender discrimination is associated with early drug use initiation. Gender discrimination, particularly at an early age, has a potential to cause harm, including drug use. Implementation of policies that foster environments that eliminate gender bias and discrimination at an early age should be prioritized. Gender-responsive treatment merits consideration by substance use treatment providers.
Public Significance Statement
This study indicates that adolescent females who experience gender discrimination, are more likely to initiate drugs at an earlier age. Targeting gender discrimination during adolescence may be important, before gender norms become rooted into one's trajectory.
Background
Peer victimization is consistently linked to adolescents’ alcohol use. However, the relative influence of relational and physical peer victimization on alcohol use, and timing of drinking ...initiation, is not well understood. In this study, we evaluate the impact of both relational and physical peer victimization on adolescent girls’ alcohol use initiation, and the extent to which depression severity moderates these associations.
Methods
Participants were 2,125 girls in the Pittsburgh Girls Study, a longitudinal community‐based study. Participants reported experiences of relational and physical peer victimization, depression severity, and alcohol use each year from ages 10 to 17. Cox proportional hazards (PH) regression analyses predicting the timing of first drink were conducted in 2 stages, testing for main effects of peer victimization in Model 1 and moderation by depression severity in Model 2.
Results
Analyses were split at age 14 to adjust for PH violations. Model 1 results supported a main effect for relational (Hazards ratio HR = 1.83, CI: 1.46 to 2.28 ≤ age 13; HR = 1.23, CI: 1.05 to 1.45 ≥ age 14) but not physical victimization on timing of alcohol use onset (HR = 1.10, CI: 0.88 to 1.39). Model 2 results show that depression severity moderates the association between relational victimization and alcohol use initiation: the association between relational victimization and early alcohol use onset was stronger for lower depression severity (−1 SD HR = 2.38, CI: 1.68 to 3.39 ≤ age 13; −1 SD HR = 1.48, CI: 1.10 to 1.52 ≥ age 14).
Conclusions
Results demonstrate that relational (and not physical) victimization predicts earlier drinking among adolescent girls. Relational peer victimization conferred greater risk for alcohol use initiation when depression severity was lower, whereas girls with high depression severity engaged in early alcohol use regardless of peer victimization. Results suggest that interventions focused on relational peer victimization may have spillover effects for delaying girls’ alcohol use initiation, particularly in early adolescence, when this association is most robust.
This study assessed the association between racial discrimination and suicidality (ideation, plan, or attempt) in African-American adolescents and young adults (n = 806, mean age = 17.9 years). ...Structured psychiatric phone interviews were conducted in offspring and their mothers in a high-risk alcoholism family study. Logistic regression analyses using offspring's own racial discrimination as a predictor revealed elevated odds of suicidality, even after adjusting for correlated psychiatric conditions (OR = 1.76) but was reduced to non-significance after adjusting for maternal experiences of racial discrimination (OR = 3.19 in males), depression, and problem drinking. Findings support a link between racial discrimination and suicidality in African-American youth that, for males, is partially explained by maternal racial discrimination.
•Discrimination was examined in relation to two drinking stages in African Americans.•Both racial and socioeconomic discrimination were investigated.•Racial discrimination predicted alcohol ...initiation only in unadjusted models.•Socioeconomic discrimination predicted initiation in females in adjusted models.•Neither form of discrimination predicted progression to problem drinking.
This study aimed to characterize the associations of racial and socioeconomic discrimination with timing of alcohol initiation and progression from initiation to problem drinking in Black youth.
Data were drawn from a high-risk family study of alcohol use disorder. Mothers and their offspring (N = 806; Mage = 17.87, SDage = 3.91; 50% female) were assessed via telephone interview. Cox proportional hazards regression analyses were used to examine associations between discrimination and timing of first drink and progression from first drink to problem drinking in two separate models. Predictor variables were considered in a step-wise fashion, starting with offspring racial and socioeconomic discrimination, then adding (2) maternal racial and/or socioeconomic discrimination experiences; (3) religious service attendance and social support as potential moderators; and (4) psychiatric and psychosocial risk factors and other substance use.
Offspring racial discrimination (HR: 2.01, CI: 1.17–3.46 ≤ age 13) and maternal experiences of discrimination (HR: 0.79, CI: 0.67−0.93) were associated with timing of initiation in the unadjusted model only; offspring socioeconomic discrimination predicted timing of initiation among female offspring, even after adjusting for all covariates (HR: 1.49, CI: 1.14–1.93). Socioeconomic discrimination predicted a quicker transition from first use to problem drinking exclusively in the unadjusted model (HR: 1.70, CI: 1.12–2.58 ≤ age 18). No moderating effects of religious service attendance or social support were observed for either alcohol outcome.
Conclusions: Findings suggest socioeconomic discrimination is a robust risk factor for initiating alcohol use in young Black female youth and should be considered in the development of targeted prevention programs.
Exposure to child maltreatment has been shown to increase lifetime risk for substance use disorders (SUD). However, this has not been systematically examined among race/ethnic groups, for whom rates ...of exposure to assaultive violence and SUD differ. This study examined variation by race/ethnicity and gender in associations of alcohol (AUD), cannabis (CUD), and tobacco (TUD) use disorders with three types of childhood interpersonal violence (cIPV): physical abuse, sexual abuse, and witnessing parental violence.
Data from the National Epidemiologic Survey of Alcohol-Related Conditions-III (N: 36 309), a US nationally representative sample, was utilized to examine associations of DSM-5 AUD, CUD and TUD with cIPV among men and women of five racial/ethnic groups. Models were adjusted for additional risk factors (e.g. parental substance use problems, participant's co-occurring SUD).
Independent contributions of childhood physical and sexual abuse to AUD, CUD, and TUD, and of witnessing parental violence to AUD and TUD were observed. Associations of cIPV and SUD were relatively similar across race/ethnicity and gender Odds Ratios (ORs) ranged from 1.1 to 1.9, although associations of physical abuse with AUD and TUD were greater among males, associations of parental violence and AUD were greater among females, and associations of parental violence with AUD were greater among Hispanic women and American Indian men.
Given the paucity of research in this area, and the potential identification of modifiable risk factors to reduce the impact of childhood interpersonal violence on SUDs, further research and consideration of tailoring prevention and intervention efforts to different populations are warranted.
Black youth are more likely than White youth to deviate from the typical sequence of initiating alcohol use before marijuana use. Although potentially informative for prevention efforts, sources of ...variation in the sequence of alcohol relative to marijuana use initiation and associations of initiation patterns with frequency of use have rarely been examined.
Data were drawn from 2,166 Pittsburgh Girls Study participants (56.9% Black, 43.1% White), collected at ages 11-17. Multinomial logistic regression analyses were conducted to identify distinctions by race and associations of socioeconomic, neighborhood, psychosocial, and psychiatric factors with alcohol and marijuana initiation patterns: alcohol first as "typical," with "atypical" including both at the same age, marijuana first, marijuana only, and alcohol only. Separate ordinal logistic regression analyses were conducted to predict frequency of alcohol and marijuana use at age 17 as a function of initiation pattern and significant correlates.
Black girls were overrepresented in the atypical initiation patterns involving marijuana use. Unique associations of race, cigarette smoking, trauma exposure, religious service attendance, depression, and conduct problems with initiation patterns were observed. Compared with the typical sequence, frequency of alcohol use was lower for all other patterns (odds ratios ORs = 0.28-0.50), but frequency of marijuana use was lower exclusively for "marijuana only" (OR = 0.42).
These findings underscore the need for prevention programs to consider heterogeneity in patterns of initiating alcohol and marijuana use and correlates of patterns among both Black and White adolescents. They also indicate that initiation sequence is a stronger predictor of frequency of use for alcohol than for marijuana.
Purpose
To characterize the association of social class discrimination with the timing of first cigarette use and progression to DSM-IV nicotine dependence (ND) in Black and White youth, examining ...variation by race, parent vs. youth experiences of discrimination, socioeconomic status (SES), and stage of smoking.
Methods
Data were drawn from 1461 youth (55.2% Black, 44.8% White; 50.2% female) and mothers in a high-risk family study of alcohol use disorder and related conditions. Cox proportional hazard regression analyses were conducted, using youth’s and mother’s social class discrimination to predict first cigarette use and progression to ND, stratifying by race. Interactions between discrimination and SES indicators (parental education and household income) were tested. Adjusted models included psychiatric covariates.
Results
In the adjusted first cigarette use models, neither youth’s nor mother’s social class discrimination was a significant predictor among Black youth, but mother’s discrimination was associated with increased risk HR = 1.53 (1.18–1.99) among White youth. In the adjusted ND models, mother’s discrimination was associated with reduced ND risk for Black youth in middle-income families HR = 0.29 (CI 0.13–0.63), but neither youth’s nor mother’s discrimination predicted transition to ND among White youth.
Conclusions
The observed race and smoking stage-specific effects suggest that social class discrimination is more impactful on early stages of smoking for White youth and later stages for Black youth. The robustness of links with mother’s discrimination experiences further suggests the importance of considering family-level effects and the need to explore possible mechanisms, such as socialization processes.
Abstract Objective To evaluate the possible association between maternal smoking during pregnancy and offspring outcomes of birth weight, pre-term birth, remediation, low scholastic achievement, ...regular smoking, attention deficit hyperactivity disorder and conduct problems while controlling for similar behaviors in parents. Methods Using telephone interviews, data were collected, in 2001 and 2004, as a part of two United States offspring-of-twins projects. Fathers, who were twins participating in the Vietnam Era Twin Registry, their female spouse and their offspring were interviewed — information on 1,342 unique pregnancies in mothers with a history of regular smoking was utilized for these analyses. The association between maternal smoking during pregnancy and birth weight, pre-term birth, remediation, low scholastic achievement, regular smoking, attention deficit hyperactivity disorder and conduct disorder while controlling for similar behaviors in parents, was examined using regression. Results Maternal smoking during pregnancy was associated with decreased birth weight, low scholastic achievement, regular smoking and attention deficit hyperactivity disorder. However, the association between maternal smoking during pregnancy and offspring attention deficit hyperactivity disorder was explained by maternal attention deficit hyperactivity disorder. Maternal smoking during pregnancy was also associated with earlier age of offspring initiation of smoking and onset of regular smoking. Conclusions Maternal smoking during pregnancy may influence certain offspring outcomes via mechanisms that are independent from genetic risk attributable to comorbid conditions. Assisting expecting mothers with their smoking cessation efforts will likely provide widespread health benefits to both mother and offspring.
Adverse psychosocial experiences operate simultaneously to affect mental health and behavior. The current study used mixture modeling to identify subgroups of young adults based on experiences of ...four types of psychosocial adversity and characterize their associations with depression, anxiety, world assumptions, substance use, and sexual risk behavior. Sexual assault, physical assault, and discrimination (interpersonal adversity) showed similar patterns within each group but diverged from neighborhood disadvantage in two groups. Groups characterized by higher interpersonal adversity reported the most negative health outcomes. Findings highlight variations in the co-occurrence of adverse experiences and differential links to risky health behaviors and mental health.
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