Running head: INVESTIGATING PREDICTORS
Investigating Predictors of Substance Use among Adolescents
Hailey Schuchart
The Pennsylvania State University – York
Ms. Laura Simone
April 21, 2013
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Substance use refers to the inappropriate consumption of medicines, drugs, or other
materials including prescription drugs, over-the-counter drugs, street drugs, alcohol, and tobacco.
Substance use is an influence on an adolescent’s physical, social, and emotional health.
Substance use has been identified as a predictor of adolescent’s risk of lower grades and a lower
GPA (Bachman, Staff, O’Malley, & Freedman-Doan, 2013). It is possible that adolescent
substance use can be influenced by stress and various family related factors, such as
socioeconomic status and having a parent who participates in substance use. Extent literature
indicates that adolescent substance use can be influenced by multiple factors including peer
pressure, spending long hours in paid employment, parent-adolescent interaction/
communication, bullying, and adolescent gender. The particular focus of this study is to
investigate the roles of stress, health complications, and coping as contributors to substance use
among adolescents.
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Annotated Bibliography
Bachman, J. G., Staff, J., O'Malley, P. M., & Freedman-Doan, P. (2013). Adolescent work
intensity, school performance, and substance use: Links vary by race/ethnicity and
socioeconomic status. Developmental Psychology. doi: 10.1037/a0031464
The authors, researchers from University of Michigan and Pennsylvania State University,
examined whether youth from certain racial/ethnic and socioeconomic backgrounds may be
more likely to suffer negative consequences from working long hours during the school year. A
sample of 314,959 tenth graders and 276,026 twelfth graders was used in this cross-sectional
study. The sample answered questions on a scale about their work intensity during the school
year, as well as the number of substances used. MTF analyses was used in this study that
confirmed 12th graders are more likely than 10th graders to be employed and to spend longer
hours on the job. Intensive work is strongly related to negative behavior, such as using
substances to relax. Results of this study show variation between population subgroups in rates
of employments and work intensity. Results suggest some differences in how work intensity
relates to academic success and negative behaviors. This study documents the boundaries of key
relationships with important policy implications for subgroups. One of the limitations in this
study is that the researchers focused on the intensity of work during high school and did not
focus on the quality of work experience.
Burstein, M., Stanger, C., & Dumenci, L. (2012). Relations between parent psychopathology,
family functioning, and adolescent problems in substance-abusing families:
Disaggregating the effects of parent gender. Child Psychiatry and Human Development,
43(4), 631-647. doi: 10.1007/s10578-012-0288-z
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In this study, the authors hypothesized that maternal and paternal ratings of family
functioning would mediate the relation between parent psychopathology and youth problems.
The sample consisted of 224 families with 325 adolescent youth between the ages of 10 and 18.
The 224 parent participants had substance abuse/dependence disorders. In this cross-sectional
study, the sample answered various questions on a scale about their family as well as substance
use among the adolescents. Many statistical analyses were used in this study, but structural
equation modeling was used to estimate the initial hypothesis. Results showed that maternal
psychopathology predicted adolescent problems and substance use. Findings showed that father
family functioning problems mediate relations between parental psychopathology. This study is
the first to distinguish maternal and paternal reports of family functioning problems as mediators.
One of the limitations in this study is that because cross-sectional data was used, the direction of
effects and causations cannot be determined.
Coley, R. L., Votruba-Drzal, E., & Schindler, H. S. (2008). Trajectories of parenting processes
and adolescent substance use: Reciprocal effects. Journal of Abnormal Child Psychology,
36(4), 613-625. doi: 10.1007/s10802-007-9205-5
In this longitudinal study, researchers hypothesized that maternal and paternal knowledge
and regular family activities will discourage later adolescent involvement in substance use.
Researchers further expected that adolescent substance use will predict declines over time in
positive parenting processes. Hierarchical Linear Modeling (HLM) was the statistical analysis
used to analyze the sample. The sample consisted of 3,317 youth, ages 12-14. Scales were used
to measure different components in this study, but an index was used for measuring adolescent
substance use.
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The results of this study suggest that retaining stable family traditions and regular time
together may be an important mechanism for families to help adolescents decrease their
interaction with substance use. Results show support for the idea that such positive family
processes help to decrease adolescent substance use, but researchers could not provide clear and
strong support in the reverse direction; that is, researchers stated that evidence is vague that
adolescent engagement in substance use impacts positive family processes. An important
strength in the research is the analytic model provided modeling trajectories of family processes
and adolescent substance use as function of previous characteristics and behaviors. The
limitations, however, is researchers are not certain that all characteristics and processes were
accounted for, and relationships between the families may be due to factors that were not
measured.
D’Amico, E., Edelen, M., Miles, J., &Morral, A. (2008). The longitudinal association between
substance use and delinquency among high-risk youth. Drug and Alcohol Dependence,
93, 85-92. doi: 10.1016/j.drugalcdep.2007.09.006
In this longitudinal study, researchers examined the association between substance use
and delinquency among adolescents over a 12 month period. The sample of this study was 449
youth who were recruited from the Los Angeles juvenile probation system. Scales were used to
measure the amount of substance the adolescent used in the past 90 days. Many other
components were measured in this study as well. The researchers used a series of cross-lagged
path models using full information maximum likelihood-robust (MLR) as their analysis.
Findings of this study suggest that substance use and delinquent behavior have a reciprocal
effect. Results also suggested that substance use predicted future delinquent behavior, and
delinquent behaviors predicted future substance use.
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This study provided a methodological advance to previous work in this area as they
controlled for time spent in a controlled environment over the amount of 12 months. However,
there are some limitations to this study. One of the limitations is that the sample was of juvenile
delinquent adolescents’, meaning it is not clear whether these results will apply to other
adolescent populations.
Fujimoto, K., & Valente, T. W. (2012). Social network influences on adolescent substance use:
Disentangling structural equivalence from cohesion. Social Science & Medicine, 74(12),
1952-1960. doi: 10.1016/j.socscimed.2012.02.009
In this study, the authors researched how peers and social networks can influence
substance use. In this cross-sectional study, researchers examined three main aims. First was to
examine peer influences based on two contagion mechanisms of cohesion and structural
equivalence. Second was to examine the extent to which behavior transmission reduces as a
function of social distance. Third, researchers wanted to examine whether cohesion and
structural equivalence differ in terms of their influences on drinking and smoking. This large
sample of 15,355 7th- 12th graders answered questions on a scale about the number of times they
drank or smoked over the past year. A logistic regression model was used to show the
association between network exposure and drinking and smoking.
Results showed that peer influence based on structural equivalence may better explain
adolescents’ drinking and/or smoking behavior rather than on cohesion in the context of
adolescent friendships at school. This study shows the usefulness of examining peer influence
process based on communication comparison, and opens the options of undoing these two
processes as a contagion mechanism in the spreading of drinking and smoking among
adolescents. However, this study was limited by the data sample because of the large range that
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was included. The study was also not sensitive to large sub-groups such as sports teams or
gangs.
Kim, M. J., Catalano, R. F., Haggerty, K. P., & Abbott, R. D. (2011). Bullying at elementary
school and problem behaviour in young adulthood: A study of bullying, violence and
substance use from age 11 to age 21. Criminal Behaviour and Mental Health, 21, 136144. doi: 10.1002/cbm.804
In this longitudinal study, the authors examine the long-term effect of childhood bullying
on problem behavior in young adulthood. Using a sample of 957 young students, the authors
examined whether bullying significantly predicted violence, heavy drinking, and marijuana use
at age 21. Violence was measured by an index that calculated the number of violent acts
committed in the past year. Substance use was measured by how many times the sample
participated in heavy drinking and marijuana use over the past year. Using multiple regression
models, the researchers found that childhood bullying had a significant association with risk of
violence, heavy drinking, and marijuana use at age 21. This study showed that childhood
bullying had unique associations with risk of heavy drinking and marijuana use after adjusting
for effects of family and peer risk factors. However, there were limitations to this study. One
limitation was that young adult violence was measured by an index that did not fully capture the
different forms of violence interaction.
Luk, J. W., Farhat, T., Iannotti, R. J., & Simons-Morton, B. G. (2010). Parent-child
communication and substance use among adolescents: Do father and mother
communication play a different role for sons and daughters?. Addictive Behaviors, 35,
426-431. doi: 10.1016/j.addbeh.2009.12.009
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The authors of this study wanted to examine whether or not parent-child communication
plays a role in adolescent substance use. In this cross-sectional study, researchers developed
three hypotheses. First was easy father and mother communication is protective for adolescent
substance use, especially in females. Second was researchers expected that the mother-daughter
dyad is the most protective pair as compared to mother-son, father-daughter, and father-son
dyads. Lastly, researchers predicted that the inverse relationship between parent-child
communication and substance use is significant for tobacco and cannabis use but not for alcohol
use. A sample of 1,308 tenth graders answered questions about five variables, one being
substance use, on a scale created by the researchers. Chi-square tests were one of the statistical
analyses used that found inconsistent support for the first hypothesis, no support for the second
and significant support for tobacco and cannabis use but not for alcohol use. One of the major
strengths with this study is the use of a nationally representative sample. However, there were
some limitations; because this study was conducted through a cross-sectional design, it limits the
ability to draw directional or casual conclusions.
Luk, J. W., Wang, J., & Simons-Morton, B. G. (2012). The co-occurrence of substance use and
bullying behaviors among U.S. adolescents: Understanding demographic characteristics
and social influences. Journal of Adolescence, 35, 1351-1360. doi:
10.1016/j.adolescence.2012.05.003
In this cross-sectional study, the authors wanted to examine three topics: (a) the extent to
which bullying and substance use behaviors occur among adolescents; (b) the demographic
differences between adolescents with different levels of involvement with bullying and substance
use; (c) and how spending more time with peers and parental figures relate to adolescents risk of
substance use, bullying, and the occurrence of both. A sample of 7,509 adolescents answered the
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question, on a scale, of how many times they participated in using substances over the past 30
days. A four-class latent class model was found to best describe the findings in this study.
Results indicate that females are more likely to use substances, less likely to be bullies, and less
likely to be substance-using bullies.
Results also showed that compared to younger adolescents, older adolescents were more
likely to be substance users and, less likely to be bullies. Compared to Caucasian adolescents,
African-American adolescents were more likely to be bullies and Hispanic adolescents were
more likely to be substance users and substance-using bullies. Last, spending time with peers is
strongly significant to substance use. This study provides more to the literature because it
included multiple indicators of adolescent involvement in substance use, and bullying provided a
unique opportunity to examine how substances use and bullying overlap. A limitation to the
study was that it only examined independent effects and did not look at the effects of parental
and peer interaction on adolescent substance use.
Marti, C. N., Stice, E., & Springer, D. W. (2010). Substance use and abuse trajectories across
adolescence: A latent trajectory analysis of a community-recruited sample of girls.
Journal of Adolescence, 33(3), 449-461. doi: 10.1016/j.adolescence.2009.06.005
The authors of this longitudinal study had three aims. First was to search for qualitatively
distinct substance use and substance abuse during adolescents. Second was to validate grouping
solutions by testing whether trajectory groups differed on early adolescent factors. Third was to
further validate the grouping solutions by testing whether the trajectory groups showed expected
differences in young adulthood outcomes. A sample of 496 adolescent girls from public and
private schools, reported the amount of times they consumed substances during the past year on
scale ranging from 0=never to 6=3-7 times a week.
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Using one-way analysis of variance (ANOVA) to examine differences across
developmental trajectory groups, results showed that the patterns of substance use developmental
trajectories in adolescent females are typical of adolescents in general. The researchers
identified four substance abuse trajectory groups: non-abusers, moderate-escalating abusers,
declining abusers, and adolescent-limited heavy abusers. The researchers estimated a dual
trajectory model that cross-classified respondents based on their trajectories for both substance
use and abuse symptoms. These models revealed that seven of a possible sixteen crossclassifications accounted for 92% of the participants. The results of this study make two unique
additions to the literature: the substance use model supports the distinction between early and
late substance users in female samples, and the substance use model is the first model for the
adolescent period. One of the main limitations to this study was the sample was mainly from an
upper middle class background, which does not take into effect lower socioeconomic groups of
adolescents.
Simons-Morton, B. (2007). Social influences on adolescent substance use. American Journal of
Health Behavior, 31(6), 672-684. doi: 10.5993/AJHB.31.6.13
The authors of this study wanted to assess the overtime relationships between adolescent
and peer substance use and parenting practices. The researcher’s purpose for this study was to
examine associations of initial and continuing peer affiliation and parent influences with
substance use progression. In addition to the purpose, some research questions were addressed:
(a) does socialization or selection explain the relationship between adolescent substance use and
affiliation with using peers?; (b) to what extent are initial and longitudinal measures of peer
substance use and parenting behaviors associated with adolescent use progression?; (c) are the
effects of parenting practices on substance use progression mediated by peer affiliation? In this
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longitudinal study, a sample of 2,453 students answered questionnaires on their background,
substance use, and social influences.
Substance use was assessed with questions on smoking and drinking. The questionnaires
asked the students how many times they engaged in using substance over the past 30 days and
over the past 12 months. They recorded their answers on a scale of 0=no use to 4=20 times or
more. The latent growth curve was used to analyze the findings. The results showed that
parenting practices were directly protective against growth in substance use. The results also
indicated that the relationship between adolescents and peer substance use were strongly
positive. These findings may be the first to show that maintenance of positive parenting can
protect against substance use. The strength of this study was that it was longitudinal and had 5
assessments over 4 years; however, this study is limited by the reliance on self-reported data.
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Investigating Predictors of Substance Use among Adolescents
Stress level is positively associated with substance use, and this association is mediated
by health complications. Within the model of mediation, the pathway between stress and health
complications was further examined for moderation. Stress level is positively associated with
health complications, and this association is moderated by coping.
Health
complications
Coping
Stress level
Substance use
Adolescent substance use is typically assessed by a standardized scale called the
Adolescent Drug Involvement Scale (ADIS). For this study, adolescents can score a total of 69
points. Substance use will be indicated by a score above 0, but frequent substance use will be
indicated by a score of 50 or higher on the ADIS.
For this particular study, the sample technique that will be used is stratified random
sampling. This type of sampling is somewhat more complicated, but the population is divided
into subgroups and random sampling techniques are used to select sample members from each
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subgroup. The advantages of this technique are that it is representative of a population. It is also
a built-in assurance that the sample will accurately reflect the numerical composition of the
various subgroups; however, there are some disadvantages to this technique. The disadvantages
are that it can be more expensive than other sampling techniques and it may be difficult to
receive a full list of all members of any population of interest.
The sample for the present study consist of 300 adolescents (N = 300) between the ages
of 10 and 24 years (M = 17.6 years). From this sample of 300 adolescents, 156 (52%) were
females and 144 (48%) were males. One-hundred twenty students (40%) were from low
socioeconomic status (SES), meaning one-hundred forty (46.7%) were from a medial SES and
the remaining forty (13.3%) were from a high SES. One-hundred twenty-six (42%) of the
sample reported seeing one of their parents use substances, seventy-five (25%) reported seeing
both parents use substances, and ninety-nine (33%) reported never seeing one or both parents use
substances.
From these characteristics, were further found that 117 (39%) of participants lived
with only their mother, 53 (17.6%) lived with only their fathers, and 130 (43.3%) lived with both
parents.
The research design that is going to be used in this study is a cross-sectional design.
Cross-sectional is when the investigator studies groups of participants differing in age at the
same point in time. This design is appropriate for this study because the sample is adolescents
ranging in ages from 10 to 24 years, and they are participating in the study at the point in time.
Some of the advantages to doing a cross-sectional design are it is more efficient than the
longitudinal design and it allows the researcher to compare many different variables at the same
time; however, there are some disadvantages to using this research design. Some of the
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disadvantages are it does not permit study of individual development trends, and age differences
may be distorted because of cohort effects.
For this study, researchers will report the means and standard deviations of all study
variables for all study participants, as well as reporting the means and standard deviations for the
Adolescent Drug Involvement Scale used within this study. Researchers will also report
correlations among all study variables for all study participants. For this particular study, three
statistical analyses will be used to test the hypothesis.
First, the statistical analysis that is going to be used to test the mediation portion of the
hypothesis is Baron and Kenny’s test of mediation. This analysis tests mediation by using a four
step process. The first step is to show that the initial variable is associated with the outcome.
This step establishes that there is an effect that may be mediated. The second step is to show that
the initial variable is associated with the mediator. This step involves treating the mediator as if
it were an outcome variable. The third step is to show that the mediator affects the outcome
variable. This step shows that it is not sufficient just to detect a statistical association between
the mediator and the outcome; the mediator and the outcome must be associated because they are
both associated with the initial variable. Meaning, the initial variable must be controlled in
establishing the effect of the mediator on the outcome. The fourth and final step is to be able to
show that when the mediator is taken into account, the association between the initial variable
and the outcome variable weakens (to indicate partial mediation) or becomes non-significant (to
indicate full mediation). If all four of these steps are met, then the data is consistent with the
hypothesis that the association between stress and adolescent substance use is mediated by health
complications.
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The second statistical analysis that is going to be used is a Two-way (factorial) ANOVA
to test the moderation portion of the hypothesis. The Two-way (factorial) ANOVA (a) tests for
significant differences in means across two independent variables and (b) tests for moderation.
In this particular statistical analysis, researchers want to graph mean levels of health
complications for individuals with high and low level stress and those with and without
successful coping techniques to demonstrate moderation. Statistical interaction/moderation takes
place when the association between stress and health complications varies, i.e., there are
significantly different slopes for those with and without successful coping techniques. If the
slopes for these two groups are different, they will be further examined to determine if they are
significantly different.
The third and final statistical analysis that is going to be used is called structural equation
modeling (SEM). This statistical analysis is used to make sure that the data is consistent with the
hypothesis model as a whole. This analysis can test for both mediation and moderation, which is
why it is being used for this particular study. The research needs to be analyzed by breaking
down and testing the mediator and moderator separately, and then testing it all together to make
sure that it comes together as a whole.
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Appendix
Substance Use Scale
On a scale of 1-5, You
use substances because:
Least
Somewhat
Most
1. It relieves stress?
1
2
3
4
5
2. It keeps you focused?
1
2
3
4
5
3. Your friends are doing
it?
1
2
3
4
5
4. Your parents do it?
1
2
3
4
5
5. You are being bullied?
1
2
3
4
5
6. You are curious about
it?
1
2
3
4
5
7. You like the way it
makes you feel?
1
2
3
4
5
8. You see celebrities in
the media doing it?
1
2
3
4
5
9. You are afraid you will
not be accepted by your
peers?
1
2
3
4
5
10. You have easy access
to it?
1
2
3
4
5
Total Score=