Sunday, 16 January 2005 - 8:45 AM

This presentation is part of: Subtance Abuse in Adolescents

Factors Associated with Adolescent Substance Abuse/Dependence: A Study of American Indians

Purpose: This study examines multiple factors of substance abuse or dependence in American Indian adolescents, who have the highest substance use rates in any other ethnic group (USDHHS, 2002). This present study is based on social ecological theory (Bronfenbrenner, 1979), which underlines negative relationships between environment (e.g., the family, peers, schools, community and culture) and problem behaviors.

Methods: A stratified sample of 401 American Indian adolescents, aged 13 to 19 years, living in Southwestern urban and reservation areas was interviewed in 2001. We assessed substance abuse/dependence (using the DIS), familial problems (family member mental health problems, family member addiction, family life stressful events and any child abuse experiences), social problems (peer misbehavior, negative neighborhood or school atmosphere, and traumatic events) and cultural environment (cultural activities and cultural pride/spirituality).

Results: Twenty six percent of American Indian youth in this sample met DSM-IV criteria for substance abuse/dependence. There was no significant difference in the prevalence between the two locations. Reservation youth had significantly more family members' mental health problems and misbehaving peers than urban youth. In contrast, urban youth had significantly more negative school atmosphere and cultural pride/spirituality than reservation youth. Adolescents with substance abuse/dependence had significantly more all familial problems (family members with mental health problems, family member addiction, family life stressful events, and any child abuse experiences) and all social problems (peer misbehavior, problematic school and neighborhood environment, and traumatic events) than those who did not have abuse/dependence. Multiple logistic regression showed that age (b=0.18, p= .00224), family member addiction (b=0.58, p= .0002), peer misbehavior (b=0.18, p < .0001) and traumatic events (b=0.24, p= .0002) were significant factors relating to abuse/dependence. Specifically, for each year of age increase, youth were 19 % more likely, in the terms of odds, to have substance abuse/dependence (95% CI: 1.03-1.39). When controlling for age, familial and social environment were related to the additional variance. For each unit increment in family member drug use, youth were 79% more likely to have abuse/dependence (95% CI: 1.32-2.44). For each unit increment in peer misbehavior, youth were 20% more likely to have abuse/dependence (95% CI: 1.14-1.25). For each unit increment in traumatic events, youth were 27% more likely to have substance abuse/dependence (95% CI: 1.12-1.44). However, cultural factors, an element of environment, were not related to adolescent substance abuse/dependence.

Implications for practice: Our multivariate results are consistent with social ecological theory that predicts adolescents with familial and/or social problems are more likely to be substance abusing or dependent. Therefore, familial and social environment should be assessed for and incorporated into prevention and intervention programs for abuse/dependence. * Funded by NIDA Grant # 1 RO1 DA13227-01

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