Is Inhalant Use Influenced By Youths' Perceptions of How Well Their Caseworkers Listen?

BACKGROUND AND PURPOSE:  Adolescent inhalant use is a serious public health problem among maltreated youth.  Examples of inhalants include glue, paint, gasoline, solvents, whipped cream dispensers, and nail polish remover (Johnston et al., 2015; NIDA, 2012a, 2012b). Inhalants are consumed by “sniffing,” “huffing,” or “snorting” fumes from paper or plastic bags, soaked rags, containers, or directly from aerosol cans.  Inhalant intoxication is similar to alcohol intoxication; it lasts only a few minutes, includes euphoria, dizziness, ataxia, and slurred speech.  Health consequences of inhalant use include brain damage, heart irregularities, optic nerve damage, hearing loss, liver damage, muscle atrophy, and death (NIDA, 2012a, 2012b)

Prior studies have found that victims of child maltreatment (NIDA, 2012a) and youth who engage in delinquency (Snyder & Howard, 2015) are especially at risk of inhalant use. One study found that the relationship between problem behaviors and the extent that caseworkers listened to them was moderated by the type of maltreatment experienced. Because physically abused children engaged in more problem behaviors the impact of having a caseworker who listened had a greater affect among physically abused children (Merritt & Snyder, 2014). This study will investigate whether children’s perceptions of caseworker support (e.g. feeling listened to) influences inhalant use after controlling for other variables associated with use.

METHODS: The sample included a subsample of 1,054 participants (11-17 years old) from Wave I (October 2008-September 2009) of the second National Survey of Child and Adolescent Well-Being (NSCAW II). The dependent variable was lifetime inhalant use (yes=1). Covariates included age, sex (Male =1), race (White =1), out-of-home care (yes =1), whether youth felt that their caseworkers listened to them most of the time (yes =1), delinquency (sum of 36 items, ranges from 0 to 36), school engagement (i.e., students’ emotional, behavioral, and academic engagement in school; Furlong & Christenson, 2008), and caseworker reported maltreatment including sexual abuse, physical abuse, and supervisory neglect. Stata 14.1 was used for analyses. We examined bivariate relationships between each of the covariates and inhalant use. Logistic regression, which is used for modeling dichotomous outcome variables, was employed to investigate correlates of inhalant use.

RESULTS:  No significant relationships existed between any of the maltreatment variables and inhalant use. Logistic regression found a negative relationship between caseworker listening and inhalant use. Youth who reported lower levels of caseworker listening were more likely to use inhalants (OR = 0.46, p< 0.01). In addition, as reports of delinquency increased youth were more likely to use inhalants (OR = 1.61, p< 0.001). White youth were more likely than youth from other racial groups to use inhalants (OR = 3.08, p< 0.05). Differences were not found based on sex, the type of maltreatment experienced, or whether youth lived in out-of-home care. No moderation relationships were found based on sex or maltreatment type and the extent caseworkers listen.

IMPLICATIONS FOR PRACTICE: This study’s findings have important implications for practice. Youths’ perceptions of caseworkers’ listening may deter inhalant use.  Furthermore, these findings underscore the need for interventions to improve caseworker-child relationships.