Exploring the Influence of Internal and Environmental Protective Factors on Adolescent Alcohol and Drug Use

Background: Adolescent use of tobacco, alcohol, and illicit drugs are associated with global rates of increased morbidity and mortality. Negative outcomes of substance use include a higher probability of aggressive behavior, delinquency, chronic substance abuse disorders in adulthood, compromised mental health, and damaged interpersonal relationships. This study explores resilience-promoting characteristics (environmental and internal protective factors) that may mitigate alcohol and other drug (AOD) use in adolescents. While internal traits may play a role in resilience, social ecological theory posits that resilience develops within social ecologies, and that positive outcomes are reflective of environments that help facilitate positive growth.

Methods: Data from the 2013 California Healthy Kids Survey (CHKS) were used for this analysis; a sample of 7^th, 9^th, and 11^th grade students (n = 36,517) was drawn from schools across the state of California. All questions were student self-report. AOD was measured with 2 items assessing the presence of AOD use within the past six months. Resilience-promoting characteristics were measured with 9 items including: if adolescents had an adult in the home who believed they would be a success, who wanted them to do their best, and listened; if adolescents knew where to go with a problem, tried to solve problems by talking/writing, and understood their moods/feelings. A series of Chi-square tests were conducted to establish the association between the independent and dependent categorical variables, followed by a logistic regression analysis to identify the effect of environmental and internal protective factors on (AOD) use in adolescents.

Results: Students who scored higher on the following protective factors indicated they were less likely to engage in AOD use. Adolescents who had an adult in their home who talked to them about their problems (OR = .886, p < .001) indicated an 11.4% decreased odds of using AOD. Adolescents who had an adult in their home who wanted them to do their best (OR = .886, p < .001) indicated an 11.4% decreased odds of using AOD. Adolescents who reported trying to work out their problems by writing/talking about them (OR = .930, p < .001); ) indicated an 7% decreased odds of using AOD. Adolescents who reported being able to understand their moods and feelings (OR = .873, p < .001) indicated an 12.7% decreased odds of using AOD.

Conclusion: The purpose of this study was to explore resilience-promoting characteristics within a social ecological framework. Results support the research hypothesis that adolescents who employ coping skills and have a supportive adult in their home are less likely to engage in AOD use. Consistent with social ecological theory, the environmental protective factors in this study consistently provided a stronger buffer against alcohol and other drug use in adolescents than the internal protective factors. Furthermore, given that the environment strongly impacts early biological development, it may be misleading to measure internal traits with the assumption that they are not influenced, or largely a byproduct of environmental variables. Implications for practice include a renewed focus on assessing environmental supports and work to develop these influences.