David W. Brook

Longitudinal Study of Co-occurring Psychiatric Disorders and Substance Use

OBJECTIVE To examine temporal priority in the relationship between psychiatric disorders and drug use. METHOD Psychiatric assessments and drug use were completed at three different points in time, spanning 9 years. Structured interviews were administered to a cohort of youths and their mothers. Subjects were selected on the basis of their residence in either of two counties in upstate New York. The sample was predominantly white male and female youths, aged 1 through 10 years upon initial collection of data. Psychiatric diagnoses were assessed by a supplemented version of the Diagnostic Interview Schedule for Children Version 1, using computer algorithms designed to match DSM-III-R criteria to combine information from mothers and youths. Substance use information was obtained in the interviews. RESULTS A significant relationship was found to exist between earlier adolescent drug use and later depressive and disruptive disorders in young adulthood, controlling for earlier psychiatric disorders. Earlier psychiatric disorders did not predict changes in young adult drug use. CONCLUSIONS Implications for policy, prevention, and treatment include (1) more medical attention needs to be given to the use of legal and illegal drugs; and (2) a decrease in drug use may result in a decrease in the incidence of later psychiatric disorders.

The role of older brothers in younger brothers' drug use viewed in the context of parent and peer influences.

The purpose of this study was to examine the impact of an older brothers drug use on his younger brothers drug use viewed in the context of parent and peer influences. The sample consisted of 278 White, middle-class male college students and their oldest brothers, who were given questionnaires assessing drug behavior. Results indicated that older brother, parental, and peer drug use each had an independent impact on younger brothers use. The degree of influence varied, with drug modeling by peers and older brothers having a stronger association with younger brother drug use than did parental drug modeling. Further, the older brothers advocacy of drugs was associated with his younger brothers use even if the older brother did not serve as a drug model. Similarly, older brother drug modeling was of importance even if he did not advocate use. Finally, interactive results suggested that older brothers who did not use drugs could offset the negative effects of parental drug risks on younger brother use. Also, younger brothers were least likely to use drugs if both older brothers and peers served as models for nonuse.

DRUG USE AMONG AFRICAN AMERICANS : ETHNIC IDENTITY AS A PROTECTIVE FACTOR

This study examined the multiple components of ethnic identity, the place of this ethnic identity set in the mediational model of the path to drug use predicted by our family interactional framework, and the protective role of each component of ethnic identity. The participants were 259 male and 368 female African Americans in late adolescence. They responded to a structured questionnaire in individual interviews. We found that few of the specific components of ethnic identity were significantly related as main effects to drug use. Most of the effect of ethnic identity was mediated by the family set of variables. Each of the components of ethnic identity offset risks or enhanced protective factors from the ecology, family, personality, and peer domains, thereby lessening drug use. This pattern highlights the importance of incorporating ethnic identity into drug prevention programs which serve African-American youth.

Risk and Protective Factors of Adolescent Drug Use: Implications for Prevention Programs

In conclusion, the current interest in the study of adolescent drug use is likely to broaden inquiry and yield a sounder base of evidence, both of which augur well for future investigations, for further comprehension of the etiology of drug use, and for prevention programs. Should the effect of prevention programs that address the childhood and adolescent risk factors identified in etiologic studies result in reduced drug use and abuse in future evaluations, empirical data will then be available that may yield further knowledge about the benefits of prevention programs.

Alcohol Use in Adolescents Whose Fathers Abuse Drugs

Abstract This study examined the interrelation of several domains, including father attributes, father-child relations, peer influences, environmental factors, and youth personality, as they related to adolescent alcohol use. Several aspects of the father-child relationship were also examined as possible protective factors against adolescent drinking. Subjects consisted of 204 HIV-positive and HIV-negative drug-abusing fathers and their adolescent children between the ages of 12–20. Data were collected via individual structured interviews of both the fathers and the youth. Results indicated that several items from each domain were related to adolescent drinking, and that an affectionate father-child bond had a protective effect. Moreover, hierarchical regression analyses demonstrated that the youths personality mediated between all other domains and adolescent alcohol use. There was also a direct effect of peer influences on adolescent drinking. Findings extend the literature on the specific mechanisms which link parental substance use with adolescent alcohol use in a high-risk population.

Marijuana Use Among the Adolescent Children of High-Risk Drug-Abusing Fathers

This study examines marijuana use among children of male drug abusers. Subjects were 83 African-American and European-American male drug abusers, of whom the majority were injection drug users, and their children. Thirty-one of the fathers were HIV-positive and 52 were HIV-negative. Using logistic regression analyses, we explored cross-sectionally the relationship between four psychosocial domains (ie, paternal attributes, adolescent problem behaviors, father-adolescent relations, and environment) and adolescent marijuana use. The fathers use of illegal drugs and his failure to cope adaptively predicted adolescent marijuana use, while a close father-child bond predicted less adolescent marijuana use. Adolescent problem behaviors predicted an increased likelihood of marijuana use. Furthermore, hierarchical regression analysis demonstrated that the adolescents problem behavior mediated the associations between both the father-adolescent relationship and environmental factors with adolescent marijuana use. Reducing the risk factors and enhancing the protective factors within each of the domains could help reduce marijuana use among the adolescent children of drug-abusing fathers. Moreover, if a father is a drug abuser, it is important to help him establish a close bond with his child in order to help attenuate the influence of his drug use on the childs marijuana use.

Earlier Marijuana Use and Later Problem Behavior in Colombian Youths

OBJECTIVE The study examined the relationship between earlier adolescent marijuana use and later adolescent behavioral problems. METHOD A community-based sample of Colombian adolescents was interviewed in 1995-1996 and 1997-1998. The time 2 (T(2)) sample consisted of 1,151 males and 1,075 females. The psychosocial measures assessed adolescent problem behavior, the peer and sibling social network, and ecological/environmental stress and cultural domains. Logistic regression analyses included controls on demographic and time 1 (T(1)) dependent measures. RESULTS The findings suggest that T(1) adolescent marijuana use was associated with increased risks for T(2) adolescent difficulty at work or school, violent experiences, peer marijuana use, and sibling marijuana problems. CONCLUSIONS This study provides important evidence in this cohort of the specific relationship between T(1) adolescent marijuana use and T(2) adolescent problem behavior in a society in which drug use, crime, violence, and low educational attainment are pervasive. Similar findings have been shown in previous research with U.S. adolescents. The findings suggest that early adolescent marijuana use is associated with an increase in problem behavior during later adolescence.

Coping in Adolescent Children of HIV-Positive and HIV-Negative Substance-Abusing Fathers

Abstract The authors examined coping in the adolescent children of drug-abusing fathers who have, or are at risk for contracting, human immunodeficiency virus (HIV). The ability to cope is an important factor in the adolescents own risk behaviors, including drug use and associated problems. Each father and his adolescent child were separately administered a structured interview regarding personality, drug use, relationships, coping, and other behaviors. Adolescent adaptive coping was found to be related to greater conventionality, less marijuana use, fewer intra- and interpersonal problems, paternal adaptive coping, and a close father-child bond. Moreover, analysis using a risk factor index indicated an exponential increase in adolescent maladaptive coping with each additional psychosocial risk. Implications for policy and intervention are also discussed.

Needle sharing : a longitudinal study of female injection drug users

The objective of this study was to examine the psychosocial risk and protective factors related to needle-sharing behavior among female intravenous drug users (IDUs) positive (N = 96) and negative (N = 128) for human immunodeficiency virus (HIV). Participants in this longitudinal study were interviewed individually at two points in time, with a 6-month interval between interviews. The interviewers used a structured questionnaire, which included psychosocial measures and questions about drug and sexual risk behaviors. Data were analyzed using Pearson correlations and hierarchical regression analyses. The findings supported a developmental model in which the psychosocial domains and HIV status predicted T1 (initial) needle-sharing behavior, which in turn was related to T2 (follow-up) needle-sharing behavior. In addition, the relationship between personality and peer risk factors and T2 needle sharing was buffered by family-related protective factors. While HIV-positive status had a direct effect on T1 needle sharing with strangers, its effect was mediated by all of the psychosocial variables in its relation to T1 needle sharing with familiar people. Comparisons of these results were made with a companion study of male IDUs. The results suggest several intervention and treatment approaches that can be implemented at different points in the developmental pathways leading to risky needle-sharing practices among female IDUs.

Correlates of marijuana use in Colombian adolescents: a focus on the impact of the ecological/cultural domain

To examine the influence of ecological/cultural factors and family, personality, and peer factors present during early adolescence that influence marijuana use in late adolescence. A community sample of 2,226 Colombian adolescents living in mixed urban-rural communities and their mothers were interviewed in their homes by trained Colombian interviewers, first in 1995-1996 and then again 2 years later. The scales used were based on item intercorrelations and grouped into the following categories: (a) adolescent personality, (b) family traits, (c) peer factors, (d) ecological/cultural variables, and (e) marijuana use. Data were examined using hierarchical regression modeling to determine the relationship between each of the domains and late adolescent marijuana use. The findings supported the family interactional theory of adolescent drug use behavior and found that factors in all of the domains had a direct effect on late adolescent marijuana use as well as indirect effects mediated through the more proximal domains in the model. Of particular interest was the strength of the influence of the ecological/cultural factors, which far exceeded that observed in similar studies done in the United States. Owing to the similarity with findings from studies conducted in the United States, interventions designed domestically could effectively be directly applied to adolescents in Colombia. The findings also suggest that prevention programs designed specifically to target ecological or cultural factors may have the most profound influence for reducing marijuana use in late adolescence.