Michael J. Cleveland

Perceived discrimination and substance use in African American parents and their children: a panel study.

The relation between perceived racial discrimination and substance use was examined in a panel of 684 African American families, using the prototype-willingness model of adolescent health risk (F. X. Gibbons, M. Gerrard, & D. Lane, 2003). Discrimination was concurrently and prospectively related to use in the parents and the children (mean age=10.5 years at Wave 1). The discrimination-->use relation in the parents was mediated by distress (anxiety and depression). Among the children, the relation was mediated by distress as well as their risk cognitions (favorability of their risk images and their willingness to use) and the extent to which they reported affiliating with friends who were using substances. Each of these relations with discrimination was positive. In contrast, effective parenting was associated with less willingness and intention to use. Theoretical and applied implications of the results are discussed.

The role of risk and protective factors in substance use across adolescence.

PURPOSE To compare the relative influence of risk and protective factors across several domains on adolescent substance use in a large sample of youth. METHODS Cross-sectional survey data were collected from students in grades 6, 8, 10, and 12 in Pennsylvania (N = 91,778). Generalized linear mixed models were estimated for each grade level to examine associations among indices of three risk factors (individual, peer, and family) and three protective factors (family, school, and community) and both recent and lifetime substance use. RESULTS The risk factors were stronger predictors of substance use outcomes compared with the protective factors, regardless of grade level or substance use type. In particular, the individual and peer risk factors were strongly related to lifetime and recent use of cigarettes, alcohol, and marijuana. Among the protective factors, the strongest associations with substance use were found in the community domain. Several age-related differences in the associations were also found, suggesting that family and community factors were more salient among younger adolescents whereas peer and school factors were stronger among older adolescents. CONCLUSIONS These findings provide support for the social development model (SDM), which proposes that adolescent substance use is associated with factors across multiple spheres of influence. Age-related differences in these associations suggest that effective interventions to reduce adolescent substance use may need to emphasize different domains of risk and protective factors at different stages of adolescent development.

A theory-based dual-focus alcohol intervention for preadolescents: The Strong African american Families program.

This study examined mediators of the Strong African American Families Program, a randomized, dual-focus prevention trial intended to delay the onset of alcohol use and reduce alcohol consumption among rural African American youths. More specifically, it demonstrated that changes in consumption 2 yrs after the intervention were mediated through 2 different paths, a social reaction path and a reasoned/intention path. The social reaction path provided evidence that relative to the control condition, the intervention decreased childrens willingness to drink by making their images of drinkers less favorable. The reasoned/intention path provided evidence that the intervention influenced the childrens intentions to drink by increasing targeted parenting behaviors related to alcohol. Furthermore, the data demonstrate that these changes in willingness and intentions were independently associated with alcohol consumption at the follow-up, and they suggest that a dual-process model approach that targets both intentions and willingness can be more successful than either approach alone.

Transitions in first-year college student drinking behaviors: does pre-college drinking moderate the effects of parent- and peer-based intervention components?

This study used Latent Transition Analysis (LTA) to examine a stage-sequential model of alcohol use among a sample of high-risk matriculating college students (N=1,275). Measures of alcohol use were collected via web-administered surveys during the summer before entering college and followed-up during the fall semester of college. Seven indicators of alcohol use were used in the LTA models, including temporal measures of typical drinking throughout the week. The results indicated that four latent statuses characterized patterns of drinking at both times, though the proportion of students in each status changed during the transition to college: (a) nondrinkers; (b) weekend nonbingers; (c) weekend bingers; and (d) heavy drinkers. Heavy drinkers were distinguished by heavy episodic drinking (HED), and increased likelihood of drinking throughout the week, especially on Thursdays. Covariates were added to the LTA model to examine the main and interaction effects of parent- and peer-based intervention components. Results indicated that participants in the parent and peer conditions were least likely to transition to the heavy drinkers status. Results also indicated that the parent condition was most effective at preventing baseline nondrinkers from transitioning to heavy drinkers whereas the peer condition was most effective at preventing escalation of use among weekend nonbingers. The results underscore the value of considering multiple dimensions of alcohol use within a person-centered approach. Differential treatment effects were found across baseline drinking class, suggesting the benefit for tailored intervention programs to reduce high-risk drinking among college students.

Does Individual Risk Moderate the Effect of Contextual-Level Protective Factors? A Latent Class Analysis of Substance Use

The current study investigated how individual risk factors interact with social contextual-level protective factors to predict problematic substance use among a sample of 12th-grade students (n = 8,879, 53% female). Results suggested six latent classes of substance use: (1) Non-Users; (2) Alcohol Experimenters; (3) Alcohol, Tobacco, and Other Drug (ATOD) Experimenters; (4) Current Smokers; (5) Binge Drinkers; and (6) Heavy Users. Binary logistic regression models provided evidence that individual risk, family, school, and community protective factors were associated with membership in the substance use latent classes. However, the significance of interaction terms suggested that these protective influences differed according to the level of individual risk. Adolescents with high levels of individual risk benefited less from a positive family or neighborhood context than adolescents with low levels of individual risk. These findings suggest that the individual risk factors may undermine the protective effect of parental supervision, discipline, and other family factors, as well as protective aspects of cohesive neighborhoods, among these adolescents. Multi-component and adaptive intervention efforts that account for different levels of ATOD use involvement, as well as distinct profiles of risk and protection, are likely to be most effective in preventing problematic substance use.

Applying General Strain Theory to Examine Perceived Discrimination’s Indirect Relation to Mexican-Heritage Youth’s Alcohol, Cigarette, and Marijuana Use

Latent growth curve modeling was used to test four hypotheses. First, this study hypothesized that acculturation-related variables (e.g., Mexican-heritage youth’s country of origin, time spent in the U.S., and language preference with family and friends) would be associated with initial levels of perceived discrimination. Guided by general strain theory (GST), this study then posed a second hypothesis: Initial levels of perceived discrimination would be indirectly related to initial levels of substance use through initial levels of acculturation stress. Third, this study hypothesized that changes in perceived discrimination would be indirectly related to changes in substance use through changes in acculturation stress. As a fourth hypothesis, it was postulated that initial levels of perceived discrimination would be indirectly related to changes in substance use through changes in acculturation stress. Mexican-heritage youth (N = 1,106) from 29 schools in Phoenix, AZ completed surveys at six waves from 5th through 8th grades. In partial support of the first hypothesis, more time spent in the U.S. and speaking English with friends were associated with lower levels of perceived discrimination. The second hypothesis was not supported. Initial levels of perceived discrimination were positively associated with initial levels of acculturation stress; however, this association was not found between initial levels of acculturation stress and substance use. The third and fourth hypotheses were supported, which buttressed predictions derived from GST. Both initial levels and increases in perceived discrimination were indirectly related to increases in substance use through increases in acculturation stress.

Perceived discrimination as a risk factor for Latina/o youth's substance use: do parent- and peer-based communication and relationship resources act as protective factors?

Based on general strain theory, it was hypothesized that as Latina/o youth experience perceived discrimination, they are more likely to develop acculturation stress and, in turn, more likely to use substances. Two additional hypotheses were set forth to examine how parent- and peer-based communication, relationship, and norm resources may function as buffers, thereby decreasing the likelihood that strained youth will use substances. Latina/o youth (N = 728) from 23 schools in Phoenix, AZ, completed surveys at three waves over 2 years. Structural equation modeling (SEM) results supported the first hypothesis. Yet, contrary to the second hypothesis, neither parent nor peer resources were significant moderators. Implications are discussed for theory and parent- and peer-based prevention research directed at perceived discrimination, acculturation stress, and substance use.

Examining the relationship between alcohol-energy drink risk profiles and high-risk drinking behaviors.

BACKGROUND The mixing of alcohol and energy drinks (AMEDs) is a trend among college students associated with higher rates of heavy episodic drinking and negative alcohol-related consequences. The goals of this study were to take a person-centered approach to identify distinct risk profiles of college students based on AMED-specific constructs (expectancies, attitudes, and norms) and examine longitudinal associations between AMED use, drinking, and consequences. METHODS A random sample of incoming freshmen (n = 387, 59% female) completed measures of AMED use, AMED-specific expectancies, attitudes, and normative beliefs, and drinking quantity and alcohol-related consequences. Data were collected at 2 occasions: spring semester of freshmen year and fall semester of sophomore year. RESULTS Latent profile analysis identified 4 subgroups of individuals: occasional AMED, anti-AMED, pro-AMED, and strong peer influence. Individuals in the pro-AMED group reported the most AMED use, drinking, and consequences. There was a unique association between profile membership and AMED use, even after controlling for drinking. CONCLUSIONS Findings highlighted the importance of AMED-specific expectancies, attitudes, and norms. The unique association between AMED risk profiles and AMED use suggests AMED use is a distinct behavior that could be targeted by AMED-specific messages included in existing brief interventions for alcohol use.

Predicting alcohol use across adolescence: relative strength of individual, family, peer, and contextual risk and protective factors.

The current study examined developmental changes in the relative influence of risk and protective factors (RPFs) across individual, family, peer, school, and community domains on adolescent alcohol use. Using longitudinal data from two independent samples, multivariate cross-lagged models were used to estimate the unique influence of each RPF on subsequent changes in recent alcohol use between early to late adolescence. The results supported the hypothesis that the influence of Individual Risk would increase during this developmental period. However, less consistent evidence was found concerning developmental changes among the other domains. Whereas the influence arising from Family Protection diminished during adolescence, the influence of Family Risk, School Protection, and Community Protection did not vary. The influence of Peer Risk showed a nonlinear pattern across adolescence, peaking during the middle adolescent years. The results of this study support a developmental approach to adolescent alcohol use and emphasize the need for prevention strategies that account for these developmental changes.

Profiles of Protection from Substance Use among Adolescents

The purpose of this study was to explore whether adolescents (N = 10,287) could be classified into homogeneous subgroups based on their protective factors and, if so, whether these constellations of protection differentially relate to adolescents’ lifetime and 30-day alcohol and tobacco use. Latent class analysis with eight protective factors—four internal and four external—were used to identify the underlying latent class structure. Five profiles of protection emerged: Adequate Protection (54%), Adequate External Protection (9%), Adequate Protection with Low Adult Communication (16%), Adequate Protection with Risky Friends (9%), and Inadequate Protection (12%). Lifetime alcohol use was associated with only a modest increase in odds of belonging to the Adequate External or Low Adult Communication latent classes, but an enormous increase in odds of having Inadequate Protection or Risky Friends. Similar effects were found for past month alcohol use. Unlike alcohol use, which was related most strongly with membership in the Risky Friends latent class (relative to Adequate Protection), cigarette use was most strongly related to membership in the Inadequate Protection latent class. Findings can be used to inform prevention programs as they illustrate the relationships that exist between adolescents’ profiles of protection and substance use.