Toni Terling Watt

THE RELATIONSHIPS AMONG ADOLESCENT PREGNANCY, PREGNANCY RESOLUTION, AND JUVENILE DELINQUENCY

We apply criminological theories of social control to explore the relationships among adolescent pregnancy, pregnancy resolution, and juvenile delinquency. While most ever-pregnant girls have especially high rates of delinquent behavior, adolescent mothers exhibit delinquency levels no higher than those of their never-pregnant peers. Unlike adolescent females who end their pregnancies through abortion, those who keep their babies experience a dramatic reduction in both smoking and marijuana use. Our results suggest that among adolescent girls, the birth of a child has a strong trajectory-modifying effect. It serves as a mechanisms of social control and substantially reduces the likelihood of delinquent behavior.

The Race/Ethnic Age Crossover Effect in Drug Use and Heavy Drinking

Abstract Existing literature suggests that Blacks and to some extent Hispanics are less likely than Whites to use substances in their youth. However, by age 35 their use rates are higher than those of Whites. This has been referred to as the race/ethnic age crossover effect in substance use. However, more research is needed to clarify whether this is true for Blacks and Hispanics, males and females, and for drugs and alcohol. It is also empirically unclear why this crossover effect occurs. The present study explores these issues. The National Household Survey of Drug Abuse is merged for four years (1999–2002) to study the race/ethnic age crossover effect (n = 208,878). The results suggest that the race/ethnic age crossover effect cannot be used to describe Hispanic relative to White substance use. However, it is applicable to Black substance use, in particular illegal drug use for Black males and heavy drinking for Black females. Additional analyses reveal that the crossover effect for Blacks is eliminated when socio-demographic controls are included. With controls, drug use and heavy drinking for Blacks are lower than that of Whites for all age groups and for both males and females. Process differences are also revealed in the effects of the socio-demographic correlates. More specifically, these analyses of composition and process suggest that drug availability/exposure is a particularly important factor which likely contributes to the crossover effect in substance use and deserves further study.

Factors Contributing to Differences in Substance Use Among Black and White Adolescents

Research reveals that Black youth are less likely to use alcohol than White youth. It has been argued that Blacks are more likely to abstain because they have less disposable income, are more religious, and have more family support and/or control than White youth. It has also been suggested that not only are these compositional characteristics different and likely to suppress use rates but also that the effects of these factors vary as well. However, there are no comprehensive empirical investigations of these explanations. This study uses the Add Health Survey to examine alcohol and drug use by race and/or ethnicity and to explore how differences in composition and process might produce differences in use. Results suggest that the socioeconomic contexts of Black and White youth differ considerably. However, differences in alcohol use are almost entirely explained by differences in process, in particular, the influence of peers and the family.Research reveals that Black youth are less likely to use alcohol than White youth. It has been argued that Blacks are more likely to abstain because they have less disposable income, are more religious, and have more family support and/or control than White youth. It has also been suggested that not only are these compositional characteristics different and likely to suppress use rates but also that the effects of these factors vary as well. However, there are no comprehensive empirical investigations of these explanations. This study uses the Add Health Survey to examine alcohol and drug use by race and/or ethnicity and to explore how differences in composition and process might produce differences in use. Results suggest that the socioeconomic contexts of Black and White youth differ considerably. However, differences in alcohol use are almost entirely explained by differences in process, in particular, the influence of peers and the family.

Race Differences in Strains Associated with Suicidal Behavior among Adolescents.

Rising adolescent suicide rates have prompted scholars and practitioners to identify predictive strains. Resulting profiles of suicidal adolescents often assume that a single model is applicable to all adolescent subgroups. Although scholars have repeatedly suggested that suicidal processes may vary for Blacks and Whites, few researchers have examined race differences in suicidal correlates. No studies have tested for process differences by race among adolescents specifically. This study examines social strains contributing to suicidal behavior among adolescents by race. Results support the presence of process differences and delineate the specific nature of these differences. Results hold theoretical and interventionist implications for the contextual nature of suicide among adolescents.

Race/Ethnic Differences in Alcohol Abuse Among Youth

ABSTRACT Objective: Black and Hispanic youth are less likely to abuse alcohol than White youth. However, the reasons for these race/ ethnic differences in alcohol abuse are unclear. The present study explores whether the variations can be explained, in part, by racial/ethnic differences in attitudes toward risk. Method: The National Household Survey of Drug Abuse, 2001 (n = 32,798) is used to explore race/ethnic differences in risk-taking attitudes and whether these attitudes serve to mediate race/ethnic differences in heavy drinking and drinking and driving. Results: Bivariate analyses reveal that Black and Hispanic youth have lower rates of alcohol abuse and a lower propensity for risk-taking than White youth. Logistic regressions reveal that the differences in risk-taking explain (but do not completely account for) observed differences in alcohol abuse. These findings are present for both males and females. Results more generally reveal that social and economic ad vantages are associated with risk-taking attitudes and thus indirectly contribute to alcohol abuse. Conclusions: Researchers have long been surprised that minority youth exhibit lower rates of alcohol abuse than White youth since socioeconomic disadvantage often contributes to substance abuse. However, the present study suggests that social and economic disadvantages might also suppress risk-taking propensities, which in turn may reduce the incidence of alcohol abuse. Additional research is needed to understand the mechanisms by which social and cultural resources affect attitudes toward risk.

Marital and Cohabiting Relationships of Adult Children of Alcoholics Evidence from the National Survey of Families and Households

The popular press has disseminated widely the idea that adult children of alcoholics (ACOAs) have relational deficiencies. This literature has been challenged due to its reliance on clinical samples; however, evidence of no difference between ACOAs and non-ACOAs has come from studies of college students. The National Survey of Families and Households is used to examine the effect of growing up in an alcoholic family on adult marital and cohabiting relationships. In support of the deficit model, results reveal that ACOAs are less likely to marry and have lower levels of marital quality and stability than non-ACOAs. Additional ACOA deficiencies that serve to mediate these relationships are also identified. However, while ACOAs commonly are profiled as women exhibiting excessive dependency, results reveal effects for men and women and evidence for relational patterns characterized by distance rather than overinvolvement. Research using more representative samples is needed to dispel misleading stereotypes.

Exploring the Impact of a Wilderness-Based Positive Youth Development Program for Urban Youth

Young people today face a multitude of challenges, especially when growing up in an urban environment. Risk factors such as poverty, exposure to gangs, drugs, and community and family violence threaten healthy development. The positive youth development (PYD) approach attempts to combat these personal and environmental challenges by providing youth with positive, asset-building experiences and meaningful, supportive relationships. There is a need for creative youth development programming that brings these two elements together in a structured and voluntary context, such as a wilderness-based program. This study explored the impact of a PYD program that utilizes mentor-supported wilderness expeditions to build developmental assets among a diverse sample of 159 urban youth in the United States. The Developmental Assets Profile was administered pre- and post-program, as well as 90 days post-program. Quantitative findings show that this type of programming can be an asset-building experience for youth facing multiple risk factors.

Alcohol use and cigarette smoking during pregnancy among American Indians/Alaska Natives.

Previous research states that American Indian/Alaska Native pregnant women exhibit high rates of alcohol use and smoking. The current study uses the National Survey of Drug Use and Health (2005–2009) to update and expand on this literature. Results reveal lower rates of alcohol use and, with compositional controls, lower rates of smoking for American Indian/Alaska Native pregnant women compared with pregnant women of other racial/ethnic groups. These findings support social–structural explanations of substance use among American Indian/Alaska Native pregnant women and refute commonly offered cultural arguments that alcohol use and smoking reflect something that is “uniquely Indian.”

Collaborative care for the treatment of depression in primary care with a low-income, spanish-speaking population: Outcomes from a community-based program evaluation

OBJECTIVE This study sought to (1) evaluate the effectiveness of a collaborative care model with a predominantly Hispanic, low-income population in a primary care setting and (2) examine depression outcomes with a subpopulation of preferentially Spanish-speaking patients compared with non-Hispanic white participants. METHOD The data were collected from September 2006 through September 2009 at the study site, the Peoples Community Clinic, Austin, Texas. Data collection was part of an evaluation of the Integrated Behavioral Health program, a collaborative care model of identifying and treating mild-to-moderate mental disorders in adults in a primary care setting. A bilingual care manager provided supportive counseling and patient education and systematically tracked patient progress in a patient registry. A consulting psychiatrist evaluated patients with diagnostic or treatment concerns. The study retrospectively examined changes in depression scores among 269 subjects as measured by the Patient Health Questionnaire (PHQ-9), the primary outcome measure. The PHQ-9 is a self-report of frequency of symptoms for each of the 9 DSM-IV criteria for depression. Logistic regression models compared race/ethnicity and language group combinations on their odds of achieving clinically meaningful depression improvement when background characteristics were controlled for. RESULTS Spanish-speaking Hispanic patients had significantly greater odds of achieving a clinically meaningful improvement in depression at 3-month follow-up (odds ratio [OR] = 2.45, P = .013) compared to non-Hispanic whites. The finding for greater improvement in the Spanish-speaking population remained after controlling for age, sex, medical comorbidities, prior treatment, and baseline depression scores. CONCLUSIONS The results suggest a model of care that is effective for a population at great risk for marginal mental health care, non-English-speaking Hispanics. Attention to patient preferences in primary care is essential to improve quality of depression treatment and may improve outcomes. In light of previous research that demonstrates insufficient evidence-based guidelines for patients with limited English proficiency and evidence that evaluation of patients in their nonprimary language or through an interpreter can lead to inaccurate mental health assessments, this study suggests an opportunity to improve the quality of mental health care for non-English-speaking Hispanics in the United States.