Trenette T. Clark

Everyday discrimination and mood and substance use disorders: A latent profile analysis with African Americans and Caribbean Blacks

BACKGROUND Perceived discrimination is a major source of health-related stress. The purpose of this study was to model the heterogeneity of everyday-discrimination experiences among African American and Caribbean Blacks and to identify differences in the prevalence of mood and substance use outcomes, including generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder among the identified subgroups. METHOD The study uses data from the National Survey of American Life obtained from a sample of African American and Caribbean Black respondents (N=4,462) between 18 and 65 years. RESULTS We used latent profile analysis and multinomial regression analyses to identify and validate latent subgroups and test hypotheses, yielding 4 classes of perceived everyday discrimination: Low Discrimination, Disrespect and Condescension, General Discrimination, and Chronic Discrimination. Findings show significant differences exist between the Low Discrimination and General Discrimination classes for major depressive disorder, alcohol-use disorder, and illicit drug-use disorder. Moreover, we find significant differences exist between the Low Discrimination and Chronic Discrimination classes for the four disorders examined. Compared with the Chronic Discrimination class, members of the other classes were significantly less likely to meet criteria for generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder. CONCLUSIONS Findings suggest elevated levels of discrimination increase risk for mood and substance-use disorders. Importantly, results suggest the prevalence of mood and substance-use disorders is a function of the type and frequency of discrimination that individuals experience.

Perceived discrimination, depressive symptoms, and substance use in young adulthood.

Perceived discrimination is an important health-related stressor. As suggested by the stress-coping model, substance use often serves as a means to reduce the negative effects of perceived discrimination. This study uses data from the National Survey of American Life-Adults to examine the structural relationship of perceived discrimination and depressive symptoms with lifetime and recent substance use among African American and African Caribbean young adults. Respondents (N=1910) were 18-35 years old. Compared with African Caribbeans, African Americans report significantly higher levels of depressive symptoms and both lifetime and recent substance use. Multiple-group structural equation modeling is used to evaluate model fit and test hypothesized models. Results show good fit of the hypothesized models in both African Americans and African Caribbeans. Full measurement and structural invariance is found across ethnicity. Mediation models explain 18.5% and 47.4% of the variance in lifetime substance use for African Americans and African Caribbeans, respectively, and 23.5% and 35.0% of the variance in recent substance use for African Americans and African Caribbeans, respectively. Mediation tests indicate depressive symptoms partially mediate the relationship between perceived discrimination and lifetime substance use and fully mediated this relationship for recent substance use. This study is the first to demonstrate a positive association between perceived racial discrimination and substance use among African Caribbean young adults. Study findings illuminate the influence of perceived discrimination on substance use and the mechanisms of this relationship among African American and African Caribbean young adults.

Individual- and community-level correlates of cigarette-smoking trajectories from age 13 to 32 in a U.S. population-based sample

BACKGROUND Characterizing smoking behavior is important for informing etiologic models and targeting prevention efforts. This study explored the effects of both individual- and community-level variables in predicting cigarette use vs. non-use and level of use among adolescents as they transition into adulthood. METHODS Data on 14,779 youths (53% female) were drawn from the National Longitudinal Study of Adolescent Health (Add Health); a nationally representative longitudinal cohort. A cohort sequential design allowed for examining trajectories of smoking typologies from age 13 to 32 years. Smoking trajectories were evaluated by using a zero-inflated Poisson (ZIP) latent growth analysis and latent class growth analysis modeling approach. RESULTS Significant relationships emerged between both individual- and community-level variables and smoking outcomes. Maternal and peer smoking predicted increases in smoking over development and were associated with a greater likelihood of belonging to any of the four identified smoking groups versus Non-Users. Conduct problems and depressive symptoms during adolescence were related to cigarette use versus non-use. State-level prevalence of adolescent smoking was related to greater cigarette use during adolescence. CONCLUSIONS Individual- and community-level variables that distinguish smoking patterns within the population aid in understanding cigarette use versus non-use and the quantity of cigarette use into adulthood. Our findings suggest that efforts to prevent cigarette use would benefit from attention to both parental and peer smoking and individual well-being. Future work is needed to better understand the role of variables in the context of multiple levels (individual and community-level) on smoking trajectories.

Age of first cigarette, alcohol, and marijuana use among U.S. biracial/ethnic youth: A population-based study

This study examines age of first cigarette, alcohol, and marijuana use among self-identified biracial youth, using data from the National Longitudinal Study of Adolescent Health (Add Health). We found an intermediate biracial phenomenon in which some biracial youth initiate substance use at ages that fall between the initiation ages of their 2 corresponding monoracial groups. When controlling for the covariates, our findings show that White-Asian biracial youth begin smoking marijuana and drinking alcohol at earlier ages than Whites and engaging in all forms of substance use at earlier ages than Asian youth. Results indicate that White-American Indian youth start smoking cigarettes at earlier ages than all biracial and monoracial groups. Our findings underscore the need for future research to examine substance-use initiation and progression among biracial/ethnic youth.

Epidemiology of drug use among biracial/ethnic youth and young adults: results from a U.S. population-based survey

Abstract This study estimates the prevalence of cigarette, alcohol, and marijuana use in a nationally representative sample of monoracial/ethnic and biracial/ethnic youth and young adults. The authors consider 16 racial/ethnic categories and used four waves of data from the National Longitudinal Study of Adolescent Health. The analysis sample consists of 20,745 individuals in Wave 1. The primary statistical methodology used in the present study is logistic regression with sample weights. Findings suggest that participants who self-report two races/ethnicities have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates. For example, Black-American Indians reported cigarette smoking rates that were significantly lower than rates reported by American Indians but significantly higher than rates reported by Blacks. Groups with the highest prevalence of cigarette smoking at Wave 1 were American Indian, White-American Indian, White, and Multiracial (people reporting three or more races/ethnicities). Groups with the highest prevalence of alcohol drinking at Wave 1 were White-American Indian, Multiracial, Hispanic, White, and White-Hispanic. Groups with the highest prevalence of marijuana smoking at Wave 1 were Black-Asian and American Indian. The authors found an interaction effect between race/ethnicity and socioeconomic status. Lower-class SES status may serve as a risk factor for biracial/ethnic adolescents while upper-class SES may serve as a protective factor for these youth. In general, biracial/ethnic individuals have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates.

The Mediating and Moderating Effects of Parent and Peer Influences upon Drug Use among African American Adolescents.

This study recruited 567 African American youth (mean age = 15.27 years; 65.1% girls) to examine the role of parent and peer contexts on drug use among African American adolescents. Data were collected on demographics, drug refusal efficacy, drug use, and various psychosocial factors including family and peer factors. When controlling for age and gender, parental monitoring and peer risky behavior completely mediated the relationship between parental attitudes toward drug use and drug refusal efficacy and partially mediated the relationship between parental attitudes toward drug use and current alcohol use. Only peer risky behavior mediated the relationships between parental attitudes toward drug use and current tobacco and marijuana use. Results also revealed several salient moderating relationships. Implications for prevention programs are provided and include strengthening current parenting skills and focusing efforts on fostering the mother-adolescent relationship.

Public or Private Religiosity: Which Is Protective for Adolescent Substance Use and by What Pathways?:

While it is well understood that adolescent religiosity is associated with the use and abuse of licit and illicit substances, few studies have revealed the pathways through which religiosity buffers youth against involvement in such behavior. The aim of this study is to examine the complexity of the relationships between religiosity, sensation seeking, injunctive norms, and adolescent substance use. Using a national sample of adolescents (N = 18,614), negative binomial regression and path analysis were used to examine the various components of the relationship between religiosity and the use of cigarettes, alcohol, and marijuana. Results indicate that private religiosity moderates the relationship between key risk factors and substance use. Public and private religiosity were associated with tolerant injunctive substance use norms which, in turn, were associated with substance use. Implications for research and theory related to religiosity and adolescent substance use are discussed.

Risk and Protective Factors for Alcohol and Marijuana Use among African-American Rural and Urban Adolescents

The purpose of this study was to examine individual, family, peer, and community risk and protective factors associated with past-30-days alcohol and marijuana use among African-American adolescents living in rural and urban communities. This study used data collected from 907 tenth- and twelfth-grade African-American students who completed the 2005 Community Youth Survey. Peer and individual risk/protective factors were more influential for urban youths while family and community risk/protective factors were more influential for rural youths. This pattern held for alcohol and marijuana use. Implications for substance use prevention programming are discussed.

Developmental Trajectories of Alcohol Use Among Monoracial and Biracial Black Adolescents and Adults

Abstract Objective: The present study investigates developmental trajectories of alcohol use from early adolescence to adulthood by age and race/ethnicity among White, Black, Black-American Indian, Black-Hispanic, and Black-White individuals and associated sociodemograhphic correlates. Method: We used a subsample of nationally representative data obtained from the National Longitudinal Study of Adolescent Health (Add Health). The analytic sample consisted of 15,278 individuals in Wave 1 (ages 11 to 21 years). The sample consists of adolescents who were in Grades 7–12 at wave one and who were followed across four waves of data collection into adulthood. Respondents could report more than one race/ethnicity. Results: We find distinct alcohol trajectories among monoracial and biracial/ethnic Blacks with all groups showing a cross-over or catch-up effect. Black-White adults demonstrated a cross-over effect by surpassing the alcohol drinking rates of Whites in adulthood, Black-American Indians showed a within-group catch-up effect by surpassing the alcohol drinking rates of monoracial and biracial/ethnic Blacks in adulthood, and monoracial Blacks were most likely to be non-drinkers in adulthood. We also show gender, socioeconomic status, and household structure differences in impact on alcohol use among monoracial and biracial/ethnic Blacks. Conclusions: Significant heterogeneity is observed regarding alcohol trajectories between monoracial and biracial/ethnic Blacks.

STRESS AND TOBACCO USE AMONG AFRICAN-AMERICAN ADOLESCENTS: THE BUFFERING EFFECT OF CULTURAL FACTORS*

Tobacco is a leading contributor to morbidity and mortality and a primary reason for health disparities among African Americans. In this study we explore the role of stress in smoking and cultural factors that protect against stress among African-American adolescents. Our sample consisted of 239 youth who were recruited into the study while enrolled in 8th and 12th grade. Measures of risk factors (stress, school transition stress, and community disorganization), moderator or protective factors (religious support and intergenerational connections), and 30-day tobacco use were collected. Hierarchical multiple regression analyses were conducted. Intergenerational connections moderated the effect of stress on past 30-day tobacco use. Religious support moderated the effect of neighborhood disorganization on past 30-day tobacco use. Religious support also moderated the effect of stress on past 30-day tobacco use. The findings have implications for prevention efforts to consider religious beliefs and practices and also to link youth with supportive adults in their community.