Conceptualizing protective family context and its effect on substance use: Comparisons across diverse ethnic-racial youth.
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ABSTRACT:
SUBMITTER: Constante K
PROVIDER: S-EPMC8209119 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Black families and youth likely consider specific racial discriminatory situations in preparation-for-bias messages and racial coping responses. Our study investigated coping responses embedded in youth-reported Black families' preparation-for-bias messages and youths' proactive coping responses to specific racially discriminatory situations-teachers' negative expectations, store employees' hyper-monitoring and police harassment. Gender and racial discrimination experience differences were considered along with relations between messages and coping. Our investigation was guided by the integrated-developmental, transactional/ecological, intersectionality, and Phenomenological Variant of Ecological Systems Theory theoretical frameworks. We conducted cluster analyses using data from 117 Black youth aged 13-14 to identify situation-specific family messages and youth coping responses. Families' messages and youths' responses varied in content and frequency based on the specific discriminatory situation, which suggests consideration of context.
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Project description:Purpose: Sexual minority youth are at increased risk for mental health problems and substance use, and accumulating evidence indicates that bisexual youth are at greatest risk. However, bisexual youth are not a homogenous group and scholars have called for greater attention to the intersections of multiple marginalized identities. As such, we examined racial/ethnic differences in mental health (sadness/hopelessness and suicidal ideation), substance use (cigarette use, binge drinking, marijuana use, and other illicit drug use), and bullying (in-person and electronic) among self-identified bisexual high school-aged youth (overall and by sex). Method: Data from the local versions of the Youth Risk Behavior Survey were pooled across jurisdictions and years (2011-2015), resulting in an analytic sample of 18,515 bisexual youth who were racially/ethnically diverse. Results: Black and Hispanic bisexual youth were less likely to report in-person and electronic bullying than White bisexual youth. In addition, Black bisexual youth were less likely to report sadness/hopelessness and suicidal ideation than White, Hispanic, and Other race/ethnicity bisexual youth. Black bisexual female youth were also less likely to report cigarette use, binge drinking, and other illicit drug use than White bisexual female youth. In contrast to most of our findings, Black bisexual youth were more likely to report marijuana use than White bisexual youth. Most of the significant racial/ethnic differences in mental health and substance use remained significant after controlling for bullying. Conclusion: These findings highlight the heterogeneity of bisexual youth and the need to consider multiple marginalized identities to understand the health disparities affecting this diverse population.
| S-EPMC6551981 | biostudies-literature
Project description:Adolescent development and wellbeing now involve how the use of social technologies (e.g., social media and other online spaces) impact daily life. Especially during crises such as COVID-19 and persistent injustices, adolescents rely on online spaces for social connectedness and informational knowledge. Psychosocial impacts, both positive and negative, have been found among racial-ethnic minority adolescents. However, the role of racial-ethnic identity on social media use and wellbeing has been understudied. The current study addresses differential associations on social media experiences and mental health (i.e., depressive, online anxiety symptoms) among a diverse group of adolescents (n = 668; ages 10-17; 45.7% non-White). Furthermore, the roles of self-identified racial-ethnic groups, identity importance, exposure to hate messaging, and gender are investigated. Our study found significant moderating effects of racial-ethnic importance, gender, and online hate messaging. Additionally, the moderating role of race-ethnicity reveals a stronger association between greater social media frequency and heightened depressive symptoms among Asian adolescents. Black adolescents showed a significant association between greater social media frequency and decreased online social anxiety. Significant effects of online hate messaging exposure also reveal associations between online behaviors and depression and online social anxiety across adolescents. As social media adoption coincides with identity exploration, this study highlights how racial-ethnic identity and its formation in the digital age is important to understand its association with online interactions that may help or hinder adolescent wellbeing. Future work should continue examining trajectories of identity formation in relation to social media content and differential mental health impacts.
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Project description:Shift-&-persist is a coping strategy that has been shown to lead to positive health outcomes in low-SES youth but has not yet been examined with respect to psychological health. This study tests whether the shift-&-persist coping strategy works in tandem with ethnic-racial identity to protect against depressive symptoms in the face of two uncontrollable stressors: economic hardship and peer discrimination. In a sample of 175 Latinx youth (51.4% female; Mage = 12.9), shift-&-persist buffered the positive relation between economic hardship and depressive symptoms. In terms of peer discrimination, among youth who reported little use of shift and persist, discrimination was related to higher depressive symptoms, whereas youth who reported higher amounts of shift and persist (at and above the mean) were protected and did not evidence this association. However, among youth with high ethnic-racial identity, shift-&-persist failed to protect against the deleterious association between peer discrimination and depressive symptoms. These findings suggest that shift-&-persist is protective for Latinx youth, although the context in which it is protective changes based on the racialized/non-racialized nature of the stressor.
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Project description:To evaluate disparities in substance abuse treatment completion between and within racial and ethnic groups in publicly funded treatment in Los Angeles County, California.The Los Angeles County Participant Reporting System with multicross-sectional annual data (2006-2009) for adult participants (n = 16,637) who received treatment from publicly funded programs (n = 276) for the first time.Retrospective analyses of county discharge and admission data. Hierarchical linear regressions models were used to test the hypotheses.Client data were collected during personal interviews at admission and discharge for most participants.African Americans and Latinos reported lower odds of completing treatment compared with Whites. Within-group analysis revealed significant heterogeneity within racial and ethnic groups, highlighting primary drug problem, days of drug use before admission, and homelessness as significant factors affecting treatment completion. Service factors, such as referral by the criminal justice system, enabled completion among Latinos and Whites only.These findings have implications for reducing health disparities among members of racial and ethnic minorities by identifying individual and service factors associated with treatment adherence, particularly for first-time clients.
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Project description:ObjectivesWe estimated racial/ethnic differences in attention-deficit/hyperactivity disorder (ADHD) care quality and treatment continuity among Medicaid-enrolled children.MethodsUsing Medicaid data from 9 states (2008 to 2011), we identified 172 322 youth (age 6 to 12) initiating ADHD medication. Outcome measures included: (1) adequate follow-up care in the (a) initiation and (b) continuation and maintenance (C&M) treatment phases; (2) combined treatment with medication and psychotherapy (versus medication alone); (3) medication discontinuation; and (4) treatment disengagement (ie, discontinued medication and received no psychotherapy). Logistic regressions controlled for confounding measures.ResultsAmong those initiating medication, three-fifths received adequate follow-up care in the initiation and C&M phases, and under two-fifths received combined treatment. Compared with whites, African American youth were less likely to receive adequate follow-up in either phase (P < .05), whereas Hispanic youth were more likely to receive adequate follow-up in the C&M phase (P < .001). African American and Hispanic youth were more likely than whites to receive combined treatment (P < .05). Over three-fifths discontinued medication, and over four-tenths disengaged from treatment. Compared with whites, African American and Hispanic children were 22.4% and 16.7% points more likely to discontinue medication, and 13.1% and 9.4% points more likely to disengage from treatment, respectively (P < .001).ConclusionsCare quality for Medicaid-enrolled youth initiating ADHD medication is poor, and racial/ethnic differences in these measures are mixed. The most important disparities occur in the higher rates of medication discontinuation among minorities, which translate into higher rates of treatment disengagement because most youth discontinuing medication receive no psychotherapy.
| S-EPMC5470500 | biostudies-literature
Project description:PurposeResearch consistently connects parental and youth substance misuse, yet less is known about the mechanisms driving this association among justice-involved youth. We examine whether harsh parenting is an explanatory mechanism for the association between parental substance use and parental mental health and youth substance use disorder in a sample of justice-involved youth.MethodsData were drawn from the Northwestern Juvenile Project, a large-scale longitudinal survey of mental health and substance misuse in a representative sample of youth in juvenile detention. Harsh parenting, child maltreatment, youth alcohol and cannabis use disorder, and parental substance misuse and mental health were assessed among 1,825 detained youth (35.95% female) at baseline, three-year follow-up, and four-year follow-up.ResultsAt baseline, over 80% of youth used alcohol and/or cannabis; at the four-year follow-up, 16.35% and 19.69% of the youth were diagnosed with alcohol and cannabis use disorder, respectively. More than 20% of youth reported their parent misused substances and 6.11% reported a parent had a severe mental health need. Black youth experienced significantly fewer types of harsh parenting compared to White youth. Multivariate path analyses revealed harsh parenting mediated the association between parental substance misuse and mental health on youth alcohol and cannabis use disorder. Harsh parenting that does not rise to the level of child maltreatment mediated the association between parental substance misuse and mental health on youth alcohol use disorder; in contrast, child maltreatment did not mediate these associations. Multigroup analyses revealed the effect of harsh parenting on youth alcohol and cannabis use disorder did not vary across sex or race-ethnic subgroups.ConclusionsHarsh parenting represents one mechanism for the intergenerational continuity of alcohol and cannabis misuse and should be regularly assessed for and addressed in juvenile justice settings.
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Project description:BACKGROUND:Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os. PURPOSE:The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables. METHODS:We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder. RESULTS:Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome. CONCLUSIONS:Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity.
| S-EPMC5139622 | biostudies-literature
Project description:While young racial/ethnic groups are the fastest growing population in the United States, data about substance-related disorders among adolescents of various racial/ethnic backgrounds are lacking.To examine the magnitude of past-year DSM-IV substance-related disorders (alcohol, marijuana, cocaine, inhalants, hallucinogens, heroin, analgesic opioids, stimulants, sedatives, and tranquilizers) among adolescents of white, Hispanic, African American, Native American, Asian or Pacific Islander, and multiple race/ethnicity.The 2005 to 2008 National Survey on Drug Use and Health.Academic research.Noninstitutionalized household adolescents aged 12 to 17 years.Substance-related disorders were assessed by standardized survey questions administered using the audio computer-assisted self-interviewing method.Of 72 561 adolescents aged 12 to 17 years, 37.0% used alcohol or drugs in the past year; 7.9% met criteria for a substance-related disorder, with Native Americans having the highest prevalence of use (47.5%) and disorder (15.0%). Analgesic opioids were the second most commonly used illegal drugs, following marijuana, in all racial/ethnic groups; analgesic opioid use was comparatively prevalent among adolescents of Native American (9.7%) and multiple race/ethnicity (8.8%). Among 27 705 past-year alcohol or drug users, Native Americans (31.5%), adolescents of multiple race/ethnicity (25.2%), adolescents of white race/ethnicity (22.9%), and Hispanics (21.0%) had the highest rates of substance-related disorders. Adolescents used marijuana more frequently than alcohol or other drugs, and 25.9% of marijuana users met criteria for marijuana abuse or dependence. After controlling for adolescents' age, socioeconomic variables, population density of residence, self-rated health, and survey year, adjusted analyses of adolescent substance users indicated elevated odds of substance-related disorders among Native Americans, adolescents of multiple race/ethnicity, adolescents of white race/ethnicity, and Hispanics compared with African Americans; African Americans did not differ from Asians or Pacific Islanders.Substance use is widespread among adolescents of Native American, white, Hispanic, and multiple race/ethnicity. These groups also are disproportionately affected by substance-related disorders.
| S-EPMC3395319 | biostudies-literature
Project description:ObjectiveTo examine racial and ethnic disparities in the receipt of minimally adequate depression treatment in Medicaid-enrolled youth.MethodMedicaid claims data of 2008 through 2011 were used to derive a cohort of youth (5-17 years old) who were diagnosed with a new episode of major depression (N = 45,816) across 9 states. Dichotomous outcomes measured the receipt of minimally adequate psychotherapy (≥4 psychotherapy visits within 12 weeks of initiation); minimally adequate medication (filled antidepressants for 84 of 144 days); any minimally adequate treatment (psychotherapy or medication); and no psychotherapy or medication. Racial/ethnic disparities in the outcome measures were estimated using logistic regression models that controlled for predisposing, enabling, and need-related factors.ResultsLess than four-tenths (38.3%) of the cohort received minimally adequate psychotherapy, 19.2% received minimally adequate pharmacotherapy, and 49.9% received any minimally adequate treatment; conversely, 16.4% received no treatment. Adjusted percentages of black (42.3%; p < .001) and Hispanic (48.2%; p < .001) youth who received minimally adequate treatment were significantly smaller than for non-Hispanic whites (54.7%) because of lower likelihoods of receiving minimally adequate psychotherapy and/or minimally adequate pharmacotherapy. In addition, adjusted percentages of black (20.2%; p < .001) and Hispanic (15.0%; p < .01) youth who received no treatment were significantly larger than for non-Hispanic white youth (12.9%).ConclusionThe percentage of Medicaid-enrolled youth who receive minimally adequate treatment for depression is small overall and even smaller for racial/ethnic minorities than for whites. Future research is needed to identify strategies that improve the overall quality of depression treatment in Medicaid-enrolled youth and decrease disparities in care.
| S-EPMC8051617 | biostudies-literature