Health and Developmental Consequences of Youth Drug Abuse

Research Findings from February, 1998 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the developmental implications of drug use. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Influences on Adolescent Substance Dependence: Conduct Disorder, Depression, Attention Deficit Hyperactivity Disorder, and Gender

Whitmore and his colleagues from the University of Colorado conducted a study to determine if prevalence and severity of conduct disorder (CD), major depression and ADHD would differ by gender, and that these conditions would associate differentially with severity of substance disorder (SD) in males and females. The subjects were 285 male and 82 female adolescents referred for treatment for comorbid CD and SD. The investigators found that males and females did not differ significantly in severity of substance involvement, major depression, or ADHD, but males had more severe CD. Major depression was the only variable significantly associated with SD severity for females, while for males, severity of CD combined with major depression and ADHD was significantly associated with SD severity. The authors concluded that among referred adolescents, CD, major depression, and ADHD may all be important concomitants of SD in males, while in females, depression may be the primary variable related to SD. Whitmore, E.A., Mikulich, S.K., Thompson, L.L., Riggs, P.D., Aarons, G.A., and Crowley, T.J., Drug and Alcohol Dependence, 47, pp. 87-97, 1997.

Risk Factors for Disruption of Primary Caregiving of Substance-Abusing Mothers

Researchers at the University of Maryland School of Medicine have identified perinatal factors (i.e., postpartum hospital stay and 2-week visit) that are predictive of disruption of primary infant caregiving among high-risk, substance-abusing mothers. Disruption of primary caregiving was defined as the infant receiving substitute care during the first 18 months of life because of the mother's inability to care for her infant due to neglect/abuse, incarceration, continued drug abuse, or homelessness (includes voluntary placement with a relative as well as protective service referral). All women in the study were at high risk for disruption based on histories of drug abuse, poverty, limited education, and other social problems. All had a history of heroin and/or cocaine use during pregnancy. Analyses were based on 152 mother-infant dyads from a larger, ongoing longitudinal study. Forty-three percent of the sample had disruption in primary caregiving. Bivariate analyses compared the disruptive care group with the non-disruptive care group on maternal and neonatal factors. Results of a multiple logistic regression showed that younger maternal age, two or more other children, positive heroin tox at delivery, and reported depressive symptoms were significantly associated with disruption of caregiving. The investigators discuss possible processes underlying these relationships, and implications of the findings for screening and service delivery. Nair, P., Black, M.M., Schuler, M., et al. Child Abuse & Neglect, 21, pp. 1039-1051, 1997.

Potential for Child Abuse

Falkin and Strauss found average scores on the Child Abuse Potential Inventory (CAP) among women substance-abusing offenders with minor children (N=300) were in the same range as scores for individuals convicted of child abuse. These scores were significantly higher for women with psychological problems and those who had experienced physical abuse as children. The children of these women may be at high risk for abuse if the women do not receive appropriate interventions after treatment. Falkin, G. and Strauss, S., The Potential for Child Abuse Among Women Offenders Who Abuse Substances, paper presented at the 7th International Conference on Family Violence, Durham, New Hampshire, June 1997.

Behavioral Self-Regulation and Liability to Substance Abuse

Researchers at the Center for Education and Drug Abuse Research (CEDAR) investigated behavioral self-regulation (BSR) as a salient component of substance abuse liability. Three dimensions of childhood behavior were used to create a dimensional model of BSR: inattention, impulsivity/ hyperactivity and aggressivity. Multiple measures and multiple informants were used to develop indices of the three traits in a sample of 10-12 year old sons of substance abusing fathers (high risk (HR); n = 180) and normal controls (low average risk (LAR); n = 200). Informants included mothers, boys and their teachers. The results confirmed the presence of a first-order latent trait of BSR. HR boys had significantly poorer scores on BSR than LAR boys. Concurrent validity of the BSR trait scores was supported by significant associations with measures of family dysfunction, deviant peer affiliations and poor school performance. These latter problems are commonly prodromal to substance abuse. Predictive validity of the (poor) BSR trait baseline scores (age 10-12 years) was supported at 2 year follow-up by significant associations of poor BSR scores with magnitude of deviant peer affiliations; trends toward significance were found for family dysfunction and poor school performance. Taken together, these results confirm and extend previous findings which indicate that poor BSR is prodromal to substance abuse. Dawes, M.A., Tarter, R.E., and Kirisci, L. Behavioral Self-Regulation: Correlates and Two Year Follow-ups for Boys at Risk for Substance Abuse. Drug and Alcohol Dependence, 45(3), pp. 165-76, 1997.

Alcohol Expectancies as Potential Mediators of Parent Alcoholism Effects on the Development of Adolescent Heavy Drinking

Children of Alcoholics (COAs) are at heightened risk for early onset of alcohol use, for heavy drinking, and for alcohol-related impairment. However, little is known about the mediating mechanisms that account for this risk. In a study of adolescents' expectancies about alcohol effects as potential mediators of their growth over time in heavy drinking, participants (n=428) were from an ongoing longitudinal study of parent alcoholism and data were collected in three annual in-person interviews with adolescents and their parents. Latent growth curve modeling analyses showed that COAs started the study at higher levels of heavy drinking and increased their heavy drinking at a steeper rate than did non-COAs over the course of the study. However, expectancies about alcohol effects could not explain these parent alcoholism effects. Although expectancies were related to adolescents' initial drinking levels, they did not prospectively predict growth over time in adolescent alcohol use. Thus, other mediating mechanisms (e.g., personality, parent and peer socialization) are necessary to explain parent alcoholism risk for escalation in heavy drinking during adolescence. Colder, C.R., Chassin, L., Stice, E., and Curran, P. Journal of Research on Adolescence, 7, pp. 359-374, 1997.

Latent Variable Modeling of Longitudinal and Multilevel Substance Use Data

Multilevel Latent Growth Modeling (MLGM) was used to analyze longitudinal and multilevel data for adolescent and parent substance use measured at four annual time points. An associative LGM model was tested for alcohol, cigarette and marijuana use with a sample of 435 families (435 target adolescents, 203 siblings, and 566 parents). Adolescents (targets and siblings) had a mean age at T1 of 13.69 years. Sufficient homogeneity in substance use within families was found, with the proportion of between variation, or intraclass correlation, for the four repeated measures, ranging from .26 to .30 for alcohol, .26 to .29 for cigarettes, and .28 to .33 for marijuana. Results revealed a significant upward trend in the development of alcohol, cigarette and marijuana use among families. The shapes of the family-level developmental curves for each substance were also strongly related. Younger family members had higher initial levels of use and developed in their use of substances at a faster rate than older family members. Males had higher levels of alcohol use than females. Single and step-parent families had higher family-levels of substance use, whereas families characterized as less educated and more economically disadvantaged had higher levels of cigarette use and developed in their use of marijuana at a greater rate. Duncan, T.E., Duncan, S.C., Alpert, A., Hops, H., Stoolmiller, M., and Muth, N. B. Latent Variable Modeling of Longitudinal and Multilevel Substance Use Data. Multivariate Behavioral Research, 32, pp. 275-318, 1997.