Abstract
Substance use often begins earlier among American Indians compared to the rest of the United States, a troubling reality that puts Native youth at risk for escalating and problematic use. We need to understand more fully patterns of emergent substance use among young American Indian adolescents, risk factors associated with escalating use trajectories, and protective factors that can be parlayed into robust prevention strategies. We used growth mixture modeling with longitudinal data from middle-school students on a Northern Plains reservation (Wave 1 N = 381, M age at baseline = 12.77, 45.6 % female) to identify subgroups exhibiting different trajectories of cigarette, alcohol, and marijuana use. We explored how both risk (e.g., exposure to stressful events, deviant peers) and protective (e.g., positive parent–child relationships, cultural identity) factors were related to these trajectories. For all substances, most youth showed trajectories characterized by low rates of substance use (nonuser classes), but many also showed patterns characterized by high and/or escalating use. Across substances, exposure to stress, early puberty, and deviant peer relationships were associated with the more problematic patterns, while strong relationships with parents and prosocial peers were associated with nonuser classes. Our measures of emergent cultural identity were generally unrelated to substance use trajectory classes among these young adolescents. The findings point to the importance of early substance use prevention programs for American Indian youth that attenuate the impact of exposure to stressful events, redirect peer relationships, and foster positive parent influences. They also point to the need to explore more fully how cultural influences can be captured.
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Notes
We initially included a third control variable—adult substance use problems. Cheadle and colleagues found strong relationships between adult substance use and adolescents’ trajectories of early use (Cheadle and Sittner Hartshorn 2012; Cheadle and Whitbeck 2011). As anticipated, the effects of adult substance use problems on class membership were strong and significant, especially for alcohol and marijuana use (odds ratios ranged from 1.35 to 4.18). However, the inclusion of this variable had only a trivial impact on the direction and magnitude of associations between class membership and the other covariates, and missing data on the adult substance use variable resulted in the loss of approximately 100 cases from each analysis. Therefore, we chose to exclude adult substance use from the analyses reported here in order to preserve power and precision for the remaining parameter estimates.
Youth’s responses to the socioeconomic items generally converged with reports from a subsample of parents in this population, although youth tended to underestimate financial hardship relative to their parents (except for reports of food stamps, which were nearly identical). Given this correspondence, combined with the fact that only a small subsample of parents provided data, we chose to present the socioeconomic data reported by youth rather than parents.
We evaluated both continuous and categorical models for the cigarette use outcome. Fit statistics for the one- and two-class categorical models were somewhat improved over the corresponding continuous models. However, we encountered estimation problems with the three- and four-class categorical models. As such, we chose to use the continuous models, which permitted exploration of a larger number of classes.
References
Barber, B. K., Stolz, H. A., & Olsen, J. A. (2005). Parental support, psychological control, and behavioral control: Assessing relevance across time, culture, and method. Monographs of the Society for Research in Child Development, 70, 1–137.
Barnes, G. M., Hoffman, J. H., Welte, J. W., Farrell, M. P., & Dintcheff, B. A. (2006). Effects of parental monitoring and peer deviance on substance use and delinquency. Journal of Marriage & the Family, 68, 1084–1104.
Beals, J., Novins, D. K., Whitesell, N. R., Spicer, P., Mitchell, C. M., Manson, S. M., et al. (2005). Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: Mental health disparities in a national context. American Journal of Psychiatry, 162(9), 1723–1732.
Beals, J., Spicer, P., Mitchell, C. M., Novins, D. K., Manson, S. M., & The AI-SUPERPFP Team. (2003). Racial disparities in alcohol use: Comparison of two American Indian reservation populations with national data. American Journal of Public Health, 93(10), 1683–1685.
Beauvais, F., Jumper Thurman, P., Burnside, M., & Plested, B. (2007). Prevalence of American Indian adolescent tobacco use: 1993–2004. Substance Use and Misuse, 42, 591–601.
Biafora, F. A., Warheit, G. J., Vega, W. A., & Gil, A. G. (2002). Stressful life events and changes in substance use among a multiracial/ethnic sample of adolescent boys. Journal of Community Psychology, 22(4), 296–311.
Biehl, M. C., Natsuaki, M. N., & Ge, X. (2007). The influence of pubertal timing on alcohol use and heavy drinking trajectories. Journal of Youth and Adolescence, 36, 153–167.
Biglan, A., Brennan, P. A., & Foster, S. L. (2004). Helping adolescents at risk: Prevention of multiple problem behaviors. New York: Guilford.
Brook, J. S., Rubenstone, E., Zhang, C., & Brooko, D. W. (2012). Maternal predictors of comorbid trajectories of cigarette smoking and marijuana use from early adolescence to adulthood. Addictive Behaviors, 37, 139–142.
Centers for Disease Control and Prevention. (2008). Alcohol-attributable deaths and years of potential life lost among American Indians and Alaskan Natives—United States, 2001–2005. Morbidity and Mortality Weekly Report, 57(34), 938–942.
Chao, R., & Tseng, V. (2002). Parenting of asians. In M. H. Bornstein (Ed.), Handbook of parenting: Vol. 4. Social conditions and applied parenting (2nd ed., pp. 59–93). Mahwah, NJ: Lawrence Erlbaum Associates.
Cheadle, J. E., & Sittner Hartshorn, K. J. (2012). Marijuana use development over the course of adolescence among North American indigenous youth. Social Science Research, 41, 1227–1240.
Cheadle, J. E., & Whitbeck, L. B. (2011). Alcohol use trajectories and problem drinking over the course of adolescence: A study of North American indigenous youth and their caretakers. Journal of Health and Social Behavior, 52(2), 228–245.
Chen, J., Balan, S., & Price, R. K. (2012). Association of contextual factors with drug use and binge drinking among white, Native American, and mixed-race adolescents in the general population. Journal of Youth and Adolescence, 41, 1426–1441.
Costello, E. J., Sung, M., Worthman, C., & Angold, A. (2007). Pubertal maturation and the development of alcohol use and abuse. Drug and Alcohol Dependence, 88S, S50–S59.
Dawson, D. A., Grant, B. F., & Ruan, W. J. (2005). The association between stress and drinking: Modifying effects of gender and vulnerability. Alcohol and Alcoholism, 40(5), 453–460.
Dixon, S. V., Graber, J. A., & Brooks-Gunn, J. (2008). The roles of respect for parental authority and parenting practices in parent–child conflict among African American, Latino, and European American families. Journal of Family Psychology, 22, 1–10.
Dohrenwend, B. P. (2000). The role of adversity and stress in psychopathology: Some evidence and its implications for theory and research. Journal of Health and Social Behavior, 41(1), 1–19.
Donovan, J. E. (2004). Adolescent alcohol initiation: A review of psychosocial risk factors. Journal of Adolescent Health, 35, 529.e7–529.e18.
Eisenberg, N., Zhou, Q., Spinrad, T. L., Valiente, C., Fabes, R. A., & Liew, J. (2005). Relations among positive parenting, children’s effortful control, and externalizing problems: A three-wave longitudinal study. Child Development, 76, 1055–1071.
Erikson, E. H. (1968). Identity: Youth and crisis. New York: Norton.
Fletcher, A., Steinberg, L., & Williams, M. (2004). Parental influences on adolescent problem behavior: Revisiting Stattin and Kerr. Child Development, 75, 781–796.
Flory, K., Lynam, D., Milich, R., Leukefeld, C., & Clayton, R. (2004). Early adolescent through young adult alcohol and marijuana use trajectories: Early predictors, young adult outcomes, and predictive utility. Development and Psychopathology, 16(1), 193–213.
Greenfield, T. K., & Kerr, W. C. (2008). Alcohol measurement methodology in epidemiology: Recent advances and opportunities. Addiction, 103, 1082–1099.
Grunbaum, J. A., Kann, L., & Kinchen, S. (2004). Youth Risk Behavior Surveillance—United States, 2003. Morbidity and Mortality Weekly Report Surveillance Summary, 53(2), 1–96.
Indian Health Service. (2009). Trends in Indian health. Washington: Government Printing Office.
Kaufman, C. E., Mitchell, C. M., Beals, J., Desserich, J. A., Wheeler, C., Keane, E. M., et al. (2010). Circle of life: Rationale, design, and baseline results of an HIV prevention intervention among young American Indian adolescents of the Northern Plains. Prevention Science, 11(1), 101–112.
Kunitz, S. J. (2008). Risk factors for polydrug use in a Native American population. Substance Use and Misuse, 43, 331–339.
LeMaster, P. L., Connell, C. M., Mitchell, C. M., & Manson, S. M. (2002). Tobacco use among American Indian adolescents: Protective and risk factors. Journal of Adolescent Health, 30, 426–432.
Li, F., Duncan, T. E., & Hops, H. (2001). Examining developmental trajectories in adolescent alcohol use using piecewise growth mixture modeling analysis. Journal of Studies on Alcohol and Drugs, 62, 199–210.
Majewska, M. D. (2002). HPA axis and stimulant dependence: An enigmatic relationship. Psychoneuroendrocinology, 27(1–2), 5–12.
Markstrom, C. A., Whitesell, N. R., & Galliher, R. V. (2011). Ethnic identity and mental health among American Indian and Alaska Native adolescents. In M. C. Sarche, P. Spicer, P. Farrell, & H. E. Fitzgerald (Eds.), American Indian and Alaska Native children and mental health: Development, context, prevention, and treatment (pp. 101–131). Denver: Praeger.
Martino, S. C., Ellickson, P. L., & McCaffrey, D. F. (2009). Multiple trajectories of peer and parental influence and their association with the development of adolescent heavy drinking. Addictive Behaviors, 34, 693–700.
Mason, C. A., Walker-Barnes, C. J., Tu, S., Simons, J., & Martinez-Arrue, R. (2004). Ethnic differences in affective meaning of parental control behaviors. The Journal of Primary Prevention, 25, 59–79.
Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide. Los Angeles: Muthén & Muthén.
National Institute on Alcohol Abuse and Alcoholism. (2004/2005). Alcohol and development in youth: A multidisciplinary overview. Alcohol Research and Health, 28(3), 107–175.
National Institute on Alcohol Abuse and Alcoholism Task Force on Recommended Alcohol Questions. (2003). National Council on Alcohol Abuse and Alcoholism Recommended Sets of Alcohol Consumption Questions—October 15–16, 2003. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.
Nez Henderson, P., Jacobsen, C., Beals, J., & The AI-SUPERPFP Team. (2005). Correlates of cigarette smoking among selected Southwest and Northern Plains tribal groups: The AI-SUPERPFP study. American Journal of Public Health, 95(5), 867–872.
Oetting, E. R., & Beauvais, F. (1990–1991). Orthogonal cultural identification theory: The cultural identification of minority adolescents. The International Journal of the Addictions, 25, 655–685.
Orlando, M., Tucker, J. S., Ellickson, P. L., & Klein, D. J. (2005). Concurrent use of alcohol and cigarettes from adolescence to young adulthood: An examination of developmental trajectories and outcomes. Substance Use and Misuse, 40, 1051–1069.
Phinney, J. S. (1992). The multigroup ethnic identity measure: A new scale for use with diverse groups. Journal of Adolescent Research, 7(2), 156–176.
Phinney, J. S., & Ong, A. D. (2007). Conceptualization and measurement of ethnic identity: Current status and future directions. Journal of Counseling Psychology, 54(3), 271–281.
Rodgers, K. B., & Fleming, W. M. (2004). Individual, family, and community factors related to alcohol use among Native American adoelscents. Adolescent and Family Health, 3(3), 140–147.
Simon, A. E., Wardle, J., Jarvis, J. J., Steggles, N., & Cartwright, M. (2003). Examining the relationship between pubertal stage, adolescent health behaviours and stress. Psychological Medicine, 13, 1369–1379.
Simons-Morton, B., Haynie, D. L., Crump, A. D., Eitel, P., & Saylor, K. E. (2001). Peer and parent influences on smoking and drinking among early adolescents. Health Education & Behavior, 28(1), 95–107.
Spaeth, M., Weichold, K., Silbereisen, R. K., & Weisner, M. (2010). Examining the differential effectiveness of a life skills program (IPSY) on alcohol use trajectories in early adolescence. Journal of Consulting and Clinical Psychology, 78(3), 334–348.
Szlemko, W. J., Wood, J. W., & Jumper Thurman, P. (2006). Native Americans and alcohol: Past, present, and future. The Journal of General Psychology, 133(4), 435–451.
Taga, K. A., Markey, C. N., & Friedman, H. S. (2006). A longitudinal investigation of associations between boys’ pubertal timing and adult behavioral healh and well-being. Journal of Youth and Adolescence, 35(3), 401–411.
U. S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity—A supplement to Mental health: A report of the Surgeon General (SMA01-3613). Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.
Van Der Vorst, H., Vermulst, A. A., Meeus, W. H. J., Dekovis, M., & Engels, R. C. M. E. (2009). Identification and prediction of drinking trajectories in early and mid-adolescence. Journal of Clinical, Child, & Adolescent Psychology, 38(3), 329–341.
van Jaarsveld, C. H. M., Fidler, J. A., Simon, A. E., & Wardle, J. (2007). Persistent impact of pubertal timing on trends in smoking, food choice, activity, and stress in adolescence. Psychosomatic Medicine, 69, 798–806.
Walls, M. L. (2008). Marijuana and alcohol use during early adolescence: Gender differences among American Indian/First Nations youth. Journal of Drug Issues, 38(4), 1139–1160.
Walls, M. L., & Whitbeck, L. B. (2011). Maturation, peer context, and indigenous girls’ early-onset substance use. Journal of Early Adolescence, 31(3), 415–422.
Walters, K. L., Simoni, J. M., & Evans-Campbell, T. (2002). Substance use among American Indians and Alaska natives: Incorporating culture in an “indigenist” stress-coping paradigm. Public Health Reports, 117(Suppl 1), S104–S117.
Westling, E., Andrews, J. A., Hampson, S. E., & Peterson, M. (2008). Pubertal timing and substance use: The effects of gender, parental monitoring, and deviant peers. Journal of Adolescent Health, 42, 555–563.
Whitbeck, L. Z., Yu, M., Johnson, K. K., Hoyt, D. R., & Walls, M. L. (2008). Diagnostic prevalence rates from early to mid-adolescence among indigenous adolescents: First results from a longitudinal study. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 890–900.
Whitesell, N. R., Beals, J., Mitchell, C. M., Keane, E., Spicer, P., Turner, R. J., et al. (2007a). The relationship of cumulative and proximal adversity to onset of substance dependence symptoms in two American Indian communities. Drug and Alcohol Dependence, 91, 279–288.
Whitesell, N. R., Beals, J., Mitchell, C. M., Manson, S. M., & Turner, R. J. (2009). Childhood exposure to adversity and risk of substance use disorder in two American Indian populations: The meditational role of early substance use initiation. Journal of Studies on Alcohol and Drugs, 70, 971–981.
Whitesell, N. R., Beals, J., Mitchell, C. M., Spicer, P., Novins, D. K., Manson, S. M., et al. (2007b). Disparities in drug use and disorder: Comparison of two American Indian reservation communities and a national sample. American Journal of Orthopsychiatry, 77, 131–141.
Whitesell, N. R., Kaufman, C. E., Keane, E. M., Big Crow, C., Shangreau, C., & Mitchell, C. M. (2012). Patterns of substance use initiation among young adolescents in a Northern Plains American Indian tribe. The American Journal of Drug and Alcohol Abuse, 39(5), 383–388.
Whitesell, N. R., Spicer, P., & Mitchell, C. M. (2005). Ethnic identity development among American Indian adolescents. Paper presented at the Society for Research in Child Development, Atlanta.
Windle, M., Spear, L. P., Fuligni, A. J., Angold, A., Brown, J. D., Pine, D., et al. (2008). Transitions into underage and problem drinking: Developmental processes and mechanisms between 10 and 15 years of age. Pediatrics, 121, S273–S289.
Witt, E. D. (2007). Puberty, hormones, and sex differences in alcohol abuse and dependence. Neurotoxicology and Teratology, 29, 81–95.
Wu, L., Woody, G. E., Yang, C., Pan, J., & Blazer, D. G. (2011). Racial/ethnic variations in substance-related disorders among adolescents in the United States. Archives of General Psychiatry, 60(11), 1176–1185.
Acknowledgments
We thank the schools and the tribal community in which these data were collected for their ongoing support, and the parents, guardians, and youth who gave so generously of their time to complete the surveys. We are grateful for the thoughtful guidance of the EAST Council, our community advisory board, who provided invaluable insights into the interpretation of findings within the local context. This project reflects the dedicated work of project staff, led by Jennifer Desserich, Angela Sam, and Cindy Wheeler, without whom the extensive data collection necessary to this longitudinal project would not have been possible. We appreciate Jacob Cheadle’s input on our analytic design. This research was funded by the National Institute on Drug Abuse (R01 DA027665) and the National Institute of Mental Health (R01 MH069086).
Author contributions
NRW contributed to the conception and design of the study; assisted with the acquisition, analysis, and interpretation of the data; and participated in the preparation of the manuscript. NLA assisted with the analysis and interpretation of data; and participated in the preparation of the manuscript. CEK, CBC, CS, EMK, and CMM contributed to the conception and design of the study; assisted with the acquisition, analysis, and interpretation of the data; and contributed to the intellectual content of the manuscript. ACM contributed to the intellectual content of the manuscript. All authors read and gave final approval of the manuscript.
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Whitesell, N.R., Asdigian, N.L., Kaufman, C.E. et al. Trajectories of Substance Use Among Young American Indian Adolescents: Patterns and Predictors. J Youth Adolescence 43, 437–453 (2014). https://doi.org/10.1007/s10964-013-0026-2
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DOI: https://doi.org/10.1007/s10964-013-0026-2