Patterns of substance use initiation among Indigenous adolescents

Background—The data for this study come from an eight-wave panel study of Indigenous (Canadian First Nations and American Indian) adolescents from three U.S. reservations and four Canadian reserves. Objectives—Our objective was to investigate variations in patterns of substance use initiation from early adolescence through early adulthood using data collected annually for 8 years. Method—At baseline the sample included 675 Indigenous adolescents (M age = 11.10, SD = .83; 50.3% girls). First, we calculated cumulative rates of substance use initiation by age. We then examined whether the cumulative initiation rates were moderated by gender using logistic regression analyses. Second, we calculated hazard rates for substance use initiation by age. Third, we focused on the ordering of two substances, paired two substances, and three substance initiation sequences. Results—If one looks only at the cumulative rates of substance use initiation there appears to be support for a sequential progression of substance use during early adolescence. In contrast to the cumulative rates of substance use initiation, the hazard analyses showed a much more mixed, less progressive sequence. Among two substance pairings a nicotine to marijuana initiation sequence was most likely, followed by a nicotine to alcohol sequence. An alcohol to marijuana sequence was nearly twice as likely as a marijuana to alcohol sequence. Refined analyses to conform to those of many of the traditional gateway studies by introducing paired two substance orderings indicated that nicotine and/or alcohol prior to marijuana use was by far the most likely sequence. In two of the three most likely three substance sequences (nicotine to alcohol to marijuana and nicotine to marijuana to alcohol) nicotine was the first substance initiated. Conclusion—This study refines the gateway hypothesis for Indigenous adolescents by providing an in-depth analysis of substance use initiation. The only evidence for a “gateway” substance that emerged in our analyses was for nicotine use which was likely to precede alcohol and marijuana use in both two-substance pairings and to a lesser extent in three-substance initiation sequences

The Historical Loss Scale: Longitudinal Measurement Equivalence and Prospective Links to Anxiety Among North American Indigenous Adolescents

Objectives—Thoughts of historical loss (i.e., the loss of culture, land, and people as a result of colonization) are conceptualized as a contributor to the contemporary distress experienced by North American Indigenous populations. Although discussions of historical loss and related constructs (e.g., historical trauma) are widespread within the Indigenous literature, empirical efforts to understand the consequence of historical loss are limited, partially because of the lack of valid assessments. In this study we evaluated the longitudinal measurement properties of the Historical Loss Scale (HLS)—a standardized measure that was developed to systematically examine the frequency with which Indigenous individuals think about historical loss—among a sample of North American Indigenous adolescents. We also test the hypothesis that thoughts of historical loss can be psychologically distressing. Methods—Via face-to-face interviews, 636 Indigenous adolescents from a single cultural group completed the HLS and a measure of anxiety at 4 time-points, which were separated by 1- to 2-year intervals (M age = 12.09 years, SD = .86, 50.0% girls at baseline). Results—Responses to the HLS were explained well by 3-factor (i.e., cultural loss, loss of people, and cultural mistreatment) and second-order factor structures. Both of these factor structures held full longitudinal metric (i.e., factor loadings) and scalar (i.e., intercepts) equivalence. In addition, using the second-order factor structure, more frequent thoughts of historical loss were associated with increased anxiety. Conclusions—The identified 3-factor and second-order HLS structures held full longitudinal measurement equivalence. Moreover, as predicted, our results suggest that historical loss can be psychologically distressing for Indigenous adolescents

Predicting the Onset of Alcohol Use and the Development of Alcohol Use Disorder Among Indigenous Adolescents

Empirical efforts to identify the predictors of drinking behavior among North American Indigenous adolescents are relatively limited. Using longitudinal data, this study considers perceived discrimination, positive drinker prototypes, and peer drinking behavior as risk factors for the onset of alcohol use and development of an alcohol use disorder among 674 Indigenous adolescents as they progressed from early to late adolescence (M age at baseline = 11.11, SD = 0.83). Results showed that positive drinker prototypes and associations with peers who drink increased the risk for the onset of drinking, while perceived discrimination and associations with peers who drink increased the risk for the development of an alcohol use disorder. The theoretical and practical implications of our results are discussed

Interactive Effects within the Prototype Willingness Model: Predicting the Drinking Behavior of Indigenous Early Adolescents

Drawing on the Prototype/Willingness Model of Adolescent Risk Behavior we used longitudinal data collected from North American Indigenous early adolescents (ages 10–12 years) to examine the interactive effects of favorable drinker prototypes, perceived drinking norms, and past year drinking behavior on subsequent drinking behavior (i.e., drinking behavior 1 year later and growth in drinking behavior from 1–5 years later). We found that the positive association between favorable drinker prototypes and drinking one year later was strongest for adolescents who were high in past year drinking and perceived low drinking norms. The interaction pattern for growth in drinking was more complex and suggested an important pattern; specifically, favorable drinker prototypes were positively associated with drinking five years later, but only for adolescents who reported no past year drinking and perceived low drinking norms. The theoretical and practical implications of these results are discussed

A Cautionary Tale: Examining the Interplay of Culturally Specific Risk and Resilience Factors in Indigenous Communities

Efforts to build empirical evidence for the protective effects of Indigenous cultural factors on psychological health have yielded mixed findings. We examine the interplay of previously hypothesized culturally relevant risk (discrimination, historical loss) and protective (spiritual activities) factors among Indigenous people. The sample includes 569 Indigenous adolescents (mean age = 17.23, SD = 0.88; 51.0% girls) and 563 Indigenous adult caregivers (mean age = 44.66, SD = 9.18; 77.4% women). Our central finding was that indigenous spirituality was associated with poorer psychological outcomes across several domains (depressive symptoms, anger, anxiety, somatization, and interpersonal difficulties), but observed effects were attenuated once perceived discrimination and historical losses were added to statistical models. Thus, consideration of relevant stressors drastically changed our conclusions, underscoring the uncertain dynamics through which specific Indigenous cultural factors impact mental health. Researchers should work in collaboration with Indigenous communities to improve measurement and empirical investigation of these complex constructs

A Cautionary Tale: Examining the Interplay of Culturally Specific Risk and Resilience Factors in Indigenous Communities

Efforts to build empirical evidence for the protective effects of Indigenous cultural factors on psychological health have yielded mixed findings. We examine the interplay of previously hypothesized culturally relevant risk (discrimination, historical loss) and protective (spiritual activities) factors among Indigenous people. The sample includes 569 Indigenous adolescents (mean age = 17.23, SD = 0.88; 51.0% girls) and 563 Indigenous adult caregivers (mean age = 44.66, SD = 9.18; 77.4% women). Our central finding was that indigenous spirituality was associated with poorer psychological outcomes across several domains (depressive symptoms, anger, anxiety, somatization, and interpersonal difficulties), but observed effects were attenuated once perceived discrimination and historical losses were added to statistical models. Thus, consideration of relevant stressors drastically changed our conclusions, underscoring the uncertain dynamics through which specific Indigenous cultural factors impact mental health. Researchers should work in collaboration with Indigenous communities to improve measurement and empirical investigation of these complex constructs

The Utility of the Prototype/Willingness Model in Predicting Alcohol Use Among North American Indigenous Adolescents

In the present study, we considered the utility of the prototype/willingness model in predicting alcohol use among North-American Indigenous adolescents. Specifically, using longitudinal data, we examined the associations among subjective drinking norms, positive drinker prototypes, drinking expectations (as a proxy of drinking willingness), and drinking behavior among a sample of Indigenous adolescents from ages 12 to 14 years. Using an autoregressive cross-lagged analysis, our results showed that subjective drinking norms and positive drinker prototypes at 12 years of age were associated with increased drinking expectations at 13 years of age, and that greater drinking expectations at 13 years of age were associated with increased drinking behavior at 14 years of age. Our results provide initial evidence that the prototype/willingness model may generalize to Indigenous adolescents, a population that has received little attention within the psychological sciences. Our results also highlight some potential ways in which existing prevention efforts aimed at reducing substance use among Indigenous adolescents may be enhanced

Interactive Effects within the Prototype Willingness Model: Predicting the Drinking Behavior of Indigenous Early Adolescents

Drawing on the Prototype/Willingness Model of Adolescent Risk Behavior we used longitudinal data collected from North American Indigenous early adolescents (ages 10–12 years) to examine the interactive effects of favorable drinker prototypes, perceived drinking norms, and past year drinking behavior on subsequent drinking behavior (i.e., drinking behavior 1 year later and growth in drinking behavior from 1–5 years later). We found that the positive association between favorable drinker prototypes and drinking one year later was strongest for adolescents who were high in past year drinking and perceived low drinking norms. The interaction pattern for growth in drinking was more complex and suggested an important pattern; specifically, favorable drinker prototypes were positively associated with drinking five years later, but only for adolescents who reported no past year drinking and perceived low drinking norms. The theoretical and practical implications of these results are discussed

Characteristics of Mothers Caring for Children During Episodes of Homelessness

This study provides a description of the physical, psychological, and substance use problems of adult homeless women who are and are not caring for children. We also examined differences in the characteristics of these two groups of women. Interviews were conducted with 148 homeless women from three mid-sized U.S. cities, 24.3% of whom were caring for at least one child. Our results showed that women caring for children were more likely to be sheltered and have health insurance. Homeless women caring for children and solitary homeless women were generally similar in terms of substance abuse problems. However, rates of Borderline Personality Disorder were higher among women caring for children than among solitary homeless women. Our results are somewhat consistent with previous research, with the exception of substance abuse problems and mental health problems, which were shown to be equally problematic for all women, regardless of current caregiving status

Characteristics of Mothers Caring for Children During Episodes of Homelessness

This study provides a description of the physical, psychological, and substance use problems of adult homeless women who are and are not caring for children. We also examined differences in the characteristics of these two groups of women. Interviews were conducted with 148 homeless women from three mid-sized U.S. cities, 24.3 % of whom were caring for at least one child. Our results showed that women caring for children were more likely to be sheltered and have health insurance. Homeless women caring for children and solitary homeless women were generally similar in terms of substance abuse problems. However, rates of Borderline Personality Disorder were higher among women caring for children than among solitary homeless women. Our results are somewhat consistent with previous research, with the exception of substance abuse problems and mental health problems, which were shown to be equally problematic for all women, regardless of current caregiving status