Family, peers, school, and culture Social and environmental factors of adolescent substance use and problem behaviors Emmanuel Kuntsche, Ph.D. s, Research Department, Lausanne Who I am / who we are... E-Mail: ekuntsche@sfa-ispa.ch (http://www.sfa-spa.ch/docuploadcollabo/ cvkuntsche.pdf) Kuntsche, E., Maffli, E., Kuntsche, S., & Delgrande Jordan, M. (2009). Addiction research centres and the nurturing of creativity: The Swiss Institute for the Prevention of Alcohol and Drug Problems. Past, Present, and Future. Addiction, 104(5), 699-704.
What I like to do with you Presentation of ideas and evidence in the literature Presentation of some of our empirical work at the Swiss Institute Understanding of scientific texts «Creative writing» as homework Organized group discussions Final exam (60 min. to answer one question) First Bloc: Today (Tuesday, May 5, 13:00-19:00) 13:00-13:10 Introduction and outline of the course 13:10-14:00 Family factors (presentation EK) 14:00-14:10 Break 14:10-15:00 Teachers 15:00-15:10 Break 15:10-16:00 The classmates and gender effects 16:00-16:10 Break 16:10-17:00 The school environment 17:00-17:30 Break 17:30-18:30 An experiment 18:30-19:00 Explaining the homework (50% of your grade)
Second Bloc: In three weeks (Tuesday, May 26, 13:00-19:00) 13:00-13:10 Introduction 13:10-13:40 Intra-group discussion 13:40-13:45 Break 13:45-15:00 Inter-group discussion 15:00-15:10 Break 15:10-16:00 Cultures and time trends (presentation) 16:00-16:10 Break 16:10-17:00 Cultures and the role of electronic media 17:00-17:30 Break 17:30-18:30 Written exam (50% of your grade) 18:30-19:00 Wrap-up, Feedback, individual meeting time The Family Introduction
Reviews & Risk Factors Among etiological variables, the family environment is particularly important for adolescent substance use (Weinberg et al., 1998, for a review). Another review stress that despite the overwhelming research on peer influence the family remains a strong factor in moderating adolescent risk behavior (Kingon and O'Sullivan, 2001). Over the last 30 years, many reviews collected a broad variety of family-based risk and protective factors for substance (e.g. Denton and Kampfe, 1994; Hawkins, Catalano & Miller, 1992, Vakalahi, 2001): financial situation, unemployment, unsupportive neighbourhood, conflicts, divorce, drinking habits of family members, weak family bonding, parenting, monitoring, just to name a few examples So what? Quantify the risk establish a hierarchy We tried to determine if different family variables such as family structure, perception of drinking habits in the family, and family bonding possess a graduated importance in predicting the frequency of alcohol intake and drunkenness of adolescents and their association with peers who drink excessively
Three levels of family predictors: 1. Level: Family structure Numerous studies have found that living in a single-parent family increases the risk of adolescents using alcohol and other psychoactive substances (e.g. Hoffmann & Johnson, 1998; Jenkins & Zunguze, 1998; Kuntsche & Silbereisen, 2004; Ledoux et al., 2002; Wallace et al., 1999). Why? Epstein et al. (1999) argue that living in a two-parent family means the level of adult supervision is higher and thus less opportunity to engage in drinking. In addition, the fact that single parents are prone to have fewer financial and fewer coping resources, and tend to suffer from greater social isolation than intact families is also likely to contribute to higher adolescent alcohol use rates (Griffin et al., 2000). 2. Level: Perception of excessive drinking in the family Empirical evidence suggests that increased parental drinking constitutes a risk factor for increased alcohol use by their children (e.g. Adalbjarnardottir & Rafnsson, 2001; Ellickson et al., 2001; Kuntsche & Meyer, 2002; Li et al., 2002; Vakalahi, 2001). Reasons: Adolescents may initiate drinking by observing and adopting parental drinking habits (Li et al., 2002; Zhang et al., 1999). Alcohol consumption by adolescents often occurs in accordance with the parental values and norms (Coleman & Hendry, 1999). Adolescents from families in which substance abuse is common are likely to suffer from both physically and emotionally and may use substances as a means to cope (Beman, 1995).
3. Level: Family bonding Finally, the literature suggests that weak family bonds, defined as communication, joint activities, and provided support, encourage adolescent alcohol and other substance use (Bahr et al., 1995; Kuntsche & Schmid, 2001; Vakalahi, 2001; Zhang et al., 1999). Crawford and Novak (2002) suggest that adolescents who spend substantial amounts of time with their parents drink less because their opportunities for engaging in drinking activities are restricted. Furthermore, speaking about their personal worries and feeling close to their parents leaves children more open to their parents influence and makes them more likely to have similar attitudes and values (see Steinberg, 2002, for a review). Hierarchy of family predictors Family structure and perception of parental drinking: Petraitis, Flay, and Miller (1995) state that substance-specific attitudes and behaviors of role models like parents are more closely related to adolescents substance use than family characteristics like parental divorce or separation. Perception of parental drinking and family bonding: Adolescents are less likely to initiate heavy drinking when they have a close relationship to family members, even if they observe problematic drinking in the family (e.g. Zhang et al., 1999). Family bonding and family structure: Studies showed that a strong attachment to family members is a stronger protective factor for adolescent drinking than the presence of two parents at home (McArdle et al., 2002; Shucksmith et al., 1997)
Family factors and drinking peers Various studies showed that the relation between family structure, perception of excessive drinking in the family and family bonding is moderated or mediated through drinking peers (Adalbjarnardottir and Rafnsson, 2001; Bahr et al., 1995; Ellickson et al., 2001; Epstein et al., 1999; Farrell and White, 1998; Li et al., 2002; Zhang et al., 1997). Therefore, we adjusted the final model of the hierarchy of family factors for the association with peers who drink excessively. Furthermore, we also tested if the hierarchy of family factors can be established for the association with peers who drink excessively as a dependent variable. Graphical representation of the hypothesized models Single-parent family Perception of excessive drinking in the family Weak family bonding Gender Age indicator Association with peers who drink excessively Alcohol use included in the first model added in the second model added in the third model
Method Sample description The data base used is part of the survey Health Behaviour in School-Aged Children (HBSC) (Currie et al., 2008) Conducted every four years in more than 43, mostly European countries, under the supervision of the WHO SIPA conducted the survey for Switzerland since 1986 Sample: 3,846 adolescents in Switzerland representative at the national level (1,712 8 th graders (45.7%) and 2,034 9 th graders; 1,846 boys (49.3%) and 1,900 girls) The total mean age was 15.26 years (SD=.80)
Statistical analyses Three models using structural equation modeling Differences in the relation between the three family variables and adolescents alcohol use were tested using χ 2 -difference tests that apply a nested goodness-of-fit strategy (Jaccard & Wan, 1996; Kuntsche & Silbereisen, 2004; Ullman, 2001). Results
Family variables predicting adolescent alcohol use (1. model) Single-parent family Perception of excessive drinking in the family Weak family bonding R 2 CFI RMSEA Frequency of alcoholic beverage intake β (t) β (χ 2 df=2).06 (3.7).11 (6.0).22 (9.1) 7.3%.95.06.04 (19.4).11 (88.4) Note. All coefficients are significant at the 0.1% error level β (t) Drunkenness.10 (5.7).12 (6.5).24 (9.9) 9.5%.95.06 β (χ 2 df=2).02 (27.6).12 (101.9) Results from the 1. model adjusted for gender and age (2. model) Single-parent family Perception of excessive drinking in the family Weak family bonding Male gender Age indicator R 2 CFI RMSEA Frequency of alcoholic beverage intake Drunkenness β (t) β (χ 2 df=2) β (t) β (χ 2 df=2).06 (3.5).10 (6.0).20 (8.5).10 (5.8).25 (12.0) 14.3%.96.05.04 (18.2).09 (76.3) Note. All coefficients are significant at the 0.1% error level.10 (5.6).11 (6.6).22 (9.5).11 (6.4).24 (12.7) 16.1%.96.05.02 (26.9).11 (90.3)
Results from the 2. model adjusted for excessively drinking peers Single-parent family Perception of exce ssive drinking in the family Weak family bonding Male gender Age indicator Excessively drinking peers R 2 CFI RMSEA Frequency of alcoholic beverage intake Drunkenness β (t) β (χ 2 df=2) β (t) β (χ 2 df=2).02 (1.4).06 (4.8).09 (5.4).07 (4.4).13 (6.9).42 (24.5) 28.8%.96.05.04 (8.5).03 (21.8).05 (3.3).08 (5.4).11 (5.8).07 (4.9).08 (5.0).53 (33.8) 39.7%.96.05 Note. All coefficients are significant at the 0.1% error level except not significant.03 (6.1).03 (19.0) Family variables predicting the association with excessively drinking peers in the third model Single-parent family Perception of excessive drinking in the family Weak family bonding R 2 Association with peers who drink excessively β (t) β (χ 2 df=2).09 (5.2) -.03 (14.5).06 (3.7).16 (80.1).22 (9.3) 7.0% Note. All coefficients are significant at the 0.1% error level
Discussion Summary of the results Family bonding was more strongly related to adolescent alcohol use than the perception of excessive drinking in the family, and this perception is more strongly related than family structure. The hierarchy of family factors persisted after adjusting for the socio-demographic variables of gender and age. Even in the final model, for adolescent alcohol use and the association with peers who drink excessively, weak family bonding was the most important predictor among all family variables. For predicting peer association, family structure is more strongly related than the perception of excessive drinking in the family. The level of explained variance is considerable (up to 40 percent)
Implications for prevention I Our results confirm that family bonding is a predominant protective factor. For preventive efforts, it is important to stress that even single parents and those with excessive drinking habits can protect their children from advanced drinking habits and risky single occasion drinking: By listening to their children s worries, by spending their free time with them, and by providing help when needed, parents can actively minimize the risk of frequent and excessive alcohol use by their children. Implications for prevention II For single parents, effective supervision of their children s activities appears to be particularly important. Yet, for them and for parents who misuse alcohol, it is not always easy to provide enough time and help for their children. Sometimes, effective parenting skills may also lack. In such cases, support from all levels is urgently needed, particularly as these parents are likely to feel ashamed about their situation and hesitate to seek professional help (Kuntsche & Schmid, 2001).
For further reading Kuntsche, E. N. & Kuendig, H. (2006). What is worse? A hierarchy of family-related risk factors predicting alcohol use in adolescence. Substance Use & Misuse, 41(1), 71-86. And now Let s have a short break