Date of Award
Doctor of Philosophy (PhD)
Research focused on the initiation and development of alcohol use among adolescents can inform professionals, families, and preventative strategies. Much of the research on adolescent substance use among this population focuses on risk. This study investigated a model of the initiation of adolescent alcohol use milestones including first full drink, first time engaging in heavy drinking, and first time being drunk, extending the risk perspective by emphasizing a model of resilience. This was done by simultaneously including risk, promotive, and protective influences in a single model. It was hypothesized that parental monitoring and reasons for abstaining and limiting drinking would have a promotive effect on alcohol use such that these predictors would relate to a decreased probability of milestone initiation. Peer influences and impulsive personality traits were hypothesized to be risk factors and increase the probability of milestone initiation. Parental monitoring was also hypothesized to have a protective effect on adolescent drinking milestones by mitigating the influence of peers and impulsive personality. The sample is comprised of roughly equal numbers of 6th, 7th, and 8th graders (N=1,023) in six middle schools. Mean age at baseline was 12.22 years (SD=0.98, range 10-15) and the sample is 52% female and 27% non-White (4% Black, 11% other), and 12% Hispanic. Rates of initiation for all three milestones increased with time and females drank more than males at each time point. Survival analysis tested the overall model and results indicate adequate model fit (Δ AIC= -200). Reasons for abstaining and limiting drinking and parental monitoring decreased the probability of alcohol use initiation, first heavy drinking, and first drunk (hazard ratios = .37/.77; .50/.77; .49/.66, respectively) Being female increased the probability of alcohol use initiation and first heavy drinking (H.R.= 1.62; 1.54). Peer influences increased the probability of alcohol use initiation (H.R.= 1.46) and sensation seeking was also a risk factor for heavy drinking (H.R.= 1.41). The influence of parental monitoring as a protective effect, mitigating the influence of peers and personality, was only partially supported as there was an interaction effect of parental monitoring and peer influences on first time being drunk. Results support a more resilient model with promotive effects remaining most significant when considered alongside risk. Further investigation of how these risk, promotive, and protective effects influence the development of future drinking patters such as regular use, or alcohol use disorders, should be considered. Results add to the burgeoning studies on reasons for abstaining and limiting drinking (RALD) and this cognitive factors’ influence on alcohol use initiation. An emphasis on these cognitions either by encouraging the maintenance of previously held RALD or helping adolescents to acquire more RALD might be beneficial for preventative strategies and merits further investigation. Research was supported by National Institute on Alcohol Abuse and Alcoholism (NIAAA) RO1 AA016838.
Keywords: Adolescence, alcohol use, resilience, parental monitoring, peers, impulsivitiy, RALD
Martin, Scott D., "RISK, PROMOTIVE, AND PROTECTIVE INFLUENCES ON ADOLESCENT ALCOHOL USE MILESTONES" (2014). Open Access Dissertations. Paper 257.