Date of Award

2020

Degree Type

Thesis

Degree Name

Master of Arts in Psychology

Specialization

Clinical Psychology

Department

Psychology

First Advisor

Nichea Spillane

Abstract

American Indian (AI) communities and researchers have identified alcohol as a primary concern for AI, acknowledging the severity of alcohol-related consequences experienced by individuals, families, and whole communities (Stanley, Harness, Swaim, & Beauvais, 2014; Yuan et al., 2010) as well as the long-term damaging effects (Radin et al., 2015). Though extant research has shown varied results regarding actual prevalence rates of alcohol use among AI adolescents (Lynne-Landsman, Komro, Kominsky, Boyd, & Maldonado-Molina, 2016; Whitbeck et al., 2014), there is strong agreement that AI youth suffer disproportionate negative consequences associated with alcohol use (Landen, Roeber, Naimi, Nielsen, & Sewell, 2014; Prevention, 2008; Indian Health Services, 2018; Szlemko, Wood, & Thurman, 2006). Despite this, there are few to no measures of alcohol-related consequences that have been validated with AI/AN samples. Thus, the purpose of this study is to evaluate the psychometric properties of the American Drug and Alcohol Survey’s (ADAS™) alcohol-related problem scale for AI adolescents, and to examine how race (AI and non-Hispanic White) moderates the relationship between alcohol consumption and alcohol-related problems. The current study (n = 2,214, 52.1% female) is a secondary data analysis study of a large population-based sample that included youth between the ages of 15-21 drawn from a large sample of adolescents living on or near a reservation. The scale had good internal consistency, Cronbach’s alpha = .834. Results from the principal component analysis suggested one-factor and confirmatory factor analysis confirmed a one-factor model. Multiple group confirmatory factor analysis found the ADAS’s™ alcohol-related problem scale was invariant across race (AI and non-Hispanic white) and sex (female and male), suggesting that the scale is appropriate for use to compare across groups (race and sex) with little to no measurement bias. However, a multi-group confirmatory factor analysis was conducted with all four groups and that model failed to reach convergence. Point-biserial correlations revealed a significant positive association between frequency of endorsing drinking over the past-12 months (r(2076) = .435, p < .001) and frequency of endorsing being drunk over the past-12 months (r(2017) = .535, p < .001) and alcohol-related problems, suggesting this scale can be considered valid. Next, two multilevel regression analyses to evaluate the effects of age, sex, alcohol use and race (level 1 variables) and accounted for nesting with community location (level 2), on alcohol-related problems. A significant main effect was found for race (b = -0.559, SE = 0.102, t = -5.485, p <.001, 95% CI [-0.759, -0.359]), and frequency of drinking over 12-months (b = 0.524, SE = 0.054, t = 9.671, p <.001, 95% CI [0.418, 0.631]), on alcohol-related problems, as well as for race (b = -0.513, SE = 0.102, t = -5.01, p <.001, 95% CI [-0.714, -0.312], and frequency of being drunk over 12-months on alcohol-related problems (b = 0.562, SE = 0.053, t = 10.700, p <.001, 95% CI [0.459, 0.666]). A significant main effect was found between the association of alcohol-related problems and drinking, and alcohol-related problems and being drunk, for both AI and non-Hispanic white adolescents. Though, simple slopes revealed these relationships were stronger for AI adolescents. Results from this study aid in the alcohol-related health disparity literature for AI adolescents and emphasize the importance of using cross-culturally validated measures with use among AI.

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