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Pathways to Drinking Among Hispanic/ Latino Adolescents: Perceived Discrimination, Ethnic Identity, and Peer Affiliations a
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Silvia L. Acosta , Michelle M. Hospital , Juliette N. Graziano , Staci a
Morris & Eric F. Wagner
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Florida International University, Miami, Florida Published online: 26 Jun 2015.
Click for updates To cite this article: Silvia L. Acosta, Michelle M. Hospital, Juliette N. Graziano, Staci Morris & Eric F. Wagner (2015): Pathways to Drinking Among Hispanic/Latino Adolescents: Perceived Discrimination, Ethnic Identity, and Peer Affiliations, Journal of Ethnicity in Substance Abuse, DOI: 10.1080/15332640.2014.993787 To link to this article: http://dx.doi.org/10.1080/15332640.2014.993787
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Journal of Ethnicity in Substance Abuse, 0:1–17, 2015 Copyright # Taylor & Francis Group, LLC ISSN: 1533-2640 print=1533-2659 online DOI: 10.1080/15332640.2014.993787
Pathways to Drinking Among Hispanic/Latino Adolescents: Perceived Discrimination, Ethnic Identity, and Peer Affiliations SILVIA L. ACOSTA, MICHELLE M. HOSPITAL, JULIETTE N. GRAZIANO, STACI MORRIS, and ERIC F. WAGNER Downloaded by [UNSW Library] at 03:28 20 August 2015
Florida International University, Miami, Florida
We examined whether discrimination experienced by Hispanic= Latino adolescents is associated (a) directly with adolescent alcohol use or (b) indirectly with adolescent alcohol use via mediation by ethnic identity and=or peer associations. Data were drawn from an NIAAA-funded randomized controlled trial evaluating the efficacy of a Guided-Self Change intervention for Hispanic=Latino youth with alcohol and interpersonal violence problems (R01 AA12180; see Wagner et al., 2014). The current sample included 371 Hispanic=Latino teenagers (mean age ¼ 16.3 years [SD ¼ 1.37]; 38% female). Using structural equation modeling (SEM), results revealed that perceived discrimination was indirectly related to alcohol consumption through positive (non-drinking) peer affiliations. Additionally, ethnic identity was found to moderate the relationship between discrimination and positive peer affiliation. These findings further our understanding about how discrimination and ethnic identity interact, as well as provide directions for how the effectiveness of prevention models may be enhanced for reducing underage drinking among Hispanic=Latino adolescents. KEYWORDS adolescents, alcohol use, ethnic identity, Hispanic= Latino, peers
Address correspondence to Eric F. Wagner, PhD, FIU-BRIDGE, 11200 S.W. 8th Street, Miami, FL 33199. E-mail: [email protected] 1
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Alcohol Use Among Hispanic=Latino Youth Among teenagers in the United States, underage alcohol use is quite prevalent; 62% of high school seniors report past-year alcohol use, almost a quarter report past-month binge drinking (i.e., having five or more drinks in a row), and 90% agree that alcohol is easy to acquire (Johnston et al., 2014). Underage alcohol consumption also can be quite dangerous. Underage drinkers are at heightened risk for injuries and emergency room visits, suicidality, interpersonal problems with family and friends, school problems, risky sex, and risky driving (Jacobus, Bava, Cohen-Zion, Mahmood, & Tapert, 2009; Teplin et al., 2005; Windle & Windle, 2005; Zufferey et al., 2007). Moreover, the more an adolescent drinks, the more likely that adolescent as an adult will experience alcohol dependence and other substance abuse, antisocial behavior, legal problems, vocational problems and unemployment, comorbid disorders, and interpersonal problems with family and friends (Danielsson, Wennberg, Tengstro¨m, & Romelsjo¨, 2010; Hicks, Iacono, & McGue, 2010). Hispanic=Latino youth appear to be especially at risk for problematic drinking behaviors (Vega & Gil, 1998a). From 1992 through the present, Hispanic=Latino 8th graders have been roughly twice as likely to report binge drinking as non-Hispanic White 8th graders, and 3 times as likely as African American 8th graders (Johnston et al., 2013). Moreover, studies of Hispanic= Latino adults indicate high levels of general alcohol use and more hazardous drinking patterns than other racial=ethnic minority groups (Finch, 2001; Galvan & Caetano, 2003; Nielsen, 2000). These findings, combined with the fact that Hispanics=Latinos constitute the largest and fastest-growing ethnic=racial minority group in the United States (U.S. Census Bureau, 2013), speak to the significance of research into putative pathways to underage alcohol use among Hispanics=Latinos.
Acculturative Stress=Discrimination and Underage Drinking One possible explanation for the high rates of drinking among Hispanic= Latino youth is stress associated with the acculturation process. Guerra and Smith (2006) define acculturation as ‘‘the differences and changes in values and behaviors that individuals make as they gradually adopt the cultural values of the dominant society’’ (p. 283). Acculturation strain theory (Vega, Zimmerman, Gil, Warheit, & Apospori, 1993) suggests that when adapting to a host culture, stressful situations may lead to problematic behaviors, including underage drinking. Other factors linked to an increase in acculturative stress include parent-child differences in rate of acculturation, language barriers, and perceived discrimination (Vega, Zimmerman, Gil, Warheit, & Apospori, 1997). Among Hispanic=Latino children and adolescents, outcomes assessing the relationship between acculturation and problem behavior proneness
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(e.g., pro-substance use attitudes, association with delinquent peers, externalization of aggressive and delinquent behaviors, & gang involvement) have been found to be significantly interrelated when predicting the likelihood of future problem behaviors (Dinh, Roosa, Tein, & Lopez, 2002). Intriguingly, Hispanic=Latino adolescents who speak both English and Spanish with friends have been found to engage in more drinking than more acculturated adolescents who only speak English with their friends (Epstein, Botvin, & Diaz, 2000). As adolescence is a time for identity development, youth experiencing difficulties with the acculturation process might feel conflicted and experience more stress than those who more easily adjusted to the host culture. As a consequence, they may turn to alcohol or other drugs as a way to cope with stress (Austin & Gilbert, 1989). According to Berry’s multidimensional model (1997), acculturation involves two independent dimensions: (1) the extent to which culture of origin is maintained and (2) the extent to which participation in mainstream society is achieved. This theoretical framework assumes individuals may choose to maintain or disregard their culture of origin while participating in various aspects of the dominant culture. Individuals who both choose to disregard their cultural identity, perhaps as a result of pressured or forced assimilation by the host society, and lack incentives to maintain relationships with the larger society, most likely as a result of experiencing discrimination, are identified as marginalized (Berry, 1997). Among adolescents, those who adopt a marginalized acculturation strategy have been found to be at greater risk for lifetime alcohol and drug use when compared to their ‘‘integrated’’ or bicultural counterparts (Fosados et al., 2007). In regard to discrimination and substance use outcomes, racial=ethnic discrimination among Hispanic=Latino youth has been associated with higher levels of depressive symptoms and increased risk for smoking cigarettes, illegal drug use, and fighting (Romero, Martinez, & Carvajal, 2007). Among Hispanic=Latino high school students, higher perceived discrimination has been found to longitudinally predict more tobacco, alcohol, and marijuana use, while stronger ethnic identity has been found to longitudinally predict less tobacco, alcohol, and marijuana use (Unger, Schwartz, Huh, Soto, & Baezconde-Garbanati, 2014). Studies conducted with other racial=ethnic minority adolescents (e.g., Asian Americans, Pacific Islanders, African Americans) have found racial discrimination to be positively associated with both mental health and substance use problems (Chen, Szalacha, & Menon, 2014; Hurd, Varner, Caldwell, & Zimmerman, 2014).
Social Support: The Role of Peer Social Relations Peer social affiliations play an important role in determining adolescent behaviors. Krohn and Thornberry’s Network Theory (1993) focuses on the relationships among individuals, peers, and family members as drivers of
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adolescent health behaviors. This perspective assumes that the behavior of individuals is influenced by their social networks, and emphasizes the structure of the social network and how integrated a particular individual is to that network. As children get older, their peer groups become more influential (Goldstein et al. 2005) in their decision-making processes, including those related to the consumption of alcohol. The overwhelming majority of the empirical work that has been published on acculturation stress and underage drinking has not included measures of peer associations and influence. There are two exceptions— Buchanan and Smokowski (2009), in a study of Hispanic=Latino teenagers, found that negative friend associations was one of several significant mediators of the relationship between perceived discrimination and substance use. Cook, Hofstetter, Kang, Hovell, and Irvin (2009), in a study of Korean American teenagers, found that acculturation was not a significant predictor of most measures of underage drinking, while peer influence, scholastic achievement=aspirations, and current smoking were. There are a number of studies examining ethnic=racial variation in peer influences on teen smoking (e.g., Brook, Pahl, & Ning, 2006; Mays, Luta, Walker, & Tercyak, 2012; Tanski, Stoolmiller, Gerrard, & Sargent, 2012; Villanti, Boulay, & Juon, 2011); these studies strongly suggest peer influences interact with acculturation stress to predict teenage substance use. The dearth of research severely limits our ability to understand how peer social processes may affect acculturation stress, as well as how peer social processes and acculturation may interact to predict underage drinking among Hispanic=Latino teenagers. Exposure to deviant peers among Mexican American adolescents has been associated with increased externalizing problems through deviant behavior (Germa´n, Gonzales, & Dumka, 2009); a similar process may be at work with underage drinking. Furthermore, firstand second-generation Mexican American adolescents tend to engage in binge drinking more often when they associate with White friends, and friends who engage in more party behaviors, than when they associate with co-ethnic and immigrant youth who engage in less party behaviors (Cavanagh, 2007). These studies speak to the importance of peer social processes in determining drinking among Hispanic=Latino adolescents, and support the contention that peer social processes need to be taken into account when examining the relation between acculturation stress and underage drinking.
Ethnic Identity and Alcohol Use Ethnic identification consists of (a) an individual’s sense of belonging to an ethnic group and (b) how strongly that individual affirms membership in the group (Phinney, 1992). The protective effects of ethnic identity have been studied extensively among young African Americans in the US; across studies, stronger ethnic identity has been found to be inversely associated with
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alcohol use and alcohol use problems (Herd & Grube, 1996). Among young Black college students, stronger ethnic identity has been shown to be significantly and inversely related to the frequency and quantity of beer, hard liquor, wine use, and marijuana use (Pugh & Bry, 2007). In sum, among African American youth a stronger ethnic identity seems to operate as a protective factor against problematic alcohol consumption. Across a variety of studies examining a range of populations, strong ethnic identity is protective for most immigrants for a range of health outcomes and related behaviors. The protective effects of ethnic identity, specifically among Hispanics=Latinos, has received some limited research attention. Stronger ethnic identity has been found to predict greater positive self-regard and greater academic success among Hispanic=Latino adolescents (Fuligni, Witkow, & Garcia, 2005; Schwartz, Zamboanga, & Jarvis, 2007). Furthermore, bicultural Hispanic=Latino adolescents, who are highly involved in their culture of origin, have reported higher self-esteem than those less involved (Smokowski, Rose, & Bacallao, 2010). On the other hand, less acculturated adolescents, who identify strongly with their culture of origin, yet have trouble becoming integrated into the host culture, may choose to associate with less acculturated peers for protection (Bacallao & Smokowski, 2009). In sum, ethnic identity may play an important mediating role in associations among acculturation stress, peer associations, and alcohol use, though the mechanisms of action remain poorly understood among Hispanic=Latino adolescents.
The Current Study The current study represents an attempt to elucidate the complex associations between acculturation and alcohol use among Hispanic=Latino adolescents. We examined whether discrimination experienced by Hispanic=Latino adolescents is (a) directly associated with adolescent alcohol use or (b) indirectly associated with adolescent alcohol use via mediation by ethnic identity and=or peer associations. The model tested examined hypothesized sequential causal links among perceived discrimination, ethnic identity, positive peer affiliation, and underage drinking. We hypothesized that discrimination and positive peer affiliation would directly impact adolescent drinking. In addition, it was expected that ethnic identity would moderate the impact of discrimination on positive peer affiliation, as well as on alcohol consumption.
METHODS Research Strategy This study was conducted with data culled from the Treatment of Alcohol Problems for Violence Prone Youth project, a 5-year National Institute on
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Alcohol Abuse and Alcoholism (NIAAA)-funded randomized controlled trial (RCT) evaluating the efficacy of a guided-self change (GSC) for Hispanic= Latino youth with alcohol and interpersonal violence problems (R01 AA12180; see Wagner et al., 2014). GSC is a brief cognitive-behavioral and motivational intervention with demonstrated effectiveness for addressing alcohol or other drug (AOD) problems (Sobell & Sobell, 2005). GSC has been standardized and manualized with English- and Spanish-speaking adolescents (Breslin, Li, Sdao-Jarvie, Tupker, & Ittig-Deland, 2002; Gil, Wagner, & Tubman, 2004; Martı´nez Martı´nez et al., 2008; Martı´nez Martı´nez, Salazar Garza, Pedroza Cabrera, Ruiz Torres, & Ayala Vela´zquez, 2008; Sobell & Sobell, 1996), which made it especially well-suited for our largely bilingual target population. At study intake, participants completed measures of perceived discrimination, ethnic identity, and positive peer affiliation; these data, along with baseline measures of alcohol use, constituted the cross-sectional dataset examined in the current study.
Participants The sample consisted of 371 substance-using, violence-prone Hispanic= Latino high school students who volunteered to participate in the GSC RCT. Students for whom written parental consent was obtained were screened according to the following inclusion criteria: (1) 15–18 years of age, (2) at least six occasions of alcohol or other drug (AOD) use in the past 90 days, and (3) at least one act of relational or predatory violence in the past 90 days (Ellickson & McGuigan, 2000). Exclusion criteria were: (1) repeated dangerous behavior such as drinking while driving, (2) current suicidal risk as identified using the general health questionnaire (Goldberg et al., 1997; Werneke, Goldberg, Yalcin, & Ustun, 2000), (3) significant health problems related to drinking (e.g., withdrawal symptoms, a significant history of blackouts), (4) pregnancy in females, as determined by self-report, and (5) cognitive impairments or developmental delays, as indicated by school evaluations and educational placement. While students of any race=ethnicity were eligible to take part in the GSC RCT, the current study focused exclusively on the Hispanic=Latino participants (n ¼ 371; 38% female; mean age ¼ 16.3 years [SD ¼ 1.37]), 41% of whom reported being born in a country other than the United States. Our participants were selected because they reported engaging in alcohol and=or drug use and aggression. Thus, despite being non-treatmentseeking high school students, our sample more resembled a clinical sample than a community sample. That said, this was not a clinical sample in the strictest sense; our study intentionally targeted Hispanic adolescents in the early stages of problems with substance use and aggressive behavior. As a result, we ended up with what might be most appropriately labeled an early intervention sample.
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Measures TIMELINE FOLLOW-BACK
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Alcohol use was measured using the Timeline Follow-Back (TLFB; Sobell, Sobell, & Ward, 1980; Sobell & Sobell, 1992, 1996). The TLFB is a widely used research and clinical assessment tool with good reliability and validity for various groups of individuals with alcohol use problems. Alcohol consumption data are collected using a calendar-like format, which includes holidays, teacher planning days, and notable events (e.g., the participant’s birthday) that serve as recall cues to enhance recall accuracy. For the current study, TLFB data included (1) total number of alcohol use days during the past 30 days and (2) total number of drinks during the past 30 days. DISCRIMINATION Perceived discrimination for Hispanic=Latinos was measured using a perceived discrimination questionnaire derived from the work of Cuellar et al. (1980) and Szapocznik et al. (1978). This perceived discrimination measure has been found to predict alcohol use in large community-based samples of Hispanic=Latino adolescents (Vega & Gil, 1998b; Gil & Vega, 1996). The scale has good construct validity and internal reliability (Vega, Zimmerman, Gil, Warheit, & Apospori, 1993). For the current study, perceived discrimination was indexed by the averaged scores across the following questions, ‘‘How often do people dislike you because you are Hispanic=Latino(a)?’’ and ‘‘How often are you treated unfairly because you are Hispanic (Latino)?’’ Possible responses ranged from ‘‘Never’’ (1) to ‘‘Always’’ (7). Higher numbers represent greater perceived discrimination. This 2-item measure has high internal consistency (a ¼ .81). ETHNIC IDENTITY Ethnic identity was measured using a questionnaire based on the work of Vega & Gil (1998b), Felix-Ortiz et al. (1994), Cuellar et al. (1980; 1995), and Szapocznik et al. (1978). The measure addresses ethnic identification in multiple contexts by presenting statements such as: ‘‘You have a strong sense of yourself as a member of your ethnic group,’’ and ‘‘You identify with other people from your ethnic group.’’ The respondent is asked to rate how well these statements describe them on a range from ‘‘Strongly Agree’’ (1) to ‘‘Strongly Disagree’’ (7). This 6-item measure has high internal consistency (a ¼ .80). Responses were coded and tabulated so that higher numbers represent less identification with the Hispanic=Latino culture.
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POSITIVE PEER AFFILIATION A revised version of the social support questionnaire, short form (Pierce, Sarason, & Sarason, 1986) was used to measure positive peer affiliation. This instrument is a valid measure of social support with high internal reliability (range: .89 to .93) (Pierce et al., 1986; Sarason, Levine, Basham, & Sarason, 1983). For each item, respondents list people to whom they can turn for support, and then rate their satisfaction with these supports (e.g., ‘‘Do you have another friend that provides help or support?’’). Information on AOD use patterns of friends’ social support also was collected, and a variable was created that tabulated a ratio between the number of friends who provide support (as identified by the respondent) and the number of friends who were ‘‘nondrinkers’’ or ‘‘abstaining=recovering’’ (as identified by the respondent in response to the question ‘‘How would you describe his=her alcohol use pattern?’’). Higher numbers represented a greater amount of positive (i.e., non-alcohol using) peer affiliation, consistent with differential association theory premises regarding negative versus positive influences from peers on engagement in deviance (Sutherland, 1974).
Analytic Strategy The present study involved the investigation of complex and multidimensional relationships; therefore, the analytic plan involved the use of structural equation modeling (SEM). Table 1 presents the means, standard deviations, and distribution values for each variable included in the model. Prior to analysis, the data for the covariance matrix were evaluated for multivariate outliers by examining leverage indices for each individual and defining an outlier as a leverage score 4 times greater than the mean leverage. No outliers were observed. Multivariate normality was evaluated using Mardia’s index (Mardia, 1980). The multivariate test was statistically significant (p < 0.05) indicating the presence of nonnormality. Examination of univariate indices of skewness and kurtosis suggested sizeable kurtosis, with some values exceeding 4.5. To deal with the nonnormality, the decision was made to use bootstrapping for purposes of model evaluation (Wilcox, 2003). For the bootstrap analyses, 2,000 bootstrap samples were taken and then used to estimate standard errors, bias-corrected confidence intervals, and p values as implemented by Analysis of Moment Structures (AMOS). The p value for overall fit of the tested models was calculated using the Bollen–Stine bootstrap approach in place of the traditional chi-square statistic (Bollen & Stine, 1993). In general, conclusions were the same in both estimation approaches. All significance tests and path coefficients reported are from the bootstrap analyses. Missing data was accommodated using the multiple data imputation technique. Five data sets were imputed using the AMOS Bayesian data imputation package. The proposed model was run with all five imputed data sets with comparable results.
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Model Fit Evaluation The fit of the model was evaluated with AMOS 7.0 using the sample covariance matrix as input and a maximum likelihood solution. The model was statistically over identified. A variety of indices of model fit was evaluated. The Bollen-Stine index yielded a statistically nonsignificant result of .48. The root mean square error of approximation (RMSEA) was .02. The comparative fit index (CFI) was 1.00. The p value for close fit (PCLOSE) was .92. The standardized root mean square residual (RMR) was 0.02. All indices suggest a good overall fitting model. Inspection of the residuals and modification indices revealed no significant points of ill-fit in the model. More focused analyses revealed no absolute standardized residuals greater than 1.96 and no theoretically meaningful modification indices of notable size. No offending estimates were evident. Figure 1 presents the parameter estimates for the structural coefficients for the significant paths. Unstandardized coefficients appear on each path. The residuals indicate the proportion of unexplained variance in the endogenous variables (i.e., they are error variances in standardized form). The variables in the model were able to account for approximately 10% of the variance in adolescent drinking as defined by days used (30-day period) and 10% of the variance in adolescent drinking as defined by total numbers of drinks in a 30-day period.
FIGURE 1 Final SEM model (n ¼ 371). The values along the pathways are unstandardized path coefficients. Arrows represent statistically significant pathways (p < .05), dotted lines represent nonsignificant paths. The values in the circles represent standardized error variances (residual terms).
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RESULTS Perceived discrimination was not directly associated with adolescent drinking. However, it was indirectly associated through mediation by positive peer affiliation. As expected (see Figure 1), positive peer affiliation was inversely related to adolescent drinking. Adolescents who reported a greater proportion of nondrinking peers reported significantly less total drinks in the previous month (unstandardized parameter estimate ¼ 2.03) and less days used in the previous month (unstandardized parameter estimate ¼ .45), holding all other variables in the model constant. Adolescents who reported experiencing more discrimination were more likely to report fewer positive peer affiliations, which in turn was associated with alcohol involvement. Additionally, ethnic identity was found to affect (i.e., moderate) the relationship between discrimination and positive peer affiliation. In the description that follows, ethnic identity is conceptualized as the moderator and discrimination is conceptualized as the focal independent variable, whose effects vary as a function of the moderator variable. As seen in the path diagram (Figure 1), the product term coefficient path of ethnic identity to the positive peer affiliation variable was statistically significant. Based upon the path coefficients in the figure, when ethnic identity is at its mean, the effect of discrimination on peer social support is .17, such that for every one unit increase in discrimination positive peer affiliation decreased by .17 units. By contrast as ethnic identity weakened, the negative impact (i.e., slope) of discrimination on positive peer affiliation changed by .28 units. In other words, stronger ethnic identity was protective for Hispanic teens in regard to alcohol use. In order to test for possible demographic confounders, an additional model run was conducted including age, nativity, language preference, and gender as covariates predicting all of the endogenous variables. Even after controlling for these demographics, all major conclusions remained the same. All reported coefficients are from the analyses conducted with the covariates included.
DISCUSSION The purpose of this study was to examine possible pathways linking the experience of discrimination to substance use for Hispanic=Latino adolescents. Previous research has not considered the impact of perceived discrimination on peer affiliation, and ultimately underage drinking. This study contributes to the literature by further enhancing our understanding of some of the mechanisms underlying Hispanic=Latino adolescents’ substance use. The present study found that perceived discrimination was indirectly related to alcohol consumption among Hispanic=Latino youth through peer
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affiliations, consistent with Buchanan & Smokowski’s (2009) findings that acculturation stress variables, including perceived discrimination, were indirectly associated with substance use (i.e., peer association mediated this relationship). Research has shown that peers are highly influential in an adolescent’s life, regardless of whether the outcome of such affiliations is positive or negative (Cavanagh, 2007; Coker, 1998; Germa´n, Gonzales, & Dumka, 2009; Spoth, Redmond, Hockaday, & Yoo, 1996; Spoth, Yoo, Kahn, & Redmond, 1996; Strunin & Demissie, 2001; Wallace & Fisher, 2007). The present study confirmed the influential role of peers in the drinking behaviors of adolescent Hispanics=Latinos, as well as illuminated the moderating influence of ethnic identity on this relation. As previously noted, the literature regarding the relationship between acculturation stress and adolescent drinking has been mixed. Some studies suggest that recent immigrant adolescents are more likely to engage in deviant behavior and are more prone to problem behaviors than their more acculturated counterparts (Dinh, Roosa, Tein, & Lopez, 2002; Epstein, Botvin, & Diaz, 2000; Guilamo-Ramos, Jaccard, Pena, & Goldberg, 2005). However, when factors such as ethnic identity are taken into consideration, the findings vary; highly ethnically identified youth have more positive feelings and higher self-esteem than less ethnically identified youth (Schwartz, Zamboanga, & Jarvis, 2007; Smokowski, Rose, & Bacallao, 2010). This suggests a need to disentangle the complex associations among ethnic identity, discrimination, and Hispanic=Latino adolescent drinking. The results from the present study also suggest that there is a complex interplay between discrimination and ethnic identity. The finding that ethnic identity moderated the relationship between discrimination and peer affiliation indicates that it may be protective for adolescents to maintain a strong sense of ethnic identity in the face of ethnic discrimination. This highlights the importance of the role ethnic identity plays with Hispanic=Latino adolescents, a finding that parallels those observed in other health conditions among racial=ethnic minority individuals (see Fuligni, Witkow, & Garcia, 2005; Nazroo & Iley, 2011; Smokowski, Rose, & Bacallao, 2010). One possible role could be that adolescents who are more involved in their culture of origin do not internalize discrimination-related stress as much as adolescents who are more involved in the host culture. Conversely, trying to cope with discrimination by disengaging from their culture of origin, while often not fully engaged in the host culture, could make the acculturation process more stressful for Hispanic=Latino adolescents. This once again highlights the need for more detailed examination of the complex relationship among discrimination, ethnic identity and adolescent problem behaviors. Another intriguing finding was that adolescents who perceived more discrimination were less likely to seek positive peer affiliations. There is a need to explore the role of positive peer affiliations in mitigating the negative effects of discrimination, and how that may contribute to protecting
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adolescents from engaging in underage drinking or substance use. Speculating from these findings to the applied domain, a possible preventive intervention could be to have teenagers at risk for experiencing discrimination participate in activities that promote ethnic identity and positive peer affiliations, which should reduce the likelihood of underage drinking and other adolescent problem behaviors. The results of this study must be interpreted within the context of the methodological limitations of the design. The data were cross-sectional and do not permit causal inference. While consistent with our model, our finding cannot ‘‘prove’’ our model. Moreover, measurement error was not accounted for, which could potentially bias the parameter estimates. Additionally, all scores were adolescent self-report, which could inflate some of the results due to shared method variance. Finally, the study was conducted with a unique geographically specific, early intervention sample, which might limit the generalizability of findings. Despite these limitations, the results are intriguing and informative, as well as plausible and practical. In sum, Hispanic=Latino adolescents are at an elevated risk for alcohol use in comparison to other minority youth, and given the long-term consequences of underage drinking, it is imperative that research and practice with this population are attentive to the dynamics that influence drinking behaviors. In addition to the typical challenges adolescents face, Hispanic=Latino youth often experience the strain of discrimination and of negotiating their relationship to their ethnic identity. The present study is an important contribution to the field of knowledge in that it serves to clarify specific factors contributing to Hispanic=Latino adolescent drinking. These findings highlight the protective roles of positive peer affiliation and ethnic identity in the complex relationships between discrimination and alcohol use for Hispanic= Latino adolescents. Our findings provide a more nuanced understanding of how discrimination and ethnic identity interact, as well as directions for how prevention models may be enhanced toward reducing underage drinking among Hispanic=Latino adolescents.
ACKNOWLEDGMENTS This article is based on lead author Silvia Acosta’s undergraduate honors thesis in the Department of Psychology at Florida International University, Miami. Partial support was provided by a grant from the National Institute of Alcohol Abuse and Alcoholism to Dr. Eric F. Wagner (R01 AA12180). The authors are grateful to Drs. Linda and Mark Sobell for their consultation on the TLFB measure. We also wish to express our appreciation to the staff and research participants associated with the Community-Based Intervention Research Group at Florida International University, whose involvement made this study possible.
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REFERENCES Austin, G. A., & Gilbert, M. J. (1989). Substance use among Latino youth. Prevention Research Update, 3, 1–28. Bacallao, M. L., & Smokowski, P. R. (2009). Obstacles to getting Ahead: How assimilation mechanisms impact Mexican immigrant families. Social work in public health, 28(1), 1–20. Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology, 46(1), 5–34. Bollen, K. A., & Stine, R. (1993). Bootstrapping goodness of fit measures in structural equation models. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 111–135). Newbury Park, CA: Sage. Breslin, C., Li, S., Sdao-Jarvie, K., Tupker, E., & Ittig-Deland, V. (2002). Brief treatment for young substance abusers: A pilot study in an addiction treatment setting. Psychology of Addictive Behaviors, 16(1), 10. Brook, J. S., Pahl, K., & Ning, Y. (2006). Peer and parental influences on longitudinal trajectories of smoking among African Americans and Puerto Ricans. Nicotine & Tobacco Research, 8(5), 639–651. Buchanan, R. L., & Smokowski, P. R. (2009). Pathways from acculturation stress to substance use among Latino adolescents. Substance Use & Misuse, 44(5), 740–762. Cavanagh, S. E. (2007). Peers, drinking, and the assimilation of Mexican American youth. Sociological Perspectives, 50, 393–416. Chen, A. C., Szalacha, L. A., & Menon, U. (2014). Perceived discrimination and its associations with mental health and substance use among Asian American and Pacific Islander undergraduate and graduate students. Journal of American College Health, 62(6), 390–398. Coker, J. K. (1998). A context for use: Examining the environmental and social factors that impact adolescent problem drinking. Dissertation Abstracts International Section A: Humanities and Social Sciences, 59(5-A), 1469. Cook, W. K., Hofstetter, C. R., Kang, M., Hovell, M. F., & Irvin, V. (2009). Rethinking acculturation: A study of alcohol use of Korean American adolescents in Southern California. Contemporary Drug Problems, 36(1–2), 217. Cuellar, I., Arnold, B., & Maldonado, R. (1995). Acculturation rating scale for Mexican Americans-II: A revision of the original ARSMA scale. Hispanic Journal of Behavioral Sciences, 17(3), 275–304. Cuellar, I., Harris, L. C., & Jasso, R. (1980). An acculturation scale for Mexican American normal and clinical populations. Hispanic Journal of Behavioral Science, 2, 199–217. Danielsson, A. K., Wennberg, P., Tengstro¨m, A., & Romelsjo¨, A. (2010). Adolescent alcohol use trajectories: Predictors and subsequent problems. Addictive Behaviors, 35(9), 848–852. Dinh, K. T., Roosa, M. W., Tein, J. Y., & Lopez, V. A. (2002). The relationship between acculturation and problem behavior proneness in a Hispanic youth sample: A longitudinal mediation model. Journal of Abnormal Child Psychology, 30(3), 295–309. Ellickson, P. L., & McGuigan, K. A. (2000). Early predictors of adolescent violence. American Journal of Public Health, 90(4), 566.
Downloaded by [UNSW Library] at 03:28 20 August 2015
14
S. L. Acosta et al.
Epstein, J. A., Botvin, G. I., & Diaz, T. (2000). Alcohol use among Hispanic adolescents: Role of linguistic acculturation and gender. Journal of Alcohol and Drug Education, 45, 18–32. Felix-Ortiz, M., Newcomb, M. D., & Myers, H. (1994). A multidimensional measure of cultural identity for Latino and Latina adolescents. Hispanic Journal of Behavioral Sciences, 16(2), 99–115. Finch, B. K. (2001). Nation of origin, gender, and neighbor differences in past-year substance use among Hispanics and non-Hispanic Whites. Hispanic Journal of Behavioral Science, 23, 88–101. Fosados, R., McClain, A., Ritt-Olson, A., Sussman, S., Soto, D., Baezconde-Garbanati, L., & Unger, J. B. (2007). The influence of acculturation on drug and alcohol use in a sample of adolescents. Addictive Behaviors, 32(12), 2990–3004. Fuligni, A. J., Witkow, M., & Garcıa, C. (2005). Ethnic identity and the academic adjustment of adolescents from Mexican, Chinese, and European backgrounds. Developmental Psychology, 41, 799–811. Galvan, F. H., & Caetano, R. (2003). Alcohol use and related problems among ethnic minorities in the United States. Alcohol Research and Health, 27(1), 87–94. Germa´n, M., Gonzales, N. A., & Dumka, L. E. (2009). Familism values as a protective factor for Mexican-origin adolescents exposed to deviant peers. Journal of Early Adolescence, 29, 16–42. Gil, A. G., & Vega, W. A. (1996). Two different worlds: Acculturation stress and adaptation among Cuban and Nicaraguan families. Journal of Social and Personal Relationships, 13(3), 435–456. Gil, A. G., Wagner, E. F., & Tubman, J. G. (2004). Culturally sensitive substance abuse intervention for Hispanic and African American adolescents: Empirical examples from the Alcohol Treatment Targeting Adolescents in Need (ATTAIN) Project. Addiction, 99(S2), 140–150. Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O., & Rutter, C. (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27(1), 191–197. Goldstein, S. E., Davis-Kean, P. E., & Eccles, J. S. (2005). Parents, peers, and problem behavior: A longitudinal investigation of the impact of relationship perceptions and characteristics on the development of adolescent problem behavior. Developmental Psychology, 41, 401–413. Guerra, N. G., & Smith, E. P., (Eds.). (2006). Preventing youth violence in a multicultural society. Washington, DC: American Psychological Association, 283. Guilamo-Ramos, V., Jaccard, J., Pen˜a, J., & Goldberg, V. (2005). Acculturation-related variables, sexual initiation, and subsequent sexual behavior among Puerto Rican, Mexican, and Cuban youth. Health Psychology, 24, 88–95. Herd, D., & Grube, J. (1996). Black identity and drinking in the US: A national study. Addiction, 91(6), 845–857. Hicks, B. M., Iacono, W. G., & McGue, M. (2010). Consequences of an adolescent onset and persistent course of alcohol dependence in men: Adolescent risk factors and adult outcomes. Alcoholism: Clinical and Experimental Research, 34(5), 819–833. Hurd, N. M., Varner, F. A., Caldwell, C. H., & Zimmerman, M. A. (2014). Does perceived racial discrimination predict changes in psychological distress and
Downloaded by [UNSW Library] at 03:28 20 August 2015
Underage Drinking Among Hispanic/Latino Adolescents
15
substance use over time? An examination among Black emerging adults. Developmental Psychology, 50(7), 1910–1918. Jacobus, J., Bava, S., Cohen-Zion, M., Mahmood, O., & Tapert, S. F. (2009). Functional consequences of marijuana use in adolescents. Pharmacology Biochemistry and Behavior, 92(4), 559–565. Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Demographic subgroup trends among adolescents for forty-six classes of licit and illicit drugs, 1975–2012 (Monitoring the Future Occasional Paper No. 79). Ann Arbor, MI: Institute for Social Research. Retrieved from http://www. monitoringthefuture.org Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan, 84. Retrieved from http:// www.monitoringthefuture.org/pubs/monographs/mtf-overview2013.pdf Krohn, M. D., & Thornberry, T. P. (1993). Network theory: A model for understanding drug abuse among African American and Hispanic youth. National Institute on Drug Abuse Research Monograph Series, 130, 102–128. Mardia, K. V. (1980). Tests of univariate and multivariate normality. In Handbook of Statistics (vol. 1, pp. 279–320), New York, NY: Wiley. Martı´nez Martı´nez, K. I., Pedroza Cabrera, F. J., Muro, V., de los A´ngeles, M., Jime´nez Pe´rez, A. L., & Salazar Garza, M. L. (2008). Consejo breve para adolescentes escolares que abusan del alcohol [School-based brief counseling for teenage drinkers]. Revista mexicana de ana´lisis de la conducta, 34(2), 247–264. ´ Martınez Martı´nez, K. I., Salazar Garza, M. L., Pedroza Cabrera, F. J., Ruiz Torres, G. M., & Ayala Vela´zquez, H. E. (2008). Resultados preliminares del Programa de Intervencio´n Breve para Adolescentes que Inician el Consumo de Alcohol y otras Drogas [Preliminary results for the Brief Intervention Program for teens who initiated use of alcohol and other drugs.]. Salud Mental, 31(2), 119–127. Mays, D., Luta, G., Walker, L. R., & Tercyak, K. P. (2012). Exposure to peers who smoke moderates the association between sports participation and cigarette smoking behavior among non-White adolescents. Addictive Behaviors, 37(10), 1114–1121. Nazroo, J., & Iley, K. (2011). Ethnicity, race and mental health. In D. Pilgrim, A. Rogers, & B. Pescosolido (Eds.), Handbook on Mental Health (pp. 80–102). London, UK: Sage. Nielsen, A. L. (2000). Examining drinking patterns and problems among Hispanic groups: Results from a national survey. Journal of Studies on Alcohol, 61(2), 301–10. Phinney, J. (1992). The multigroup ethnic identity measure: A new scale for use with diverse groups. Journal of Adolescent Research, 7, 156–176. Pierce, G. R., Sarason, I. G., & Sarason, B. R. (1986, May). Social support questionnaire, short form: Psychometrics, personality correlates, and theory. Paper presented at the Western Psychological Association Convention. Seattle, WA. Pugh, L. A., & Bry, B. H. (2007). The protective effects of ethnic identity for alcohol and marijuana use among Black young adults. Cultural Diversity and Ethnic Minority Psychology, 13(2), 187–193.
Downloaded by [UNSW Library] at 03:28 20 August 2015
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S. L. Acosta et al.
Romero, A. J., Martinez, D., & Carvajal, S. C. (2007). Bicultural stress and adolescent risk behaviours in a community sample of Latinos & non-Latino European Americans. Ethnicity & Health, 12, 443–463. Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44, 127–139. Schwartz, S. J., Zamboanga, B. L., & Jarvis, L. H. (2007). Ethnic identity and acculturation in Hispanic early adolescents: Mediated relationships to academic grades, prosocial behavior, and externalizing symptoms. Cultural Diversity and Ethnic Minority Psychology, 13, 364–373. Smokowski, P. R., Rose, R. A., & Bacallao, M. (2010). Influence of risk factors and cultural assets on Latino adolescents’ trajectories of self-esteem and internalizing symptoms. Child Psychiatry and Human Development, 41, 133–155. Sobell, L. C., & Sobell, M. B. (Eds.) (1992). Timeline followback: A technique for assessing self-reported alcohol consumption. New Jersey: Humana. Sobell, L. C., & Sobell, M. B. (1996). Timeline followback users’ manual for alcohol use. Toronto, Canada: Addiction Research Foundation. Sobell, L. C., Sobell, M. B., & Ward, E. (Eds.), (1980). Evaluating alcohol and drug abuse treatment effectiveness: Recent advances (pp. 129–150). New York, NY: Pergamon. Sobell, M. B., & Sobell, L. C. (1996). Problem drinkers: Guided self-change treatment. New York, NY: Guilford. Sobell, M. B., & Sobell, L. C. (2005). Guided self-change model of treatment for substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 199–210. Spoth, R., Redmond, C., Hockaday, C., & Yoo, S. (1996). Protective factors and young adolescent tendency to abstain from alcohol use: A model using two waves of intervention study data. American Journal of Community Psychology, 24, 749–770. Spoth, R., Yoo, S., Kahn, J., & Redmond, C. (1996). A model of the effects of protective parent and peer factors on young adolescent alcohol refusal skills. Journal of Primary Prevention, 16, 373–394. Strunin, L., & Demissie, S. (2001). Cultural identification and alcohol use among ‘‘Black’’ adolescents. Substance Use and Misuse, 36(14), 2025–2041. Sutherland, E. H. (1974). Criminology (9th ed.). Philadelphia, PA: Lippincott. Szapocznik, J., Scopetta, M. A., Kurtines, W., & Aranalde, M. D. (1978). Theory and measurement of acculturation. Interamerican Journal of Psychology, 12(2), 113–130. Tanski, S. E., Stoolmiller, M., Gerrard, M., & Sargent, J. D. (2012). Moderation of the association between media exposure and youth smoking onset: Race=ethnicity, and parent smoking. Prevention Science, 13(1), 55–63. Teplin, L. A., Elkington, K. S., McClelland, G. M., Abram, K. M., Mericle, A. A., & Washburn, J. J. (2005). Major mental disorders, substance use disorders, comorbidity, and HIV-AIDS risk behaviors in juvenile detainees. Psychiatric Services, 56(7), 823–828. Unger, J. B., Schwartz, S. J., Huh, J., Soto, D. W., & Baezconde-Garbanati, L. (2014). Acculturation and perceived discrimination: Predictors of substance use
Downloaded by [UNSW Library] at 03:28 20 August 2015
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trajectories from adolescence to emerging adulthood among Hispanics. Addictive Behaviors, 39(9), 1293–1296. U.S. Census Bureau. (2013). Hispanic heritage month 2013: Sept. 15–Oct. 15. Facts for features. U.S. Department of Commerce. Retrieved from http://www.census.gov/ newsroom/releases/archives/facts_for_features_special_editions/cb13-ff19.html Vega, W. A., & Gil, A. G. (1998a). Drug use and ethnicity in early adolescence. New York, NY: Plenum. Vega, W. A., & Gil, A. G. (1998b). A model for explaining drug use behavior among Hispanic adolescents. Drugs & Society, 14(1–2), 57–74. Vega, W. A., Zimmerman, R., Gil, A., Warheit, G. J., & Apospori, E. (Eds.). (1993). Acculturation strain theory: Its application in explaining drug use behavior among Cuban and other Hispanic youth. In M. R. De la Rosa & J. L. R. Adrados (Eds.), Drug abuse among minority youth: Methodological issues and recent research advances (NIDA Research Monograph Series 130, pp. 144–166). Rockville, MD: National Institute on Drug Abuse. Vega, W. A., Zimmerman, R., Gil, A., Warheit, G. J., & Apospori, E. (1997). Acculturation strain theory: Its application in explaining drug use behavior among Cuban and other Hispanic youth. Substance Use & Misuse, 32(12 & 13), 1943–1948. Villanti, A., Boulay, M., & Juon, H. (2011). Peer, parent and media influences on adolescent smoking by developmental stage. Addictive Behaviors, 36(1–2), 133–136. Wagner, E. F., Graziano, J. N., Morris, S. L., & Gil, A. G. (2014). A randomized controlled trial of guided self-change with minority adolescents. Journal of Consulting and Clinical Psychology, 82(6), 1128–1139. Wallace, S. A., & Fisher, C. B. (2007). Substance use attitudes among urban Black adolescents: The role of parent, peer, and cultural factors. Journal of Youth and Adolescence, 36, 441–451. ¨ stu¨n, B. T. (2000). The stability of the Werneke, U., Goldberg, D. P., Yalcin, I., & U factor structure of the general health questionnaire. Psychological Medicine, 30(04), 823–829. Wilcox, R. (2003). Applying contemporary statistical techniques. San Diego, CA: Academic. Windle, M., Mun, E. Y., & Windle, R. C. (2005). Adolescent-to-young adulthood heavy drinking trajectories and their prospective predictors. Journal of Studies on Alcohol and Drugs, 66(3), 313–323. Zufferey, A., Michaud, P. A., Jeannin, A., Berchtold, A., Chossis, I., van Melle, G., & Joan-Carles, S. (2007) Cumulative risk factors for adolescent alcohol misuse and its perceived consequences among 16- to 20-year-old adolescents in Switzerland. Preventive Medicine, 45(2–3), 233–239.
Journal of Ethnicity in Substance Abuse Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wesa20
Pathways to Drinking Among Hispanic/ Latino Adolescents: Perceived Discrimination, Ethnic Identity, and Peer Affiliations a
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Silvia L. Acosta , Michelle M. Hospital , Juliette N. Graziano , Staci a
Morris & Eric F. Wagner
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Florida International University, Miami, Florida Published online: 26 Jun 2015.
Click for updates To cite this article: Silvia L. Acosta, Michelle M. Hospital, Juliette N. Graziano, Staci Morris & Eric F. Wagner (2015): Pathways to Drinking Among Hispanic/Latino Adolescents: Perceived Discrimination, Ethnic Identity, and Peer Affiliations, Journal of Ethnicity in Substance Abuse, DOI: 10.1080/15332640.2014.993787 To link to this article: http://dx.doi.org/10.1080/15332640.2014.993787
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Journal of Ethnicity in Substance Abuse, 0:1–17, 2015 Copyright # Taylor & Francis Group, LLC ISSN: 1533-2640 print=1533-2659 online DOI: 10.1080/15332640.2014.993787
Pathways to Drinking Among Hispanic/Latino Adolescents: Perceived Discrimination, Ethnic Identity, and Peer Affiliations SILVIA L. ACOSTA, MICHELLE M. HOSPITAL, JULIETTE N. GRAZIANO, STACI MORRIS, and ERIC F. WAGNER Downloaded by [UNSW Library] at 03:28 20 August 2015
Florida International University, Miami, Florida
We examined whether discrimination experienced by Hispanic= Latino adolescents is associated (a) directly with adolescent alcohol use or (b) indirectly with adolescent alcohol use via mediation by ethnic identity and=or peer associations. Data were drawn from an NIAAA-funded randomized controlled trial evaluating the efficacy of a Guided-Self Change intervention for Hispanic=Latino youth with alcohol and interpersonal violence problems (R01 AA12180; see Wagner et al., 2014). The current sample included 371 Hispanic=Latino teenagers (mean age ¼ 16.3 years [SD ¼ 1.37]; 38% female). Using structural equation modeling (SEM), results revealed that perceived discrimination was indirectly related to alcohol consumption through positive (non-drinking) peer affiliations. Additionally, ethnic identity was found to moderate the relationship between discrimination and positive peer affiliation. These findings further our understanding about how discrimination and ethnic identity interact, as well as provide directions for how the effectiveness of prevention models may be enhanced for reducing underage drinking among Hispanic=Latino adolescents. KEYWORDS adolescents, alcohol use, ethnic identity, Hispanic= Latino, peers
Address correspondence to Eric F. Wagner, PhD, FIU-BRIDGE, 11200 S.W. 8th Street, Miami, FL 33199. E-mail: [email protected] 1
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Alcohol Use Among Hispanic=Latino Youth Among teenagers in the United States, underage alcohol use is quite prevalent; 62% of high school seniors report past-year alcohol use, almost a quarter report past-month binge drinking (i.e., having five or more drinks in a row), and 90% agree that alcohol is easy to acquire (Johnston et al., 2014). Underage alcohol consumption also can be quite dangerous. Underage drinkers are at heightened risk for injuries and emergency room visits, suicidality, interpersonal problems with family and friends, school problems, risky sex, and risky driving (Jacobus, Bava, Cohen-Zion, Mahmood, & Tapert, 2009; Teplin et al., 2005; Windle & Windle, 2005; Zufferey et al., 2007). Moreover, the more an adolescent drinks, the more likely that adolescent as an adult will experience alcohol dependence and other substance abuse, antisocial behavior, legal problems, vocational problems and unemployment, comorbid disorders, and interpersonal problems with family and friends (Danielsson, Wennberg, Tengstro¨m, & Romelsjo¨, 2010; Hicks, Iacono, & McGue, 2010). Hispanic=Latino youth appear to be especially at risk for problematic drinking behaviors (Vega & Gil, 1998a). From 1992 through the present, Hispanic=Latino 8th graders have been roughly twice as likely to report binge drinking as non-Hispanic White 8th graders, and 3 times as likely as African American 8th graders (Johnston et al., 2013). Moreover, studies of Hispanic= Latino adults indicate high levels of general alcohol use and more hazardous drinking patterns than other racial=ethnic minority groups (Finch, 2001; Galvan & Caetano, 2003; Nielsen, 2000). These findings, combined with the fact that Hispanics=Latinos constitute the largest and fastest-growing ethnic=racial minority group in the United States (U.S. Census Bureau, 2013), speak to the significance of research into putative pathways to underage alcohol use among Hispanics=Latinos.
Acculturative Stress=Discrimination and Underage Drinking One possible explanation for the high rates of drinking among Hispanic= Latino youth is stress associated with the acculturation process. Guerra and Smith (2006) define acculturation as ‘‘the differences and changes in values and behaviors that individuals make as they gradually adopt the cultural values of the dominant society’’ (p. 283). Acculturation strain theory (Vega, Zimmerman, Gil, Warheit, & Apospori, 1993) suggests that when adapting to a host culture, stressful situations may lead to problematic behaviors, including underage drinking. Other factors linked to an increase in acculturative stress include parent-child differences in rate of acculturation, language barriers, and perceived discrimination (Vega, Zimmerman, Gil, Warheit, & Apospori, 1997). Among Hispanic=Latino children and adolescents, outcomes assessing the relationship between acculturation and problem behavior proneness
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(e.g., pro-substance use attitudes, association with delinquent peers, externalization of aggressive and delinquent behaviors, & gang involvement) have been found to be significantly interrelated when predicting the likelihood of future problem behaviors (Dinh, Roosa, Tein, & Lopez, 2002). Intriguingly, Hispanic=Latino adolescents who speak both English and Spanish with friends have been found to engage in more drinking than more acculturated adolescents who only speak English with their friends (Epstein, Botvin, & Diaz, 2000). As adolescence is a time for identity development, youth experiencing difficulties with the acculturation process might feel conflicted and experience more stress than those who more easily adjusted to the host culture. As a consequence, they may turn to alcohol or other drugs as a way to cope with stress (Austin & Gilbert, 1989). According to Berry’s multidimensional model (1997), acculturation involves two independent dimensions: (1) the extent to which culture of origin is maintained and (2) the extent to which participation in mainstream society is achieved. This theoretical framework assumes individuals may choose to maintain or disregard their culture of origin while participating in various aspects of the dominant culture. Individuals who both choose to disregard their cultural identity, perhaps as a result of pressured or forced assimilation by the host society, and lack incentives to maintain relationships with the larger society, most likely as a result of experiencing discrimination, are identified as marginalized (Berry, 1997). Among adolescents, those who adopt a marginalized acculturation strategy have been found to be at greater risk for lifetime alcohol and drug use when compared to their ‘‘integrated’’ or bicultural counterparts (Fosados et al., 2007). In regard to discrimination and substance use outcomes, racial=ethnic discrimination among Hispanic=Latino youth has been associated with higher levels of depressive symptoms and increased risk for smoking cigarettes, illegal drug use, and fighting (Romero, Martinez, & Carvajal, 2007). Among Hispanic=Latino high school students, higher perceived discrimination has been found to longitudinally predict more tobacco, alcohol, and marijuana use, while stronger ethnic identity has been found to longitudinally predict less tobacco, alcohol, and marijuana use (Unger, Schwartz, Huh, Soto, & Baezconde-Garbanati, 2014). Studies conducted with other racial=ethnic minority adolescents (e.g., Asian Americans, Pacific Islanders, African Americans) have found racial discrimination to be positively associated with both mental health and substance use problems (Chen, Szalacha, & Menon, 2014; Hurd, Varner, Caldwell, & Zimmerman, 2014).
Social Support: The Role of Peer Social Relations Peer social affiliations play an important role in determining adolescent behaviors. Krohn and Thornberry’s Network Theory (1993) focuses on the relationships among individuals, peers, and family members as drivers of
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adolescent health behaviors. This perspective assumes that the behavior of individuals is influenced by their social networks, and emphasizes the structure of the social network and how integrated a particular individual is to that network. As children get older, their peer groups become more influential (Goldstein et al. 2005) in their decision-making processes, including those related to the consumption of alcohol. The overwhelming majority of the empirical work that has been published on acculturation stress and underage drinking has not included measures of peer associations and influence. There are two exceptions— Buchanan and Smokowski (2009), in a study of Hispanic=Latino teenagers, found that negative friend associations was one of several significant mediators of the relationship between perceived discrimination and substance use. Cook, Hofstetter, Kang, Hovell, and Irvin (2009), in a study of Korean American teenagers, found that acculturation was not a significant predictor of most measures of underage drinking, while peer influence, scholastic achievement=aspirations, and current smoking were. There are a number of studies examining ethnic=racial variation in peer influences on teen smoking (e.g., Brook, Pahl, & Ning, 2006; Mays, Luta, Walker, & Tercyak, 2012; Tanski, Stoolmiller, Gerrard, & Sargent, 2012; Villanti, Boulay, & Juon, 2011); these studies strongly suggest peer influences interact with acculturation stress to predict teenage substance use. The dearth of research severely limits our ability to understand how peer social processes may affect acculturation stress, as well as how peer social processes and acculturation may interact to predict underage drinking among Hispanic=Latino teenagers. Exposure to deviant peers among Mexican American adolescents has been associated with increased externalizing problems through deviant behavior (Germa´n, Gonzales, & Dumka, 2009); a similar process may be at work with underage drinking. Furthermore, firstand second-generation Mexican American adolescents tend to engage in binge drinking more often when they associate with White friends, and friends who engage in more party behaviors, than when they associate with co-ethnic and immigrant youth who engage in less party behaviors (Cavanagh, 2007). These studies speak to the importance of peer social processes in determining drinking among Hispanic=Latino adolescents, and support the contention that peer social processes need to be taken into account when examining the relation between acculturation stress and underage drinking.
Ethnic Identity and Alcohol Use Ethnic identification consists of (a) an individual’s sense of belonging to an ethnic group and (b) how strongly that individual affirms membership in the group (Phinney, 1992). The protective effects of ethnic identity have been studied extensively among young African Americans in the US; across studies, stronger ethnic identity has been found to be inversely associated with
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alcohol use and alcohol use problems (Herd & Grube, 1996). Among young Black college students, stronger ethnic identity has been shown to be significantly and inversely related to the frequency and quantity of beer, hard liquor, wine use, and marijuana use (Pugh & Bry, 2007). In sum, among African American youth a stronger ethnic identity seems to operate as a protective factor against problematic alcohol consumption. Across a variety of studies examining a range of populations, strong ethnic identity is protective for most immigrants for a range of health outcomes and related behaviors. The protective effects of ethnic identity, specifically among Hispanics=Latinos, has received some limited research attention. Stronger ethnic identity has been found to predict greater positive self-regard and greater academic success among Hispanic=Latino adolescents (Fuligni, Witkow, & Garcia, 2005; Schwartz, Zamboanga, & Jarvis, 2007). Furthermore, bicultural Hispanic=Latino adolescents, who are highly involved in their culture of origin, have reported higher self-esteem than those less involved (Smokowski, Rose, & Bacallao, 2010). On the other hand, less acculturated adolescents, who identify strongly with their culture of origin, yet have trouble becoming integrated into the host culture, may choose to associate with less acculturated peers for protection (Bacallao & Smokowski, 2009). In sum, ethnic identity may play an important mediating role in associations among acculturation stress, peer associations, and alcohol use, though the mechanisms of action remain poorly understood among Hispanic=Latino adolescents.
The Current Study The current study represents an attempt to elucidate the complex associations between acculturation and alcohol use among Hispanic=Latino adolescents. We examined whether discrimination experienced by Hispanic=Latino adolescents is (a) directly associated with adolescent alcohol use or (b) indirectly associated with adolescent alcohol use via mediation by ethnic identity and=or peer associations. The model tested examined hypothesized sequential causal links among perceived discrimination, ethnic identity, positive peer affiliation, and underage drinking. We hypothesized that discrimination and positive peer affiliation would directly impact adolescent drinking. In addition, it was expected that ethnic identity would moderate the impact of discrimination on positive peer affiliation, as well as on alcohol consumption.
METHODS Research Strategy This study was conducted with data culled from the Treatment of Alcohol Problems for Violence Prone Youth project, a 5-year National Institute on
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Alcohol Abuse and Alcoholism (NIAAA)-funded randomized controlled trial (RCT) evaluating the efficacy of a guided-self change (GSC) for Hispanic= Latino youth with alcohol and interpersonal violence problems (R01 AA12180; see Wagner et al., 2014). GSC is a brief cognitive-behavioral and motivational intervention with demonstrated effectiveness for addressing alcohol or other drug (AOD) problems (Sobell & Sobell, 2005). GSC has been standardized and manualized with English- and Spanish-speaking adolescents (Breslin, Li, Sdao-Jarvie, Tupker, & Ittig-Deland, 2002; Gil, Wagner, & Tubman, 2004; Martı´nez Martı´nez et al., 2008; Martı´nez Martı´nez, Salazar Garza, Pedroza Cabrera, Ruiz Torres, & Ayala Vela´zquez, 2008; Sobell & Sobell, 1996), which made it especially well-suited for our largely bilingual target population. At study intake, participants completed measures of perceived discrimination, ethnic identity, and positive peer affiliation; these data, along with baseline measures of alcohol use, constituted the cross-sectional dataset examined in the current study.
Participants The sample consisted of 371 substance-using, violence-prone Hispanic= Latino high school students who volunteered to participate in the GSC RCT. Students for whom written parental consent was obtained were screened according to the following inclusion criteria: (1) 15–18 years of age, (2) at least six occasions of alcohol or other drug (AOD) use in the past 90 days, and (3) at least one act of relational or predatory violence in the past 90 days (Ellickson & McGuigan, 2000). Exclusion criteria were: (1) repeated dangerous behavior such as drinking while driving, (2) current suicidal risk as identified using the general health questionnaire (Goldberg et al., 1997; Werneke, Goldberg, Yalcin, & Ustun, 2000), (3) significant health problems related to drinking (e.g., withdrawal symptoms, a significant history of blackouts), (4) pregnancy in females, as determined by self-report, and (5) cognitive impairments or developmental delays, as indicated by school evaluations and educational placement. While students of any race=ethnicity were eligible to take part in the GSC RCT, the current study focused exclusively on the Hispanic=Latino participants (n ¼ 371; 38% female; mean age ¼ 16.3 years [SD ¼ 1.37]), 41% of whom reported being born in a country other than the United States. Our participants were selected because they reported engaging in alcohol and=or drug use and aggression. Thus, despite being non-treatmentseeking high school students, our sample more resembled a clinical sample than a community sample. That said, this was not a clinical sample in the strictest sense; our study intentionally targeted Hispanic adolescents in the early stages of problems with substance use and aggressive behavior. As a result, we ended up with what might be most appropriately labeled an early intervention sample.
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Measures TIMELINE FOLLOW-BACK
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Alcohol use was measured using the Timeline Follow-Back (TLFB; Sobell, Sobell, & Ward, 1980; Sobell & Sobell, 1992, 1996). The TLFB is a widely used research and clinical assessment tool with good reliability and validity for various groups of individuals with alcohol use problems. Alcohol consumption data are collected using a calendar-like format, which includes holidays, teacher planning days, and notable events (e.g., the participant’s birthday) that serve as recall cues to enhance recall accuracy. For the current study, TLFB data included (1) total number of alcohol use days during the past 30 days and (2) total number of drinks during the past 30 days. DISCRIMINATION Perceived discrimination for Hispanic=Latinos was measured using a perceived discrimination questionnaire derived from the work of Cuellar et al. (1980) and Szapocznik et al. (1978). This perceived discrimination measure has been found to predict alcohol use in large community-based samples of Hispanic=Latino adolescents (Vega & Gil, 1998b; Gil & Vega, 1996). The scale has good construct validity and internal reliability (Vega, Zimmerman, Gil, Warheit, & Apospori, 1993). For the current study, perceived discrimination was indexed by the averaged scores across the following questions, ‘‘How often do people dislike you because you are Hispanic=Latino(a)?’’ and ‘‘How often are you treated unfairly because you are Hispanic (Latino)?’’ Possible responses ranged from ‘‘Never’’ (1) to ‘‘Always’’ (7). Higher numbers represent greater perceived discrimination. This 2-item measure has high internal consistency (a ¼ .81). ETHNIC IDENTITY Ethnic identity was measured using a questionnaire based on the work of Vega & Gil (1998b), Felix-Ortiz et al. (1994), Cuellar et al. (1980; 1995), and Szapocznik et al. (1978). The measure addresses ethnic identification in multiple contexts by presenting statements such as: ‘‘You have a strong sense of yourself as a member of your ethnic group,’’ and ‘‘You identify with other people from your ethnic group.’’ The respondent is asked to rate how well these statements describe them on a range from ‘‘Strongly Agree’’ (1) to ‘‘Strongly Disagree’’ (7). This 6-item measure has high internal consistency (a ¼ .80). Responses were coded and tabulated so that higher numbers represent less identification with the Hispanic=Latino culture.
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POSITIVE PEER AFFILIATION A revised version of the social support questionnaire, short form (Pierce, Sarason, & Sarason, 1986) was used to measure positive peer affiliation. This instrument is a valid measure of social support with high internal reliability (range: .89 to .93) (Pierce et al., 1986; Sarason, Levine, Basham, & Sarason, 1983). For each item, respondents list people to whom they can turn for support, and then rate their satisfaction with these supports (e.g., ‘‘Do you have another friend that provides help or support?’’). Information on AOD use patterns of friends’ social support also was collected, and a variable was created that tabulated a ratio between the number of friends who provide support (as identified by the respondent) and the number of friends who were ‘‘nondrinkers’’ or ‘‘abstaining=recovering’’ (as identified by the respondent in response to the question ‘‘How would you describe his=her alcohol use pattern?’’). Higher numbers represented a greater amount of positive (i.e., non-alcohol using) peer affiliation, consistent with differential association theory premises regarding negative versus positive influences from peers on engagement in deviance (Sutherland, 1974).
Analytic Strategy The present study involved the investigation of complex and multidimensional relationships; therefore, the analytic plan involved the use of structural equation modeling (SEM). Table 1 presents the means, standard deviations, and distribution values for each variable included in the model. Prior to analysis, the data for the covariance matrix were evaluated for multivariate outliers by examining leverage indices for each individual and defining an outlier as a leverage score 4 times greater than the mean leverage. No outliers were observed. Multivariate normality was evaluated using Mardia’s index (Mardia, 1980). The multivariate test was statistically significant (p < 0.05) indicating the presence of nonnormality. Examination of univariate indices of skewness and kurtosis suggested sizeable kurtosis, with some values exceeding 4.5. To deal with the nonnormality, the decision was made to use bootstrapping for purposes of model evaluation (Wilcox, 2003). For the bootstrap analyses, 2,000 bootstrap samples were taken and then used to estimate standard errors, bias-corrected confidence intervals, and p values as implemented by Analysis of Moment Structures (AMOS). The p value for overall fit of the tested models was calculated using the Bollen–Stine bootstrap approach in place of the traditional chi-square statistic (Bollen & Stine, 1993). In general, conclusions were the same in both estimation approaches. All significance tests and path coefficients reported are from the bootstrap analyses. Missing data was accommodated using the multiple data imputation technique. Five data sets were imputed using the AMOS Bayesian data imputation package. The proposed model was run with all five imputed data sets with comparable results.
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Model Fit Evaluation The fit of the model was evaluated with AMOS 7.0 using the sample covariance matrix as input and a maximum likelihood solution. The model was statistically over identified. A variety of indices of model fit was evaluated. The Bollen-Stine index yielded a statistically nonsignificant result of .48. The root mean square error of approximation (RMSEA) was .02. The comparative fit index (CFI) was 1.00. The p value for close fit (PCLOSE) was .92. The standardized root mean square residual (RMR) was 0.02. All indices suggest a good overall fitting model. Inspection of the residuals and modification indices revealed no significant points of ill-fit in the model. More focused analyses revealed no absolute standardized residuals greater than 1.96 and no theoretically meaningful modification indices of notable size. No offending estimates were evident. Figure 1 presents the parameter estimates for the structural coefficients for the significant paths. Unstandardized coefficients appear on each path. The residuals indicate the proportion of unexplained variance in the endogenous variables (i.e., they are error variances in standardized form). The variables in the model were able to account for approximately 10% of the variance in adolescent drinking as defined by days used (30-day period) and 10% of the variance in adolescent drinking as defined by total numbers of drinks in a 30-day period.
FIGURE 1 Final SEM model (n ¼ 371). The values along the pathways are unstandardized path coefficients. Arrows represent statistically significant pathways (p < .05), dotted lines represent nonsignificant paths. The values in the circles represent standardized error variances (residual terms).
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RESULTS Perceived discrimination was not directly associated with adolescent drinking. However, it was indirectly associated through mediation by positive peer affiliation. As expected (see Figure 1), positive peer affiliation was inversely related to adolescent drinking. Adolescents who reported a greater proportion of nondrinking peers reported significantly less total drinks in the previous month (unstandardized parameter estimate ¼ 2.03) and less days used in the previous month (unstandardized parameter estimate ¼ .45), holding all other variables in the model constant. Adolescents who reported experiencing more discrimination were more likely to report fewer positive peer affiliations, which in turn was associated with alcohol involvement. Additionally, ethnic identity was found to affect (i.e., moderate) the relationship between discrimination and positive peer affiliation. In the description that follows, ethnic identity is conceptualized as the moderator and discrimination is conceptualized as the focal independent variable, whose effects vary as a function of the moderator variable. As seen in the path diagram (Figure 1), the product term coefficient path of ethnic identity to the positive peer affiliation variable was statistically significant. Based upon the path coefficients in the figure, when ethnic identity is at its mean, the effect of discrimination on peer social support is .17, such that for every one unit increase in discrimination positive peer affiliation decreased by .17 units. By contrast as ethnic identity weakened, the negative impact (i.e., slope) of discrimination on positive peer affiliation changed by .28 units. In other words, stronger ethnic identity was protective for Hispanic teens in regard to alcohol use. In order to test for possible demographic confounders, an additional model run was conducted including age, nativity, language preference, and gender as covariates predicting all of the endogenous variables. Even after controlling for these demographics, all major conclusions remained the same. All reported coefficients are from the analyses conducted with the covariates included.
DISCUSSION The purpose of this study was to examine possible pathways linking the experience of discrimination to substance use for Hispanic=Latino adolescents. Previous research has not considered the impact of perceived discrimination on peer affiliation, and ultimately underage drinking. This study contributes to the literature by further enhancing our understanding of some of the mechanisms underlying Hispanic=Latino adolescents’ substance use. The present study found that perceived discrimination was indirectly related to alcohol consumption among Hispanic=Latino youth through peer
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affiliations, consistent with Buchanan & Smokowski’s (2009) findings that acculturation stress variables, including perceived discrimination, were indirectly associated with substance use (i.e., peer association mediated this relationship). Research has shown that peers are highly influential in an adolescent’s life, regardless of whether the outcome of such affiliations is positive or negative (Cavanagh, 2007; Coker, 1998; Germa´n, Gonzales, & Dumka, 2009; Spoth, Redmond, Hockaday, & Yoo, 1996; Spoth, Yoo, Kahn, & Redmond, 1996; Strunin & Demissie, 2001; Wallace & Fisher, 2007). The present study confirmed the influential role of peers in the drinking behaviors of adolescent Hispanics=Latinos, as well as illuminated the moderating influence of ethnic identity on this relation. As previously noted, the literature regarding the relationship between acculturation stress and adolescent drinking has been mixed. Some studies suggest that recent immigrant adolescents are more likely to engage in deviant behavior and are more prone to problem behaviors than their more acculturated counterparts (Dinh, Roosa, Tein, & Lopez, 2002; Epstein, Botvin, & Diaz, 2000; Guilamo-Ramos, Jaccard, Pena, & Goldberg, 2005). However, when factors such as ethnic identity are taken into consideration, the findings vary; highly ethnically identified youth have more positive feelings and higher self-esteem than less ethnically identified youth (Schwartz, Zamboanga, & Jarvis, 2007; Smokowski, Rose, & Bacallao, 2010). This suggests a need to disentangle the complex associations among ethnic identity, discrimination, and Hispanic=Latino adolescent drinking. The results from the present study also suggest that there is a complex interplay between discrimination and ethnic identity. The finding that ethnic identity moderated the relationship between discrimination and peer affiliation indicates that it may be protective for adolescents to maintain a strong sense of ethnic identity in the face of ethnic discrimination. This highlights the importance of the role ethnic identity plays with Hispanic=Latino adolescents, a finding that parallels those observed in other health conditions among racial=ethnic minority individuals (see Fuligni, Witkow, & Garcia, 2005; Nazroo & Iley, 2011; Smokowski, Rose, & Bacallao, 2010). One possible role could be that adolescents who are more involved in their culture of origin do not internalize discrimination-related stress as much as adolescents who are more involved in the host culture. Conversely, trying to cope with discrimination by disengaging from their culture of origin, while often not fully engaged in the host culture, could make the acculturation process more stressful for Hispanic=Latino adolescents. This once again highlights the need for more detailed examination of the complex relationship among discrimination, ethnic identity and adolescent problem behaviors. Another intriguing finding was that adolescents who perceived more discrimination were less likely to seek positive peer affiliations. There is a need to explore the role of positive peer affiliations in mitigating the negative effects of discrimination, and how that may contribute to protecting
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adolescents from engaging in underage drinking or substance use. Speculating from these findings to the applied domain, a possible preventive intervention could be to have teenagers at risk for experiencing discrimination participate in activities that promote ethnic identity and positive peer affiliations, which should reduce the likelihood of underage drinking and other adolescent problem behaviors. The results of this study must be interpreted within the context of the methodological limitations of the design. The data were cross-sectional and do not permit causal inference. While consistent with our model, our finding cannot ‘‘prove’’ our model. Moreover, measurement error was not accounted for, which could potentially bias the parameter estimates. Additionally, all scores were adolescent self-report, which could inflate some of the results due to shared method variance. Finally, the study was conducted with a unique geographically specific, early intervention sample, which might limit the generalizability of findings. Despite these limitations, the results are intriguing and informative, as well as plausible and practical. In sum, Hispanic=Latino adolescents are at an elevated risk for alcohol use in comparison to other minority youth, and given the long-term consequences of underage drinking, it is imperative that research and practice with this population are attentive to the dynamics that influence drinking behaviors. In addition to the typical challenges adolescents face, Hispanic=Latino youth often experience the strain of discrimination and of negotiating their relationship to their ethnic identity. The present study is an important contribution to the field of knowledge in that it serves to clarify specific factors contributing to Hispanic=Latino adolescent drinking. These findings highlight the protective roles of positive peer affiliation and ethnic identity in the complex relationships between discrimination and alcohol use for Hispanic= Latino adolescents. Our findings provide a more nuanced understanding of how discrimination and ethnic identity interact, as well as directions for how prevention models may be enhanced toward reducing underage drinking among Hispanic=Latino adolescents.
ACKNOWLEDGMENTS This article is based on lead author Silvia Acosta’s undergraduate honors thesis in the Department of Psychology at Florida International University, Miami. Partial support was provided by a grant from the National Institute of Alcohol Abuse and Alcoholism to Dr. Eric F. Wagner (R01 AA12180). The authors are grateful to Drs. Linda and Mark Sobell for their consultation on the TLFB measure. We also wish to express our appreciation to the staff and research participants associated with the Community-Based Intervention Research Group at Florida International University, whose involvement made this study possible.
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REFERENCES Austin, G. A., & Gilbert, M. J. (1989). Substance use among Latino youth. Prevention Research Update, 3, 1–28. Bacallao, M. L., & Smokowski, P. R. (2009). Obstacles to getting Ahead: How assimilation mechanisms impact Mexican immigrant families. Social work in public health, 28(1), 1–20. Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology, 46(1), 5–34. Bollen, K. A., & Stine, R. (1993). Bootstrapping goodness of fit measures in structural equation models. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 111–135). Newbury Park, CA: Sage. Breslin, C., Li, S., Sdao-Jarvie, K., Tupker, E., & Ittig-Deland, V. (2002). Brief treatment for young substance abusers: A pilot study in an addiction treatment setting. Psychology of Addictive Behaviors, 16(1), 10. Brook, J. S., Pahl, K., & Ning, Y. (2006). Peer and parental influences on longitudinal trajectories of smoking among African Americans and Puerto Ricans. Nicotine & Tobacco Research, 8(5), 639–651. Buchanan, R. L., & Smokowski, P. R. (2009). Pathways from acculturation stress to substance use among Latino adolescents. Substance Use & Misuse, 44(5), 740–762. Cavanagh, S. E. (2007). Peers, drinking, and the assimilation of Mexican American youth. Sociological Perspectives, 50, 393–416. Chen, A. C., Szalacha, L. A., & Menon, U. (2014). Perceived discrimination and its associations with mental health and substance use among Asian American and Pacific Islander undergraduate and graduate students. Journal of American College Health, 62(6), 390–398. Coker, J. K. (1998). A context for use: Examining the environmental and social factors that impact adolescent problem drinking. Dissertation Abstracts International Section A: Humanities and Social Sciences, 59(5-A), 1469. Cook, W. K., Hofstetter, C. R., Kang, M., Hovell, M. F., & Irvin, V. (2009). Rethinking acculturation: A study of alcohol use of Korean American adolescents in Southern California. Contemporary Drug Problems, 36(1–2), 217. Cuellar, I., Arnold, B., & Maldonado, R. (1995). Acculturation rating scale for Mexican Americans-II: A revision of the original ARSMA scale. Hispanic Journal of Behavioral Sciences, 17(3), 275–304. Cuellar, I., Harris, L. C., & Jasso, R. (1980). An acculturation scale for Mexican American normal and clinical populations. Hispanic Journal of Behavioral Science, 2, 199–217. Danielsson, A. K., Wennberg, P., Tengstro¨m, A., & Romelsjo¨, A. (2010). Adolescent alcohol use trajectories: Predictors and subsequent problems. Addictive Behaviors, 35(9), 848–852. Dinh, K. T., Roosa, M. W., Tein, J. Y., & Lopez, V. A. (2002). The relationship between acculturation and problem behavior proneness in a Hispanic youth sample: A longitudinal mediation model. Journal of Abnormal Child Psychology, 30(3), 295–309. Ellickson, P. L., & McGuigan, K. A. (2000). Early predictors of adolescent violence. American Journal of Public Health, 90(4), 566.
Downloaded by [UNSW Library] at 03:28 20 August 2015
14
S. L. Acosta et al.
Epstein, J. A., Botvin, G. I., & Diaz, T. (2000). Alcohol use among Hispanic adolescents: Role of linguistic acculturation and gender. Journal of Alcohol and Drug Education, 45, 18–32. Felix-Ortiz, M., Newcomb, M. D., & Myers, H. (1994). A multidimensional measure of cultural identity for Latino and Latina adolescents. Hispanic Journal of Behavioral Sciences, 16(2), 99–115. Finch, B. K. (2001). Nation of origin, gender, and neighbor differences in past-year substance use among Hispanics and non-Hispanic Whites. Hispanic Journal of Behavioral Science, 23, 88–101. Fosados, R., McClain, A., Ritt-Olson, A., Sussman, S., Soto, D., Baezconde-Garbanati, L., & Unger, J. B. (2007). The influence of acculturation on drug and alcohol use in a sample of adolescents. Addictive Behaviors, 32(12), 2990–3004. Fuligni, A. J., Witkow, M., & Garcıa, C. (2005). Ethnic identity and the academic adjustment of adolescents from Mexican, Chinese, and European backgrounds. Developmental Psychology, 41, 799–811. Galvan, F. H., & Caetano, R. (2003). Alcohol use and related problems among ethnic minorities in the United States. Alcohol Research and Health, 27(1), 87–94. Germa´n, M., Gonzales, N. A., & Dumka, L. E. (2009). Familism values as a protective factor for Mexican-origin adolescents exposed to deviant peers. Journal of Early Adolescence, 29, 16–42. Gil, A. G., & Vega, W. A. (1996). Two different worlds: Acculturation stress and adaptation among Cuban and Nicaraguan families. Journal of Social and Personal Relationships, 13(3), 435–456. Gil, A. G., Wagner, E. F., & Tubman, J. G. (2004). Culturally sensitive substance abuse intervention for Hispanic and African American adolescents: Empirical examples from the Alcohol Treatment Targeting Adolescents in Need (ATTAIN) Project. Addiction, 99(S2), 140–150. Goldberg, D. P., Gater, R., Sartorius, N., Ustun, T. B., Piccinelli, M., Gureje, O., & Rutter, C. (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27(1), 191–197. Goldstein, S. E., Davis-Kean, P. E., & Eccles, J. S. (2005). Parents, peers, and problem behavior: A longitudinal investigation of the impact of relationship perceptions and characteristics on the development of adolescent problem behavior. Developmental Psychology, 41, 401–413. Guerra, N. G., & Smith, E. P., (Eds.). (2006). Preventing youth violence in a multicultural society. Washington, DC: American Psychological Association, 283. Guilamo-Ramos, V., Jaccard, J., Pen˜a, J., & Goldberg, V. (2005). Acculturation-related variables, sexual initiation, and subsequent sexual behavior among Puerto Rican, Mexican, and Cuban youth. Health Psychology, 24, 88–95. Herd, D., & Grube, J. (1996). Black identity and drinking in the US: A national study. Addiction, 91(6), 845–857. Hicks, B. M., Iacono, W. G., & McGue, M. (2010). Consequences of an adolescent onset and persistent course of alcohol dependence in men: Adolescent risk factors and adult outcomes. Alcoholism: Clinical and Experimental Research, 34(5), 819–833. Hurd, N. M., Varner, F. A., Caldwell, C. H., & Zimmerman, M. A. (2014). Does perceived racial discrimination predict changes in psychological distress and
Downloaded by [UNSW Library] at 03:28 20 August 2015
Underage Drinking Among Hispanic/Latino Adolescents
15
substance use over time? An examination among Black emerging adults. Developmental Psychology, 50(7), 1910–1918. Jacobus, J., Bava, S., Cohen-Zion, M., Mahmood, O., & Tapert, S. F. (2009). Functional consequences of marijuana use in adolescents. Pharmacology Biochemistry and Behavior, 92(4), 559–565. Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2013). Demographic subgroup trends among adolescents for forty-six classes of licit and illicit drugs, 1975–2012 (Monitoring the Future Occasional Paper No. 79). Ann Arbor, MI: Institute for Social Research. Retrieved from http://www. monitoringthefuture.org Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2014). Monitoring the Future national survey results on drug use, 1975–2013: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan, 84. Retrieved from http:// www.monitoringthefuture.org/pubs/monographs/mtf-overview2013.pdf Krohn, M. D., & Thornberry, T. P. (1993). Network theory: A model for understanding drug abuse among African American and Hispanic youth. National Institute on Drug Abuse Research Monograph Series, 130, 102–128. Mardia, K. V. (1980). Tests of univariate and multivariate normality. In Handbook of Statistics (vol. 1, pp. 279–320), New York, NY: Wiley. Martı´nez Martı´nez, K. I., Pedroza Cabrera, F. J., Muro, V., de los A´ngeles, M., Jime´nez Pe´rez, A. L., & Salazar Garza, M. L. (2008). Consejo breve para adolescentes escolares que abusan del alcohol [School-based brief counseling for teenage drinkers]. Revista mexicana de ana´lisis de la conducta, 34(2), 247–264. ´ Martınez Martı´nez, K. I., Salazar Garza, M. L., Pedroza Cabrera, F. J., Ruiz Torres, G. M., & Ayala Vela´zquez, H. E. (2008). Resultados preliminares del Programa de Intervencio´n Breve para Adolescentes que Inician el Consumo de Alcohol y otras Drogas [Preliminary results for the Brief Intervention Program for teens who initiated use of alcohol and other drugs.]. Salud Mental, 31(2), 119–127. Mays, D., Luta, G., Walker, L. R., & Tercyak, K. P. (2012). Exposure to peers who smoke moderates the association between sports participation and cigarette smoking behavior among non-White adolescents. Addictive Behaviors, 37(10), 1114–1121. Nazroo, J., & Iley, K. (2011). Ethnicity, race and mental health. In D. Pilgrim, A. Rogers, & B. Pescosolido (Eds.), Handbook on Mental Health (pp. 80–102). London, UK: Sage. Nielsen, A. L. (2000). Examining drinking patterns and problems among Hispanic groups: Results from a national survey. Journal of Studies on Alcohol, 61(2), 301–10. Phinney, J. (1992). The multigroup ethnic identity measure: A new scale for use with diverse groups. Journal of Adolescent Research, 7, 156–176. Pierce, G. R., Sarason, I. G., & Sarason, B. R. (1986, May). Social support questionnaire, short form: Psychometrics, personality correlates, and theory. Paper presented at the Western Psychological Association Convention. Seattle, WA. Pugh, L. A., & Bry, B. H. (2007). The protective effects of ethnic identity for alcohol and marijuana use among Black young adults. Cultural Diversity and Ethnic Minority Psychology, 13(2), 187–193.
Downloaded by [UNSW Library] at 03:28 20 August 2015
16
S. L. Acosta et al.
Romero, A. J., Martinez, D., & Carvajal, S. C. (2007). Bicultural stress and adolescent risk behaviours in a community sample of Latinos & non-Latino European Americans. Ethnicity & Health, 12, 443–463. Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44, 127–139. Schwartz, S. J., Zamboanga, B. L., & Jarvis, L. H. (2007). Ethnic identity and acculturation in Hispanic early adolescents: Mediated relationships to academic grades, prosocial behavior, and externalizing symptoms. Cultural Diversity and Ethnic Minority Psychology, 13, 364–373. Smokowski, P. R., Rose, R. A., & Bacallao, M. (2010). Influence of risk factors and cultural assets on Latino adolescents’ trajectories of self-esteem and internalizing symptoms. Child Psychiatry and Human Development, 41, 133–155. Sobell, L. C., & Sobell, M. B. (Eds.) (1992). Timeline followback: A technique for assessing self-reported alcohol consumption. New Jersey: Humana. Sobell, L. C., & Sobell, M. B. (1996). Timeline followback users’ manual for alcohol use. Toronto, Canada: Addiction Research Foundation. Sobell, L. C., Sobell, M. B., & Ward, E. (Eds.), (1980). Evaluating alcohol and drug abuse treatment effectiveness: Recent advances (pp. 129–150). New York, NY: Pergamon. Sobell, M. B., & Sobell, L. C. (1996). Problem drinkers: Guided self-change treatment. New York, NY: Guilford. Sobell, M. B., & Sobell, L. C. (2005). Guided self-change model of treatment for substance use disorders. Journal of Cognitive Psychotherapy, 19(3), 199–210. Spoth, R., Redmond, C., Hockaday, C., & Yoo, S. (1996). Protective factors and young adolescent tendency to abstain from alcohol use: A model using two waves of intervention study data. American Journal of Community Psychology, 24, 749–770. Spoth, R., Yoo, S., Kahn, J., & Redmond, C. (1996). A model of the effects of protective parent and peer factors on young adolescent alcohol refusal skills. Journal of Primary Prevention, 16, 373–394. Strunin, L., & Demissie, S. (2001). Cultural identification and alcohol use among ‘‘Black’’ adolescents. Substance Use and Misuse, 36(14), 2025–2041. Sutherland, E. H. (1974). Criminology (9th ed.). Philadelphia, PA: Lippincott. Szapocznik, J., Scopetta, M. A., Kurtines, W., & Aranalde, M. D. (1978). Theory and measurement of acculturation. Interamerican Journal of Psychology, 12(2), 113–130. Tanski, S. E., Stoolmiller, M., Gerrard, M., & Sargent, J. D. (2012). Moderation of the association between media exposure and youth smoking onset: Race=ethnicity, and parent smoking. Prevention Science, 13(1), 55–63. Teplin, L. A., Elkington, K. S., McClelland, G. M., Abram, K. M., Mericle, A. A., & Washburn, J. J. (2005). Major mental disorders, substance use disorders, comorbidity, and HIV-AIDS risk behaviors in juvenile detainees. Psychiatric Services, 56(7), 823–828. Unger, J. B., Schwartz, S. J., Huh, J., Soto, D. W., & Baezconde-Garbanati, L. (2014). Acculturation and perceived discrimination: Predictors of substance use
Downloaded by [UNSW Library] at 03:28 20 August 2015
Underage Drinking Among Hispanic/Latino Adolescents
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trajectories from adolescence to emerging adulthood among Hispanics. Addictive Behaviors, 39(9), 1293–1296. U.S. Census Bureau. (2013). Hispanic heritage month 2013: Sept. 15–Oct. 15. Facts for features. U.S. Department of Commerce. Retrieved from http://www.census.gov/ newsroom/releases/archives/facts_for_features_special_editions/cb13-ff19.html Vega, W. A., & Gil, A. G. (1998a). Drug use and ethnicity in early adolescence. New York, NY: Plenum. Vega, W. A., & Gil, A. G. (1998b). A model for explaining drug use behavior among Hispanic adolescents. Drugs & Society, 14(1–2), 57–74. Vega, W. A., Zimmerman, R., Gil, A., Warheit, G. J., & Apospori, E. (Eds.). (1993). Acculturation strain theory: Its application in explaining drug use behavior among Cuban and other Hispanic youth. In M. R. De la Rosa & J. L. R. Adrados (Eds.), Drug abuse among minority youth: Methodological issues and recent research advances (NIDA Research Monograph Series 130, pp. 144–166). Rockville, MD: National Institute on Drug Abuse. Vega, W. A., Zimmerman, R., Gil, A., Warheit, G. J., & Apospori, E. (1997). Acculturation strain theory: Its application in explaining drug use behavior among Cuban and other Hispanic youth. Substance Use & Misuse, 32(12 & 13), 1943–1948. Villanti, A., Boulay, M., & Juon, H. (2011). Peer, parent and media influences on adolescent smoking by developmental stage. Addictive Behaviors, 36(1–2), 133–136. Wagner, E. F., Graziano, J. N., Morris, S. L., & Gil, A. G. (2014). A randomized controlled trial of guided self-change with minority adolescents. Journal of Consulting and Clinical Psychology, 82(6), 1128–1139. Wallace, S. A., & Fisher, C. B. (2007). Substance use attitudes among urban Black adolescents: The role of parent, peer, and cultural factors. Journal of Youth and Adolescence, 36, 441–451. ¨ stu¨n, B. T. (2000). The stability of the Werneke, U., Goldberg, D. P., Yalcin, I., & U factor structure of the general health questionnaire. Psychological Medicine, 30(04), 823–829. Wilcox, R. (2003). Applying contemporary statistical techniques. San Diego, CA: Academic. Windle, M., Mun, E. Y., & Windle, R. C. (2005). Adolescent-to-young adulthood heavy drinking trajectories and their prospective predictors. Journal of Studies on Alcohol and Drugs, 66(3), 313–323. Zufferey, A., Michaud, P. A., Jeannin, A., Berchtold, A., Chossis, I., van Melle, G., & Joan-Carles, S. (2007) Cumulative risk factors for adolescent alcohol misuse and its perceived consequences among 16- to 20-year-old adolescents in Switzerland. Preventive Medicine, 45(2–3), 233–239.
