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1.  Alcohol Sales and Risk of Serious Assault 
PLoS Medicine  2008;5(5):e104.
Alcohol is a contributing cause of unintentional injuries, such as motor vehicle crashes. Prior research on the association between alcohol use and violent injury was limited to survey-based data, and the inclusion of cases from a single trauma centre, without adequate controls. Beyond these limitations was the inability of prior researchers to comprehensively capture most alcohol sales. In Ontario, most alcohol is sold through retail outlets run by the provincial government, and hospitals are financed under a provincial health care system. We assessed the risk of being hospitalized due to assault in association with retail alcohol sales across Ontario.
Methods and Findings
We performed a population-based case-crossover analysis of all persons aged 13 years and older hospitalized for assault in Ontario from 1 April 2002 to 1 December 2004. On the day prior to each assault case's hospitalization, the volume of alcohol sold at the store in closest proximity to the victim's home was compared to the volume of alcohol sold at the same store 7 d earlier. Conditional logistic regression analysis was used to determine the associated relative risk (RR) of assault per 1,000 l higher daily sales of alcohol. Of the 3,212 persons admitted to hospital for assault, nearly 25% were between the ages of 13 and 20 y, and 83% were male. A total of 1,150 assaults (36%) involved the use of a sharp or blunt weapon, and 1,532 (48%) arose during an unarmed brawl or fight. For every 1,000 l more of alcohol sold per store per day, the relative risk of being hospitalized for assault was 1.13 (95% confidence interval [CI] 1.02–1.26). The risk was accentuated for males (1.18, 95% CI 1.05–1.33), youth aged 13 to 20 y (1.21, 95% CI 0.99–1.46), and those in urban areas (1.19, 95% CI 1.06–1.35).
The risk of being a victim of serious assault increases with alcohol sales, especially among young urban men. Akin to reducing the risk of driving while impaired, consideration should be given to novel methods of preventing alcohol-related violence.
In a population-based case-crossover analysis, Joel Ray and colleagues find that the risk of being a victim of serious assault increases with retail alcohol sales, especially among young urban men.
Editors' Summary
Alcohol has been produced and consumed around the world since prehistoric times. In the Western world it is now the most commonly consumed psychoactive drug (a substance that changes mood, behavior, and thought processes). The World Health Organization reports that there are 76.3 million persons with alcohol use disorders worldwide. Alcohol consumption is an important factor in unintentional injuries, such as motor vehicle crashes, and in violent criminal behavior. In the United Kingdom, for example, a higher proportion of heavy drinkers than light drinkers cause violent criminal offenses. Other figures suggest that people (in particular, young men) have an increased risk of committing a criminally violent offense within 24 h of drinking alcohol. There is also some evidence that suggests that the victims as well as the perpetrators of assaults have often been drinking recently, possibly because alcohol impairs the victim's ability to judge potentially explosive situations.
Why Was This Study Done?
The researchers wanted to know more about the relationship between alcohol and intentional violence. The recognition of a clear link between driving when impaired by alcohol and motor vehicle crashes has led many countries to introduce public awareness programs that stigmatize drunk driving. If a clear link between alcohol consumption by the people involved in violent crime could also be established, similar programs might reduce alcohol-related assaults. The researchers tested the hypothesis that the risk of being hospitalized due to a violent assault increases when there are increased alcohol sales in the immediate vicinity of the victim's place of residence.
What Did the Researchers Do and Find?
The researchers did their study in Ontario, Canada for three reasons. First, Ontario is Canada's largest province. Second, the province keeps detailed computerized medical records, including records of people hospitalized from being violently assaulted. Third, most alcohol is sold in government-run shops, and the district has the infrastructure to allow daily alcohol sales to be tracked. The researchers identified more than 3,000 people over the age of 13 y who were hospitalized in the province because of a serious assault during a 32-mo period. They compared the volume of alcohol sold at the liquor store nearest to the victim's home the day before the assault with the volume sold at the same store a week earlier (this type of study is called a “case-crossover” study). For every extra 1,000 l of alcohol sold per store per day (a doubling of alcohol sales), the overall risk of being hospitalized for assault increased by 13%. The risk was highest in three subgroups of people: men (18% increased risk), youths aged 13 to 20 y (21% increased risk), and those living in urban areas (19% increased risk). At peak times of alcohol sales, the risk of assault was 41% higher than at times when alcohol sales were lowest.
What Do These Findings Mean?
These findings indicate that the risk of being seriously assaulted increases with the amount of alcohol sold locally the day before the assault and show that the individuals most at risk are young men living in urban areas. Because the study considers only serious assaults and alcohol sold in shops (i.e., not including alcohol sold in bars), it probably underestimates the association between alcohol and assault. It also does not indicate whether the victim or perpetrator of the assault (or both) had been drinking, and its findings may not apply to countries with different drinking habits. Nevertheless, these findings support the idea that the consumption of alcohol contributes to the occurrence of medical injuries from intentional violence. Increasing the price of alcohol or making alcohol harder to obtain might help to reduce the occurrence of alcohol-related assaults. The researchers suggest that a particularly effective approach may be to stigmatize alcohol-related brawling, analogous to the way that driving under the influence of alcohol has been made socially unacceptable.
Additional Information.
Please access these Web sites via the online version of this summary at
This study is further discussed in a PLoS Medicine Perspective by Bennetts and Seabrook
The US National Institute on Alcohol Abuse and Alcoholism provides information on all aspects of alcohol abuse, including an article on alcohol use and violence among young adults
Alcohol-related assault is examined in the British Crime Survey
Alcohol Concern, the UK national agency on alcohol misuse, provides fact sheets on the health impacts of alcohol, young people's drinking, and alcohol and crime
The Canadian Centre for Addiction and Mental Health in Toronto provides information about alcohol addiction (in English and French)
PMCID: PMC2375945  PMID: 18479181
2.  Kick back and destroy the ride: Alcohol-related violence and associations with drinking patterns and delinquency in adolescence 
To assess how drinking patterns and delinquency are associated with self-reported experiences of alcohol-related violence in an adolescent population.
Population and research design
Cross-sectional data were acquired from the Scania drug use survey 2005, consisting of 3847 students in 9th grade. Abstainers were omitted and 1873 responses analyzed, with binary and multi-variable logistic regression modeling.
All drinking pattern indicators were statistically significantly associated with alcohol-related violence, high usual volume of distilled spirits consumed (OR 2.2, CI 95 % 1.7–2.9) being the strongest. Delinquency had, when included in the analysis, a significant effect (OR 2.5, CI 95 % 1.8–3.6); however, the drinking pattern indicators also remained statistically significant. An analysis of the effect moderation between usual volume of distilled spirits consumed and delinquency showed that there was a synergetic effect between them (SI 1.6, CI 95 % 1.1–2.4). A separate analysis for non-delinquent students, those with little experience of delinquency, and those who engaged regularly in delinquent activities, showed that the effects of different drinking patterns, especially use of distilled spirits, were significant in both groups, however, differently distributed.
The results show that alcohol consumption pattern, with usual volume of distilled spirits being the most prominent one, had an effect on alcohol-related violence, and that this effect was amplified by delinquent behavior. The analyses also showed that there are similarities, regarding risk factors for alcohol-related violence, between delinquent and non-delinquent youth. This, indicating that consumption pattern cannot be discarded as a key factor in alcohol-related violence in adolescence.
Policy implications
The study shows that alcohol-related violence in adolescence is related to both alcohol consumption patterns, e.g. usual volume of distilled spirits consumed, and delinquency. In order to prevent the harm outcome, both phenomenons have to be targeted, either by alcohol or broader social policy initiatives.
PMCID: PMC1936421  PMID: 17605765
3.  The Longitudinal Relationship between Peer Violence and Popularity and Delinquency in Adolescent Boys: Examining Effects by Family Functioning 
Journal of youth and adolescence  2012;42(11):1651-1660.
Mapping the relationship of peer influences and parental/family characteristics on delinquency can help expand the understanding of findings that show an interdependence between peer and family predictors. This study explored the longitudinal relationship between two characteristics of peer relationships (violence and perceived popularity) with subsequent individual delinquency and the moderating role of family characteristics (cohesion and parental monitoring) using data from the Chicago Youth Development Study. Participants were 364 inner-city residing adolescent boys (54% African American; 40% Hispanic). After controlling for the effects of age and ethnicity, peer violence is positively related to boys’ delinquency. The effect of popularity depends on parental monitoring, such that the relationship between popularity and delinquency is positive when parental monitoring is low, but there is no relationship when parental monitoring is high. Furthermore, parental monitoring contributes to the relationship between peer violence and delinquency such that there is a stronger relationship when parental monitoring is low. Additionally, there is a stronger relationship between peer violence and delinquency for boys from high cohesive families. Findings point to the value of attention to multiple aspects of peer and family relationships in explaining and intervening in the risk for delinquency. Furthermore, findings indicate the importance of family-focused interventions in preventing delinquency.
PMCID: PMC4122220  PMID: 23160661
delinquency; family functioning; peer violence; perceived popularity
4.  Early Adolescent, Multi-ethnic, Urban Youth’s Exposure To Patterns Of Alcohol-related Neighborhood Characteristics 
Journal of community health  2009;34(5):361-369.
This study identified heterogeneous classes of alcohol-related neighborhood characteristics to which multi-ethnic, early adolescents in urban communities are exposed. The sample comprised 4,215 youth from 42 community areas in Chicago, Illinois who completed surveys at the beginning of 6th grade (2002). Neighborhood measures included: (1) mean number of alcohol outlets per 1,000 population per community area; (2) alcohol purchase attempt rate by pseudo-underage youth; (3) average number of alcohol advertisements within 1500 feet of each school per community; and (4) a Census 2000-based deprivation index. Parents and community leaders provided data on perceived neighborhood problems and parental prevention actions, and neighborhood strength and preventive action by communities, law enforcement, and community organizations, respectively. Multilevel latent class analysis identified the number and characteristics of heterogeneous latent neighborhood classes in which these youth are exposed. Five classes best described the heterogeneity among the sample: (1) Low social capital/low exposure/high access to alcohol (19.8%), (2) Low social capital/low exposure/low access to alcohol (24.5%), (3) Moderate social capital/low exposure/high access to alcohol (30.0%), (4) Moderate social capital/moderate exposure/low access to alcohol (20.1%), and (5) High social capital/moderate exposure/high access to alcohol (5.6%). The racial/ethnic distribution among the classes varied considerably. Results suggest there is substantive heterogeneity among this seemingly homogeneous urban population. Further, they highlight the socioeconomic disadvantage of these inner-city communities and the resource disparity across the racial/ethnic groups. Understanding the nuances among communities may lend to development of more efficacious preventive interventions and policy initiatives, inform theory, and help prioritize limited resources.
PMCID: PMC2738760  PMID: 19517222
Adolescents; Communities; Alcohol access; Social capital; Latent class analysis
5.  Early Violent Death Among Delinquent Youth: A Prospective Longitudinal Study 
Pediatrics  2005;115(6):1586-1593.
Youth processed in the juvenile justice system are at great risk for early violent death. Groups at greatest risk, ie, racial/ethnic minorities, male youth, and urban youth, are overrepresented in the juvenile justice system. We compared mortality rates for delinquent youth with those for the general population, controlling for differences in gender, race/ethnicity, and age.
This prospective longitudinal study examined mortality rates among 1829 youth (1172 male and 657 female) enrolled in the Northwestern Juvenile Project, a study of health needs and outcomes of delinquent youth. Participants, 10 to 18 years of age, were sampled randomly from intake at the Cook County Juvenile Temporary Detention Center in Chicago, Illinois, between 1995 and 1998. The sample was stratified according to gender, race/ethnicity (African American, non-Hispanic white, Hispanic, or other), age (10–13 or ≥14 years), and legal status (processed as a juvenile or as an adult), to obtain enough participants for examination of key subgroups. The sample included 1005 African American (54.9%), 296 non-Hispanic white (16.2%), 524 Hispanic (28.17%), and 4 other-race/ethnicity (0.2%) subjects. The mean age at enrollment was 14.9 years (median age: 15 years). The refusal rate was 4.2%. As of March 31, 2004, we had monitored participants for 0.5 to 8.4 years (mean: 7.1 years; median: 7.2 years; interquartile range: 6.5–7.8 years); the aggregate exposure for all participants was 12 944 person-years. Data on deaths and causes of death were obtained from family reports or records and were then verified by the local medical examiner or the National Death Index. For comparisons of mortality rates for delinquents and the general population, all data were weighted according to the racial/ethnic, gender, and age characteristics of the detention center; these weighted standardized populations were used to calculate reported percentages and mortality ratios. We calculated mortality ratios by comparing our sample’s mortality rates with those for the general population of Cook County, controlling for differences in gender, race/ethnicity, and age.
Sixty-five youth died during the follow-up period. All deaths were from external causes. As determined by using the weighted percentages to estimate causes of death, 95.5% of deaths were homicides or legal interventions (90.1% homicides and 5.4% legal interventions), 1.1% of all deaths were suicides, 1.3% were from motor vehicle accidents, 0.5% were from other accidents, and 1.6% were from other external causes. Among homicides, 93.0% were from gunshot wounds. The overall mortality rate was >4 times the general-population rate. The mortality rate among female youth was nearly 8 times the general-population rate. African American male youth had the highest mortality rate (887 deaths per 100 000 person-years).
Early violent death among delinquent and general-population youth affects racial/ethnic minorities disproportionately and should be addressed as are other health disparities. Future studies should identify the most promising modifiable risk factors and preventive interventions, explore the causes of death among delinquent female youth, and examine whether minority youth express suicidal intent by putting themselves at risk for homicide.
PMCID: PMC1351295  PMID: 15930220
juvenile; delinquent; death; homicide; detainees; gun violence; mortality; CI, confidence interval; CIBS, bootstrap confidence interval
6.  Alcohol Outlet Density, Parental Monitoring, and Adolescent Deviance: A Multilevel Analysis 
Lower levels of parental monitoring are associated with youth problem behaviors, including substance use and delinquency. Recent studies employing routine activities theory have hypothesized that greater densities of alcohol outlets, particularly bars, may provide parents more opportunities to socialize outside the home. This, in turn, may decrease a parent's ability to effectively monitor the activities of his or her child, resulting in more deviant behaviors by the adolescent. Using hierarchical linear modeling (HLM), the current study assesses whether or not greater densities of alcohol outlets in zip code areas (n = 50) interact with levels of parental monitoring to affect levels of deviance among adolescents aged 14 to 16 (n = 1,541). The study finds that adolescents who have higher grade point averages and have not used alcohol report the lowest levels of deviant behaviors. Furthermore, the density of bars interacts with reports of parental monitoring such that adolescents in areas with more bars per roadway mile report lower levels of parental monitoring behaviors, which is associated with higher levels of deviance. These findings suggest that in those areas with greater densities of bars parents may be spending more time away from home, making monitoring of their adolescents more difficult, or parents may be drinking more frequently, thus impairing their ability to adequately monitor their children. Policies and practices that limit the number of bars in neighborhood areas with large populations of adolescents may reduce deviant behaviors.
PMCID: PMC2678752  PMID: 20161331
7.  Risk-Taking Behavior among Adolescents with Prenatal Drug Exposure and Extrauterine Environmental Adversity 
High-risk environments characterized by familial substance use, poverty, inadequate parental monitoring, and violence exposure are associated with an increased propensity for adolescents to engage in risk-taking behaviors (e.g., substance use, sexual behavior, and delinquency). However, additional factors such as drug exposure in utero and deficits in inhibitory control among drug-exposed youth may further influence the likelihood that adolescents in high-risk environments will engage in risk-taking behavior. This study examined the influence of prenatal substance exposure, inhibitory control, and sociodemographic/environmental risk factors on risk-taking behaviors in a large cohort of adolescents with and without prenatal cocaine exposure (PCE).
Risk-taking behavior (delinquency, substance use, and sexual activity) was assessed in 963 adolescents (433 cocaine-exposed, 530 nonexposed) at 15 years of age.
PCE predicted later arrests and early onset of sexual behavior in controlled analyses. Associations were partially mediated, however, by adolescent inhibitory control problems. PCE was not associated with substance use at this age. In addition, male gender, low parental involvement, and violence exposure were associated with greater odds of engaging in risk-taking behavior across the observed domains.
Study findings substantiate concern regarding the association between prenatal substance exposure and related risk factors and the long-term outcomes of exposed youth. Access to the appropriate social, educational, and medical services are essential in preventing and intervening with risk-taking behaviors and the potential consequences (e.g., adverse health outcomes, incarceration), especially among high-risk adolescent youth and their families.
PMCID: PMC4139145  PMID: 24220515
prenatal drug exposure; cocaine; adolescence; risk-taking behavior
8.  Understanding AIDS-Risk Behavior Among Adolescents in Psychiatric Care: Links to Psychopathology and Peer Relationships 
Severely mentally ill youths are at elevated risk for human immunodeficiency virus infection, but little is known about acquired immunodeficiency syndrome (AIDS) risk behavior in adolescents who seek outpatient mental health services or about the links between psychiatric problems and particular high-risk behaviors. This pilot study used structural equation modeling to conduct a path analysis to explore the direct and indirect effects of adolescent psychopathology on risky sex, drug/alcohol use, and needle use.
Ethnically diverse youths (N = 86) and their caregivers who sought outpatient psychiatric services in Chicago completed questionnaires of adolescent psychopathology. Youths reported their relationship attitudes, peer influence, sexual behavior, and drug/alcohol use.
Different AIDS-risk behaviors were associated with distinct forms of adolescent psychopathology (e.g., delinquency was linked to drug/alcohol use, whereas aggression was related to risky sexual behavior), and peer influence mediated these linkages. Some patterns were similar for caregiver- and adolescent-reported problems (e.g., peer influence mediated the relation between delinquency and drug/alcohol use), but others were different (e.g., caregiver-reported delinquency was associated with risky sex, whereas adolescent-reported delinquency was not).
Findings underscore the complexity of factors (types of informants and dimensions of psychopathology) that underlie AIDS risk in troubled youths, and they offer specific directions for designing and implementing uniquely tailored AIDS prevention programs, for example, by targeting delinquent behavior and including high-risk peers and important family members in interventions.
PMCID: PMC1201503  PMID: 11392341
acquired immunodeficiency syndrome; AIDS risk; psychopathology; adolescents; peer influence
9.  Alcohol Use and Related Behaviors among Late Adolescent Urban Youth: Peer and Parent Influences 
Peer and parent influences on alcohol use and related risky behaviors were examined in a sample of late adolescent (M = 17.3 years; SD = 1.11 years) urban youth. Participants (N = 400) completed an online measure assessing peer influences of alcohol use and alcohol offers, and parent influences of rules against alcohol use and perceived levels of emotional family support, relative to youths’ alcohol use, binge drinking, alcohol-related consequences, and intentions to drink. Hierarchical regression analyses revealed that increased peer alcohol use and alcohol offers were associated with youths’ increased drinking, binge drinking, alcohol-related consequences, and intentions to drink. Controlling for peer influences, parental rules against alcohol use were associated with decreased drinking, binge drinking, and intentions to drink; increased levels of family support was associated with decreased alcohol-related consequences and intentions to drink. These findings suggest that parental influences, albeit small relative to peer influences, are associated with fewer instances of monthly alcohol use and related risky behaviors among late adolescent urban youth.
PMCID: PMC4167796  PMID: 25246757
youth; alcohol; peers; parents; influences
10.  Parenting Practices as Predictors of Substance Use, Delinquency, and Aggression Among Urban Minority Youth: Moderating Effects of Family Structure and Gender 
This study examined how parenting factors were associated with adolescent problem behaviors among urban minority youth and to what extent these relationships were moderated by family structure and gender. Sixth-grade students (N = 228) reported how often they use alcohol, smoke cigarettes, or engage in aggressive or delinquent behaviors; a parent or guardian reported their monitoring and other parenting practices. Findings indicated that boys and those from single-parent families engaged in the highest rates of problem behavior. More parental monitoring was associated with less delinquency overall, as well as less drinking in boys only. Eating family dinners together was associated with less aggression overall, as well as less delinquency in youth from single-parent families and in girls. Unsupervised time at home alone was associated with more smoking for girls only. Implications for prevention interventions are discussed.
PMCID: PMC3962786  PMID: 10860116
11.  Growth in adolescent delinquency and alcohol use in relation to young adult crime, alcohol use disorders, and risky sex: a comparison of youth from low- versus middle-income backgrounds 
This study examined adolescent delinquency and alcohol use in relation to young adult crime, alcohol use disorders (AUDs), and risky sex. Analyses further examined the influences of late childhood involvement in these problem behavior outcomes, with mediation through teen delinquency and alcohol use, and examined differences in the pathways for youth from low- compared to middle-income backgrounds.
Multiple-group latent growth curve modeling was conducted using data collected from a sample of 808 youth followed from age 10 to age 24. Self-report assessments included delinquent involvement, alcohol use, and sexual activity in late childhood; delinquency and alcohol use in adolescence; and crime, AUDs, and risky sex in early adulthood.
Late childhood delinquent involvement was associated with young adult crime, AUDs, and risky sex indirectly through adolescent delinquency, and had a persistent direct effect on crime. Adolescent delinquency also mediated the relation between early sex onset and crime. Early alcohol use predicted a higher level of, and a faster rate of increase in, adolescent drinking, which predicted, in turn, young adult AUDs and risky sex. Significant group differences indicated stronger associations between adolescent delinquency and each young adult outcome for youth from low- compared to those from middle-income backgrounds.
Early intervention may help prevent the development of crime, AUDs, and risky sex behaviors, especially among disadvantaged youth.
PMCID: PMC2980793  PMID: 20659188
Alcohol abuse; delinquency; longitudinal studies; sexual behaviour; social class
12.  Parents, Friends, and Romantic Partners: Enmeshment in Deviant Networks and Adolescent Delinquency Involvement 
Journal of youth and adolescence  2008;38(3):367-383.
Adolescent networks include parents, friends, and romantic partners, but research on the social learning mechanisms related to delinquency has not typically examined the characteristics of all three domains simultaneously. Employing data from the Toledo Adolescent Relationships Study (n = 957), we assess the relationship of romantic partners’ delinquency with respondents’ self-reported involvement after taking parents’ and peers’ deviance into account. Next, we explore the associations between enmeshment level (number of deviant networks), enmeshment type (specific combinations of deviant networks), and delinquency. Parents,’ peers,’ and partners’ deviance are each related to respondents’ self-reported behavior, but affiliation with a greater number of deviant networks is associated with higher delinquency involvement. Results that consider enmeshment type indicate that those with both above average romantic partner and friend delinquency report especially high levels of self-reported involvement. In all comparisons, however, adolescents with deviant romantic partners are more delinquent than those youths with more prosocial partners, regardless of friends’ and parents’ behavior. Results highlight the importance of capturing the adolescent’s entire network of affiliations, rather than viewing these in isolation, and suggest the need for additional research on romantic partner influences on delinquent behavior and other adolescent outcomes.
PMCID: PMC2967015  PMID: 19636751
delinquency; social networks; adolescence; network enmeshment
13.  The influence of parental monitoring and parent-adolescent communication on Bahamian adolescent risk involvement: A three-year longitudinal examination 
The literature suggests that parental monitoring can best be conceptualized and measured through the domains of parental knowledge, youth disclosure, parental solicitation, and parental control. Using longitudinal data on 913 grade-six Bahamian students followed over a period of three years, we examined the unique and independent roles of these domains of parental monitoring and parent–adolescent communication in relation to adolescent involvement in delinquency, substance use, and sexual risk behaviors. The results obtained with mixed-effects models indicate that parental knowledge, youth disclosure, and parental control are negatively associated with both delinquency and substance use. Open parent—adolescent communication was associated with decreased sexual risk behavior, whereas problematic parent–adolescent communication was associated with increased sexual risk behavior. The results obtained with path models indicate that youth disclosure is a significant longitudinal predictor of reduced adolescent delinquency and that parental control during early adolescence predicted reduced substance use in middle adolescence. The findings suggest that parental knowledge, youth disclosure and parental control differ in their impacts on substance use, delinquency and sexual risk behaviors. Problematic parent–adolescent communication is consistently associated with increases in all three types of adolescent risk behaviors. Future parental monitoring interventions should focus on enhancing parents’ interpersonal communication skills and emphasize the differences in and importance of the unique components of parental monitoring.
PMCID: PMC4049067  PMID: 24161101
adolescent; parental knowledge; youth disclosure; parental solicitation; parental control; parent–adolescent communication; risk behaviors; Bahamas
14.  The Roles of Perceived Neighborhood Disorganization, Social Cohesion, and Social Control in Urban Thai Adolescents’ Substance Use and Delinquency 
Youth & society  2011;45(3):404-427.
Substance use and delinquency in Thai adolescents are growing public health concerns. Research has linked neighborhood characteristics to these outcomes, with explanations focused on neighborhood disorganization, social cohesion, and social control. This study examines the independent associations of these neighborhood constructs with Thai adolescents’ substance use and delinquency, through peer deviance, to determine which neighborhood aspects are particularly important. Families (N=420) with adolescents aged 13–14 were randomly selected from 7 districts in Bangkok, Thailand. Structural equation modeling showed that adolescents’, but not parents’, perceptions of greater disorganization were related to increased rates of both minor and serious delinquency. Surprisingly, greater neighborhood cohesion was related to greater minor delinquency. Peer deviance was unrelated to neighborhood variables. Findings can inform prevention strategies for Thai adolescents, as results suggest that neighborhoods are important for adolescent behaviors regardless of culture. Further work should help communities make use of social cohesion to benefit residents.
PMCID: PMC3896918  PMID: 24465060
Neighborhood disorganization; social cohesion; social control; adolescents
15.  Preventing the Link Between SES and High-Risk Behaviors: “Value-Added” Education, Drug Use and Delinquency in High-Risk, Urban Schools 
We examined whether schools achieving better than expected educational outcomes for their students influence the risk of drug use and delinquency among urban, racial/ethnic minority youth. Adolescents (n=2,621), who were primarily African American and Hispanic and enrolled in Chicago public schools (n=61), completed surveys in 6th (aged 12) and 8th (aged 14) grades. Value-added education was derived from standardized residuals of regression equations predicting school-level academic achievement and attendance from students’ sociodemographic profiles and defined as having higher academic achievement and attendance than that expected given the sociodemographic profile of the schools’ student composition. Multilevel logistic regression estimated the effects of value-added education on students’ drug use and delinquency. After considering initial risk behavior, value-added education was associated with lower incidence of alcohol, cigarette and marijuana use; stealing; and participating in a group-against-group fight. Significant beneficial effects of value-added education remained for cigarette and marijuana use, stealing and participating in a group-against-group fight after adjustment for individual- and school-level covariates. Alcohol use (past month and heavy episodic) showed marginally significant trends in the hypothesized direction after these adjustments. Inner-city schools may break the links between social disadvantage, drug use and delinquency. Identifying the processes related to value-added education in order to improve school environments is warranted given the high costs associated with individual-level interventions.
PMCID: PMC3707388  PMID: 21360062
Schools; Drug use; Delinquency; Urban; Adolescents
16.  Examining the Link between Neighborhood Context and Parental Messages to their Adolescent Children About Violence 
Living in violent neighborhoods has been shown to alter adolescent’s social-cognitions and increase aggressive behavior. A similar process may also occur for parents and result in parental support of aggressive behavior. This research examines the influence of perceived neighborhood violence and neighborhood collective efficacy on parents’ attitudes toward violence and the messages they give their adolescent children about how to resolve interpersonal conflict.
These data come from 143 African-American parents and their adolescent children recruited from 3 inner-city middle schools to participate in a parenting intervention. Models were fit using structural equation modeling in Mplus.
Contrary to expectations, exposure to neighborhood violence was not predictive of either aggressive attitudes or conflict solutions for parents or adolescents. Rather, a mixed effect was found for neighborhood collective efficacy, with higher perceived neighborhood collective efficacy related to less violent attitudes for adolescents but not parents. Collective efficacy also predicted the messages that parents gave their adolescents about interpersonal conflict, with higher collective efficacy related to messages that were less supportive of violence.
Parent and adolescent perception of neighborhood collective efficacy influences the messages that adolescents receive about interpersonal conflict resolution. This suggests that for parents living in violent neighborhoods their appraisal of the neighborhood is more important in shaping conflict resolution messages than parents’ own experiences with violence. Parent and family-based programs to prevent youth violence need to address neighborhood factors that influence the messages adolescents receive about how to resolve conflict.
PMCID: PMC3124663  PMID: 21700158
Adolescents; Violence; Parenting; Collective Efficacy; Parent/child communications
17.  Gene-Environment Interplay in the Association between Pubertal Timing and Delinquency in Adolescent Girls 
Journal of abnormal psychology  2011;121(1):73-87.
Early pubertal timing places girls at elevated risk for a breadth of negative outcomes, including involvement in delinquent behavior. While previous developmental research has emphasized the unique social challenges faced by early maturing girls, this relation is complicated by genetic influences for both delinquent behavior and pubertal timing, which are seldom controlled for in existing research. The current study uses genetically informed data on 924 female-female twin and sibling pairs drawn from the National Longitudinal Study of Adolescent Health to (1) disentangle biological versus environmental mechanisms for the effects of early pubertal timing and (2) test for gene-environment interactions. Results indicate that early pubertal timing influences girls’ delinquency through a complex interplay between biological risk and environmental experiences. Genes related to earlier age at menarche and higher perceived development significantly predict increased involvement in both non-violent and violent delinquency. Moreover, after accounting for this genetic association between pubertal timing and delinquency, the impact of non-shared environmental influences on delinquency are significantly moderated by pubertal timing, such that the non-shared environment is most important among early maturing girls. This interaction effect is particularly evident for non-violent delinquency. Overall, results suggest early maturing girls are vulnerable to an interaction between genetic and environmental risks for delinquent behavior.
PMCID: PMC4079281  PMID: 21668078
18.  Longitudinal Outcomes of an Alcohol Abuse Prevention Program for Urban Adolescents 
This randomized clinical trial examined longitudinal outcomes from an alcohol abuse prevention program aimed at urban youths.
Study participants were an ethnically and racially heterogeneous sample of early adolescents, recruited from community-based agencies in greater New York City and its environs. Once they assented to study participation and gained parental permission, youths were divided into three arms: youth intervention delivered by CD-ROM (CD), the same youth intervention plus parent intervention (CDP), and control. Once all youths completed baseline measures, those in CD and CDP arms received a computerized 10-session alcohol abuse prevention program. Parents of youths in the CDP arm received supplemental materials to support and strengthen their children's learning. All youths completed postintervention and annual follow-up measures, and CD- and CDP-arm participants received annual booster intervention sessions.
Seven years following postintervention testing and relative to control-arm youths, youths in CD and CDP arms reported less alcohol use, cigarette use, binge drinking, and peer pressure to drink; fewer drinking friends; greater refusal of alcohol use opportunities; and lower intentions to drink. No differences were observed between CD and CDP arms.
Study findings lend support to the potential of computerized, skills-based prevention programs to help urban youth reduce their risks for underage drinking.
PMCID: PMC2859450  PMID: 20413081
Urban adolescents; Alcohol abuse; Prevention; Computer intervention
19.  Effects of a Family Intervention in Reducing HIV Risk Behaviors Among High-Risk Hispanic Adolescents 
To determine the efficacy of a family intervention in reducing human immunodeficiency virus (HIV) risk behaviors among Hispanic delinquent adolescents.
Randomized controlled trial.
Miami–Dade County Public School System and Miami–Dade County’s Department of Juvenile Services, Florida.
A total of 242 Hispanic delinquent youth aged 12 to 17 years and their primary caregivers completed outcome assessments at baseline and 3 months after intervention.
Participants were randomized to either Familias Unidas (120 participants), a Hispanic-specific, family intervention designed to reduce HIV risk behaviors among Hispanic youth, or a community practice control condition (122 participants).
Main Outcome Measures
Self-reported measures included unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, number of sexual partners, and incidence of sexually transmitted diseases. Family functioning (eg, parent-adolescent communication, positive parenting, and parental monitoring) was also assessed via self-report measures.
Compared with community practice, Familias Unidas was efficacious in increasing condom use during vaginal and anal sex during the past 90 days, reducing the number of days adolescents were under the influence of drugs or alcohol and had sex without a condom, reducing sexual partners, and preventing unprotected anal sex at the last sexual intercourse. Familias Unidas was also efficacious, relative to community practice, in increasing family functioning and most notably in increasing parent-adolescent communication and positive parenting.
These results suggest that culturally tailored, family-centered prevention interventions may be appropriate and efficacious in reducing HIV risk behaviors among Hispanic delinquent adolescents.
Trial Registration Identifier: NCT01257022
PMCID: PMC3703443  PMID: 21969363
20.  Developmental Associations Between Externalizing Behaviors, Peer Delinquency, Drug Use, Perceived Neighborhood Crime, and Violent Behavior in Urban Communities 
Aggressive behavior  2011;37(4):349-361.
This study examines the precursors of violent behavior among urban, racial/ethnic minority adults. Data are from an on-going study of male and female African Americans and Puerto Ricans, interviewed at four time waves, Time 1-Time 4 (T1-T4), from adolescence to adulthood. Structural Equation Modeling was used to analyze the developmental pathways, beginning in mid-adolescence (T1; X̄ age=14.0 years), to violent behavior in adulthood (T4; X̄ age=29.2 years). The variables assessed were: components of externalizing behaviors (i.e., rebelliousness, delinquency; T1, T3); illicit drug use (T2); peer delinquency (T2); perceived neighborhood crime (T4); and violent behavior (T3, T4). Results showed that the participants' externalizing behaviors (rebelliousness and delinquency) were relatively stable from mid-adolescence (T1; X̄ age=14.0 years) to early adulthood (T3; X̄ age=24.4 years). The participants' externalizing behaviors in mid-adolescence also had a direct pathway to peer delinquency in late adolescence (T2; X̄ age=19.1 years). Peer delinquency, in turn, had a direct pathway to the participants' illicit drug use in late adolescence (T2), and to externalizing behaviors in early adulthood (T3). The participants' illicit drug use (T2; X̄ age=19.1 years) had both direct and indirect paths to violent behavior in adulthood (T4). The participants' externalizing behaviors in early adulthood (T3) were linked with violent behavior at T3, and perceived neighborhood crime (T4), both of which had direct pathways to violent behavior in adulthood (T4). The findings suggest developmental periods during which externalizing behaviors, exposure to delinquent peers, illegal drug use, and neighborhood crime could be targeted by prevention and intervention programs in order to reduce violent behavior.
PMCID: PMC3100438  PMID: 21544831
violent behavior; externalizing behaviors; drug use; peer; neighborhood
21.  The Effects of Exposure to Violence and Victimization across Life Domains on Adolescent Substance Use 
Child abuse & neglect  2013;37(11):899-909.
This study uses longitudinal data from the Project on Human Development in Chicago Neighborhoods (PHDCN) to examine the effects of exposure to school violence, community violence, child abuse, and parental intimate partner violence (IPV) on youths’ subsequent alcohol and marijuana use. We also examine the cumulative effects of being exposed to violence across these domains.
Longitudinal data were obtained from 1,655 adolescents and their primary caregivers participating in the PHDCN. The effects of adolescents’ exposure to various forms of violence across different life domains were examined relative to adolescents’ frequency of alcohol and marijuana use three years later. Multivariate statistical models were employed to control for a range of child, parent, and family risk factors.
Exposure to violence in a one-year period increased the frequency of substance use three years later, though the specific relationships between victimization and use varied for alcohol and marijuana use. Community violence and child abuse, but not school violence or exposure to IPV, were predictive of future marijuana use. None of the independent measures of exposure to violence significantly predicted future alcohol use. Finally, the accumulation of exposure to violence across life domains was detrimental to both future alcohol and marijuana use.
The findings support prior research indicating that exposure to multiple forms of violence, across multiple domains of life, negatively impacts adolescent outcomes, including substance use. The findings also suggest that the context in which exposure to violence occurs should be considered in future research, since the more domains in which youth are exposed to violence, the fewer “safe havens” they have available. Finally, a better understanding of the types of violence youth encounter and the contexts in which these experiences occur can help inform intervention efforts aimed at reducing victimization and its negative consequences.
PMCID: PMC4137799  PMID: 23743232
Victimization; exposure to violence; poly-victimization; substance use; alcohol use; marijuana use; adolescents
22.  The relation between abuse and violent delinquency: The conversion of shame to blame in juvenile offenders 
Child abuse & neglect  2011;35(7):459-467.
While the relationship between abusive parenting and violent delinquency has been well established, the cognitive and emotional processes by which this occurs remains relatively unidentified. The objective of this work is to apply a conceptual model linking abusive parenting to the conversion of shame into blaming others and therefore to violent delinquency.
A retrospective study of 112 adolescents (90 male; 22 female; ages 12 to 19 years; M = 15.6; SD = 1.4) who were incarcerated in a juvenile detention facility pending criminal charges, completed measures of exposure to abusive and nonabusive discipline, expressed and converted shame, and violent delinquency.
Findings tend to confirm the conceptual model. Subjects who converted shame (i.e., low expressed shame, high blaming others) tended to have more exposure to abusive parenting and showed more violent delinquent behavior than their peers who showed expressed shame. Subjects who showed expressed shame (i.e., high expressed shame, low blaming others) showed less violent delinquency than those who showed converted shame.
Abusive parenting impacts delinquency directly and indirectly through the effects of shame that is converted. Abusive parenting leads to the conversion of shame to blaming others, which in turn leads to violent delinquent behavior.
Practice implications
For juvenile offenders, the conversion of shame into blaming others appears to contribute to pathological outcomes in relation to trauma. Translation of this work into clinical practice is recommended.
PMCID: PMC3763505  PMID: 21783253
23.  Relationship Between Neighborhood Context, Family Management Practices and Alcohol Use Among Urban, Multi-ethnic, Young Adolescents 
We examined relationships between alcohol-related neighborhood context, protective home and family management practices, and alcohol use among urban, racial/ethnic minority, adolescents. The sample comprised 5,655 youth who were primarily low SES (72%), African American (43%) and Hispanic (29%). Participants completed surveys in 2002–2005 (ages 11–14 years). Items assessed alcohol use, accessibility of alcohol at home and parental family management practices. Neighborhood context measures included: (1) alcohol outlet density; (2) commercial alcohol accessibility; (3) alcohol advertisement exposure; and (4) perceived neighborhood strength, reported by parents and community leaders. Structural equation modeling was used to assess direct and indirect relationships between alcohol-related neighborhood context at baseline, home alcohol access and family management practices in 7th grade, and alcohol use in 8th grade. Neighborhood strength was negatively associated with alcohol use (β=−0.078, p≤.05) and exposure to alcohol advertisements was positively associated with alcohol use (β=0.043, p≤.05). Neighborhood strength and commercial alcohol access were associated with home alcohol access (β=0.050, p≤.05 and β=−0.150, p≤.001, respectively) and family management practices (β=−0.061, p≤.01 and β=0.083, p≤.001, respectively). Home alcohol access showed a positive association with alcohol use (β=0.401, p≤.001). Tests for indirect effects suggest that home alcohol access may partially mediate the relationship between neighborhood strength and alcohol use (β=0.025, p<.062). Results suggest inner-city parents respond to environmental risk, such that as neighborhood risk increases, so also do protective home and family management practices. Parent engagement in restricting alcohol access and improving family management practices may be key to preventive efforts to reduce alcohol use.
PMCID: PMC2783307  PMID: 19381808
Adolescents; Communities; Family; Context; Alcohol
24.  Substance Use and Delinquency among Adolescents with Childhood ADHD: The Protective Role of Parenting 
Several domains of parenting have been identified as important for adolescent well-being. Whether these same domains are equally beneficial for adolescents with ADHD histories remains an empirical and clinically important question. This study examined whether parental knowledge of their teen’s activities and whereabouts, consistency, support, and parent-adolescent conflict are associated with substance use and delinquency similarly for adolescents with and without a diagnosis of ADHD in childhood. A sample of 242 adolescents, 142 diagnosed with ADHD in childhood and prospectively followed into adolescence, and 100 without ADHD in childhood, were the focus of study. The relations between adolescent-reported outcomes (i.e. substance use and delinquency) and parenting behaviors were tested using latent variable modeling to determine both the effects of general (common) and specific (unique) parenting behaviors for participants with and without a history of ADHD. Adolescents’ report of parental knowledge was a significant correlate of delinquency and substance use above and beyond other parenting variables and the variance in common across the parenting variables. More knowledge was associated with less delinquency and substance use for all participants, but parental knowledge was more strongly associated with alcohol use for adolescents with versus without childhood ADHD. These correlational findings suggest that, despite the increased difficulty of parenting youths with ADHD histories, actions taken by parents and youth to increase parental awareness may provide some protection against behavioral transgressions known to be elevated in this population.
PMCID: PMC3355197  PMID: 22329747
25.  Thai Parenting Practices, Family Rituals and Risky Adolescent Behaviors: Alcohol Use, Cigarette Use and Delinquency 
Data were obtained from face-to-face interviews conducted with 420 randomly selected families (one parent, one 13-14 year old teen) in their homes from seven districts of Bangkok, Thailand. Adolescent risky behaviors that may be influenced by parenting practices and family rituals include alcohol use, cigarette use, and delinquency. Measures include: parental monitoring, parenting style, parental closeness, parental communication, and family rituals. Findings reveal increased alcohol use among Thai adolescents exposed to risks in family rituals. Lower prevalence of cigarette use is indicated among youth exposed to authoritative parenting and greater levels of parental monitoring. Serious delinquency is related to more risks in family rituals, but for girls only. Minor delinquency is related to less rule-setting, but also for girls only. These analyses provide support for using a risk and protective framework for guiding prevention strategies in Thailand. The relationship between family rituals and adolescent behaviors warrants further investigation and especially the elements of family rituals that reflect positive vs. the negative forces in the family dynamics.
PMCID: PMC3917565  PMID: 24511362
Adolescent alcohol and cigarette use; delinquency; parenting practices; family rituals; cross-cultural

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