Joan S. Tucker

Objective: This study identified psychosocial factors that may deter adolescents living in permissive households from heavy drinking in Grades 9 and 11. Method: Longitudinal data were obtained from 710 youth who completed surveys from Grades 7 to 11. Permissive household was defined based on adolescent reports of whether the parents (1) would be upset if the adolescent drank or used marijuana, (2) knew their child's whereabouts when the adolescent was away from home, and (3) set curfews. Frequency of heavy drinking in the last 30 days was the number of days the adolescent had at least three alcoholic drinks. Results: Three quarters of adolescents from permissive households reported heavy drinking at Grade 9, with less frequent heavy drinking among those who concurrently reported less exposure to peer and adult drinking, less peer approval of drinking, weaker positive beliefs about drinking, a stronger academic orientation, higher resistance self-efficacy, and less delinquency. Further, social influences and alcohol beliefs predicted the frequency of heavy drinking 2 years later among adolescents from permissive households. Although most of these factors were also relevant for adolescents from nonpermissive households, social influences, alcohol beliefs and resistance self-efficacy were stronger predictors of heavy drinking at Grade 9 among youth from permissive households. Conclusions: Growing up in a permissive household was associated with heavy drinking. Nonetheless, several psychosocial factors were associated with less frequent heavy drinking even within this at-risk population. Alcohol prevention programs that target prodrinking peer and adult influences, positive attitudes toward drinking, and resistance self-efficacy may be particularly important in deterring heavy drinking among adolescents living in permissive households. (J. Stud. Alcohol Drugs 69: 528-534, 2008).

This study investigated associations of substance use, relationship abuse and HIV self-protective behavior with unprotected sex among 290 impoverished women with a non-cohabitating primary partner. Unprotected sex was associated with having a physically or psychologically abusive partner among low-income housed women, and having an abusive partner who also drank to intoxication among women living in shelters. Indicators of HIV self-protective behavior were associated with less frequent unprotected sex among sheltered women, even after accounting for abuse and substance use within the relationship. Results suggest the need for HIV-prevention interventions to address the problems of partner substance use and relationship abuse.

Social control has the potential to encourage engagement in a healthy lifestyle, but its effectiveness may depend on the nature of the influence attempt. Participants (N = 282) described a situation in which someone attempted to influence their health-related behavior. Experiencing positive social control was associated with a greater tendency to change the behavior and less ignoring/doing nothing, whereas negative social control was associated with a lesser tendency to change the behavior and more hiding of unhealthy behavior. These associations could be accounted for by affective responses to the social control attempts. Results emphasize the need to better understand the regulatory influence of relationships on health behavior and the conditions under which social control is most likely to have health-promoting effects.

This longitudinal study compared Grade 8 solitary cigarette smokers (n = 541), drinkers (n = 577), and marijuana users (n = 148) with adolescents who restricted their use of these substances to social settings (ns = 562, 1,426, and 388, respectively) on adolescent functioning and young adult outcomes. In Grade 8, solitary users held more positive beliefs about the consequences of substance use, earned poorer grades, engaged in more deviant behavior, and devoted less time to school and more time to social activities. By age 23, these solitary users had lower educational attainment, poorer self-rated health, and greater substance use problems. Results indicate the importance of better understanding and addressing the needs of this understudied group of high-risk youth.

In a sample of 810 women residing in shelters and low-income housing, this 6-month prospective study investigated associations of recent violence and substance use withHIV-related sexual behaviors and cognitions. Controlling for baseline sexual behavior, partner violence at baseline was associated with less sexual activity and unprotected sex at follow-up. Non-partner violence at baseline was associated with a higher likelihood of being sexually active at follow-up (housed women), but less frequent sexual activity. Drinking to intoxication at baseline was associated with less ability to refuse unwanted sex (sheltered women) and higher perceived susceptibility to HIV at follow-up, whereas baseline drug use was associated with greater perceived ability to refuse unwanted sex and condom use self-efficacy. These findings differed in important ways from cross-sectional associations, emphasizing the need for additional prospective research to fully understand the impact of violence and substance use on women’s HIV-related behaviors and cognitions.

Social control can positively influence health behaviors, but changes in social networks over time may cause older adults to experience less health-related social control. The size and composition of social control networks, and receipt of health-related social control, were examined in a probability sample of 509 household residents (aged 25–80 years) in Los Angeles County who completed a telephone survey. Compared with younger and middle-aged adults, older adults identified fewer people who attempted to influence their health behaviors and fewer health behaviors that others urged them to change. Older adults also reported less frequent social control attempts aimed at modifying their health behaviors, even after health status, health habits, and social network characteristics were controlled for. Possible explanations for these age-related differences are discussed.

This study used data from 1,889 HIV-positive patients on antiretroviral (ARV) medications who participated in the HIV Cost and Services Utilization Study to investigate whether nonadherence to ARV medications among patients with mental health and substance use problems could be explained by difficulty getting and negative attitudes toward ARV medications, poor fit of the regimen with lifestyle, lack of instruction and cues for remembering the regimen from a health care provider, and poor support from others for taking ARV medications. Difficulty getting ARV medications and poor fit with lifestyle were significant mediators of nonadherence for patients with a probable psychiatric disorder. Difficulty getting medication was a mediator for heavy drinkers, and poor fit with lifestyle was a mediator for drug users who drank heavily. Further research is needed to identify and address the barriers to adherence in these populations.