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Substance Use:

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Sheri Bath

on 8 December 2013

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Transcript of Substance Use:

Substance Use:
Trajectories from Early Adolescence to Emerging Adulthood
By: Sheri L. Bath & Kristina De Los Santos

Psychosocial Stages of Development
Adolescence Vs. Emerging Adulthood
Biopsychosocial Factors of Substance Abuse
Objective/Purpose
Our objective is to investigate how adolescence effects emerging adulthood when substance abuse is a factor. We researched the psychosocial stage of development and protective and risk factors that contribute to substance abuse.
Population of Interest
Emerging Adulthood
18-24 years

Developmental Tasks
Autonomy from parents
Gender identity
Internalized morality
Career Choice

Identity Explorations
Arnett (2005) argues that although identity development is mainly associated with adolescence, the major part of exploration occurs during emerging adulthood.
Age of Instability
Emerging adulthood can be one of the most
unstable
developmental periods
changes in: jobs, love partners, educational status, location, etc.
Increased instability can promote substance use & self-medication
due to anxiety & sadness
higher rates of psychopathology (ex. Major Depression)
Feeling In-Between
Feeling neither adolescent nor fully adult
Important markers of adult status
accepting responsibility
making independent decisions
financial independence
finishing education
marriage & parenthood
Conceptions of adulthood pertaining to substance use
avoid drunk driving
avoid illegal drugs
no longer being an adolescent allows the choice of whether to use substances or not
Self-focused Age
Biological Factors
Research by Baker (2011) found....
a genetic component for substance abuse in adults
Heritability tends to be higher in adult males
Research suggests that genetic factors are important in adulthood, whereas environmental factors are more important at younger ages and adolescence
Psychological Factors
According to MayoClinic....
Using drugs can become a way of coping with anxiety, depression and loneliness
A lack of attachment with parents may increase the risk of addiction
Having a psychological problem, such as depression, attention-deficit/hyperactivity disorder or post-traumatic stress disorder, makes a person more likely to become dependent on drugs
Social Factors
According to MayoClinic....
Peer pressure, particularly among young people is a strong factor in use and abuse of drugs
Taking a highly addictive drug, such as heroin and cocaine, cause addiction more quickly than others
Protective Factors of Substance Abuse
Social Roles
Transitions to adult work and family roles may reduce substance use and abuse because the constraints of adult roles are incompatible with continued substance use.
Parenting
White & Jackson (2004/2005) found that parental drinking patterns can affect drinking tendencies in their children
in emerging adulthood, there is less parental monitoring
modeling parents' consumption behaviors
Risk Factors in Adolescence
Risk factors for substance USE differ from risk factors for substance ABUSE and DEPENDENCE
Substance initiation and use are greatly influenced by
social
and
environmental
factors (e.g. peers using)
On the other hand, developing a SUD appears far more influenced by individual
biological
and
psychological
factors
According to this study, there is a relationship between SUD's and.....
Learning disabilities
Prenatal substance exposure (at least with alcohol)
Differences in dopamine systems
Early use
Co-occurring psychiatric illness
Family history
Peer use
Chaotic home environments, especially when parents abuse substances or suffer from mental illness
Ineffective parenting, especially with children with difficult temperaments or conduct disorders
Lack of parent-child attachments
Inappropriate shy or aggressive behavior in the classroom
Failure in school performance
Poor social coping skills
Affiliations with deviant peers
Perceived approval of drug using behaviors in family, work, school, peer, and community environments
Poverty
Availability of drugs
Route of Administration
Child Abuse/Neglect

Research has found risk factors during adolescent development,which directly impact emerging adulthood, in those who develop problems with substance abuse
In conclusion...
The evidence in this presentation illustrates how adolescence directly impacts emerging adulthood.
The psychosocial stages of development & the psychosocial process can impact the development of a substance use disorder (SUD)
Biopsychosocial factors can either mediate or moderate the development of a SUD.
Risk factors that present themselves in adolescence can contribute to substance abuse in adulthood.
Protective factors during both adolescence and adulthood can lessen the occurrence of developing a SUD.
When developing programs and interventions, it is important to target youths
before
adolescence in order to prevent initiation of substance use.
References
Developmental Tasks
Physical Maturation (Puberty)
Formal Operations
Emotional Development
Membership in peer groups
Romantic and Sexual Relationships
Early Adolescence
12-18 years

The Psychosocial Process
Group Identity vs. Alienation
positive side of the psychosocial crisis
a positive sense of group identity provides confidence that he/she is connected to society
While seeking group affiliations, adolescents are confronted by how well their personal needs and values fit with the groups they are a member of
Needs for social approval, affiliation, leadership, power and status are shown in group identifications made and rejected during this stage
Group Identity
Cognitive processes that support group identity formation:
Group representations
Group operations
Reflective thinking about groups
During adolescence, one's ethnic group becomes a significant reference group
Junior Jonathan Omaraie believes in some negative effects of cliques. “[Cliques] cause a ton of problems for people, like drama, loss of friends, stereotypes, etc” says Omaraie.
Within cliques, some believe there can be a type of hierarchy. “I think that the football and basketball players definitely are in a higher social clique than say, the drama kids,” said Omaraie. “In those types of sports, the best athlete always seems to be at the top of that particular clique’s social hierarchy.”
Source: http://www.highschoogle.com/high-school-students-mixed-about-cliques/
Alienation
withdrawal or separation of people or their affections from an object or position of former attachment
A sense of social estrangement, an absence of social support or meaningful social connection (p. 375)
Dilemmas are associated with issues of common identity, common bond, or both
Alienation associated with common identity occur when people are stereotyped or discriminated against
Alienation associated with common bond could include harsh parenting or neglect that leads to a lack of social skills
Central Process:
Peer Pressure
a demand for conformity to group norms and a demonstration of commitment and loyalty
Brown (2004) suggested four modes of peer influence...
direct suggestion (e.g.smoke weed or risk rejection)
modeling (e.g. imitating others)
normative regulation (e.g. teasing to influence behavior)
opportunities for unsupervised activities (e.g. party where beer is served)
The Psychosocial Crisis:
Individual Identity vs. Identity Confusion
Individual Identity
Identity Confusion
The Central Process: Role Experimentation
involves the integration of past, present, and future
from the past- adults reevaluate their childhood identifications
from the present- adults examine their talents and abilities
from the future-one determines their life goals
The public vs private faces of identity
Private self- or "sense of self" refers to a persons inner uniqueness, being in control of ones thoughts, and being self-reflective
Public self- includes the roles one plays and the expectations of others. Individual may move through social reference groups
Negative identity may develop if society has labeled a person in a negative way (e.g. failure, gangster, druggie, loser). A person begins to validate those labels and continue to behave in ways that strengthen it
Relationship of Crisis and Commitment to Identity Status
Source: http://www3.uakron.edu/witt/adol/selfidentity.htm
more maladaptive resolution of the crisis
People in this state are unable to make a commitment to a view of themselves or unable to integrate the roles the play
This could be from a lack of self-esteem or opposing value systems
They may struggle with low self-esteem or problem solving techniques of avoidance
Identity confused are less conscientious, more likely to experience negative emotions, and more disagreeable
may struggle with depression
The way men and women handle role experimentation is different
Uncertainty of identity is more likely to produce anxiety in women than in men
Moratorium status has been linked to higher levels of self doubt in women
In emerging adulthood (or later adolescence) there is an experimentation of roles that represent possibilities for future identities
For example, a young person may take many jobs or switch majors in college
Dating is a form of role experimentation
Psychosocial moratorium- a period of free experimentation before a final identity is achieved
This may never happen for those who marry or have children early or who begin working right after high school
Source: Newman, 2012
Source : Newman, 2012
Source: Newman, 2012
Source: Newman, 2012
Source: Newman, 2012

Source: Newman, 2012
Source: Newman, 2012
Weinberg (2001) found....
Self-control
Positive relationships
Parental Monitoring and Support
Academic Competence
Anti-drug policies in the schools
Strong Neighborhood Attachment
Positive involvement with social institutions (Faith-based organizations, School, Community)
Strong bonds with family
National Institute of Drug Abuse, 2002.
National Institute of Drug Abuse, 2002
Source: National Institute of Drug Abuse, 2010
According to the MayoClinic....
Drug addiction runs in families and involves genetics
Men are twice as likely to have drug problems
According to the National Institute of Health......
The genes that people are born with– in combination with environmental influences– account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of mental disorders may influence risk for drug abuse and addiction.
Studies of identical twins indicate that as much as half of an individual's risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genes.
http://www.drugabuse.gov/publications/topics-in-brief/genetics-addiction
Dishion & Owen (2002) found that having friends who use drugs or support drug use is the most robust predictor of substance use during adolescence
This short video illustrates the reality that using drugs often leads to death. Many of these untimely deaths are adolescents or young adults. On a positive note, the video shows the efforts being made to educate teens on their choices and that society is not giving up on them.
Arnett, J.J. (2005). The developmental context of substance use in emerging adulthood.
Journal of Drug Issues, 35
, 235-253.

Baker, J.H., Maes, H.H., Larsson, H., Lichtenstein, P., & Kendler, K.S. (2011). Sex differences and developmental stability in genetic and enviornmental influences on psychoactive substance consumption from early adolescence to young adulthood.
Psychological Medicine, 41
, 1907-1916. doi: 10.1017/S003329171000259X.

Dishion, T.J. & Owen, L.D. (2002). A longitudinal analysis of friendships and substance use: Bidirectional influence from adolescence to adulthood.
Developmental Psychology, 38
, 480-491.

Genetics of addiction: The blueprint of health and disease. (2008). Retrieved from: http://www.drugabuse.gov/publications/topics-in-brief/genetics-addiction.

King, K.M. & Chassin, L. (2004). Mediating and moderated effects of adolescent behavioral undercontrol and parenting in the prediction of drug use disorders in emerging adulthood.
Psychology of Addictive Behaviors, 18
(3), 239-249.

King, K.M., Nguyen, H.V., Kosterman, R., Bailey, J.A. & Hawkins, J.D. (2012). Co-occurrence of sexual risk behaviors and substance use across emerging adulthood: Evidence for state- and trait-level associations.
Addiction, 107
, 1288-1296.

Kukuchka, K. (2012). High school students mixed about cliques. Retrieved from: http://www.highschoogle.com/high-school-students-mixed-about-cliques/.


The transition period from adolescence to adulthood is also known as emerging adulthood. Emerging adulthood typically lasts from age 18-25 years old.
dramatic increases in freedom
new responsibilities
developing self-regulation
peaks in alcohol & drug use disorders
Source: King et al. (2012)
Age of Possibilities
Love Relationships
Identity Project
Source: www.identityproject.com
During adolescence, most experience their initial romantic relationships & sexual experiences.
In emerging adulthood, identity-related explorations in love usually take place.
What kind of person they wish to form a long-term partnership with?
What qualities are most important in a life-long partner?
Source: Arnett (2005)
Work Experiences
In adolescence, most teenagers have their first part-time job.
In emerging adulthood,work becomes more identity-focused & critical.
What kind of work they want to do long-term?
What are their abilities & interests?
Source: Arnett (2005)
Substance Use
"Identity Status" Model
Places individuals into one of four categories based on levels of exploration & commitment:

Individual
DIFFUSION
low exploration, low commitment
not yet explored different developmental alternatives
little to no commitments
FORECLOSURE
ACHIEVEMENT
high exploration, high commitment
completed a period of active exploration
related commitments

MORATORIUM
high exploration, low commitment
most characterized by identity explorations
in emerging adults, may show highest rates of substance use
low exploration, high commitment
made commitments without fully exploring them or other options
Source: Schwartz (2001)
Desire for a wide range of experiences prior to entering adulthood
Trying substances
Sensation seeking
states of consciousness induced by various different substances
relieve identity confusion & temporarily escape reality
Sensation seeking at ages 15-18 predicted changes in substance use at ages 18-21.
Source: Arnett (2005)
Opportunity for dramatic change
free from family environment (if environment was pathogenic, as a result of leaving it may lead to a healthier lifestyle
expression of resilience
optimism
"Things will turn out good in the long-run"
Substance use
may not realize the negative consequences that are likely to result (optimism bias)
Children & adolescents are self-focused, but have their parents & teachers to answer to
Emerging adults, often set rules & standards for themselves
self-focused age period
freer than individuals in other age periods to make decisions independently (without permission/consent of others)
ex. groceries, where to live, job, etc.
Beyond emerging adulthood
endure commitments, set standards/expectations of behaviors, maintain roles --> requires less self-focusing & more consideration of others
Source: Arnett (2005)
Source: Arnett (2005)
Source: Arnett (2005)
Source: Arnett (2005)
White & Jackson (2004/2005) found that attending college may represent a special risk to emerging adults
increase in alcohol availability
acceptance of drinking on college campuses
heavier rates of drinking
Sociodemographic Characteristics: Alcohol Use in Emerging Adults
Sociodemographic
Characteristics
GENDER
19-30 years old
45% of men & 26.7% of women reported heavy drinking within the previous two weeks
7% of men & 3% of women reported daily drinking
RACE/ETHNICITY
Whites & Native Americans report the most drinking
Hispanics in between
African Americans & Asians drink the least
MARITAL STATUS & PARENTHOOD
Marital Status
Married women: greatest decreases in drinking behavior
Married men: fewer increases in drinking
Divorce led to increased drinking
COLLEGE STATUS
Regardless of college attendance, heavy drinking is pervasive in the early 20s
College students had lower rates of daily drinking than non-college students
However, when college students did drink, they consumed greater amounts
Rates of alcohol dependence were lower for college students than for 18-24 year-olds in general population
EMPLOYMENT
Full-time employment after high school was correlated with slight increases in drinking within past 30 days
Joining the military after high school
greater than average increases in current drinking & heavy drinking
Unemployed men, not women, reduced their drinking
Source: White & Jackson (2004/2005)
Peaks of Drinking
Whites: 19-22 years old
African Americans & Hispanics: later peaks that last longer
Parenthood
reduced alcohol use for men & women
most women who become pregnant eliminate alcohol use
Impulsivity, Sensation-Seeking & Risk-Taking
Sensation-seeking: the pursuit of novel, intense experiences
consistent predictor of substance in adolescence & emerging adults
Sensation-seeking & impulsivity are linked to higher rates of substance use, deviant behavior & noncomformity
Optimistic Bias
do not see themselves as vulnerable to any negative consequences from substance use
leads to higher risk-taking & use
Substance use is more influenced by perceived benefits than perceived risks
Parent-child relationship attributes that affect substance use:
attachment
bonding
parenting style
abuse or neglect
discipline
monitoring
conflict
King & Chassin (2004)
Poor parenting & behavioral undercontrol (impulsivity, sensation seeking, aggressiveness) may increase likelihood of children's:
school failure
emotional distress
interpersonal difficulties
affiliation with deviant peers
substance use disorders
References cont'd
MayoClinic. (2011). Drug addiction. Retrieved from: http://www.mayoclinic.com/health/drug-addiction/DS00183.

Newman, B.M. & Newman, P.R. (2012). Development through life: A psychosocial approach. Australia: Wadsworth.

Schwartz, S.J. (2001). The evolution of Eriksonian and neo-Eriksonian identity theory and research: A review and integration.
Identity: An International Journal of Theory and Research, 1,
7-58.

Staff, J., Schulenberg, J.E., Maslowsky, J., Bachman, J.G, O'Malley, P.M., Maggs, J.L, & Johnston, L.D. (2010). Substance use changes and social role transitions: Proximal developmental effects on ongoing trajectories from late adolescence through early adulthood.
Development and Psychopathology, 22
, 917-932.

Weinberg, N.Z. (2001). Risk factors for Adolescent substance abuse.
Journal of Learning Disabilities, 34
(4), 343-351.

White, H. R. & Jackson, K. (2004/2005). Social and psychological influences on emerging adult drinking behavior.
Alcohol Research and Health, 28
(4), 182-190.
Lee, Winters & Wall (2010)
Lee et al. (2010) based their study on risk cumulation theory. The theory states that as risk factors continue to increase, there is a greater likelihood of developing dependence/abuse of substances with early onset.
Contributing variables to substance use disorders:
Male
Dropping out of school
Attention deficit hyperactivity disorder (ADHD)
Conduct disorder (CD)
Oppositional defiant disorder (ODD)
Early age onset of alcohol, cannabis, illicit drug use
Family history of drug involvement
Staff et al. (2010) found that....
Family roles have powerful effects on alcohol and substance use
Rates of substance use declined between 5%-14% for men and 2%-13% for women when they were married.
Conversely, divorce contributes to a rise in alcohol, cigarette use and marijuana use.
Getting engaged also reduced substance use for men and women, although not as strong a protective factor as marriage.
Rates of substance use also declines with fertility behaviors (e.g. when a women is pregnant). Men also reduce alcohol use when their spouse/girlfriend are pregnant.
Military enrollment reduced illicit drug use
Cohabitation with a significant other reduced drug use
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