Kliewer Wendy, Murrelle Lenn
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia 23284-2018, USA.
J Adolesc Health. 2007 May;40(5):448-55. doi: 10.1016/j.jadohealth.2006.11.148. Epub 2007 Mar 26.
To identify the prevalence of substance use and problems with use, and risk and protective factors at different levels of the adolescent's ecology associated with substance use among adolescents in selected Central American countries.
Results of a survey of 17,215 students from Panama, Costa Rica, and Guatemala conducted in 2000-2001 served as the basis for the analyses. Lifetime use of alcohol, tobacco, marijuana, and five other drugs (inhalants, tranquilizers, cocaine, crack, and ecstasy), and problems with drugs and alcohol were the outcome variables. Risk factors included dysregulation, family problems with drugs/alcohol, negative family interactions, school disengagement, peer deviance, and exposure to community violence. Protective factors included a personal belief in God, positive family interactions, parent religiosity, and positive student-teacher interaction. Both hierarchical linear regression and logistic regression analyses were used to model main and interaction effects of risk and protective factors.
There was a linear association between number of risk and protective factors and substance use, however, risk factors were more strongly associated with substance use than were protective factors. There were significant risk-by-protective-factor interactions for alcohol and marijuana use, and for problems with drugs and alcohol. Risk interacted most consistently with a personal belief in God, but also with parent religiosity and with student-teacher communication.
It is important to consider risk and protective factors at different levels of an adolescent's ecology. Prevention and intervention efforts should focus on interactions adolescents have in different microsystems (e.g., with parents, teachers, and peers).
确定中美洲部分国家青少年中物质使用及使用问题的流行情况,以及与青少年物质使用相关的不同生态水平的风险和保护因素。
2000 - 2001年对来自巴拿马、哥斯达黎加和危地马拉的17215名学生进行的一项调查结果作为分析的基础。酒精、烟草、大麻及其他五种药物(吸入剂、镇静剂、可卡因、快克和摇头丸)的终生使用情况,以及药物和酒精问题为结果变量。风险因素包括调节障碍、家庭药物/酒精问题、负面家庭互动、学校脱离、同伴偏差和接触社区暴力。保护因素包括个人对上帝的信仰、积极的家庭互动、父母的宗教信仰以及积极的师生互动。分层线性回归和逻辑回归分析均用于对风险和保护因素的主要及交互作用进行建模。
风险和保护因素的数量与物质使用之间存在线性关联,然而,风险因素与物质使用的关联比保护因素更强。在酒精和大麻使用以及药物和酒精问题方面,存在显著的风险与保护因素交互作用。风险与个人对上帝的信仰交互作用最为一致,但也与父母的宗教信仰以及师生沟通存在交互作用。
考虑青少年不同生态水平的风险和保护因素很重要。预防和干预措施应关注青少年在不同微观系统(如与父母、教师和同伴)中的互动。