Scheier L M, Botvin G J, Baker E
Department of Public Health, Cornell University Medical College, New York, N.Y. 10021, USA.
J Stud Alcohol. 1997 Nov;58(6):652-67. doi: 10.15288/jsa.1997.58.652.
Determinants of initial alcohol use may differ from predictors of accelerated or problematic consumption. Social influences may be strong predictors of initial drinking; however, later stages of problem drinking may be linked developmentally to intrapersonal deficits. This study prospectively examined the influence of chronic and changing risk and protective status in predicting adolescent alcohol involvement and transitions in alcohol use.
Data were obtained from a three-wave cohort (N = 823) of 8th-10th grade nonintervention students participating in a school-based drug abuse prevention trial. Cognitive, attitudinal and social influence measures were dichotomized using empirical cut-offs to designate risk or protective status. Using a conceptually based assignment scheme, additive risk indices were created assessing chronic (averaging across time) and changing features of competence, psychological and interpersonal functioning, cognitive-affective and social influences. Three chronic and change protective indices were created tapping competence, psychological, and interpersonal functioning.
Controlling for initial drinking and gender, chronic risk for social influence and psychological functioning and increased risk for social influences and competency predicted subsequent drinking behavior. Chronic psychological protection attenuated subsequent drinking. Using categorical measures of drinking behavior to designate nonuse, experimental or moderate-heavy use, chronic social influence and competency risk were associated with an increased likelihood of accelerated drinking, whereas improved psychological functioning diminished the likelihood of increased drinking behavior.
Findings underscore the need for implementing prevention strategies that reinforce developmentally appropriate skills and enhance personal competence and psychological functioning as effective barriers against initial and more problematic alcohol use. The unique contribution of protective forces also underscores that risk reduction and protection enhancement are complementary processes and are both required to offset social influences for alcohol consumption.
初次饮酒的决定因素可能与饮酒加速或出现问题的预测因素不同。社会影响可能是初次饮酒的有力预测因素;然而,饮酒问题的后期阶段可能在发展上与个人缺陷有关。本研究前瞻性地考察了慢性和变化的风险及保护状况对预测青少年饮酒参与情况及饮酒行为转变的影响。
数据来自一个三波队列(N = 823),该队列由参与一项校内药物滥用预防试验的8至10年级未干预学生组成。认知、态度和社会影响测量指标通过实证临界值进行二分,以确定风险或保护状况。采用基于概念的赋值方案,创建了累加风险指数,评估能力、心理和人际功能、认知情感和社会影响的慢性(跨时间平均)和变化特征。创建了三个慢性和变化保护指数,分别涉及能力、心理和人际功能。
在控制初次饮酒和性别因素后,社会影响和心理功能的慢性风险以及社会影响和能力的风险增加预测了随后的饮酒行为。慢性心理保护减弱了随后的饮酒行为。使用饮酒行为的分类测量指标来界定不饮酒、尝试饮酒或中度至重度饮酒,慢性社会影响和能力风险与饮酒加速的可能性增加相关,而心理功能改善则降低了饮酒行为增加的可能性。
研究结果强调需要实施预防策略,强化与发展阶段相适应的技能,提高个人能力和心理功能,以此作为预防初次饮酒及更严重饮酒问题的有效屏障。保护因素的独特作用还强调,降低风险和增强保护是相辅相成的过程,两者对于抵消饮酒的社会影响都是必需的。