Examination of Personality, Social and Cognitive Factors on the Co-Occurrence of Health Risk Behaviors among Multi-Problem Youth: The Utility of An Integrative Framework

Abstract

Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the cooccurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use. Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth.This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.vii The co-occurrence of alcohol and other drug (AOD) use and sexual risk behaviors (SRBs) is a serious public health problem that has been linked to deleterious outcomes among adolescents. Consequently, understanding how relations among putative risk factors increase the co-occurrence of AOD use and SRBs is crucial for developing developmentally-appropriate prevention and treatment efforts. Chapter One of this dissertation has a specific structure. First, this chapter presents a rationale for studying co-occurring AOD use and SRBs from a multivariate perspective. Second, this chapter presents a summary of existing research studies examining putative risk factors associated with both AOD use and SRB among adolescents. Third, this chapter provides a brief discussion regarding the integrative model that guided the current study. Last, the significance of the current study for the development of prevention and intervention programs targeting high risk samples of adolescents is summarized. Current Research on Co-Occurring Alcohol and other Drug Use, and Sexual Risk BehaviorsCurrent research on the co-occurrence of sexual risk behaviors (SRBs) and alcohol and other drug (AOD) use supports the importance of a multivariate framework that specifies the influence of multi-level factors (e....