The relationship of cumulative and proximal adversity to onset of substance dependence symptoms in two American Indian communities

Abstract

The proximal and distal effects of adversity on the onset of symptoms of substance dependence during adolescence were explored in two culturally distinct American Indian (AI) reservation communities (Northern Plains and Southwest). Data (N=3,084) were from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP). The age-related risk of symptom onset increased gradually from age 11 through age 16, remained relatively high through age 18, then declined rapidly. Both tribe and gender were related to onset of dependence symptoms; men and Northern Plains tribal members were at greatest risk and Southwest women were at particularly low risk of symptom onset across adolescence. For all tribe and gender groups, both proximal and cumulative distal experiences of adversity were associated with substantially increased risk of symptom onset. The relationship of adversity to onset of substance dependence symptoms remained strong when previous symptoms of psychiatric disorder and childhood conduct problems were considered. These findings suggest that efforts to help children and adolescents in AI communities develop constructive mechanisms for coping with adversity may be especially valuable in substance dependence prevention.

Social contextual risk factors for stimulant use among adolescent American Indians

“…For example, one study reported an increase of approximately 6% in alcohol use from 7 th grade to 12 th grade (Blum et al, 1992) while another study linked early marijuana use (i.e., 11–12 years) to greater odds of marijuana abuse/dependence in late adolescence (Cheadle and Sittner Hartshorn, 2012). Several other studies have shown that substance use begins early among AI adolescents, and early use is a clear marker of risk for prolonged and problematic use (Novins and Baron, 2004; Whitbeck et al, 2008; Whitesell et al, 2007). Together these findings suggest early intervention/prevention is key to eliminating and reducing these observed substance use disparities.…”

Childhood Exposure to Adversity and Risk of Substance-Use Disorder in Two American Indian Populations: The Meditational Role of Early Substance-Use Initiation

“…evidence of clear links between adversity and suD in other populations (Dawson et al, 2005;Dohrenwend, 2000;Kessler et al, 1997;lloyd, 1995, 2003) has led to speculation that the harsh and often violent conditions on some reservations may be one root cause of substance-use disparities. a growing body of research on the association of adversity with substance-use problems among american indians supports this possibility, but many questions remain (hawkins et al, 2004;Koss et al, 2003;libby et al, 2004;Robin et al, 1999;Rodgers and Fleming, 2003;Walters et al, 2002;Whitesell et al, 2007a).…”

“…on the other hand, once substance use has begun, misuse of substances can make individuals more prone to put themselves in risky situations (e.g., driving while intoxicated and fighting) and encounter adversity (e.g., automobile accidents, physical assault) (hingson et al, 2008; spooner, 1999; turner and lloyd, 2003). empirical evidence supports the role of stressors in the initiation and early development of substance use (leMaster et al, 2002;Whitesell et al, 2007a). Yet most agree that once use is initiated, the developmental progression is characterized by a cyclical interplay of stress and increasing substance use (aneshensel, 1999; brennan et al, 1999; stewart and conrod, 2002), both because use increases subsequent exposure to stressful events and because it may interfere with adaptive responses to such events (chilcoat and Menard, 2003).…”

“…although adversity at any age appears to result in increased risk of substance use, such use is associated with much greater risk of suD if it first occurs in late childhood or early adolescence rather than in adulthood (anthony and petronis, 1995;hawkins et al, 1992;hingson et al, 2008;Kunitz, 2008;Novins and barón, 2004;Robins and przybeck, 1985;stueve and o'Donnell, 2005;Warner et al, 2007;Whitesell et al, 2007a;York et al, 2004). Researchers trying to understand the potent impact of early substance use have focused on how the unique biological, social, cognitive, emotional, and identity processes at work in adolescence relate to susceptibility to either the initiation or escalation of substance use.…”

School context and American Indian substance use

“…No other individual-level predictor was found to be a significant predictor across each of the four models. This is not a novel finding, since other studies have also found that such stressors (LeMaster, Connell, Mitchell, & Manson, 2002; Whitesell, Beals, Mitchell, Keane, Spicer, & Turner, 2007; Cheadle & Whitbeck, 2011) and exposure to delinquent peers (Cheadle & Whitbeck, 2011) are predictive of AI substance use, but it does promote further confidence in the generalizability of such predictors of substance use across racial and ethnic groups.…”