SAN DIEGO – Adolescents with a history of alcohol use report a significant range of risk behaviors for problematic substance use and other problem behaviors, a study of adolescents being treated in the emergency department for an alcohol-related incident shows.
“Alcohol-positive adolescents with a history of problematic alcohol use prior to the emergency department visit should receive greater attention in the discharge planning process, especially with the parents,” lead author Anne M. Fairlie said in an interview after the study was presented during a poster session at the annual scientific conference of the Research Society on Alcoholism.
“Attention should be given to the broader clinical picture [such as a] history of drinking and peer and parental influences, not just presentation as alcohol positive in order to ensure adequate evaluation and disposition planning,” she said.
Ms. Fairlie, a graduate research assistant in the behavioral science Ph.D. program in psychology at the University of Rhode Island, Kingston, and her associates examined three groups of adolescents: 45 who scored at or above the clinical cutoff (16 or above) on the Adolescent Drinking Inventory (ADI); 68 who scored below the clinical cutoff on the ADI while being treated in the pediatric or adult emergency department of a level I regional care center after an alcohol-related incident; and 64 adolescents who were alcohol negative while being treated in the pediatric or adult emergency departments, or in community settings. The mean age of the subjects was 15 years.
Alcohol-positive adolescents were identified as either having consumed alcohol within 6 hours of admission or tested positive for alcohol via blood-drawn test, while alcohol-negative adolescents did not report consuming alcohol within 6 hours of admission, did not have a positive blood test or breathalyzer (if administered), and scored 3 or lower on the Alcohol Use Disorders Identification Test.
Other measures used in the study included the Center for Epidemiologic Studies–Depression scale, the Behavior Assessment System for Children, and the Parental Strictness/Supervision Scale. The researchers performed one-way analyses of covariance while controlling for age.
Adolescents who scored at or above the clinical cutoff on the ADI reported significantly more alcohol use, compared with those who scored below the clinical cutoff on the ADI, followed by adolescents in the alcohol-negative group. For example, the mean number of days per month alcohol was consumed was 5.28 among adolescents who scored at or above the clinical cutoff on the ADI, 0.94 among those who scored below the clinical cutoff on the ADI, and 0.13 among those in the alcohol-negative group. This pattern continued in the number of days drank per month, the number of days per month five or more drinks in a row were consumed, the maximum number of drinks consumed on one occasion, and the number of days marijuana was used in the past month.
According to parental reports, adolescents in the alcohol-negative group had significantly fewer internalizing and externalizing symptoms, compared with adolescents in the other two groups.
Ms. Fairlie and her associates also found that adolescents who scored at or above the clinical cutoff on the ADI reported significantly higher scores on peer substance use and peer tolerance of substance use (mean scores of 1.63 and 2.59, respectively), compared with those who scored below the clinical cutoff on the ADI (0.79 and 2.00), followed by adolescents in the alcohol-negative group (0.46 and 1.57).
In addition, adolescents who scored at or above the clinical cutoff on the ADI reported significantly lower scores on the Parental Strictness/Supervision scale, compared with their peers in the other two groups.
No differences in depressive symptoms among the study participants were observed.
Ms. Fairlie acknowledged certain limitations of the study, including the homogeneity of the study participants. Most were non-Hispanic whites, “which inhibits our ability to generalize the findings to adolescents from various racial and ethnic backgrounds,” she said.
Also, “the data are cross-sectional and, therefore, longitudinal relationships cannot be examined. There are likely reciprocal relationships among substance abuse, teen behavior, and peer and parental influences.” These relationships may differ over time among the groups of adolescents examined in the current study.
Vitals
Major Finding: Adolescents who score at or above the clinical cutoff on the ADI are at risk for problematic substance use and behaviors.
Data Source: Study of 177 adolescents admitted to ED after an alcohol-related incident.
Disclosures: One investigator received a grant from the National Institute on Alcohol Abuse and Alcoholism.