A Model of School Problems, Academic Failure, Alcohol Initiation, and the Relationship to Adult Heroin Injection

Abstract

The current study uses structural equation modeling to investigate factors associated with alcohol initiation and injection heroin use. Baseline data from the NEURO-HIV Epidemiologic Study in Baltimore, Maryland, were used. Participants were 404 injection heroin users (M_age = 32.72) with a history of regular injection in their lifetime. Latent variables were created for self-reported school problems and academic failure. The final model indicated that greater school problems were associated with earlier alcohol initiation (ß = −0.22, p < .001) and earlier alcohol initiation was associated with greater frequency of recent heroin use (ß = −0.12, p < .05). Academic failure was directly related to greater frequency of recent heroin injection (ß = 0.15, p < .01). The results expand research investigating the relationship between adolescent behavior and illicit drug use in adulthood.

RÉSUMÉ

Représentation des problèmes à l’école, de l’échec scolaire, de l'initiation à l'alcool et lien avec l'injection d'héroïne chez l'adulte

La présente étude s'inspire de la modélisation par équation structurelle pour analyser les facteurs liés à l'initiation à l'alcool et à la consommation d'héroïne par injection. Nous avons utilisé les données de base issues de l’étude épidémiologique NEURO-HIV réalisée à Baltimore dans le Maryland. Le groupe de participants était composé de 404 consommateurs d'héroïne par injection (M_age = 32.72) ayant déjà utilisé régulièrement l'injection dans leur vie. Nous avons créé des variables latentes pour les problèmes à l’école et l’échec scolaire que les intéressés ont eux-mêmes signalés. D'après la représentation finale, les problèmes à l’école plus graves sont liés à l'initiation précoce à l'alcool (ß = −0.22, p < .001) et l'initiation précoce à l'alcool est liée à une fréquence plus élevée de consommation récente d'héroïne (ß = −0.12, p < .05). L’échec scolaire est directement lié à une fréquence plus élevée d'injection récente d'héroïne (ß = 0.15, p < .01). Les résultats élargissent la recherche qui analyse le lien entre le comportement des adolescents et la consommation illégale de drogues chez l'adulte.

Mots-clés: initiation à l'alcool, injection d'héroïne, modélisation par équation structurelle, comportement des adolescents

RESUMEN

Modelo de problemas escolares, fracasos académicos, iniciación en el consumo de alcohol y la relación con la inyección de heroína en adultos

El estudio actual utiliza el modelo de ecuación estructural para investigar los factores vinculados con la iniciación en el consumo de alcohol y el uso de la inyección de heroína. Se utilizaron los datos basales obtenidos en el Estudio Epidemiológico NEURO-HIV realizado en Baltimore, Maryland. Los participantes fueron 404 usuarios de la inyección de heroína (M_edad = 32.72) con antecedentes de inyección regular durante toda su vida. Se crearon variables latentes para los problemas escolares y los fracasos académicos autoinformados. El modelo final indicó que los problemas escolares mayores estuvieron vinculados con la iniciación temprana en el consumo de alcohol (ß = −0.22, p < .001) y la iniciación más temprana en el consumo de alcohol estuvo vinculada con el uso más frecuente de heroína en el último tiempo (ß = −0.12, p < .05). El fracaso académico estuvo directamente relacionado con el uso más frecuente de la inyección de heroína en el último tiempo (ß = 0.15, p < .01). Los resultados amplían la investigación que estudia la relación entre el comportamiento adolescente y el uso de drogas ilícitas en la edad adulta.

Palabras clave: iniciación en el consumo de alcohol, inyección de heroína, modelo de ecuación estructural, comportamiento adolescente

Keywords :

• alcohol initiation
• heroin injection
• structural equation modeling
• adolescent behavior

THE AUTHORS

Dr. Rebecca C. Trenz, Ph.D., M.A., is currently a Visiting Assistant Professor at Mercy College, Dobbs Ferry, NY, USA. Prior to her current position, Dr. Trenz completed a postdoctoral fellowship in the Drug Dependence and Epidemiology Training Program at the Johns Hopkins School of Public Health. Dr. Trenz has two main areas of research: psychosocial factors associated with illicit drug use in adulthood and sex risk behavior among high-risk, substance-using populations. Her work includes manuscripts that identify factors associated with early substance use exposure and illicit drug use in adulthood. She is also interested in exploring the role of alcohol use in sex risk behavior and infectious disease among illicit drug users. Other research interests include perceptions of motivational climate, achievement goals, satisfaction, persistence, and performance in competitive learning environments. In addition, Dr. Trenz enjoys applying statistical techniques such as structural equation modeling and latent class analysis to large datasets to further address her research interests.

Dr. Paul Harrell, Ph.D., M.A., is a postdoctoral fellow at Johns Hopkins University School of Public Health, Baltimore, MD, USA. His current research involves drug dependence epidemiology with a focus on understanding mechanisms underlying patterns of polydrug use. Other research interests include behavioral pharmacology and expectancies, particularly the “placebo effect.” He has over 10 years of experience conducting research with people, including adolescents/adults with mental and substance disorders. His experience includes all aspects of the research process: successful grant applications, participant recruitment, supervision of data collection, and successful manuscript submissions to Drug and Alcohol Dependence, Psychopharmacology, and Journal of Substance Abuse Treatment. His early research experience included work on a clinical trial of buprenorphine for opioid-dependent adolescents at Johns Hopkins School of Medicine. The results were published in Journal of the American Medical Association (JAMA). In addition, his career involved research rotations at American University, the National Institute of Mental Health Section on Neuroimaging, and the National Institute on Drug Abuse. He finishes his fellowship in June of 2012 and plans on continuing work researching mind–body interrelations and cognitive/social factors that impact mental and/or behavioral health. He looks forward to accelerating his research productivity with the goal of improvements in all aspects of public health. He lives in Baltimore, MD.

Dr. Michael Scherer's, Ph.D., M.S., research interest is in alcohol use among polysubstance users. He is particularly interested in how the role of social networks, cognitive abilities, and the personality factors that influence risk-taking behavior may be adapted or augmented to provide support in reducing the use of deleterious substances. In this endeavor, he completed a master's degree in Rehabilitation Counseling and a doctoral degree in Counseling Psychology. He is currently completing his postdoctoral training at the Johns Hopkins Bloomberg School of Public Health, after which he intends to continue to work in academia to further explore addictions and innovative new ways in which to approach their treatment.

Dr. Brent E. Mancha, Ph.D., M.H.S., is a Research Associate in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health (JHSPH), Baltimore, MD, USA. He is currently Assistant Director of the Hubert H. Humphrey Fellowship Program at Johns Hopkins. He is a graduate of the Ph.D. program in the Department of Mental Health at JHSPH and an alumnus of the National Institute on Drug Abuse (NIDA) Drug Dependence Epidemiology Training (DDET) Program. During his first 2 years of doctoral study, he was a recipient of the NIMH Child Mental Health Services Training Program fellowship. While at Johns Hopkins, he has worked extensively with Dr. William W. Latimer. Dr. Mancha's research focuses on the epidemiology of alcohol and drug dependence, with a special interest in alcohol use during adolescence. His dissertation examined patterns of DSM-IV alcohol problems among youths from the United States and Puerto Rico and utilized latent class analysis to examine different profiles of adolescent drinkers. Dr. Mancha coordinates the Johns Hopkins Humphrey Fellows Program and also works as part of a research team analyzing data, writing and publishing manuscripts, and preparing abstracts and presentations for scientific conferences.

Dr. William W. Latimer, Ph.D., M.P.H., is the Elizabeth Faulk Professor and Chair of the Department of Clinical and Health Psychology in the College of Public Health and Health Professions at the University of Florida, Gainesville, FL, USA. Dr. Latimer's research has been NIDA funded since 1995 and focuses on the epidemiology, prevention, and treatment of infectious disease and drug dependence, with a special focus on neurobehavioral risk factors of disease, treatment engagement, and outcome. Dr. Latimer's epidemiologic research focuses on neuropsychological and social-behavioral risk factors of HIV and other infectious diseases among drug-using populations in the United States, South Africa, and Russia. Dr. Latimer's HIV and drug prevention research focuses on evaluation of efficacy and effectiveness of interventions that coordinate cognitive-behavioral and family systems approaches. Dr. Latimer's drug treatment research also focuses on evaluating neurobehavioral and process factors influencing the efficacy and effectiveness of cognitive-behavioral, family systems, and 12-step approaches for adolescent and adult drug abuse. Since 2001, Dr. Latimer has conducted five R01 studies in Baltimore City, including randomized trial studies to test IFCBT efficacy to reduce HIV risk behavior and foster drug abstinence among adults with drug dependence and epidemiologic studies of HIV risk behavior among adult heroin and cocaine addicts.