The editorial team of the Journal of Ethnicity in Substance Abuse aims to contribute to the accumulation of research on substance abuse across diverse racial and ethnic groups. The range of ethnic groups included in this issue certainly reflects that diversity. Specifically, the articles in this issue address substance use among African Americans (Williams; Wright et al.), Asians (Yeh et al.), two other specific Asian groups (Thai [Saengcharnchai et al.] and Chinese [Sun]), Hispanics (Wright et al.), Philippines (Tuliao et al.), non-Hispanic Whites (Wright et al.), heterogeneous U.S. samples (Tuliao et al.) and even a group described as non-Whites (Ureche et al.). However, what stands out about this issue is that the set of articles illustrates three lessons for conducting culturally competent substance abuse research.
The first lesson is that measures standardized within one group need to be evaluated to determine whether they are operating differently across ethnic groups. The article by Tuliao and colleagues on the Alcohol Use Disorder Identification Test (AUDIT) illustrates this lesson nicely. Previous researchers have proposed that certain tests are necessary before assuming that a measure is assessing the same characteristic across groups. If one is using confirmatory factor analysis (CFA), the two most commonly reported CFA analyses are configural (i.e., similar factor structure) and metric (i.e., similar factor loadings). However, other tests can be conducted to establish strict equivalence. Tuliao and colleagues found that U.S. and Philippine samples had similar factor structures and factor loadings. However, the two groups differed on the mean factor scores, which suggests some degree of nonequivalence on the AUDIT across these two groups.
The second lesson is that substance abuse findings based on one group may not generalize to another group. Several articles in this issue illustrate this lesson. Wright and colleagues reported significant differences between Whites and African Americans both on the perceived harmfulness of substance abuse and on the relation of a relatively unstudied variable, exposure to music lyrics and videos, to substance use. Similarly, unlike the findings reported for South Africans, Saengcharnchai and colleagues found that the number of heavy drinking days was correlated with health-related quality of life among Thai patients. Yeh and colleagues illustrated that important differences exist even within an ethnic group. Specifically, depressive symptoms were associated with more alcohol use among U.S.-born Asian college students but not among foreign-born Asians.
The third lesson is a natural extension of the differences mentioned in the second lesson. Specifically, several articles illustrate that the unique cofactors across groups may mandate differences in the factors that need to be addressed in treatment. Although two articles address trauma, the conclusions for treatment are quite different. Sun’s work suggests that exposure to trauma in the early lives of Chinese heroin users may be a treatment issue. By contrast, although Williams agrees that trauma is relevant when working with African American substance abusers as well, that author advocates for a broader conceptualization of trauma in treatment that includes what is referred to as structurally traumatized communities.
In addition to other factors affecting treatment outcomes, Ureche et al. examine whether racial matching between the therapist and the client will affect self-disclosure in treatment. The matched and unmatched adolescent clients in that study did not differ in their self-disclosure of substance use. However, the unexpected finding that the unmatched adolescents were more likely than the matched to self-disclose ADHD symptoms suggests that the field has much to learn about the dynamics of racial matching on the therapist–client relationship.