An examination of the association between early initiation of substance use and interrelated multilevel risk and protective factors among adolescents

Autoři: Carlos Andres Trujillo aff001;  Diana Obando aff002;  Angela Trujillo aff002
Působiště autorů: School of Management, Universidad de los Andes, Bogota, Colombia aff001;  Department of Psychology, Universidad de La Sabana, Chía, Cundinamarca, Colombia aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article


One of the major goals of drug use prevention programs is to delay the age of onset of substance use. What is called early initiation, usually occurring in adolescents under the age of 15, is a salient predictor of Substance Use Disorders later in adulthood. The causes of early initiation are complex and multifaceted and this has led to the identification of a rich set of risk and protective factors that influence age of onset. Nonetheless, there is little knowledge about the interdependence of these factors in their impact on early initiation. This paper addresses this question by applying Multiple Correspondence Analysis to data on family, community and social risk and protective factors from over 1200 adolescents. We find that community and to a lesser extent social factors are the most clearly associated to early initiation and we compare our results to those obtained from linear regression analyses of the same data that do not incorporate interdependence and find opposite results. We discuss the differences between linear regressions and MCA to evaluate the interplay of risk and protective factors and the implications of our findings for health policy and the design of prevention interventions aimed at delaying age of onset.

Klíčová slova:

Adolescents – Alcohol consumption – Alcoholism – Antisocial behavior – Behavior – Drug abuse – Prosocial behavior


1. Brecht M, Greenwell L, Anglin MD. Substance use pathways to methamphetamine use among treated users. Addict Behav. 2007 Jan 1;32(1):24–38. doi: 10.1016/j.addbeh.2006.03.017 16675150

2. Griffin KW, Botvin GJ, Scheier LM, Nichols TR. Factors associated with regular marijuana use among high school students: A long-term follow-up study. Subst Use Misuse. 2002 Jan 1;37(2):225–238. doi: 10.1081/ja-120001979 11863277

3. Grant BF, Dawson DA. Age of onset of drug use and its association with DSM-IV drug abuse and dependence: Results from the National Longitudinal Alcohol Epidemiologic Survey. J Subst Abuse. 1998;10(2):163–173. doi: 10.1016/s0899-3289(99)80131-x 9854701

4. Poudel A, Gautam S. Age of onset of substance use and psychosocial problems among individuals with substance use disorders. BMC Psychiatry. 2017 Dec;17(1):10. doi: 10.1186/s12888-016-1191-0 28077106

5. DeWit DJ, Adlaf EM, Offord DR, Ogborne AC. Age at first alcohol use: a risk factor for the development of alcohol disorders. Am J Psychiatry 2000 May 1;157(5):745–50. doi: 10.1176/appi.ajp.157.5.745 10784467

6. Trenz RC, Scherer M, Harrell P, Zur J, Sinha A, Latimer W. Early onset of drug and polysubstance use as predictors of injection drug use among adult drug users. Addict Behav. 2012 Apr 1;37(4):367–372. doi: 10.1016/j.addbeh.2011.11.011 22172686

7. Jessor R, Turbin MS, Costa FM, Dong Q, Zhang H, Wang C. Adolescent problem behavior in China and the United States: A cross‐national study of psychosocial protective factors. J Res Adolesc. 2003 Sep;13(3):329–60.

8. Jones TM, Hill KG, Epstein M, Lee JO, Hawkins JD, Catalano RF. Understanding the interplay of individual and social–developmental factors in the progression of substance use and mental health from childhood to adulthood. Dev Psychopathol. 2016 Aug;28(3):721–41. doi: 10.1017/S0954579416000274 27427802

9. Bacio G, Estrada Y, Huang S, Martínez M, Sardinas K, Prado G. Ecodevelopmental predictors of early initiation of alcohol, tobacco, and drug use among Hispanic adolescents. J Sch Psychol. 2015;53(3):195–208. doi: 10.1016/j.jsp.2015.02.001 26054814

10. Hair JF, Black WC, Babin BJ, Anderson RE, Tathan RL. Multivariate data analysis. 6 edition. India. Pearson Education 2006. 663–670

11. Griffin KW, Botvin GJ. Evidence-based interventions for preventing substance use disorders in adolescents. Child Adolesc Psychiatr Clin N Am. 2010;19(3):505–526. doi: 10.1016/j.chc.2010.03.005 20682218

12. Newcomb MD, Locke T. Health, social, and psychological consequences of drug use and abuse. Sloboda Z (ed). Epidemiology of drug abuse. New York: Springer; 2005. pp. 45–59.

13. Kessler RC, Amminger GP, Aguilar‐Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. Current opinion in psychiatry. 2007 Jul;20(4):359.-364. doi: 10.1097/YCO.0b013e32816ebc8c 17551351

14. Liang W, Chikritzhs T. Age at first use of alcohol predicts the risk of heavy alcohol use in early adulthood: A longitudinal study in the United States. Int J Drug Policy. 2015 Feb 1;26(2):131–134. doi: 10.1016/j.drugpo.2014.07.001 25107830

15. Fisher LB, Miles IW, Austin SB, Camargo CA, Colditz GA. Predictors of initiation of alcohol use among US adolescents: findings from a prospective cohort study. Arch Pediatr Adolesc Med, 2007 Oct 1;161(10):959–966. doi: 10.1001/archpedi.161.10.959 17909139

16. Pilatti A, Caneto F, Garimaldi JA, Vera BD, Pautassi RM. Contribution of time of drinking onset and family history of alcohol problems in alcohol and drug use behaviors in Argentinean college students. Alcohol Alcohol. 2013 Dec 8;49(2):128–137. doi: 10.1093/alcalc/agt176 24322673

17. Lopes BM, Gonçalves PD, Ometto M, dos Santos B, Cavallet M, Chaim-Avancini TM, et al. Distinct cognitive performance and patterns of drug use among early and late onset cocaine users. Addict Behav. 2017;73: 41–47. doi: 10.1016/j.addbeh.2017.04.013 28475942

18. Rioux C, Castellanos-Ryan N, Parent S, Vitaro F, Tremblay RE, Séguin JR. Age of Cannabis Use Onset and Adult Drug Abuse Symptoms: A Prospective Study of Common Risk Factors and Indirect Effects. Can J Psychiatry 2018;63(7):457–464. doi: 10.1177/0706743718760289 29682999

19. Kaplow JB, Curran P J, Dodge KA. Child, parent, and peer predictors of early-onset substance use: A multisite longitudinal study. J Abnorm Child Psychol. 2002;30(3):199–216. doi: 10.1023/a:1015183927979 12041707

20. Malmberg M, Overbeek G, Monshouwer K, Lammers J, Vollebergh WA, Engels RC. Substance use risk profiles and associations with early substance use in adolescence. J Behav Med. 2010;33(6):474–485. doi: 10.1007/s10865-010-9278-4 20625809

21. Maggs JL, Staff J, Patrick ME, Wray-Lake L. Very early drinking: Event history models predicting alcohol use initiation from age 4 to 11 years. Addict Behav. 2019;89:121–127. doi: 10.1016/j.addbeh.2018.09.030 30290300

22. Armenta B, Sittner K, Whitbeck L. Predicting the Onset of Alcohol Use and the Development of Alcohol Use Disorder Among Indigenous Adolescents. Child Dev. 2016;87(3):870–882. doi: 10.1111/cdev.12506 27028364

23. Visser L, De Winter AF, Vollebergh WA, Verhulst FC, Reijneveld SA. Do child’s psychosocial functioning, and parent and family characteristics predict early alcohol use? The TRAILS study. Eur J Public Health. 2014;25(1):38–43. doi: 10.1093/eurpub/cku072 24935960

24. Donovan J, Molina B. Antecedent Predictors of Children's Initiation of Sipping/Tasting Alcohol. Alcohol Clin Exp Res. 2014;38(9):2488–2495. doi: 10.1111/acer.12517 25159887

25. Dawson D. The link between family history and early onset alcoholism: earlier initiation of drinking or more rapid development of dependence?. J Stud Alcohol. 2000;61(5):637–646. doi: 10.15288/jsa.2000.61.637 11022800

26. Burlew A, Johnson C, Flowers A, Peteet B, Griffith-Henry K, Buchanan N. Neighborhood Risk, Parental Supervision and the Onset of Substance Use among African American Adolescents. J Child Fam Stud 2009;18(6):680–689.

27. Enstad F, Pedersen W, Nilsen W, von Soest T. Predicting early onset of intoxication versus drinking—A population-based prospective study of Norwegian adolescents. Addict Behav Rep. 2017;6:1–7. doi: 10.1016/j.abrep.2017.04.002 29450232

28. Atherton O, Conger R, Ferrer E, Robins R. Risk and Protective Factors for Early Substance Use Initiation: A Longitudinal Study of Mexican-Origin Youth. J Res Adolesc. 2015;26(4):864–879. doi: 10.1111/jora.12235 27990071

29. Ryan S, Jorm A, Lubman D. Parenting Factors Associated with Reduced Adolescent Alcohol Use: A Systematic Review of Longitudinal Studies. Aust N Z J Psychiatry. 2010;44(9):774–783. doi: 10.1080/00048674.2010.501759 20815663

30. Hemovich V, Lac A, Crano WD. Understanding early-onset drug and alcohol outcomes among youth: The role of family structure, social factors, and interpersonal perceptions of use. Psychol Health Med. 2011;16(3):249–267. doi: 10.1080/13548506.2010.532560 21491334

31. Trujillo A, Obando D, Trujillo CA. Family dynamics and alcohol and marijuana use among adolescents: The mediating role of negative emotional symptoms and sensation seeking. Addict Behav. 2016;62:99–107. doi: 10.1016/j.addbeh.2016.06.020 27344116

32. Sánchez Z, García L, Nappo SA. Razões para o não-uso de drogas ilícitas entre jovens em situação de risco. Rev Saude Publica 2005;39.

33. Wills T, Resko J, Ainette M, Mendoza D. Smoking Onset in Adolescence: A Person-Centered Analysis With Time-Varying Predictors. Health Psychol. 2004;23(2):158–167. doi: 10.1037/0278-6133.23.2.158 15008661

34. Moral M, Rodríguez F, Ovejero A. Correlatos psicosociales del consumo de sustancias psicoactivas en adolescentes españoles.Salud Publica Mex. 2010;52:406–415. doi: 10.1590/s0036-36342010000500008 21031247

35. Mosqueda-Díaz A, Ferriani MDGC. Factores protectores y de riesgo familiar relacionados al fenómeno de drogas, presentes en familias de adolescentes tempranos de Valparaíso, Chile. Rev Lat Am Enfermagem. 2011;19:789–795. doi: 10.1590/s0104-11692011000700017 21739061

36. Hawkins JD, Catalano RF, Miller JY. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychol Bull. 1992;112(1):64. doi: 10.1037/0033-2909.112.1.64 1529040

37. Oman RF, Vesely S, Aspy CB, McLeroy KR, Rodine S, Marshall L. The potential protective effect of youth assets on adolescent alcohol and drug use. Am J Public Health 2004;94(8):1425–1430. doi: 10.2105/ajph.94.8.1425 15284054

38. Arthur MW, Hawkins JD, Pollard JA, Catalano RF, Baglioni AJ. Measuring risk and protective factors for use, delinquency, and other adolescent problem behaviors: The Communities That Care Youth Survey. Eval Rev. 2002;26(6): 575–601. doi: 10.1177/0193841X0202600601 12465571

39. Hair JF, Black WC, Babin BJ, Anderson RE, Tathan RL. Multivariate data analysis. 6 edition. India. Pearson Education 2006. 663–670

40. Greenacre M. Correspondence analysis in practice. 3rd edition. New York. Chapman and Hall/CRC; 2017.

41. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) Underage Drinking: Why do adolescents drink, what are the risks, and how can underage drinking be prevented?. Alcohol Alert 67. Washington, DC: NIAAA, 2006. Available from:

42. Lemstra M, Bennett N, Nannapaneni U, Neudorf C, Warren L, Kershaw T, Scott C. A systematic review of school-based marijuana and alcohol prevention programs targeting adolescents aged 10–15. Addiction Research & Theory. 2010 Jan 1;18(1):84–96.

43. Bronfenbrenner U. Ecological models of human development. Readings on the development of children. 1994;2(1):37–43.

44. Deater–Deckard K, Dodge KA, Bates JE, Pettit GS. Multiple risk factors in the development of externalizing behavior problems: Group and individual differences. Development and psychopathology. 1998 Sep;10(3):469–93. doi: 10.1017/s0954579498001709 9741678

45. Evans GW. The environment of childhood poverty. Am Psychol. 2004 Feb;59(2):77. doi: 10.1037/0003-066X.59.2.77 14992634

46. Gabalda MK, Thompson MP, Kaslow NJ. Risk and protective factors for psychological adjustment among low-income, African American children. J Fam Issues. 2010 Apr;31(4):423–44.

47. Le Roux B, Rouanet H. Multiple correspondence analysis. Los Angeles. Sage; 2006.

48. Tucker JS, Pollard MS, De La Haye K, Kennedy DP, Green HD Jr. Neighborhood characteristics and the initiation of marijuana use and binge drinking. Drug Alcohol Depend. 2013 Feb 1;128(1–2):83–9. doi: 10.1016/j.drugalcdep.2012.08.006 22938829

49. Dunn MG, Mezzich AC. Development in Childhood and Adolescence: Implications for Prevention Research and Practice. In: Tolan P, Szapocznik J, Sambrano S. eds. Preventing youth substance abuse: Science-based programs for children and adolescents. Washington, DC: American Psychological Association; 2007. p 21–24

50. Lopez-Quintero C, Neumark Y. Prevalence and determinants of resistance to use drugs among adolescents who had an opportunity to use drugs. Drug Alcohol Depend. 2015 Apr 1;149:55–62. doi: 10.1016/j.drugalcdep.2015.01.015 25659896

Článek vyšel v časopise


2019 Číslo 12
Nejčtenější tento týden