Risk and Protective Factors for Substance Abuse and Other Youth Problem Behavior

Risk and Protective Factors for Substance Abuse and Other Youth Problem Behavior

As was stated in the introduction, the Utah Division of Substance Abuse and the Social Research Institute have been engaged in a project to determine the factors that place youth at risk for substance abuse and those that help protect youth from substance abuse. In medical research, risk factors have been found for heart disease and other heath problems. Through media campaigns to inform the general public about the risk factors for heart disease, most people are now aware that behaviors such as eating high fat diets, smoking, and lack of exercise, place them at risk for heart disease. Social scientists have defined a set of risk factors for substance abuse, delinquency, violence, teen pregnancy, and school dropout.

Dr. J. David Hawkins, Dr. Richard F. Catalano, and their colleagues at the University of Washington have reviewed more than 30 years of existing work on risk factors from various fields and have completed extensive work of their own to identify risk factors for youth problem behaviors. They identified risk factors in important areas of daily life: 1) the community, 2) the family, 3) the school, and 4) within individuals themselves and their peer interactions. Many of the problem behaviors faced by youth -- delinquency, substance abuse, violence, school dropout, and teen pregnancy -- share many common risk factors. Thus, reducing those common risk factors will have the benefit of reducing several problem behaviors.

Another benefit of using the risk and protective factor model in dealing with adolescent social problems is that it provides a method of measuring levels of risk and protection. Areas with the highest risk and lowest protection can then be addressed by programs designed to reduce youth problem behavior. Once the intervention has been implemented, the risk factor levels can again be measured to determine the effectiveness of the intervention.

The risk and protective factors have been organized into the four important areas of a young person's life and are summarized below. Following each risk and protective factor, and placed in parentheses, are the problem behaviors that are linked to that factor.

Community Risk Factors

Availability of Drugs

(Substance Abuse)

The more available drugs are in a community, the higher the risk that young people will abuse drugs in that community. Perceived availability of drugs is also associated with risk. For example, in schools where children just think drugs are more available, a higher rate of drug use occurs.

Availability of Firearms

(Delinquency and Violence)

Firearm availability and firearm homicide have increased together since the late 1950's. If a gun is present in the home, it is much more likely to be used against a relative or friend than an intruder or stranger. Also, when a firearm is used in a crime or assault instead of another weapon or no weapon, the outcome is much more likely to be fatal. While a few studies report no association between firearm availability and violence, more studies show a positive relationship. Given the lethality of firearms, the increase in the likelihood of conflict escalating into homicide when guns are present, and the strong association between availability of guns and homicide rates, firearm availability is included as a risk factor.

Community Laws and Norms Favorable Toward Drug Use, Firearms, and Crime

(Substance Abuse, Delinquency, and Violence)

Community norms -- the attitudes and policies a community holds about drug use and crime -- are communicated in a variety of ways: through laws and written policies, through informal social practices, and through the expectations parents and other community members have of young people. When laws and community standards are favorable toward drug use or crime, or even if they are just unclear, children are at higher risk.

Media Portrayals of Violence

(Violence)

The role of portrayals of violence on the behavior of viewers, especially young viewers, has been debated for more than three decades. Research over that time period has shown a clear correlation between media portrayal of violence and the development of aggressive and violent behavior. Exposure to violence in the media appears to have an impact on children in several ways: children learn from watching actors model violent behavior, as well as learning violent problem-solving strategies; media portrayals of violence appear to alter children's attitudes and sensitivity to violence.

Transitions and Mobility

(Substance Abuse, Delinquency, and School Dropout)

Even normal school transitions predict increases in problem behaviors. When children move from elementary school to middle school or from middle school to high school, significant increases in the rates of drug use, school misbehavior, and delinquency result.

Communities with high rates of mobility appear to be linked to an increased risk of drug use and crime problems. The more often people in a community move, the greater the risk of both criminal behavior and drug-related problems in families. While some people find buffers against the negative effects of mobility by making connections in new communities, others are less likely to have the resources to deal with the effects of frequent moves, and are more likely to have problems.

Low Neighborhood Attachment and Community Disorganization

(Substance Abuse, Delinquency, and Violence)

Higher rates of drug problems, juvenile delinquency and violence occur in communities or neighborhoods where people have little attachment to the community, where the rates of vandalism are high, and where there is low surveillance of public places. These conditions are not limited to low-income neighborhoods -- they can also be found in wealthier neighborhoods. The less homogeneous a community (in terms of race, class, religion, and even the mix of industrial to residential neighborhoods) the less connected its residents may feel to the overall community, and the more difficult it is to establish clear community goals and identity. The challenge of creating neighborhood attachment and organization is greater in these neighborhoods.

Perhaps the most significant issue affecting community attachment is whether residents feel they can make a difference in their own lives. If the key players in the neighborhood -- merchants, teachers, police, human services personnel -- live outside the neighborhood, residents' sense of commitment will be less. Lower rates of voter participation and parental involvement in schools also indicate lower attachment to the community.

Extreme Economic Deprivation

(Substance Abuse, Delinquency, Violence, Teen Pregnancy, and School Dropout)

Children who live in deteriorating and crime-ridden neighborhoods characterized by extreme poverty are more likely to develop problems with delinquency, violence, teen pregnancy, and school dropout. Children who live in these areas, and have behavior and adjustment problems early in life, are also more likely to have problems with drugs later on.

Family Risk Factors

Family History of the Problem Behavior

(Substance Abuse, Delinquency, Teen Pregnancy, and School Dropout)

If children are raised in a family with a history of addiction to alcohol or other drugs, the risk of their having alcohol and other drug problems themselves increases. If children are born or raised in a family with a history of criminal activity, their risk of juvenile delinquency increases. Similarly, children who are raised by a teenage mother are more likely to be teen parents, and children of dropouts are more likely to be dropouts.

Family Management Problems

(Substance Abuse, Delinquency, Violence, Teen Pregnancy, and School Dropout)

Poor family management practices include lack of clear expectations for behavior, failure of parents to monitor their children (knowing where they are and who they are with), and excessively severe or inconsistent punishment.

Family Conflict

(Substance Abuse, Delinquency, Violence, Teen Pregnancy, and School Dropout)

Persistent, serious conflict between primary care givers or between care givers and children appears to enhance risk for children raised in these families. Conflict between family members appears to be more important than family structure. Whether the family is headed by two biological parents, a single parent, or some other primary care giver, children raised in families high in conflict appear to be at risk for all of the problem behaviors.

Favorable Parental Attitudes and Involvement in the Behavior

(Substance Abuse, Delinquency, and Violence)

Parental attitudes and behavior toward drugs, crime, and violence influence the attitudes and behavior of their children. Parental approval of young people's moderate drinking, even under parental supervision, increases the risk of the young person using marijuana. Similarly, children of parents who excuse their children for breaking the law are more likely to develop problems with juvenile delinquency. In families where parents display violent behavior toward those outside or inside the family, there is an increase in the risk that a child will become violent. Further, in families where parents involve children in their own drug or alcohol behavior -- for example, asking the child to light the parent's cigarette or to get the parent a beer -- there is an increased likelihood that their children will become drug abusers in adolescence.

School Risk Factors

Early and Persistent Antisocial Behavior

(Substance Abuse, Delinquency, Violence, Teen Pregnancy, and School Dropout)

Boys who are aggressive in grades K-3 are at higher risk for substance abuse and delinquency. When a boy's aggressive behavior in the early grades is combined with isolation or withdrawal, there is an even greater risk of problems in adolescence. This increased risk also applies to aggressive behavior combined with hyperactivity or attention deficit disorder.

This risk factor also includes persistent antisocial behavior in early adolescence, like misbehaving in school, skipping school, and getting into fights with other children. Young people, both girls and boys, who engage in these behaviors during early adolescence are at increased risk for drug abuse, delinquency, violence, school dropout, and teen pregnancy.

Academic Failure in Elementary School

(Substance Abuse, Delinquency, Violence, Teen Pregnancy, and School Dropout)

Beginning in the late elementary grades, academic failure increases the risk of drug abuse, delinquency, violence, teen pregnancy, and school dropout. Children fail for many reasons. It appears that the experience of failure -- not necessarily the ability -- increases the risk of problem behaviors.

Lack of Commitment to School

(Substance Abuse, Delinquency, Teen Pregnancy, and School Dropout)

Lack of commitment to school means the young person has ceased to see the role of student as a viable one. Young people who have lost this commitment to school are at higher risk for all four problem behaviors.

Individual and Peer Risk Factors

Alienation, Rebelliousness, and Lack of Bonding to Society

(Substance Abuse, Delinquency, Violence, and School Dropout)

Young people who feel they are not part of society, are not bound by rules, don't believe in trying to be successful or responsible, or who take an active rebellious stance toward society are at higher risk of drug abuse, delinquency, violence, and school dropout.

Friends Who Engage in the Problem Behavior

(Substance Abuse, Delinquency, Violence, Teen Pregnancy, and School Dropout)

Youth who associate with peers who engage in problem behaviors are much more likely to engage in the same problem behaviors. This is one of the most consistent predictors the research has identified. Even when young people come from well-managed families and do not experience other risk factors, just hanging out with those who engage in problem behaviors greatly increases their risks. However, young people who experience a low number of risk factors are less likely to associate with those who are involved in problem behaviors.

Favorable Attitudes Toward the Problem Behavior

(Substance Abuse, Delinquency, Teen Pregnancy, and School Dropout)

During the elementary school years, children usually express anti-drug, anti-crime, pro-social attitudes. They have difficulty imagining why people use drugs, commit crimes, and drop out of school. In middle school, as others they know participate in such activities, their attitudes often shift toward greater acceptance of these behaviors. This places them at higher risk.

Early Initiation of the Problem Behavior

(Substance Abuse, Delinquency, Violence, Teen Pregnancy, and School Dropout)

The earlier young people begin using drugs, committing crimes, engaging in violent activity, becoming sexually active, and dropping out of school, the greater the likelihood that they will have problems with these behaviors later on. For example, research shows that young people who initiate drug use before age fifteen are at twice the risk of having drug problems as those who wait until after age nineteen.

Constitutional Factors

(Substance Abuse, Delinquency, and Violence)

Constitutional factors are factors that may have a biological or physiological basis. These factors are often seen in young people with behaviors such as sensation-seeking, low harm-avoidance, and lack of impulse control. These factors appear to increase the risk of young people abusing drugs, engaging in delinquent behavior, and/or committing violent acts.

Protective Factors

Some young people who are exposed to multiple risk factors do not become substance abusers, juvenile delinquents, teen parents, or school dropouts. Balancing the risk factors are protective factors, those aspects of people's lives that counter risk factors or provide buffers against them. They protect by either reducing the impact of the risks or by changing the way a person responds to the risks. A key strategy to counter risk factors is to enhance protective factors that promote positive behavior, health, well-being, and personal success. Research indicates that protective factors fall into three basic categories: Individual Characteristics, Bonding, and Healthy Beliefs and Clear Standards:

Individual Characteristics

Research has identified four individual characteristics as protective factors. These attributes are considered to be inherent in the youngster and are difficult, if not impossible, to change. They consist of:

Gender. Given equal exposure to risks, girls are less likely to develop health and behavior problems in adolescence than are boys.

A Resilient Temperament. Young people who have the ability to adjust to or recover from misfortune or changes are at reduced risk.

A Positive Social Orientation. Young people who are good natured, enjoy social interactions, and elicit positive attention from others are at reduced risk.

Intelligence. Bright children are less likely to become delinquent or drop out of school. However, intelligence does not protect against substance abuse.

Bonding

Research indicates that one of the most effective ways to reduce children's risk is to strengthen their bond with positive, pro-social family members, teachers, or other significant adults, and/or pro-social friends. Children who are attached to positive families, friends, schools, and community, and who are committed to achieving the goals value by these groups, are less likely to develop problems in adolescence. Children who are bonded to others with healthy beliefs are less likely to do things that threaten that bond, such as use drugs, commit crimes, or drop out of school. For example, if children are attached to their parents and want to please them, they will be less likely to risk breaking this connection by doing things of which their parents strongly disapprove. Studies of successful children who live in high risk neighborhoods or situations indicate that strong bonds with a care giver can keep children from getting into trouble. Positive bonding makes up for many other disadvantages caused by other risk factors or environmental characteristics.

Healthy Beliefs and Clear Standards

Bonding is only part of the protective equation. Research indicates that another group of protective factors falls into the category of healthy beliefs and clear standards. The people with whom children are bonded need to have clear, positive standards for behavior. The content of these standards is what protects young people. For example, being opposed to youth alcohol and drug use is a standard that has been shown to protect young people from the damaging effects of substance abuse risk factors. Children whose parents have high expectations for their school success and achievement are less likely to drop out of school. Clear standards against criminal activity and early, unprotected sexual activity have a similar protective effect.

The negative effects of risk factors can be reduced when schools, families, and/or peer groups teach their children healthy beliefs and set clear standards for their behavior. Examples of healthy beliefs include believing it is best for children to be drug and crime free and to do well in school. Examples of clear standards include establishing clear no drug and alcohol family rules, establishing the expectation that a youngster does well in school, and having consistent family rules against problem behaviors.

Risk and Protective Factor Scales

Many of the questions on the survey have been combined into risk and protective factor scales. This allows the information contained in items that measure the same type of information to be summarized as a scale score. All of the scales are scored so that the higher the score the greater the risk for risk factors and the greater the protection for protective factors. Most of the risk and protective factors are scored on a four-point scale from 1 to 4 with 1 being low and 4 being high. Thus, for the first scale shown in Table 17, Availability of Drugs, the 2.1 for the general population would indicate that they would find AODs "sort of hard to get", while the 2.9 score for probationers indicates that for them AODs are "sort of easy to get" (see questions 79 through 83 on the questionnaire in the Appendix). There are some scales that do not have a 4-point scale. A 5-point scale was used for Transitions and Mobility, Laws and Norms Favorable Toward Drug Use, and Academic Failure; and a 2-point scales was used for Family History of Antisocial Behavior. Each scale score is simply the mean of how the items in the scale were marked by the respondent. A review of the items in the risk factor scales with a 5 or a 2-point scale will reveal why a different base was used. For example, the Family History of Antisocial Behavior scale questions are answered "Yes" = 2 or "No" = 1 and thus the mean of the items range between 1, no history or antisocial behavior, and 2, all questions answer "Yes".

A Comparison of Probationers and Youth from the General Population

A review of the risk and protective scale scores in Table 17 shows that For Every Scale those on probation are significantly (p<.0001) higher in risk and lower in protection than youth in the general population. Areas where there appears to be a fairly large difference (.7 or greater) between probationers and the youth from the general population are discussed below.

In the Community, probationers report drugs and alcohol to be more available, they perceive that the laws and norms of the community are more favorable to drug use, there is considerable transition and mobility in their communities, and they are not attached to their communities.

In the Family, probationers report that their parents are not monitoring them as closely as parents from the general population. They are also not as attached to their parents or see as many opportunities for positive involvement with their families.

At School, probationers are more prone to academic failure, and have little commitment to school.

With their Peers and for the individuals themselves, probationers are more likely to engage in anti-social behavior, have early initiation of anti-social behavior, and interact with anti-social peers. They have favorable attitudes toward drug use, have friends who use drugs, engage in sensation seeking, are less religious, and lack social skills.

Table 17 - Comparison Between Youth From the General Public and Those on Probation on the Risk and Protective Factor Scales

The question numbers which comprise each scale follow the scale label in parentheses.	Scale Scores
	Youth on Probation			Youth in Community
SCALES WITHIN 4 DOMAINS	Male	Female	Total	Male	Female	Total
Community Risk Factors
Perceived availability of alcohol, drugs, and firearms (79-83)	2.8*	3.0*	2.9	2.1	2.0	2.1
Low Neighborhood Attachment(216, 218, 220)	2.3*	2.5*	2.4	1.6	1.6	1.6
Disorganization (223, 225-228)	1.8	1.8	1.8	1.4	1.3	1.4
Transition and mobility (224, 230, 236, 243)	2.8	2.9	2.8	2.1	2.1	2.1
Laws and norms favorable drug use (66-68, 84-88, 90)	3.0*	3.1*	3.0	2.0	2.0	2.0
Community Protective Factors
Opportunities for conventional involvement (231-235)	2.7	2.6	2.7	3.3	3.3	3.3
Rewards for conventional involvement (217, 221, 222)	2.2	2.1	2.2	2.7	2.9	2.8
Family Risk Factors
Management problems (179-182, 184, 186)	1.9	1.9	1.9	1.4	1.5	1.5
Discipline problems (185, 187, 188)	2.4	2.2	2.4	1.7	1.6	1.6
Conflict (197, 201-203)	2.3*	2.5*	2.4	2.1	2.1	2.1
Family history of antisocial behavior (173-176, 178, 237)	1.5*	1.6*	1.5	1.2	1.3	1.3
Parental attitudes favorable toward drug use (167-172)	1.4	1.4	1.4	1.1	1.1	1.1
	Youth on Probation			Youth in Community
	Male	Female	Total	Male	Female	Total
Family Protective Factors
Family attachment (189, 190, 193, 194)	2.7*	2.6*	2.7	3.2	3.2	3.2
Opportunities for positive involvement (191, 198, 200)	2.7*	2.6*	2.7	3.2	3.3	3.2
Rewards for conventional involvement (195, 196, 241, 242)	2.8	2.7	2.8	3.3	3.3	3.3
School Risk Factors
Academic failure (39, 65)	2.8*	2.9*	2.8	1.9	1.8	1.9
Little commitment to school (55, 59, 60,64)	2.1	2.1	2.1	1.4	1.3	1.4
School Protective Factors
Opportunities for positive involvement (51, 52, 54, 57)	2.6	2.5	2.6	3.0	3.1	3.0
Rewards for conventional involvement (53, 62)	2.5	2.5	2.5	2.9	3.0	2.9
Peer/Individual Risk Factors
Rebelliousness (73, 74, 75)	2.1	2.2	2.1	1.7	1.5	1.6
Early initiation of anti-social behavior (128-136)	3.8	3.6	3.8	.9	.6	.8
Antisocial behavior (150, 151, 153-158)	1.9*	1.7*	1.9	1.1	1.1	1.1
Attitudes favorable to antisocial behavior (70, 137, 139, 140)	1.9	1.8	1.9	1.4	1.4	1.4
Favorable attitudes toward drug use (159-162)	2.2*	2.4*	2.2	1.3	1.3	1.3
Interaction with antisocial peers (143-149)	2.3	2.3	2.3	1.2	1.2	1.2
Friends use of drugs (119-122)	3.0*	3.5*	3.1	1.6	1.7	1.7
	Youth on Probation			Youth in Community
	Male	Female	Total	Male	Female	Total
Sensation seeking (116-118)	3.4	3.3	3.4	2.7	2.3	2.5
Reward for antisocial involvement (123-126)	1.7	1.7**	1.7	1.5	1.6**	1.5
Impulsivity (205-207)	2.5	2.5	2.5	2.1	2.0	2.1
Peer/Individual Protective
Pro-social orientation (213-215)	3.0	3.1	3.0	3.3	3.5	3.4
Religiosity (114)	2.2	2.1	2.2	3.2	3.3	3.2
Belief in moral order (69-72)	2.9	3.0	2.9	3.3	3.6	3.4
Resiliency (208, 210)	2.7*	2.6*	2.7	2.8	2.8	2.8
Social skills (163-166)	2.5	2.6	2.5	3.1	3.4	3.2

Note: * Indicates significant (p<.05) male-female differences

Male and Female Differences

Table 17 also shows the male and female scores on each of the scales. Both male and female probationers were significantly higher in risk and lower in protection that their peers in the general population. The only non-significant (p>.05) difference is shown by ** and occurred for females on the Reward for anti-social behavior scale.

The scores of males on probation were compared to those of females on probation. The results of these comparisons were quite surprising, with females probationers being more at risk and having less protection than males on probation. Scales where males and females were significantly different (p<.05) are shown with an *. A review of the areas where females differed from males shows females to have less attachment to their neighborhoods, view the laws and norms of the community to be more favorable to drug use, and perceive alcohol and drugs to be more available. They have more family conflict, come from families with a history of anti-social behavior, are not as attached to their families, and do not see as many opportunities for positive involvement with their families. At school they have a greater risk for academic failure. They have more favorable attitudes toward drug use than male probationers, tend to have more friends that use drugs, and they are less resilient than male probationers. The one area that females are less at risk than males is they are less likely to engage in antisocial behavior.

These differences between male and female probationers are even more serious when the male-female differences of the general population are reviewed. For the general population, females are generally less at risk and have more protection than males, just the opposite of the females on probation.

NEED FOR SUBSTANCE ABUSE TREATMENT

The needs assessment project to determine the need for substance abuse treatment among adolescents in Utah is currently being conducted. While the results from that project are not yet available, the questions to determine whether or not an adolescent needed treatment were incorporated into this Juvenile Probation survey. The questions allowed an analysis of how many youth met the American Psychiatric Association DSM-III-R diagnostic criteria for substance abuse or dependence for seven substances. The substances included: alcohol, marijuana, cocaine, hallucinogens, heroin and other opiates, stimulants and inhalants.

Diagnostic Criteria for Substance Abuse and Dependence

For an individual to receive a diagnosis of Psychoactive Substance Dependence according to the DSM-III-R, an individual must meet at least three of nine criteria for substance dependence and the symptoms must have persisted for at least one month or occurred repeatedly over a longer period of time. The nine criteria for Psychoactive Substance Dependence include: 1) substance often taken in larger amounts or over a longer period than the person intended, 2) persistent desire to cut down or control substance use, 3) a great deal of time spent in activities necessary to get the substance, taking the substance, or recovering from its effects, 4) frequent intoxication or withdrawal symptoms when expected to fulfill major role obligations at work, school, or home, or when substance use is physically hazardous, 5) important social occupational or recreational activities given up or reduced because of substance use, 6) continued substance use despite knowledge of having a persistent or recurrent social, psychological, or physical problem that is caused or exacerbated by the use of the substance, 7) marked tolerance, or markedly diminished effect with continued use of the same amount, 8) characteristic withdrawal symptoms, and 9) the substance is often taken to relieve or avoid withdrawal symptoms.

Individuals also need treatment if they meet the criteria for Psychoactive Substance Abuse. The diagnostic criteria for Psychoactive Substance Abuse include: 1) a maladaptive pattern of psychoactive substance use indicated by at least one of the following: a) continued use despite knowledge of having a persistent or recurrent social, occupational, psychological, or physical problem that is caused or exacerbated by use of the psychoactive substance, or b) recurrent use in situation in which use is physically hazardous (e.g., driving while intoxicated), 2) some symptoms of the disturbance have persisted for at least one month, or have occurred repeatedly over a longer period of time, and 3) never met the criteria for Psychoactive Substance Dependence for this substance.

Table 18 - Need for Substance Abuse Treatment by Youth on Probation

	Percent Needing Treatment
	For Dependence			For Abuse			Dependence/Abuse
Substance	Male	Fem	Total	Male	Fem	Total	Male	Fem	Total
Alcohol	18.4	16.7	18.1	1.9	.7	1.8	20.3	17.4	19.9
Marijuana	23.7	21.5	23.2	2.1	.7	1.9	25.8	22.2	25.1
Cocaine	7.0	8.3	7.3	1.4	.7	1.3	8.4	9.0	8.6
Hallucinogens	7.5	4.2	7.1	1.3	1.4	1.3	8.8	5.6	8.1
Heroin/other opiates	3.9	2.1	3.7	1.6	.7	1.4	5.5	2.8	5.1
Stimulants	8.3	10.5	8.7	1.3	.7	1.2	9.6	11.2	9.9
Inhalants	4.3	2.8	4.2	1.4	.7	1.3	5.7	3.5	5.5
All Drugs (not alcohol)	27.0	27.1	26.9	4.0	2.8	3.8	29.1	27.8	28.9
Total (alcohol or drugs)	30.2	33.3	30.5	4.4	2.8	4.2	32.1	34.0	32.3

The questions, numbers 279 through 362, were used to determine if the probationer met the criteria for substance abuse or dependence. Table 18 contains the need for substance abuse treatment by gender for the seven types of substances. While no direct comparison of Utah youth is available at this time, a recent estimate of the need for treatment among youth by the DSA placed the need for treatment at 7.2%. That estimate

was based upon the 1994 school survey results and included youth who used alcohol or another drug one or more times in the past 30 days and admitted to a problem associated with the use of the substance. A 1996 statewide telephone assessment of the need for treatment for substance abuse in adults using the same questions as were used in the Juvenile Probation Survey showed that 6.2% of the population 18 years of age and over needed treatment in the last year. The need for treatment among males was 8.8% and females was 3.7%. These results are presented to allow a comparison of the need for treatment found among the probationers.

As can be seen in Table 18, the percent of probationers who need substance abuse treatment far exceeds the percent of individuals in the general population that need substance abuse treatment. The need for treatment is divided into the seven categories of substances, gender, and whether treatment is needed for abuse or dependence. Some type of substance abuse treatment is needed by 32.3% of those on probation.

Male and Female Differences in Need for Treatment

Since the diagnosis of dependence and abuse are mutually exclusive events, an individual cannot have a diagnosis of both substance abuse and dependence, the total percentage needing treatment for each substance category is simply the sum of those with a diagnosis of dependence and those with a diagnosis of abuse. However, because the All Drugs and Total categories only count each person once no matter how many drugs they need treatment for, the categories cannot be simply added. Analysis shows that for males, the total need for treatment for drugs is 29.1%, for alcohol 20.3% and their total need for treatment is 32.1%. For females the total treatment need for drugs is 27.8%, for alcohol 17.4%, and total percent needing treatment is 34.0%.

Males and females do not differ significantly (p>.05) on any of the need for treatment measures. This is surprising since males typically use much more of the treatment resources than females. In 1996, only 26% of the admissions to treatment in Utah were females. That this survey showed that females have a higher need for treatment than males (34.0% compared to 32.1%) indicates that providing substance abuse treatment for females on probation should be a high priority.

Focus Groups

Facilitated by Russ Van Vleet and Mark Winiger

It is difficult to capture the thoughts and feeling of youth through questionnaires. Thus, some of the issues that might have been most important in placing these youth into probation status with the Juvenile Court were investigated through focus groups. Focus groups were scheduled in Salt Lake City, Ogden and Provo as a follow-up to the survey in an attempt to determine probationer's attitudes toward the probation experience, and the areas that were problematic for them and resulted in their placement on probation. A total of 19 youth were interviewed (7 Caucasian male, 2 female Caucasian, 4 male Hispanic, 5 female Hispanic, 1 female Polynesian) the largest group being 10, in Salt Lake, a group of 5 in Provo, and a group of 4 in Ogden It should be noted that the probationers scheduled to appear in Provo, with the exception of one youth, did not make the scheduled meeting. Therefore, the probation officer coordinating the effort went to the Detention Center, located next door, and brought four youth to the group. All were probationers but they had not completed the survey questionnaire.

An attempt was made to meet with youth who had completed their probation in order to assess if attitude differences existed between active probationers and those who had completed their probation. Only one youth in both Provo and Salt Lake appeared for the interview out of 10 scheduled. The interview in Ogden was then canceled since comparative groups were no longer possible.

Information from the interviews was organized into the following categories: Probation contact, School, ATODs, Guns, Gangs, Religiosity, Probation support, Neighborhoods, and Other discussion issues.

Probation Contact

The youth were very consistent in stating that they saw their probation officers on a regular basis. Weekly contact was the norm. Those contacts were almost exclusively within the probation office. There seemed to be little contact with probationers, by court personnel, outside of the formal office interview.

School

The majority were attending regular school with some in alternative schools. Alternative school attendance was mostly due to school failure brought on by non-attendance. Youth seemed to verify the long held notion of school difficulty leading to other problems. These youth saw passing grades, C's, as commendable and could not determine whether the academic or social problems led to their difficulty in school. Those in alternative schools expressed the most anger toward teachers and other youth who, they felt, had ostracized them.

Alcohol Tobacco and Other Drugs

Alcohol usage appears to be almost universal. There was not one youth in the focus groups who claimed to be a non-drinker. The majority admitted to some drug usage although they were not willing to be specific. Most said they had tried marijuana. The majority of their family members drink although the source of alcohol was friends. They claimed that getting drugs was as easy as purchasing food. Dealers are flourishing, known to everyone, and they are even willing to front the drugs on promise of payment. Twenty dollars ($20) seemed to be plenty of money to buy the drugs and alcohol that was needed. Regarding alcohol, simply asking someone going into a liquor store was sufficiently resourceful to supply the necessary alcohol. Using alcohol and to a lesser extent drug experimentation seemed as natural as breathing to these youth. It seemed difficult for them to understand that some people did not use. Only one youth admitted alcohol usage to the extent of passing out on a weekly basis due to his alcohol consumption, but all claimed weekly alcohol consumption. With respect to smoking cigarettes, every person interviewed smoked. These youth connect health hazard with smoking, however, they do not connect health hazards with alcohol or drug usage. Most of these youth claimed to want to quit smoking. They talked about it as a dirty habit, not good for them, but something you just did growing up.

Guns

Only two youth claimed to have carried a weapon. In each instance it was for protection. All claimed to have access to guns. Going price is $20 for a small, .22 caliber handgun. Once again, guns are available from "friends". When pressed who these friends are most indicated that guns were always from your "homeboys". You did not need to be a gang member to use the local gangs to supply you with guns. It was almost as if they saw the gang as providing a needed service to them. The other 17 interviewed had not used a weapon, attempted to buy one, or thought there had been a time when they needed one.

Gangs

Only one youth claimed to be an active gang member, a Hispanic male. One Polynesian female claimed gang affiliation but not currently active with "her homeboys". All know people in gangs but the majority opinion seemed to be that gangs were not really impacting their lives. Some even called gang membership pathetic. They talked as if gangs were only for those youth who could not fit anywhere else. Gang membership was held up as a sign of weakness rather than strength. None claimed pressure to join gangs. Only one felt threatened by gangs. They claimed they would not engage in illegal behavior either for gang membership or to gain favor with gang members.

Religiosity

Questions about religion and spiritual beliefs, interestingly enough, elicited the most emotion. Most seemed angry that this topic was being investigated. They appeared to think that it was inappropriate to try to make a connection between religiosity and delinquency. Two females claimed interest in attending church but did not attend due to transportation difficulties. The others were not interested in church, did not attend, and were most animated talking about their feelings about church and God. The implication was that religion was personal and we should not be asking them about it.

Neighborhoods

The majority described living in working class neighborhoods. No one lived in upscale communities. Two youth lived in a trailer court, one in a home in an industrial area, several in very large apartment complexes. One of the Hispanic youth who claimed gang activity was the only one who said that gangs were an issue in his neighborhood. Interestingly enough, he was the one who seemed to have the most connection to his "hood", claiming to love his community, his neighbors and intended to remain in that neighborhood during his adult years.

Other Discussion Issues

Following a review of the areas listed above, time was spent in a less formal, round-table discussion regarding attitudes toward probation, the juvenile court, youth corrections and the possible deterrent value of tougher laws. The major question the facilitators hoped to answer was whether probation helped youth to become less troubled and less delinquent. The answer is yes, probation did help these youth. One youth put it most succinctly, "Probation is like cough medicine, you don't want to take it but it usually makes you feel better."

The one area where probation seemed to be most helpful was in a reduction in drug and alcohol usage during the term of the probation. Most youth claimed to be reducing or eliminating their drug and alcohol usage while on probation due to the random drug testing performed by probation staff. (They talked of hating the randomness but admitted that it was effective). They did not want their probation time extended which surely would occur, in their minds, if they failed drug tests.

Most probationers felt their parents were supportive of probation, at least to the extent of getting them to probation appointments. The hassle and cost of transportation also placed pressure on these youth to complete their probation. This is sort of an unintended consequence of probation meetings being in the probation office.

The attempt to determine if attitudes were different between active probationers and those who completed probation failed due to a lack of attendance. In a sampling of the two individuals who completed probation, one female probationer in Salt Lake and one male in Provo, it was clear that while they were reluctant to praise probation they were much more positive about their experience and the benefits of probation than were the active probationers.

With respect to deterrence, there was unequivocal rejection of tougher laws or the use of incarceration as a deterrent to future offending. Most described their incarceration time as humiliating and anger provoking. Even though attempts had been made to publicize the passage of youthful offender legislation and the possible dire consequences for serious youth offending, not one probationer knew of the law or expressed interest in being informed about it.

There was an interesting geographical disparity. There was an almost time warp quality to the difference between youth in Provo and those in Salt Lake City and Ogden. Meetings with youth in Salt Lake and Ogden elicited the expected concerns about gangs, schools, guns etc. Youth in Provo were most adamant about the social classes. The "Preppies" v. Everyone else. There seems to be a much more defined line between youth from privileged neighborhoods and those from less fortunate economic circumstances in Provo. Some of the Provo youth claimed that gangs hadn't made it around the Point of the Mountain yet.

Lastly, these youth offered some optimism. They thought that the court should be more positive, "trying to help them instead of just trying to catch them." These kids were not anti-court they just didn't connect it to anything other than negative consequences. They also talked about guns and gangs, not with admiration or respect, but almost with disdain. They suggest that the glory days of gang-banging might be winding down.

Summary

As with the 1992 survey, Drug and Alcohol use Among Juvenile Probationers in Utah , the results of the current survey show that juvenile probationers used more alcohol, tobacco, and other drugs than youth in the general population, and were more at risk for mental health problems, delinquency, and antisocial activities. Additionally, the current survey clearly shows that when compared to youth in the general population, probationers have more risk and less protection for substance abuse and other problems in the four important areas of their daily lives: the community, the family, the school, and within individuals themselves and their peer interactions.

In the community, probationers report drugs and alcohol to be more available, they perceive that the laws and norms of the community are more favorable to drug use, and there is considerable transition and mobility in their communities. In their families, they report that they are not as attached to their families or see as many opportunities for positive involvement with their families as youth from the general population. They report that their parents are not monitoring them as closely as parents from the general population. At school, they are more prone to academic failure, and have less commitment to school. With their peers and for the individuals themselves, probationers are more likely to engage in anti-social behavior, have early initiation of anti-social behavior, interact with anti-social peers, have favorable attitudes toward drug use, have friends who use drugs, are less religious, and lack social skills. They are also more likely to need treatment for substance abuse with 32% meeting the DSM-III-R diagnosis of substance abuse or dependence. The estimate for youth in the general population that need substance abuse treatment is 7%.

Positive Trends

The juvenile probationers in 1997 are less likely to use cigarettes, alcohol, hallucinogens and stimulants than they were in 1992. They have been exposed to skill training opportunities more than the probationers in 1992, and they report less of an intention toward the future use of alcohol and marijuana. Also, gang membership among probationers has decreased from 20% belonging to a gang in 1992 to 17% reporting gang membership in 1997. Probationers in the focus groups indicated that gangs were not really impacting their lives.

Negative Trends

For juvenile probationers, school enrollment is down from 1992 levels. Since school attachment and the opportunities for success that can be found in the educational system provide important protective factors for these youth, any decrease in the availability of educational opportunities compromises their bonding, positive behavior, and chances of personal success.

The use of marijuana, inhalants and cocaine are up from 1992 survey levels. The use of these "harder drugs" have serious societal implications. The biological insult to adolescents using these drugs compromises their efforts to achieve personal success; bond with their community, schools, and family; and develop a realistic sense of well being and personal health.

Two alarming trends are: 1) the apparent ease with which drugs and alcohol can be obtained, and 2) the rise in the percentage of youth who do not perceive a risk associated with drug and alcohol use. Easy access and the belief that drugs and alcohol are harmless is a recipe for increased ATOD use rates in the future. Again these indicators are higher than reported in 1992.

Females in particular are in more need of treatment than reported in 1992. The percentage of females that need treatment in 1997 is higher that the percentage of males that need treatment. The female probationers also are more at risk for substance abuse and other problems than males. When compared to males in this survey, they report that alcohol and other drugs are more available to them, they have more favorable attitudes toward drug use, and they view the laws and norms of the community to be more favorable to drug use. They have more family conflict, come from families with a history of anti-social behavior, are not as attached to their families, and do not see as many opportunities for positive involvement with their families. At school they have a greater risk for academic failure, tend to have more friends that use drugs, and they are less resilient than male probationers.

These differences between male and female probationers are even more serious when the male-female differences of the general population are reviewed. For the general population, females are generally less at risk and have more protection than males, just the opposite of the females on probation. Thus, every effort should be made to provide treatment opportunities that are specifically designed for the females on probation.

There has been a reduction in the proportion of probationers definitely intending to use alcohol and marijuana. In 1992, 32% were sure to drink alcohol and 18% were sure to smoke marijuana in the coming year, while in 1997, only 18% were sure to use alcohol and 14% smoke marijuana. The intention to use other drugs remains unchanged from 1992. While this could be seen as a positive indicator, it may not be. Although it would seem that a desire to quit using alcohol and marijuana is a good thing, it is possible that the real issue is that because these youth have serious substance abuse problems, they are more likely to endorse the idea of quitting than someone who does not have as great a need for treatment. With the prevalence of harder drug use increasing, it seems that this group of youth has a serious substance abuse problem.

The arrests rate for juvenile drug violations also points to a greater substance abuse problem for youth currently on probation. Data from the Utah Bureau of Criminal Identification, Department of Public Safety shows that the arrest rate for drug law violations (possession, sale, use, growing, manufacturing of illegal drugs) per 100,000 juveniles (age 10-17) increased from 188.43 in 1991 to 685.20 in 1995. This indicates that a trend of increasing criminal activity for juveniles is occurring.

Conclusion

Since there is a significant drop in the use of cigarettes and alcohol from 1992 to 1997, it would seem wise to determine why this has occurred and to replicate this methodology with marijuana and cocaine. Perhaps the "media blitz" surrounding the tobacco industry and the harmful effects of cigarette smoking has managed to impact youth prevalence rates of tobacco products. The interviews with youth in the focus groups suggest that probationers have learned that tobacco is very harmful, however, they do not perceive alcohol and other drugs as that harmful. The techniques for providing information about the harmfulness of tobacco should be explored for use in combating the perceived benign nature of alcohol and other drugs. Using the types of messages that have been used with tobacco would be a strategy worth investigating for use with marijuana and cocaine which also have serious and profound health consequences.

It would also be appropriate to address why fewer probationers are seeking substance abuse treatment. Is this a function of managed health care, insufficient funding for children at risk, systemic access problems, poor assessment and triage, or something less obvious. This seems to be an important question which needs further investigation.

Finally, the information in this report shows that compared to youth in the general population, probationers in Utah are more at risk for substance abuse and other problems; have higher rates of use of alcohol, tobacco, and other drugs; and have a higher need for substance abuse treatment. The challenge for the juvenile probation system is to provide an array of successful treatment programs that address probationers' problem behaviors. In order to be successful, treatment programs need to be run according to established protocols that have been shown to be effective with youth on probation. A key component of a successful treatment system is a strong evaluation component that will ensure that programs are being implemented as they were designed and are having positive outcomes on the lives of the youth who participate.

Those working with juvenile probationers should investigate and implement programs that are well researched and have been shown to reduce youth problem behaviors. Without successful programs to address the problems of these youth, they will become prime candidates to move into the adult criminal justice system.

The Utah State Courts mission is to provide the people an open, fair, efficient, and independent system for the advancement of justice under the law.