Purpose: To examine the social-ecological determinants of substance use treatment entry among serious juvenile offenders over a 7 year period. Using the social-ecological framework, relevant predictors of substance use from the literature were used to assess risk (and protective) factors at the individual, parental, peer and neighborhood level.
Method: Serious juvenile offenders (N=1354, Mage baseline=16.0 years, SD=1.14) were prospectively followed over 7 years (Mage Conclusion=23.0 years, SD=1.15). Cox regression with time invariant and time varying predictors was used to predict time to first substance use treatment entry.
Results: Results for each dimension, separately, varied slightly from the full model. In the full model peer delinquency, peer arrests, post-traumatic stress disorder (PTSD), impulse control, temperament, and emotional regulation remained salient risk (and protective) factors for treatment entry.
Conclusion: Associating with more deviant peers and having more of your peers arrested over the 7 year study period was associated with substantial increase in time to treatment entry. Furthermore, one of the strongest risk factors for treatment entry was a PTSD diagnosis. Treatment implications are discussed regarding peer affiliation and PTSD symptomology as well as potential neurological and biological contributors to increased risk for treatment entry.
Keywords: Adolescence; Emerging adulthood; Juvenile offenders; Substance use; Substance use treatment.
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