Factors Contributing to Underage Drinking

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The studies used for this systematic review primarily captivated the negative aspects of alcohol use and sought to either diminish or inhibit adolescent alcohol use. The methods for this research involved a combination of longitudinal studies, quantitative studies, qualitative studies, systematic reviews, and cross-sectional studies. Profound data from articles gathered through NUSS, ECBO host, and various other databases were utilized. Among numerous articles, 25 were chosen and consistently exhibited underage drinking is a true public health concern. The population of interest for this literature review was school-age adolescents, primarily within the United States.

The literature review encompassed articles and databases that pertained to peer pressure and alcohol use among adolescents. Topics of interest discussed included adolescent, adolescent onset, alcoholism, underage drinking, peer influence, parental influence and social influence. The main purpose of this study was to determine whether there is any correlation between peer influence and alcoholism among adolescents. As such, the peer-reviewed journal articles for this systematic review reflect that peer effects are important determinants of drinking behavior even after controlling for potential biases. Each adolescent alcohol related influence discussed further substantiates the need for additional research.

The studies also implicate that adolescents interpret alcohol use as an appealing, reputation building activity, and that relationships encourages adolescents to seek chances to underage drink. The literature provided supports the necessity to understand how peer pressure correlates to drinking behaviors among adolescents and the need for adolescent alcohol treatment. This systematic review defined adolescence as a transitional period leading to adulthood, in which physical, cognitive, emotional, social, morals and values are developed. There was also the consideration of society and culture as influencing elements.

The rudiments of alcoholism and the introduction of underage drinking in early life were consistent among the articles reviewed. As previously uncovered, alcohol dependence increased when onset was combined with genetics, personality, rate of maturation and development, risk level, social factors and environmental factors (Institute of Medicine and National Research Council, 2011; NIAAA, 2017). Researchers, Donovan and Molina (2008), suggested that sipping and tasting alcohol builds curiosity leading to initiation. Further analysis recognized the reciprocation of parental and peer behavior. In addition to parenting, peer delinquency was associated as increased risks, as well as, the four-factor model of vulnerability (Trucco et al., 2014; Nair et al., 2016).

This proposes that alcoholism and alcohol use onset carry a multitude of factors that adolescents should comprehend in order to deviate from unhealthy behaviors. Peer influences were highly recognized as having a substantiating role. Research suggests that peer influence is the leading cause of social drinking with alcoholism following, which feeds into the generalization that adolescents often make behavior choices based on what they perceive as the social norm (Pandina, 2010). Typically, adolescents who have observed their peers’ drinking will have a higher chance to partake in drinking than adolescents who have not been exposed. This type of peer socialization correlates as a pathway of manipulation towards alcohol use onset.

Subsequently, affiliating with deviant peers and poor selection of friends motivates adolescent decision-making (Trucco, Colder, & Wieczorek, 2011; Osgood et al., 2013). Researchers proposed measures to delay or inhibit underage drinking, such as education on how to respond to peer pressure with proper social skills and refusal strategies. This suggests that peer influences can also be redirected by increased self-esteem and self-efficacy. Additionally, research on social learning theory did not help parents moderate peer-influenced behavior based on perceived peer approval (Trucco, Colder, & Wieczorek, 2011). Parents are typically the number one role model in their child’s life; thus, this portion of the literature review was necessary and divulging.

The literature showed that parental influence has a great impact on adolescent alcohol use and their future alcohol intake. Often, adolescents in this transitional period want to be treated as adults and this is a critical time to discuss alcohol usage. It is important for parents to set a positive example, be truthful with them about expectations, and establish healthy behaviors. This literature review revealed that parents do not always have a positive impact dependent upon their own childhood, their philosophy about alcohol, and their consumption of alcohol. One study identified that parents often provide alcohol as a way to regulate usage.

Another study delved into lack of parent involvement as an element to alcoholism. A comparison review of parenting strategies within the United States and the United Kingdom suggested that parenting variables could diminish early alcohol use. Parental modelling, limited alcohol availability, parent monitoring, positive relationship, involvement and open communication were among the strategies associated achieving positive outcomes (Ryan et al., 2010). Alcohol specific socialization practices such as having clear rules and consequences for drinking alcohol, and the quality of the parent-child relationship may be more germane to adolescent alcohol use than general parenting practices (Kerr et al., 2010; Strandberg & Bodin, 2011). This implicates that parenting factors can minimize and prevent initiation.

Social influences on alcohol use by means of social media and social networks served as a forceful stimulus in this systematic review. Social media has the ability to reach a large target audience and by doing so underage drinking is often seen a social norm. Adolescents can be vulnerable to both the perception and misperception that underage drinking is normal behavior therefore, limiting alcohol advertisement to adolescents is ideal. A multivariate structural model suggested that explaining drinking behaviors, peer selection, and peer influence could purge potential biases (Ali & Dwyer, 2010). Additionally, Alcohol permissive messages, negative alcohol messages, and parental messages disclosed better alcohol use outcomes (Reimuller et al., 2011).

The consistency of findings across numerous observational studies, the temporality of exposure and drinking behaviors observed conclude that advertising increases perceptibility of adolescent alcohol use (Anderson et al., 2009). This systematic review implicates that advertising using social media and social network increases the chances of underage drinking. Overall, this systematic analysis allowed for increased understanding of early adolescent behaviors as they relate to alcohol use patterns, how personality changes may escalate alcohol use, and a reciprocating correlation between adolescent behavior and alcohol consumption.

This systematic review had several limitations. A limitation of this systematic review is that is limited to the subject matter: adolescents, alcoholism, and influences. Since the studies of this systematic review were primarily conducted in the United States, a limitation could be selection bias. Additionally, the participants used in most of the studies reviewed were put in a generalized group using adolescents, alcohol initiation, and influences with limited parameters. Another limitation of the review is that the population was restricted to adolescents and not the entire population, which could have swayed the results a certain way.

It may have also been beneficial, to identify the differences in alcohol drinking behavior based on gender. The strengths of this systematic reviewed are the use of peer-reviewed journal articles and the use of trustworthy government sources that focused on the adolescent age group. This study provided an important insight into the impact of peer, parental, and social influences on underage drinking. It also presented explanations for drinking outcomes, as a result, of the different forms of adolescent influence. The systematic review further allowed for examination and enhanced knowledge of influences associated with adolescent alcoholism and onset.

Conclusion

The research questions posed from this literature review were; is alcoholism among adolescents connected to peer pressure and is there a significant association between alcohol use and alcoholism based on initiation. Different types of peer pressure were linked as motivators between adolescent alcohol onset and alcoholism in this systematic review. The findings of this study also demonstrated the relation of an array of modifiable psychosocial risk factors assessed in middle childhood to early-onset drinking. Adolescents with friends who assert overt peer pressure are more likely to drink more often. The influence of peer pressure was mediated by subjects’ self-efficacy to resist pressures toward alcohol use.

Hence, one main takeaway is that adolescents are often motivated to think and partake in behaviors due to the influence of their peers. Social reinforcement by peers is notable for its influence among adolescents, but it is not the only factor associated with underage drinking. A second takeaway is that an adolescent’s social environment greatly amplifies alcohol onset when considering peer influences, parental influences, social influences, and perceived social norms. The literature review has consistent evidence to link social influence with the interest of alcohol among non-drinking adolescents and heightened consumption among their drinking peers. The role that each of these influences has on adolescents should be studied more in depth.

Often, risky behaviors identified during adolescents can be seen as indicators leading to unhealthy behaviors in young adulthood. Conversely, it is noted that people from different cultures may not have experience in dealing with these types of influences. Results from the studies conducted have underscored the importance of peer influence, parental influence, social influence and students’ cognitive defense in alcohol consumption. The implication of this study further relays the need to understand behaviors leading to adolescent alcohol use. Researchers and government officials need to develop ways to increase alcohol education and develop intervention strategies to reduce alcohol use among adolescents. In conclusion, additional longitudinal, qualitative and quantitative studies are needed to expand on this public health concern.

References

Ali, M. M., & Dwyer, D. S. (2010). Social Network Effects in Alcohol Consumption Among Adolescents. Addictive Behaviors, 35(4), 337-342. doi: 10.1016/j.addbeh.2009.12.002.
Anderson, P., Bruijn, A., Angus, K., Gordon, R., & Hastings, G. (2009). Impact of Alcohol Advertising and Media Exposure on Adolescent Alcohol Use: A Systematic Review of Longitudinal Studies. Alcohol and Alcoholism, 44(3), 229-243. doi: 10.1093/alcalc/agn115.
Donovan, J. E., & Molina, B. S. (2008). Children’s Introduction to Alcohol Use: Sips and Tastes. Alcoholism: Clinical and Experimental Research, 32(1), 108-119. doi: 10.1111/j.1530-0277.2007.00565.x.
IOM (Institute of Medicince) and NRC (National Research Council). (2011). The Science of Adolescent Risk-Taking: Workshop Report. Committee on the Science of Adolescence. Washington, DC: The National Academies Press.
Kerr, M., Stattin, H., & Burk, W. J. (2010). A Reinterpretation of Parental Monitoring in Longitudinal Perspective. Journal of Research on Adolescence, 20(1), 39-64. doi: 10.111/j.1532-7795.2009.00623.x.
National Institute on Alcohol Abuse and Alcoholism. (2017). Underage Drinking. Retrieved from https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/underage-drinking
Osgood, D. W., Ragan, D. T., Wallace, L., Gest, S. D., Feinberg, M. E., & Moody, J. (2013). Peers and the Emergence of Alcohol Use: Influence and Selection Processes in Adolescent Friendship Networks. Journal of Research on Adolescence : The Official Journal of the Society for Research on Adolescence, 23(3), 500-512. doi: 10.1111/jora.12059.
Pandina, R. J., Johnson, V. L., & White, H. R. (2010). Peer Influences on Substance Use During Adolescence and Emerging Adulthood. Washington, DC: American Psychological Association.
Reimuller, A., Hussong, A., & Ennett, S. T. (2011). The Influence of Alcohol-Specific Communication on Adolescent Alcohol Use and Alcohol-Related Consequences. Prevention Science : The Official Journal of the Society for Prevention Research, 12(4). doi: 10.1007/s11121-011-0227-4.
Ryan, S. M., Jorm, A. F., & Lubman, D. I. (2010). Parenting Factors Associated with Reduced Adolescent Alcohol Use: A Systematic Review of Longitudinal Studies. Australian & New Zealand Journal of Psychiatry, 44(9), 774-783.
Strandberg, A. K., & Bodin, M. C. (2011). Alcohol-Specific Parenting Within a Cluster-Randomized Effectiveness Trial of a Swedish Primary Prevention Program. Health Education, 111(2), 92-102. doi: 10.1108/09654281111108526.
Trucco, E. M., Colder, C. R., & Wieczxorek, W. F. (2011). Vulnerability to Peer Influence: A Moderated Mediation Study of Early Adolescent Alcohol Use Initiation. Addictive Behaviors, 36(7), 729-736. doi: 10.1016/j.addbeh.2011.02.008.
Trucco, E. M., Colder, C. R., Wieczorek, W. F., Lengua, L. J., & Hawk, L. W. (2014). Early Adolescent Alcohol Use in Context: How Neighborhoods, Parents and Peers Impact Youth. Development and Psychopathology, 26(2), 425-436. doi: 10.1017/S0954579414000042.

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Factors Contributing to Underage Drinking

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