Parental attention can be protective factor to lower risk of drug abuse among adolescents

Dec 4 2017

Parents who require children to follow rules and keep a constant eye on their activities, endeavoring to know where they are, who they are with and what they are doing, run less risk of facing problems when their children enter adolescence, such as abuse of alcohol and other drugs.

The likelihood of such problems becomes smaller still when, in addition to using rules and keeping a close eye on their children, parents talk to them, explain what the rules are for, are present in their day-to-day lives, and are supportive when they experience difficulties. In the literature, this parenting style is called responsiveness.

The research project that produced these findings was conducted at the Federal University of São Paulo (UNIFESP), surveying 6,381 children aged 11-15 in six Brazilian cities. The results have just been published in the journal Drug and Alcohol Dependence.

"The key conclusion is that parenting style can be a protective factor or a risk factor for the consumption of alcohol and other drugs in adolescence. This means the drug abuse prevention programs implemented by schools should not just raise the children's awareness but also focus on training parenting skills," said Zila Sanchez, a professor at the university's Medical School (EPM-UNIFESP) and principal investigator for the project, which is supported by the São Paulo Research Foundation - FAPESP.

Data collection took place at 62 public schools in Tubarão and Florianópolis, Santa Catarina State; São Paulo and São Bernardo do Campo, São Paulo State; Fortaleza, Ceará State; and Brasília, in the Federal District. The subjects were seventh- and eighth-grade primary school students with an average age of 12.5.

"We opted to work with schoolchildren in their early teens in order to find out whether parenting style already influences substance abuse at the start of adolescence," Sanchez said. "Because prevalence of consumption is very low when they're so young, our questionnaire asked if they had used drugs at least once in the previous year."

Research crosses parental and drug use profiles

The questionnaire was administered by researchers in the classroom without the presence of teachers in order to avoid inhibition and embarrassment. Participants completed it themselves and placed it anonymously in a brown envelope. In addition to drug use, it also asked about how the adolescents perceived their parents (parenting style), socioeconomic conditions, sexual behavior, and school violence, among other topics.

The responses were analyzed during Juliana Valente's PhD research, with a scholarship from FAPESP and supervision by Sanchez.

A statistical model called latent class analysis was used to identify three groups with similar patterns of drug use. "Abstainers/low users" were the most prevalent, accounting for 81.54% of the sample, followed by "alcohol users/binge drinkers" at 16.65%. "Polydrug users", who reported using tobacco, marijuana, cocaine, crack and/or inhalants such as benzene or glue in the previous year, as well as alcohol, accounted for 1.8%.

"The next step was to see if parenting styles were associated with any of these drug use profiles," Sanchez explained. "To this end, parenting styles were analyzed in four different groups, in accordance with the adolescents' own assessment and criteria established in the scientific literature."

Based on an assessment scale widely used in international studies and validated in Brazil, parental profiles were scored according to "demandingness", which relates to the degree to which parents monitor their children's activities and require them to follow rules, and "responsiveness", relating to the degree of parental sensitivity to children's needs and openness to dialogue.

Parents with high scores in both domains were classified as "authoritative". Those with high scores in demandingness alone were classified as "authoritarian". Responsive parents who neither monitored their children's activities nor required rule-keeping were considered "indulgent". Finally, parents with low scores in both domains were classified as "neglectful".

In line with the findings of surveys performed in other countries, the "authoritative" style was the most protective, followed by the "authoritarian" and "indulgent" styles. As the researchers note in the article, "neglectful" parents put adolescents at greater risk of belonging to the two classes of drug user identified by the study: alcohol users/binge drinkers, and polydrug users.

"The fact that an 'authoritative' style is more protective and a 'neglectful' style is riskier was expected, but there was disagreement about the 'authoritarian' and 'indulgent' styles in the literature. It wasn't clear which was better. The findings of our study reinforce the idea that demandingness, in the sense of more parental monitoring and use of rules, is a style that protects adolescents by preventing drug consumption," Valente said.

Well-off adolescents drink most

The researchers were particularly struck by the finding that the higher the interviewees' social class the more likely they were to belong to the binge drinker or polydrug user group. According to Sanchez, this result runs counter to those of surveys conducted in the US and Europe, where poverty is considered a risk factor for binge drinking and drug abuse in adolescence. On the other hand, it matches the findings of previous studies of the same age group conducted in Brazil.

"This is a very intriguing result and shows we can't simply import data relating to risk factors and protection for use in prevention programs here without taking cultural differences into account," Sanchez said.

For Valente, the statistical analysis did not support a link between different parenting styles and specific social classes because parenting styles were evenly distributed across household income brackets.

Data collection took place in late 2014 as part of a project funded by the Brazilian Ministry of Health, which commissioned the UNIFESP researchers to evaluate the effectiveness of a drug use prevention program called #Tamojunto in 62 selected schools.

"The program was brought from Europe, where it achieved good results, and adapted by the Ministry of Health," Valente said. "It was designed not just to convey knowledge of drugs to adolescents but also to develop personal and interpersonal skills. Here in Brazil, however, we didn't observe effectiveness based on the same metrics as in Europe."

According to Sanchez, the data analyzed during Valente's PhD and used as a basis for the article just published were collected before implementation of the program #Tamojunto and have no relation to its results.