http://informahealthcare.com/ada ISSN: 0095-2990 (print), 1097-9891 (electronic) Am J Drug Alcohol Abuse, 2014; 40(4): 342–348 ! 2014 Informa Healthcare USA, Inc. DOI: 10.3109/00952990.2014.910518
Alcohol use, externalizing problems, and depressive symptoms among American Indian youth: The role of self-efficacy Inga Mileviciute, MS1, Walter D. Scott, PhD1, and Alicia C. Mousseau, PhD2 Department of Psychology, University of Wyoming and 2Little Wound School, Kyle, South Dakota, USA
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Abstract
Keywords
Background: There is a need to understand resiliency factors which can be used to inform and design interventions to prevent externalizing problems, substance use, and depressive symptoms among American Indian (AI) youth. Objectives: The present study examined the role of self-efficacy in externalizing problems, alcohol use, and depressive symptoms among AI youth from the North American plains. Methods: Participants for this study included 146 (53 boys and 93 girls) adolescents, with an age range of 13–18 (M ¼ 14.5) years of age. Results: High self-efficacy for resisting negative peer influences predicted both lower rates of alcohol use and fewer externalizing behaviors. Furthermore, higher levels of both academic and social self-efficacy predicted fewer depressive symptoms. The hypothesis that academic self-efficacy would predict depressive symptoms was not supported. Conclusion: As expected, the best-fitting path model showed self-efficacy for resisting negative peer influences predicting both alcohol use and externalizing problems, and social self-efficacy (as well as being female) predicting depressive symptoms among AI youth. Therefore, this study supports the importance of self-efficacy beliefs for alcohol use and externalizing problems, as well as depressive symptoms, among AI youth.
Alcohol use, American Indian, depressive symptoms, externalizing behaviors, self-efficacy
Introduction Although considerable heterogeneity exists among American Indian (AI) youth populations, they remain, in general, at a higher risk for developing substance use problems (1). Moreover, AI youth appear to initiate substance use earlier, which predicts subsequent, more persistent, and problematic use (2,3). The seriousness of addressing this problem is further underscored by the fact that the development of such substance use patterns is associated with other serious mental health issues, including externalizing problems and depressive symptoms (4). Therefore, there is a tremendous need to understand risk and resiliency factors, which can be used to inform and design interventions to prevent externalizing problems, substance use, and depressive symptoms among AI youth. Unfortunately, the science on AI youth substance use remains at a relatively nascent stage, and there are few facts that can inform such interventions. Nevertheless, as a recent special issue of The American Journal of Drug and Alcohol Abuse revealed (5), some progress has been made, particularly in the identification of risk factors. However, research
Address correspondence to Inga Mileviciute, MS, Univesity of Wyoming, 1000 E. University Ave., Laramie, WY, 82071, USA. Tel: +1 (307) 766 2926. E-mail: [email protected]
History Received 13 November 2013 Revised 2 February 2014 Accepted 23 March 2014 Published online 20 June 2014
findings identifying strengths or resiliency variables that protect against the development of substance use in AI youth is more limited (5). American Indian communities and scholars have emphasized the particular need for interventions to be based in part on recognition of the assets and strengths that exist in AI youth populations (5). In the present study, we investigate the role of an individual variable that may serve as a protective factor in the development of substance use and other problems experienced by AI youth. Specifically, we investigate whether self-efficacy beliefs for academic activities, social relations, and resisting negative peer influences are related to fewer problems with alcohol use, externalizing behaviors, and depressive symptoms in a sample of AI youth from the northern plains. Self-regulation, self-efficacy, and youth resiliency Adolescence is a period in which youth increasingly reflect on their values, their futures, and the kind of person they want to become. These changes reflect the emergence of selfregulatory skills. Broadly, self-regulation refers to the ability to influence one’s own feelings, thoughts, and behaviors to meet internal standards or goals (6). The development of selfregulatory skills appears to be particularly important for youth who confront extreme adversity, where self-regulatory skills in at-risk youth predict successful psychosocial development and resiliency (7).
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DOI: 10.3109/00952990.2014.910518
Alcohol use, externalizing problems, and depressive symptoms
The ability to self-regulate involves specific cognitive capacities (8). For instance, people self-regulate by constructing goals, or mental representations of desired or undesired future states, and then directing and sustaining action towards reaching these imagined future states (8). In successful selfregulation, however, no cognitive skill plays a more central role than self-efficacy beliefs (8,9). Self-efficacy refers to beliefs about one’s capability of executing a given behavior in a given context (8). One can construct optimal representations of desired future states but if ability to enact behaviors to obtain such goals is doubted self-regulatory efforts are likely to fail. Compared to individuals who doubt their abilities, youth who hold high self-efficacy beliefs are more motivated and in the face of adversity are more likely to continue their efforts toward achieving a given purpose (10). Self-efficacy beliefs are best measured by domain; that is, youth possess varying self-efficacy beliefs depending on the domains being assessed. For developing youth, strong self-efficacy beliefs in three domains may be particularly important: academic, social, and resisting negative peer influences. Academically, developing youth increasingly consider their futures and the implications of their academic performance for their futures (8). Socially, developing youth increasingly view their status in social relationships to be a defining feature of the self, more important than physical or psychological characteristics (11). Finally, for developing youth, the influence of peers assumes greater importance, particularly when it comes to engaging in transgressive behaviors, such as using substances or doing other activities that can lead to trouble (12). Not surprisingly, self-efficacy in these domains appears to predict mental health problems (8,13,14), including substance use. For instance, in a two-year longitudinal study with early adolescents, high self-efficacy for resisting negative peer influences and for performing academic activities predicted less engagement in such transgressive behaviors as using alcohol and drugs, stealing, aggression, and truancy (15). In another study, high self-efficacy to resist negative peer pressure predicted less current and future engagement in problematic behaviors (16). Similarly, Caprara and colleagues (17) found that adolescents with a strong sense of self-efficacy for resisting negative peer pressure were less likely to engage in transgressive behaviors, which included aggression, destructiveness, cheating and lying. Finally, Nash and colleagues (18) found that high self-efficacy for resisting peer influence to use alcohol was related to less drinking and fewer problems associated with drinking. Self-efficacy also contributes to youth internalizing problems, particularly those involving negative affect (19,20). For example, one study found that young children who believed they possessed adequate social skills were less likely to experience internalizing problems in adolescence (21). Furthermore, Hermann and Betz (22) found that social selfefficacy had a direct relationship to depressive symptoms, as well as an indirect relationship in which individuals with higher social self-efficacy exhibited more expressiveness (i.e. caring and sensitive qualities) and less shyness, which in turn were related to fewer depressive symptoms. Self-efficacy for academic performances has also shown to be negatively related to depression (23).
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Although self-efficacy beliefs have been shown to be important for mental health in a number of studies with youth, there is some reason to doubt whether these findings would generalize to AI youth (24). For instance, cross-cultural research has shown that the impact of positive self-referent thinking can vary in individualistic and collectivistic cultural contexts (25). In European American cultural contexts, which emphasize self-autonomy and independence, adopting a more positive self-view is associated with affective well-being. However, in East Asian and Japanese cultural contexts, which place more of an emphasis on social harmony and interdependence, the relationship between positive self-views and affective well-being is not as strong (26,27). In contrast to the implications of this cross-cultural research, Bandura (28) has argued that possessing a high sense of self-efficacy is just as critical in interdependent cultures as in independent cultures, offering Mahatma Gandhi, Martin Luther King, Jr, and Nelson Mandela as examples of individuals who each required a robust sense of personal self-efficacy for achieving interdependent aims. So far the evidence with AI youth appears to support Bandura’s (28) contention. In several studies investigating the role of self-efficacy in AI youth depression, Scott and colleagues have identified high academic self-efficacy beliefs as a possible protective factor against the experience of depressive symptoms (24,29,30). For instance, in a longitudinal study, Scott and Dearing (29) found that increases in self-efficacy within AI youth predicted fewer subsequent depressive symptoms. Unfortunately, all these findings are limited to depression. There is a need for additional research to explore whether self-efficacy beliefs relate to other mental health outcomes, such as alcohol use and externalizing problems in AI youth. Present study In the present study, the relationship between self-efficacy, alcohol use, externalizing problems, and depressive symptoms among AI youth was examined. Specifically, it was predicted that high self-efficacy for resisting negative peer influences would predict less alcohol use and fewer externalizing behaviors among AI youth. Further, we expected that high social and academic self-efficacy would predict fewer depressive symptoms among AI youth.
Methods Participants Participants for this study included 146 (53 boys and 93 girls) AI students from the northern plains. All participants were enrolled in a summer program for youth to assist with transition from middle to high school and from high school to higher education. Youth participating in this particular academic summer camp had to complete an application and receive recommendations from their teachers. In turn, students who expressed a strong desire to be more prepared to enter high school, and/or learn more about higher education were accepted into the program. Academic performance and attendance records are also taken into consideration in the selection of students for the camp. However, GPA was not a
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disqualifying factor for acceptance to the academic summer camp. Eighty-five percent of the participants lived on one of seven reservations located in the North American plains and 80% attended school on a reservation. Age range of the participants was from 13–18 (M ¼ 14.5) years of age. No exclusionary criteria or incentives were employed. Measures
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Self-Efficacy Questionnaire-Modified (SEQ-M) To assess self-efficacy, a subset of scales from a slightly modified version of a multidimensional self-efficacy questionnaire was used (31). The modified version of the multidimensional self-efficacy questionnaire (31) was developed by first administering the full scale to several focus groups of AI youth from another northern plains reservation (not included in the present study). Based on feedback concerning item comprehensibility and relevance from these AI youth, 42 items were selected from the original instrument covering three domains (i.e. academic activities, social activities, and resisting negative peer influences). The original SEQ has demonstrated acceptable levels of internal consistency, test-retest reliability, and validity (31). The SEQM has been used in other studies with AI students ranging in age from 10–19 (24,29) on northern plains reservations and has demonstrated good to excellent reliability (i.e. academic self-efficacy ¼ 0.95, social self-efficacy ¼ 0.86, and resisting negative peer influences self-efficacy ¼ 0.82). In the present study, the SEQ-M demonstrated similar good to excellent reliability for the academic, social, and resisting negative peer influences self-efficacy subscales ( ¼ 0.91, ¼ 0.84, and ¼ 0.87, respectively). Childhood Depression Inventory (CDI) (32,33) The CDI was administered to assess depressive symptoms. The CDI is a widely used self-report measure of childhood (i.e. children and adolescents 7–17 years old) depression and it possesses adequate psychometric properties (34–36). Furthermore, the CDI has been shown to possess good psychometric properties with similar samples of AI youth from a northern plains tribe (29,37). In the present study, the CDI demonstrated similar good to excellent reliability ( ¼ 0.88). Youth Self-Report (YSR) (38) For youth (i.e. designed for 11–18-year-olds) self-report of externalizing behaviors, the YSR was used. The Externalizing scale includes the Rule-breaking Behavior subscale, and the Aggressive Behavior subscale. The YSR is a widely used scale which is based on new national norms that were collected February 1999–January 2000, and has acceptable reliability and validity (38). In the present study, the externalizing subscale showed good reliability ( ¼ 0.89).
Am J Drug Alcohol Abuse, 2014; 40(4): 342–348
the spectrum of alcohol use disorders in various settings and with diverse populations and has found Cronbach’s a and item-total correlations to be in the 0.80 s (40–42). Furthermore, the validity of the AUDIT has been examined with adolescent populations and has been found to surpass other tools used to differentiate problem drinkers from nonproblem drinkers among 14–18-year-olds (43,44). In the present study, the scale showed good reliability ( ¼ 0.85). Procedure Two graduate students (the first and third authors) from the University of Wyoming administered the surveys at the aforementioned summer education transition program. Informed consent was obtained according to the procedure established by the summer transition program. Specifically, an active consent procedure was used for both parents/ guardians and student participants. When parents/guardians registered their child on site, they were asked to sign an informed consent. In addition, an assent procedure was used for all student participants. If active parental consent existed and active assent from the student was obtained, participants were asked to complete an online questionnaire containing the measures querying about their alcohol use, self-efficacy, mood, and externalizing behaviors. Data was collected from participants prior to their attendance of the classes and skills training that were part of the camp’s curriculum. Data analytic approach Path analyses were conducted to test the hypothesized path models. Because studies show that depressive symptoms increase throughout adolescence among girls, but remain more stable over time among boys (45), gender was also included in the path model. In the hypothesized model, we expected that self-efficacy to resist negative peer influences would predict alcohol use and externalizing behaviors and that gender, academic self-efficacy, and social self-efficacy would predict depressive symptoms (see Figure 1). Given the cross-sectional nature of our data, we also explored alternative path models to provide fit comparisons (46). For evaluating model fit, we used a set of recommended Model 1 Resisting Negative Peer Influences Self-Efficacy
−0.38**
Externalizing Behaviors
−0.35** Alcohol Use
Academic Self-Efficacy Social Self-Efficacy
0.02 −0.35*
0.45** Depressive Symptoms
0.28**
Alcohol Use Disorders Identification Test (AUDIT) (39) To screen for alcohol problems, the AUDIT was administered. The AUDIT is a 10-item scale that screens for hazardous drinking, alcohol dependence or harmful use. Research supports the use of the AUDIT as a means of screening for
Gender Male=1, Female=2
Figure 1. Hypothesized path model (* ¼ p50.01; ** ¼ p50.001, two-tailed).
Alcohol use, externalizing problems, and depressive symptoms
DOI: 10.3109/00952990.2014.910518
fit indexes (47) which included the model Chi-square model statistic, the Root Mean Square Error of Approximation (RMSEA) with a 90% confidence interval, the Comparative Fit Index (CFI), the Standardized Root Mean Square Residual (SRMR) and the Akaike’s Information Criterion (AIC). Good fitting models are suggested when the RMSEA is less than or equal to 0.08, the CFI is above 0.90, and the SRMR is below 0.05 (47). For the AIC, smaller values represent better fitting overall models.
Results
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Descriptive statistics and correlations Table 1 provides means, standard deviations and the range for all variables in the analysis. Table 1 also includes t-test values for the comparisons of the means between boys and girls for each variable. Correlational analyses are presented in Table 2. Missing and multivariate non-normal data
Table 1. Means, standard deviations, and range, of variables used in the path analyses. Mean
SD
Range
98.97 50.68 33.19 9.27 9.56 2.51
18.98 10.27 8.35 7.43 6.71 4.62
43–144 13–70 6–42 0–35 0–37 0–32
SE, Self-efficacy; Resistive SE, self-efficacy to resist negative peer influence; CDI, Children’s Depression Inventory; YSR, externalizing subscale on the Youth Self-Report; AUDIT, Alcohol Use Disorders Identification Test.
1. 2. 3. 4. 5. 6.
Academic SE Social SE Resistive SE CDI YSR Alcohol use
Hypothesized model The hypothesized model (see Figure 1) showed an excellent fit to the data (see Table 3). As predicted, self-efficacy to resist negative peer influences significantly predicted alcohol use ( ¼ 0.35, p50.001) and externalizing behaviors ( ¼ 0.38, p50.001) among AI youth. Further, as predicted, social self-efficacy ( ¼ 0.35, p50.01) and gender (i.e. being female; ¼ 0.28, p50.001) directly predicted depressive symptoms. However, contrary to predictions, academic self-efficacy ( ¼ 0.02, p ¼ 0.83) did not predict depressive symptoms.
The first alternative model tested was one in which we had all self-efficacy measures (i.e. academic, social, resisting negative peer influences) predicting all outcomes (i.e. externalizing, alcohol use, and depressive symptoms). Although the first alternative model showed an excellent fit to the data (see Table 3), there were a number of individual parameters which were non-significant, rendering this model inadequate. Specifically, neither social ( ¼ 0.14, p ¼ 0.17) or academic ( ¼ 0.16, p ¼ 0.14) self-efficacy significantly predicted externalizing problems. Further, social ( ¼ 0.06, p ¼ 0.68) and academic ( ¼ 0.20, p ¼ 0.18) did not predict alcohol use either. Finally, neither resisting negative peer influences ( ¼ 0.11, p ¼ 0.28) nor academic ( ¼ 0.02, p ¼ 0.86) self-efficacy predicted depressive symptoms. Alternative model 2: reversed model
Table 2. Bivariate correlations among study variables. Variable
In addition, however, our data also violated multivariate assumptions of normality. Therefore, we used the robust maximum likelihood estimator (MLR; 49), as it is the recommended estimator for dealing with both issues of missing data and multivariate non-normality (47).
Alternative model 1: all efficacy predictors
Across all youth, one participant had data missing on the CDI. Maximum likelihood estimation is the recommended alternative to discarding participants who are missing data (48).
Academic SE Social SE Resistive SE CDI YSR AUDIT
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1
2
3
4
5
6
– 0.70** 0.42** 0.26* 0.25* 0.04
– 0.42** 0.33** 0.16 0.001
– 0.24* 0.44** 0.36**
– 0.45** 0.13
– 0.39**
–
A reversed path model was also tested to examine whether it provided a better fit to the data. Specifically, this model had alcohol use and externalizing problems predicting self-efficacy to resist negative peer influences, and depressive symptoms predicting social and academic self-efficacy. In short, this model showed an unacceptable overall fit to the data (see Table 3). Best-fitting final model
SE, Self-efficacy; Resistive SE, self-efficacy to resist negative peer influence; CDI, Children’s Depression Inventory; YSR, externalizing subscale on the Youth Self-Report; *50.01 (two-tailed), **p50.001 (two-tailed).
Byrne (47) recommends that the final models in SEM should represent the best fitting and most parsimonious of the tested models. Taking into consideration overall fit indices as well as the significance or non-significance of individual parameters,
Table 3. Model fit statistics for estimated path models. Model 1 2 3 4
Description Hypothesized model Alternate model 1: Reversed Alternate model 2: All efficacy Final model
2 (df, p value)
CFI
SRMR
5.46 34.55 0.99 10.75
1.00 0.85 1.00 0.92
0.03 0.09 0.01 0.05
(10, 0.86) (9, 0.00) (5, 0.96) (5, 0.06)
RMSEA (90% CI) 0.00 0.14 0.00 0.08
(0.00–0.05) (0.09–0.19) (0.00–0.00) (0.00–0.15)
AIC 6256.57 5371.11 6000.29 4824.33
CFI, Comparative Fit Index; SRMR, Standardized Root Mean Square Residual; RMSEA 90% CI, Root Mean Square Error of Approximation with a 90% confidence interval; AIC, Akaike’s Information Criterion.
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−0.41**
Externalizing Behaviors
−0.35** 0.27** Alcohol Use
0.46**
0.45**
Social Self-Efficacy
−0.33** 0.28**
Gender Male=1, Female=2
Depressive Symptoms
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Figure 2. Final path model (** ¼ p50.001, two-tailed).
our hypothesized model emerged with the strongest support of the three tested models. However, as academic self-efficacy did not significantly predict depressive symptoms in the hypothesized model, it was removed in the final ‘‘best-fitting’’ path model (see Figure 2). In short, this best-fitting model provided an excellent fit to the data (see Table 3), including having the lowest AIC value. In addition, all individual parameters were significant in the predicted directions (see Figure 2). Specifically, self-efficacy to resist negative peer influences significantly predicted alcohol use ( ¼ 0.35, p50.001) and externalizing behaviors ( ¼ 0.41, p50.001). Further, as predicted, social self-efficacy ( ¼ 0.33, p50.001) and gender (i.e. being female; ¼ 0.28, p50.001) directly predicted depressive symptoms.
Discussion The purpose of this study was to test whether self-efficacy beliefs in academic, social, and resisting negative peer influence domains predicted alcohol use, externalizing behaviors, and depressive symptoms among youth of North American Plain tribes. It was expected that high self-efficacy for resisting negative peer influences would predict both lower rates of alcohol use and fewer externalizing behaviors. It was also hypothesized that higher levels of both academic and social self-efficacy would predict fewer depressive symptoms. In short, most of our hypotheses were supported. In fact, the best-fitting path model showed nearly all hypothesized relationships being significant, with self-efficacy for resisting negative peer influences predicting both alcohol use and externalizing problems, and social self-efficacy (as well as being female) predicting depressive symptoms among AI youth. The only pathway that was not supported was academic self-efficacy to depressive symptoms. We discuss each of these findings and identify limitations of our study as well as directions for future research. In support of previous findings (e.g. 7,50), we found that self-efficacy to resist negative peer influences significantly contributed to both lower alcohol use and fewer externalizing problems. The use of substances by one’s peers is one of the most consistently strong predictors of substance youth among youth (51,52). A large, robust literature documents the strong relationship between negative peer influence and deviant behaviors. For AI youth from the northern plains, these
observations may be especially problematic as the rates for substance use disorders has been observed to be three times that of rates observed in other youth populations (2,5) and rates of lifetime conduct disorder are about twice the rate of other youth populations (2). In other words, it could be that AI youth are in relatively risky peer contexts in which temptations to engage in delinquent behaviors are more prevalent. Therefore, the belief that one is capable of resisting these peer influences may be an especially important predictor of lower substance use and fewer externalizing behaviors, particularly relevant to the context in which AI youth live their lives. In contrast to previous research with AI youth from the northern plains (24,29), in which academic self-efficacy emerged as the strongest predictor of depressive symptoms, we did not find academic self-efficacy to predict depressive symptoms. Rather, social self-efficacy emerged as the strongest predictor of depressive symptoms. Initially, we thought that this finding might reflect the unique sample we examined in our study, which consisted of a sample of youth attending a summer program to assist with the transition from middle to high school and from high school to higher education. In previous research, Scott and colleagues’ participants were AI middle and high school youth who were sampled in regular schools from a different tribe and reservations than the current study (24,29). The youth in the present study possibly were more accomplished academically, and thus may have had a more restricted range in self-efficacy beliefs. However, in comparing the standard deviations for academic self-efficacy for the AI youth in the present study with those of these two other studies in which the same academic self-efficacy measure was administered (i.e. 24,29), the present study’s standard deviation was actually the highest (present SD ¼ 1.05 compared to SDs of 0.81 and 0.93 in the two other studies). Perhaps not surprisingly given the nature of the summer camp, the participants in the present study did report high mean academic self-efficacy scores (5.5 compared to 4.96 and 4.8). Alternatively, it is possible that social self-efficacy emerged as more influential for depressive symptoms in the present study because youth were less well-acquainted with their peers. That is, the youth in this study were in a new social context in which they were interacting with less familiar youth they were meeting in the context of this summer camp experience. It is possible that in a more novel social context, such as the one which existed in this study, social self-efficacy emerges as more important. In Etz and colleagues’ (5) special issue, a theme emerged in which authors argued for the need for future substance abuse research to identify assets and strengths that exist in AI youth populations. It was argued that such a research program would increase the likelihood of successfully engaging AI communities in efforts to develop more effective prevention and treatment efforts. Our findings, particularly when combined with the findings of Scott and colleagues (24,29,30), suggest that AI youth share more similarities than dissimilarities relative to youth of other ethnicities. As in other populations, self-efficacy emerged as an important source of resiliency among AI youth and thus should be considered as an important factor when implementing prevention or intervention programs.
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DOI: 10.3109/00952990.2014.910518
Alcohol use, externalizing problems, and depressive symptoms
Although future longitudinal work examining self-efficacy beliefs and substance use in AI youth populations is needed before one can infer stronger implications, our results are consistent with the idea that prevention and treatment programs for AI youth need to focus on building self-efficacy to resist negative peer influence as a means to prevent such high risk activities. Within the realm of interventions for substance use, the most effective treatments (e.g. motivational interviewing, motivational enhancement therapy, cognitivebehavioral treatment) all have a strong focus on building one’s self-efficacy and skills to manage high-risk situations and life stressors, to resist the urge to use when experiencing distress, and to find alternatives to substance use (53). This seems to suggest that prevention strategies could also be applied to enhance self-efficacy in resisting peer influence to use alcohol. Overall, the findings from this study and previous research point to the fact that a strong sense of self-efficacy in resisting negative peer influences, in successfully performing academic activities and in connecting in positive peer relationships is likely to be a critical variable in promoting resiliency (54), maybe even more so in AI communities (29). Some limitations of this study should be acknowledged. First, the current study employed a cross-sectional design and therefore it is not possible to determine whether the relationships suggested by path models are truly causal. Second, all measures collected from the adolescents were self-report. Although some constructs, like depression and self-efficacy, might be better reported by youth, multiple informants would strengthen the validity of the constructs measured in this study. Third, although our reversed path models in which we had outcomes (i.e. alcohol use, externalizing behaviors, and depressive symptoms) predicting self-efficacy variables showed poor fit to our data, it is likely that if causal relationships do in fact exist between these constructs then they are probably reciprocal to some extent. That is, if individuals exhibit consistent patterns of using alcohol, acting out, and feeling depressed, these experiences are most likely influencing their self-efficacy beliefs for resisting negative peer influences, as well as performing well academically and socially. Future studies should utilize longitudinal designs to examine whether changes in self-efficacy beliefs predict later changes in alcohol use and externalizing behaviors. This study underscores the importance of self-efficacy beliefs for development of alcohol use initiation and externalizing problems, as well as depressive symptoms among AI youth, all of which are known to have adverse longterm developmental consequences. Although there is stronger evidence for the role of self-efficacy beliefs in the depressive experiences of AI youth, we hope this initial study identifying a relationship between self-efficacy beliefs and substance use and externalizing behaviors will stimulate more research into these domains. Ultimately, it is hoped that these findings can inform effective programs promoting resiliency in AI communities.
Declaration of interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.
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23. Miller AK, Markman KD. Depression, regulatory focus, and motivation. Personality and individual differences 2007;43:427–436. 24. Scott WD, Dearing E, Reynolds WR, Lindsay JE, Baird GL, Hamill S. Cognitive self-regulation and depression: examining academic self-efficacy and goal characteristics in youth of a Northern Plains tribe. Journal of Research on Adolescence 2008;18:379–394. 25. Kitayama S, Markus HR. Yin and yang of the Japanese self: the cultural psychology of personality coherence. In: Cervone D, Shoda Y, eds. The coherence of personality: social cognitive bases of personality consistency, variability, and organization. New York: Guilford Press; 1999:242–302. 26. Heine SJ, Lehman DR. Culture, self-discrepancies, and selfsatisfaction. Pers Soc Psychol Bull 1999;25:915–925. 27. Kitayama S, Markus HR. The pursuit of happiness and the realization of sympathy: cultural patterns of self, social relations, and well-being. In: Diener E, Suh EM, eds. Culture and subjective well-being. Cambridge, MA: MIT Press; 2000. 28. Bandura A. Social cognitive theory in cultural context. Appl Psychol 2002;51:269–290. 29. Scott WD, Dearing E. A longitudinal study of self-efficacy and depressive symptoms in youth of a North American Plains tribe. Dev Psychopathol 2012;24:607–622. 30. Tyser J, Scott WD, Readdy T, McCrea S. The role of goal representations, cultural identity, and dispositional optimism in the depressive experiences of American Indian youth from a northern plains tribe. J Youth Adolesc 2013;43:329–342. 31. Bandura A, Pastorelli C, Barbaranelli C, Caprara GV. Self-efficacy pathways to child depression. J Pers Soc Psychol 1999;76:258–269. 32. Kovacs M. The Children’s Depression Inventory (CDI). Psychopharmacol Bull 1985;21:995–998. 33. Kovacs M. Manual for the Children’s Depression Inventory. North Tonawanda, NJ: Multi-Health Systems; 1992. 34. Craighead WE, Smucker MR, Craighead LW, Ilardi SS. Factor analysis of the Children’s Depression Inventory in acommunity sample. Psychol Assess 1998;10:156–165. 35. Saylor CF, Finch AJ, Spirito A, Bennett B. The Children’s Depression Inventory: a systematic evaluation of psychometric properties. J Consult Clin Psychol 1984;52:955–967. 36. Smucker MR, Craighead WE, Craighead LW, Green BJ. Normative and reliability data for the Children’s Depression Inventory. J Abnorm Child Psychol 1986;14:25–40. 37. Hamill S, Scott WD, Dearing E, Pepper C. Affective style and depressive symptoms in youth of a North American Plains tribe: the moderating roles of cultural Identity, grade level, and behavioral inhibition. Pers Indiv Differ 2009;47:110–115. 38. Achenbach TM, Rescorla LA. Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families; 2001.
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Alcohol use, externalizing problems, and depressive symptoms among American Indian youth: The role of self-efficacy Inga Mileviciute, MS1, Walter D. Scott, PhD1, and Alicia C. Mousseau, PhD2 Department of Psychology, University of Wyoming and 2Little Wound School, Kyle, South Dakota, USA
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Background: There is a need to understand resiliency factors which can be used to inform and design interventions to prevent externalizing problems, substance use, and depressive symptoms among American Indian (AI) youth. Objectives: The present study examined the role of self-efficacy in externalizing problems, alcohol use, and depressive symptoms among AI youth from the North American plains. Methods: Participants for this study included 146 (53 boys and 93 girls) adolescents, with an age range of 13–18 (M ¼ 14.5) years of age. Results: High self-efficacy for resisting negative peer influences predicted both lower rates of alcohol use and fewer externalizing behaviors. Furthermore, higher levels of both academic and social self-efficacy predicted fewer depressive symptoms. The hypothesis that academic self-efficacy would predict depressive symptoms was not supported. Conclusion: As expected, the best-fitting path model showed self-efficacy for resisting negative peer influences predicting both alcohol use and externalizing problems, and social self-efficacy (as well as being female) predicting depressive symptoms among AI youth. Therefore, this study supports the importance of self-efficacy beliefs for alcohol use and externalizing problems, as well as depressive symptoms, among AI youth.
Alcohol use, American Indian, depressive symptoms, externalizing behaviors, self-efficacy
Introduction Although considerable heterogeneity exists among American Indian (AI) youth populations, they remain, in general, at a higher risk for developing substance use problems (1). Moreover, AI youth appear to initiate substance use earlier, which predicts subsequent, more persistent, and problematic use (2,3). The seriousness of addressing this problem is further underscored by the fact that the development of such substance use patterns is associated with other serious mental health issues, including externalizing problems and depressive symptoms (4). Therefore, there is a tremendous need to understand risk and resiliency factors, which can be used to inform and design interventions to prevent externalizing problems, substance use, and depressive symptoms among AI youth. Unfortunately, the science on AI youth substance use remains at a relatively nascent stage, and there are few facts that can inform such interventions. Nevertheless, as a recent special issue of The American Journal of Drug and Alcohol Abuse revealed (5), some progress has been made, particularly in the identification of risk factors. However, research
Address correspondence to Inga Mileviciute, MS, Univesity of Wyoming, 1000 E. University Ave., Laramie, WY, 82071, USA. Tel: +1 (307) 766 2926. E-mail: [email protected]
History Received 13 November 2013 Revised 2 February 2014 Accepted 23 March 2014 Published online 20 June 2014
findings identifying strengths or resiliency variables that protect against the development of substance use in AI youth is more limited (5). American Indian communities and scholars have emphasized the particular need for interventions to be based in part on recognition of the assets and strengths that exist in AI youth populations (5). In the present study, we investigate the role of an individual variable that may serve as a protective factor in the development of substance use and other problems experienced by AI youth. Specifically, we investigate whether self-efficacy beliefs for academic activities, social relations, and resisting negative peer influences are related to fewer problems with alcohol use, externalizing behaviors, and depressive symptoms in a sample of AI youth from the northern plains. Self-regulation, self-efficacy, and youth resiliency Adolescence is a period in which youth increasingly reflect on their values, their futures, and the kind of person they want to become. These changes reflect the emergence of selfregulatory skills. Broadly, self-regulation refers to the ability to influence one’s own feelings, thoughts, and behaviors to meet internal standards or goals (6). The development of selfregulatory skills appears to be particularly important for youth who confront extreme adversity, where self-regulatory skills in at-risk youth predict successful psychosocial development and resiliency (7).
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DOI: 10.3109/00952990.2014.910518
Alcohol use, externalizing problems, and depressive symptoms
The ability to self-regulate involves specific cognitive capacities (8). For instance, people self-regulate by constructing goals, or mental representations of desired or undesired future states, and then directing and sustaining action towards reaching these imagined future states (8). In successful selfregulation, however, no cognitive skill plays a more central role than self-efficacy beliefs (8,9). Self-efficacy refers to beliefs about one’s capability of executing a given behavior in a given context (8). One can construct optimal representations of desired future states but if ability to enact behaviors to obtain such goals is doubted self-regulatory efforts are likely to fail. Compared to individuals who doubt their abilities, youth who hold high self-efficacy beliefs are more motivated and in the face of adversity are more likely to continue their efforts toward achieving a given purpose (10). Self-efficacy beliefs are best measured by domain; that is, youth possess varying self-efficacy beliefs depending on the domains being assessed. For developing youth, strong self-efficacy beliefs in three domains may be particularly important: academic, social, and resisting negative peer influences. Academically, developing youth increasingly consider their futures and the implications of their academic performance for their futures (8). Socially, developing youth increasingly view their status in social relationships to be a defining feature of the self, more important than physical or psychological characteristics (11). Finally, for developing youth, the influence of peers assumes greater importance, particularly when it comes to engaging in transgressive behaviors, such as using substances or doing other activities that can lead to trouble (12). Not surprisingly, self-efficacy in these domains appears to predict mental health problems (8,13,14), including substance use. For instance, in a two-year longitudinal study with early adolescents, high self-efficacy for resisting negative peer influences and for performing academic activities predicted less engagement in such transgressive behaviors as using alcohol and drugs, stealing, aggression, and truancy (15). In another study, high self-efficacy to resist negative peer pressure predicted less current and future engagement in problematic behaviors (16). Similarly, Caprara and colleagues (17) found that adolescents with a strong sense of self-efficacy for resisting negative peer pressure were less likely to engage in transgressive behaviors, which included aggression, destructiveness, cheating and lying. Finally, Nash and colleagues (18) found that high self-efficacy for resisting peer influence to use alcohol was related to less drinking and fewer problems associated with drinking. Self-efficacy also contributes to youth internalizing problems, particularly those involving negative affect (19,20). For example, one study found that young children who believed they possessed adequate social skills were less likely to experience internalizing problems in adolescence (21). Furthermore, Hermann and Betz (22) found that social selfefficacy had a direct relationship to depressive symptoms, as well as an indirect relationship in which individuals with higher social self-efficacy exhibited more expressiveness (i.e. caring and sensitive qualities) and less shyness, which in turn were related to fewer depressive symptoms. Self-efficacy for academic performances has also shown to be negatively related to depression (23).
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Although self-efficacy beliefs have been shown to be important for mental health in a number of studies with youth, there is some reason to doubt whether these findings would generalize to AI youth (24). For instance, cross-cultural research has shown that the impact of positive self-referent thinking can vary in individualistic and collectivistic cultural contexts (25). In European American cultural contexts, which emphasize self-autonomy and independence, adopting a more positive self-view is associated with affective well-being. However, in East Asian and Japanese cultural contexts, which place more of an emphasis on social harmony and interdependence, the relationship between positive self-views and affective well-being is not as strong (26,27). In contrast to the implications of this cross-cultural research, Bandura (28) has argued that possessing a high sense of self-efficacy is just as critical in interdependent cultures as in independent cultures, offering Mahatma Gandhi, Martin Luther King, Jr, and Nelson Mandela as examples of individuals who each required a robust sense of personal self-efficacy for achieving interdependent aims. So far the evidence with AI youth appears to support Bandura’s (28) contention. In several studies investigating the role of self-efficacy in AI youth depression, Scott and colleagues have identified high academic self-efficacy beliefs as a possible protective factor against the experience of depressive symptoms (24,29,30). For instance, in a longitudinal study, Scott and Dearing (29) found that increases in self-efficacy within AI youth predicted fewer subsequent depressive symptoms. Unfortunately, all these findings are limited to depression. There is a need for additional research to explore whether self-efficacy beliefs relate to other mental health outcomes, such as alcohol use and externalizing problems in AI youth. Present study In the present study, the relationship between self-efficacy, alcohol use, externalizing problems, and depressive symptoms among AI youth was examined. Specifically, it was predicted that high self-efficacy for resisting negative peer influences would predict less alcohol use and fewer externalizing behaviors among AI youth. Further, we expected that high social and academic self-efficacy would predict fewer depressive symptoms among AI youth.
Methods Participants Participants for this study included 146 (53 boys and 93 girls) AI students from the northern plains. All participants were enrolled in a summer program for youth to assist with transition from middle to high school and from high school to higher education. Youth participating in this particular academic summer camp had to complete an application and receive recommendations from their teachers. In turn, students who expressed a strong desire to be more prepared to enter high school, and/or learn more about higher education were accepted into the program. Academic performance and attendance records are also taken into consideration in the selection of students for the camp. However, GPA was not a
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disqualifying factor for acceptance to the academic summer camp. Eighty-five percent of the participants lived on one of seven reservations located in the North American plains and 80% attended school on a reservation. Age range of the participants was from 13–18 (M ¼ 14.5) years of age. No exclusionary criteria or incentives were employed. Measures
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Self-Efficacy Questionnaire-Modified (SEQ-M) To assess self-efficacy, a subset of scales from a slightly modified version of a multidimensional self-efficacy questionnaire was used (31). The modified version of the multidimensional self-efficacy questionnaire (31) was developed by first administering the full scale to several focus groups of AI youth from another northern plains reservation (not included in the present study). Based on feedback concerning item comprehensibility and relevance from these AI youth, 42 items were selected from the original instrument covering three domains (i.e. academic activities, social activities, and resisting negative peer influences). The original SEQ has demonstrated acceptable levels of internal consistency, test-retest reliability, and validity (31). The SEQM has been used in other studies with AI students ranging in age from 10–19 (24,29) on northern plains reservations and has demonstrated good to excellent reliability (i.e. academic self-efficacy ¼ 0.95, social self-efficacy ¼ 0.86, and resisting negative peer influences self-efficacy ¼ 0.82). In the present study, the SEQ-M demonstrated similar good to excellent reliability for the academic, social, and resisting negative peer influences self-efficacy subscales ( ¼ 0.91, ¼ 0.84, and ¼ 0.87, respectively). Childhood Depression Inventory (CDI) (32,33) The CDI was administered to assess depressive symptoms. The CDI is a widely used self-report measure of childhood (i.e. children and adolescents 7–17 years old) depression and it possesses adequate psychometric properties (34–36). Furthermore, the CDI has been shown to possess good psychometric properties with similar samples of AI youth from a northern plains tribe (29,37). In the present study, the CDI demonstrated similar good to excellent reliability ( ¼ 0.88). Youth Self-Report (YSR) (38) For youth (i.e. designed for 11–18-year-olds) self-report of externalizing behaviors, the YSR was used. The Externalizing scale includes the Rule-breaking Behavior subscale, and the Aggressive Behavior subscale. The YSR is a widely used scale which is based on new national norms that were collected February 1999–January 2000, and has acceptable reliability and validity (38). In the present study, the externalizing subscale showed good reliability ( ¼ 0.89).
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the spectrum of alcohol use disorders in various settings and with diverse populations and has found Cronbach’s a and item-total correlations to be in the 0.80 s (40–42). Furthermore, the validity of the AUDIT has been examined with adolescent populations and has been found to surpass other tools used to differentiate problem drinkers from nonproblem drinkers among 14–18-year-olds (43,44). In the present study, the scale showed good reliability ( ¼ 0.85). Procedure Two graduate students (the first and third authors) from the University of Wyoming administered the surveys at the aforementioned summer education transition program. Informed consent was obtained according to the procedure established by the summer transition program. Specifically, an active consent procedure was used for both parents/ guardians and student participants. When parents/guardians registered their child on site, they were asked to sign an informed consent. In addition, an assent procedure was used for all student participants. If active parental consent existed and active assent from the student was obtained, participants were asked to complete an online questionnaire containing the measures querying about their alcohol use, self-efficacy, mood, and externalizing behaviors. Data was collected from participants prior to their attendance of the classes and skills training that were part of the camp’s curriculum. Data analytic approach Path analyses were conducted to test the hypothesized path models. Because studies show that depressive symptoms increase throughout adolescence among girls, but remain more stable over time among boys (45), gender was also included in the path model. In the hypothesized model, we expected that self-efficacy to resist negative peer influences would predict alcohol use and externalizing behaviors and that gender, academic self-efficacy, and social self-efficacy would predict depressive symptoms (see Figure 1). Given the cross-sectional nature of our data, we also explored alternative path models to provide fit comparisons (46). For evaluating model fit, we used a set of recommended Model 1 Resisting Negative Peer Influences Self-Efficacy
−0.38**
Externalizing Behaviors
−0.35** Alcohol Use
Academic Self-Efficacy Social Self-Efficacy
0.02 −0.35*
0.45** Depressive Symptoms
0.28**
Alcohol Use Disorders Identification Test (AUDIT) (39) To screen for alcohol problems, the AUDIT was administered. The AUDIT is a 10-item scale that screens for hazardous drinking, alcohol dependence or harmful use. Research supports the use of the AUDIT as a means of screening for
Gender Male=1, Female=2
Figure 1. Hypothesized path model (* ¼ p50.01; ** ¼ p50.001, two-tailed).
Alcohol use, externalizing problems, and depressive symptoms
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fit indexes (47) which included the model Chi-square model statistic, the Root Mean Square Error of Approximation (RMSEA) with a 90% confidence interval, the Comparative Fit Index (CFI), the Standardized Root Mean Square Residual (SRMR) and the Akaike’s Information Criterion (AIC). Good fitting models are suggested when the RMSEA is less than or equal to 0.08, the CFI is above 0.90, and the SRMR is below 0.05 (47). For the AIC, smaller values represent better fitting overall models.
Results
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Descriptive statistics and correlations Table 1 provides means, standard deviations and the range for all variables in the analysis. Table 1 also includes t-test values for the comparisons of the means between boys and girls for each variable. Correlational analyses are presented in Table 2. Missing and multivariate non-normal data
Table 1. Means, standard deviations, and range, of variables used in the path analyses. Mean
SD
Range
98.97 50.68 33.19 9.27 9.56 2.51
18.98 10.27 8.35 7.43 6.71 4.62
43–144 13–70 6–42 0–35 0–37 0–32
SE, Self-efficacy; Resistive SE, self-efficacy to resist negative peer influence; CDI, Children’s Depression Inventory; YSR, externalizing subscale on the Youth Self-Report; AUDIT, Alcohol Use Disorders Identification Test.
1. 2. 3. 4. 5. 6.
Academic SE Social SE Resistive SE CDI YSR Alcohol use
Hypothesized model The hypothesized model (see Figure 1) showed an excellent fit to the data (see Table 3). As predicted, self-efficacy to resist negative peer influences significantly predicted alcohol use ( ¼ 0.35, p50.001) and externalizing behaviors ( ¼ 0.38, p50.001) among AI youth. Further, as predicted, social self-efficacy ( ¼ 0.35, p50.01) and gender (i.e. being female; ¼ 0.28, p50.001) directly predicted depressive symptoms. However, contrary to predictions, academic self-efficacy ( ¼ 0.02, p ¼ 0.83) did not predict depressive symptoms.
The first alternative model tested was one in which we had all self-efficacy measures (i.e. academic, social, resisting negative peer influences) predicting all outcomes (i.e. externalizing, alcohol use, and depressive symptoms). Although the first alternative model showed an excellent fit to the data (see Table 3), there were a number of individual parameters which were non-significant, rendering this model inadequate. Specifically, neither social ( ¼ 0.14, p ¼ 0.17) or academic ( ¼ 0.16, p ¼ 0.14) self-efficacy significantly predicted externalizing problems. Further, social ( ¼ 0.06, p ¼ 0.68) and academic ( ¼ 0.20, p ¼ 0.18) did not predict alcohol use either. Finally, neither resisting negative peer influences ( ¼ 0.11, p ¼ 0.28) nor academic ( ¼ 0.02, p ¼ 0.86) self-efficacy predicted depressive symptoms. Alternative model 2: reversed model
Table 2. Bivariate correlations among study variables. Variable
In addition, however, our data also violated multivariate assumptions of normality. Therefore, we used the robust maximum likelihood estimator (MLR; 49), as it is the recommended estimator for dealing with both issues of missing data and multivariate non-normality (47).
Alternative model 1: all efficacy predictors
Across all youth, one participant had data missing on the CDI. Maximum likelihood estimation is the recommended alternative to discarding participants who are missing data (48).
Academic SE Social SE Resistive SE CDI YSR AUDIT
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1
2
3
4
5
6
– 0.70** 0.42** 0.26* 0.25* 0.04
– 0.42** 0.33** 0.16 0.001
– 0.24* 0.44** 0.36**
– 0.45** 0.13
– 0.39**
–
A reversed path model was also tested to examine whether it provided a better fit to the data. Specifically, this model had alcohol use and externalizing problems predicting self-efficacy to resist negative peer influences, and depressive symptoms predicting social and academic self-efficacy. In short, this model showed an unacceptable overall fit to the data (see Table 3). Best-fitting final model
SE, Self-efficacy; Resistive SE, self-efficacy to resist negative peer influence; CDI, Children’s Depression Inventory; YSR, externalizing subscale on the Youth Self-Report; *50.01 (two-tailed), **p50.001 (two-tailed).
Byrne (47) recommends that the final models in SEM should represent the best fitting and most parsimonious of the tested models. Taking into consideration overall fit indices as well as the significance or non-significance of individual parameters,
Table 3. Model fit statistics for estimated path models. Model 1 2 3 4
Description Hypothesized model Alternate model 1: Reversed Alternate model 2: All efficacy Final model
2 (df, p value)
CFI
SRMR
5.46 34.55 0.99 10.75
1.00 0.85 1.00 0.92
0.03 0.09 0.01 0.05
(10, 0.86) (9, 0.00) (5, 0.96) (5, 0.06)
RMSEA (90% CI) 0.00 0.14 0.00 0.08
(0.00–0.05) (0.09–0.19) (0.00–0.00) (0.00–0.15)
AIC 6256.57 5371.11 6000.29 4824.33
CFI, Comparative Fit Index; SRMR, Standardized Root Mean Square Residual; RMSEA 90% CI, Root Mean Square Error of Approximation with a 90% confidence interval; AIC, Akaike’s Information Criterion.
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−0.41**
Externalizing Behaviors
−0.35** 0.27** Alcohol Use
0.46**
0.45**
Social Self-Efficacy
−0.33** 0.28**
Gender Male=1, Female=2
Depressive Symptoms
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Figure 2. Final path model (** ¼ p50.001, two-tailed).
our hypothesized model emerged with the strongest support of the three tested models. However, as academic self-efficacy did not significantly predict depressive symptoms in the hypothesized model, it was removed in the final ‘‘best-fitting’’ path model (see Figure 2). In short, this best-fitting model provided an excellent fit to the data (see Table 3), including having the lowest AIC value. In addition, all individual parameters were significant in the predicted directions (see Figure 2). Specifically, self-efficacy to resist negative peer influences significantly predicted alcohol use ( ¼ 0.35, p50.001) and externalizing behaviors ( ¼ 0.41, p50.001). Further, as predicted, social self-efficacy ( ¼ 0.33, p50.001) and gender (i.e. being female; ¼ 0.28, p50.001) directly predicted depressive symptoms.
Discussion The purpose of this study was to test whether self-efficacy beliefs in academic, social, and resisting negative peer influence domains predicted alcohol use, externalizing behaviors, and depressive symptoms among youth of North American Plain tribes. It was expected that high self-efficacy for resisting negative peer influences would predict both lower rates of alcohol use and fewer externalizing behaviors. It was also hypothesized that higher levels of both academic and social self-efficacy would predict fewer depressive symptoms. In short, most of our hypotheses were supported. In fact, the best-fitting path model showed nearly all hypothesized relationships being significant, with self-efficacy for resisting negative peer influences predicting both alcohol use and externalizing problems, and social self-efficacy (as well as being female) predicting depressive symptoms among AI youth. The only pathway that was not supported was academic self-efficacy to depressive symptoms. We discuss each of these findings and identify limitations of our study as well as directions for future research. In support of previous findings (e.g. 7,50), we found that self-efficacy to resist negative peer influences significantly contributed to both lower alcohol use and fewer externalizing problems. The use of substances by one’s peers is one of the most consistently strong predictors of substance youth among youth (51,52). A large, robust literature documents the strong relationship between negative peer influence and deviant behaviors. For AI youth from the northern plains, these
observations may be especially problematic as the rates for substance use disorders has been observed to be three times that of rates observed in other youth populations (2,5) and rates of lifetime conduct disorder are about twice the rate of other youth populations (2). In other words, it could be that AI youth are in relatively risky peer contexts in which temptations to engage in delinquent behaviors are more prevalent. Therefore, the belief that one is capable of resisting these peer influences may be an especially important predictor of lower substance use and fewer externalizing behaviors, particularly relevant to the context in which AI youth live their lives. In contrast to previous research with AI youth from the northern plains (24,29), in which academic self-efficacy emerged as the strongest predictor of depressive symptoms, we did not find academic self-efficacy to predict depressive symptoms. Rather, social self-efficacy emerged as the strongest predictor of depressive symptoms. Initially, we thought that this finding might reflect the unique sample we examined in our study, which consisted of a sample of youth attending a summer program to assist with the transition from middle to high school and from high school to higher education. In previous research, Scott and colleagues’ participants were AI middle and high school youth who were sampled in regular schools from a different tribe and reservations than the current study (24,29). The youth in the present study possibly were more accomplished academically, and thus may have had a more restricted range in self-efficacy beliefs. However, in comparing the standard deviations for academic self-efficacy for the AI youth in the present study with those of these two other studies in which the same academic self-efficacy measure was administered (i.e. 24,29), the present study’s standard deviation was actually the highest (present SD ¼ 1.05 compared to SDs of 0.81 and 0.93 in the two other studies). Perhaps not surprisingly given the nature of the summer camp, the participants in the present study did report high mean academic self-efficacy scores (5.5 compared to 4.96 and 4.8). Alternatively, it is possible that social self-efficacy emerged as more influential for depressive symptoms in the present study because youth were less well-acquainted with their peers. That is, the youth in this study were in a new social context in which they were interacting with less familiar youth they were meeting in the context of this summer camp experience. It is possible that in a more novel social context, such as the one which existed in this study, social self-efficacy emerges as more important. In Etz and colleagues’ (5) special issue, a theme emerged in which authors argued for the need for future substance abuse research to identify assets and strengths that exist in AI youth populations. It was argued that such a research program would increase the likelihood of successfully engaging AI communities in efforts to develop more effective prevention and treatment efforts. Our findings, particularly when combined with the findings of Scott and colleagues (24,29,30), suggest that AI youth share more similarities than dissimilarities relative to youth of other ethnicities. As in other populations, self-efficacy emerged as an important source of resiliency among AI youth and thus should be considered as an important factor when implementing prevention or intervention programs.
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DOI: 10.3109/00952990.2014.910518
Alcohol use, externalizing problems, and depressive symptoms
Although future longitudinal work examining self-efficacy beliefs and substance use in AI youth populations is needed before one can infer stronger implications, our results are consistent with the idea that prevention and treatment programs for AI youth need to focus on building self-efficacy to resist negative peer influence as a means to prevent such high risk activities. Within the realm of interventions for substance use, the most effective treatments (e.g. motivational interviewing, motivational enhancement therapy, cognitivebehavioral treatment) all have a strong focus on building one’s self-efficacy and skills to manage high-risk situations and life stressors, to resist the urge to use when experiencing distress, and to find alternatives to substance use (53). This seems to suggest that prevention strategies could also be applied to enhance self-efficacy in resisting peer influence to use alcohol. Overall, the findings from this study and previous research point to the fact that a strong sense of self-efficacy in resisting negative peer influences, in successfully performing academic activities and in connecting in positive peer relationships is likely to be a critical variable in promoting resiliency (54), maybe even more so in AI communities (29). Some limitations of this study should be acknowledged. First, the current study employed a cross-sectional design and therefore it is not possible to determine whether the relationships suggested by path models are truly causal. Second, all measures collected from the adolescents were self-report. Although some constructs, like depression and self-efficacy, might be better reported by youth, multiple informants would strengthen the validity of the constructs measured in this study. Third, although our reversed path models in which we had outcomes (i.e. alcohol use, externalizing behaviors, and depressive symptoms) predicting self-efficacy variables showed poor fit to our data, it is likely that if causal relationships do in fact exist between these constructs then they are probably reciprocal to some extent. That is, if individuals exhibit consistent patterns of using alcohol, acting out, and feeling depressed, these experiences are most likely influencing their self-efficacy beliefs for resisting negative peer influences, as well as performing well academically and socially. Future studies should utilize longitudinal designs to examine whether changes in self-efficacy beliefs predict later changes in alcohol use and externalizing behaviors. This study underscores the importance of self-efficacy beliefs for development of alcohol use initiation and externalizing problems, as well as depressive symptoms among AI youth, all of which are known to have adverse longterm developmental consequences. Although there is stronger evidence for the role of self-efficacy beliefs in the depressive experiences of AI youth, we hope this initial study identifying a relationship between self-efficacy beliefs and substance use and externalizing behaviors will stimulate more research into these domains. Ultimately, it is hoped that these findings can inform effective programs promoting resiliency in AI communities.
Declaration of interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.
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