Social Competence and Substance Use Among Rural ... - Springer Link

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Journal of Youth and Adolescence [jya]

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Style file version Nov. 19th, 1999

Journal of Youth and Adolescence, Vol. 30, No. 4, 2001

Social Competence and Substance Use Among Rural Youth: Mediating Role of Social Benefit Expectancies of Use Kenneth W. Griffin,1 Jennifer A. Epstein,2 Gilbert J. Botvin,3 and Richard L. Spoth4 Received December 28, 2000; accepted April 6, 2001

The present study examined the mechanisms by which social competence may be associated with substance use during early adolescence. The sample consisted of rural youth (N = 1,568) attending 36 junior high schools in a midwestern state. Structural equation modeling indicated that social competence had a direct protective association with substance use in that those youth who were more socially confident, assertive, and had better communication skills reported less smoking and drinking. Further analyses revealed that the relationship between social competence and substance use was fully mediated by social benefit expectancies of use. These findings suggest that poorly competent youth turn to smoking and alcohol use because they perceive that there are important social benefits to doing so, such as having more friends, looking grown up and “cool,” and having more 1 Assistant Professor, Department of Public Health, Weill Medical College, Cornell University. Received

PhD in social/health psychology from State University of New York at Stony Brook. Major research interests are in tobacco, alcohol, and drug abuse etiology and prevention, violence etiology and prevention, prevention program evaluation, and quality of life and psychological adaptation in the chronically ill. To whom correspondence should be addressed at Institute for Prevention Research, Weill Medical College, Cornell University, 411 East 69th Street, New York, New York 10021; e-mail: [email protected]. 2 Assistant Professor, Department of Public Health, Weill Medical College, Cornell University. Received PhD in social psychology from Columbia University. Major research interests are in tobacco, alcohol, and drug abuse etiology and prevention. 3 Professor, Departments of Public Health and Psychiatry, Weill Medical College, Cornell University. Received PhD in developmental psychology from Columbia University. Major research interests are in tobacco, alcohol, and drug abuse prevention, violence prevention, AIDS risk reduction among adolescents, health promotion and disease prevention, and smoking cessation. 4 Senior Research Scientist in Prevention, Institute for Social and Behavioral Research, Iowa State University. Received PhD from University of Iowa. Major research interests are in efficacy of youthand family-focused universal preventive interventions, engaging youth and families in preventive interventions, family-focused interventions in nonmajority populations, and diffusion of empirically supported interventions through school/community-university partnerships. 485 C 2001 Plenum Publishing Corporation 0047-2891/01/0800-0485$19.50/0 °

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fun. Prevention programs that teach youth interpersonal skills may reduce the initiation of substance use by improving social competence and providing youth with more adaptive means of gaining approval from peers.

INTRODUCTION Adolescent substance use continues to be an important social problem across the United States and is prevalent among youth living in urban, suburban, and rural areas. A recent secondary analysis of data from the Monitoring the Future study found differing trends over the past few decades in rates of substance use among rural and urban youth: In 1976, high school seniors from urban areas had higher prevalence rates of substance use than youth from rural areas, but by 1992 rural and urban students had similar rates overall and rural youth had higher rates of heavy alcohol and cigarette use (Cronk and Sarvela, 1997). In the last few years, the use of a number of substances has decreased more in urban areas relative to nonurban ones, resulting in higher rates of use for some substances in nonurban environments (Johnston et al., 2000). Furthermore, there appears to be a gap in the literature regarding the risk and protective processes that contribute to adolescent substance use among youth residing in rural areas (Fahs et al., 1999; Farrell et al., 1992). Greater understanding of these processes can help in the development and refinement of effective prevention programs for rural youth (Spoth, 1997). Social Competence as a Protective Factor Social competence is a broad construct encompassing a variety of social skills and aptitudes and has been shown to play a key role in youth development (Gullotta et al., 1990; Zins et al., 2000). Young people face a variety of new developmental tasks during the transition to adolescence such as establishing autonomy from parents and developing an extended peer group (Schulenberg et al., 1997; Utech and Hoving, 1969). A high degree of social competence may help youth succeed in these tasks, particularly when they enter new social and academic environments. During the entry into middle school, young people face several new challenges that require new adult-like skills (Blyth et al., 1983; Simmons and Blyth, 1987), and youth with good interpersonal skills may be better equipped to meet these challenges. In particular, assertiveness, the ability to communicate clearly, knowing how to initiate and end conversations appropriately, and the ability to make requests, refuse unwanted requests, and use other interpersonal negotiation strategies may help foster success as youth enter these new environments (Brion-Meisels and Selman, 1984; Zins et al., 2000). Several previous studies have shown that youth with good social competence skills have lower rates of substance use, depression, delinquency, aggression, and

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other problem behaviors (Dalley et al., 1994; Pentz, 1983; Scheier et al., 1999). For example, a study of elementary school youth showed that those scoring poorly on self-reported and teacher-rated measures of social competence were more likely to initiate substance use early (Jackson et al., 1997). Furthermore, over the past few decades there has been a growing recognition of the value of skills training in the areas of social and interpersonal competence as a means of preventing drug use, antisocial and aggressive behavior, high-risk sexual behavior, and promoting overall school success (Botvin, 2000; Botvin and Scheier, 1997; Frey et al., 2000; Pentz, 1983; Weissberg et al., 1997; Zins et al., 2000). Drug refusal skills are believed to be a key component of the protective effects of social competence in terms of adolescent substance use. Socially competent youth appear to be better able to refuse offers of cigarettes, alcohol, or other substances by peers (Charlton et al., 1999; Scheier et al., 1999). In addition, several studies have shown that refusal skills training is an important component of effective prevention programs (Shope et al., 1993; Wynn et al., 1997).

Social Competence: Beyond Refusal Skills However, because social competence is a broad construct encompassing many skills and abilities, there may be a variety of ways in which it is protective. According to problem behavior theory (PBT; Jessor and Jessor, 1977), problem behaviors are learned through a process of modeling, imitation, and reinforcement and are influenced by an adolescent’s cognitions, attitudes, and beliefs. PBT proposes that, from the perspective of the adolescent, problem behaviors serve a functional purpose in that they help youth achieve social or personal goals that they don’t believe they can achieve in more adaptive ways. For example, youth with poor social competence may feel that they lack the confidence or social skills to gain the acceptance and approval of peers in new situations. Youth with poor social competence may come to view substance use as a viable way of achieving these desirable social goals. In the process, these youth may adopt specific beliefs or expectancies regarding the social benefits of substance use. Smoking, alcohol use, and other drug use may come to be viewed as a valid way of achieving acceptance from peers who offer them drugs. Furthermore, poorly competent youth may perceive that engaging in substance use can provide social benefits such as looking grown-up and “cool.” In other words, the role of poor social competence in adolescent drug use is likely to extend beyond simply being less skilled at refusing drug offers. Rather than the inability to refuse, those with poor social competence may develop expectancies regarding the social benefits of use, and decide that acquiescing to peer pressure to engage in substance use can help them achieve important social goals. Conversely, because youth with strong social competence skills may achieve interpersonal goals in a more adaptive manner,

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they may view the prospect of engaging in substance use as less attractive and less useful. Goals of the Present Study Based on the theoretical rationale outlined in the previous paragraphs, the present study focuses on the role of social competence skills in adolescent substance use among a sample of rural youth. The relationships of social competence with social benefit expectancies of substance use and how these variables may contribute to adolescent substance use will be examined. The following hypotheses are tested: (1) social competence is directly associated with less smoking and drinking; (2) the relationship between social competence and smoking is mediated by social benefit expectancies of smoking; and (3) the relationship between social competence and drinking is mediated by social benefit expectancies of drinking. METHOD Sample Students from 36 junior high schools in northern and eastern Iowa were participants in the present study. All students in regular education 7th grade classrooms of participating schools were selected for inclusion in the study, and virtually all eligible students participated in the study. The sample for the present study (N = 1,568) was predominantly White (95%), and 53% were male.5 About 86% of participants lived in 2-parent families, 12% lived in single-parent families, and the remainder lived with other guardians. Procedure Students completed a self-report questionnaire in school during a 45-min class period that assessed substance use behaviors and several psychosocial variables hypothesized to be associated with the initiation and escalation of substance use in adolescents. Unique identification codes were placed on each survey rather than student names in order to ensure confidentiality. Students were informed that their responses would be confidential and not be made available to school personnel, teachers, or parents. Two forms of the questionnaire were administered, each with 5 From

an original sample of 1,572 students who completed the survey, 4 cases with 50% or more missing data were eliminated from further analyses. For the remaining 1,568 participants, a fullinformation, maximum likelihood, regression-based procedure was used to impute the remaining missing data points.

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the identical items but presented in a different order. A “bogus pipeline” procedure was used, entailing the measurement and recording of the carbon monoxide levels for each student at the time the assessment was conducted. Applying this procedure suggested to students that they should be honest in answering the questions related to tobacco and other substance use. Measures In the present study, latent factors of Social Competence, Expectancies of Social Benefits of Smoking and Drinking, and Smoking and Drinking were constructed to test the hypothesized models. Indicator reliabilities were calculated using Cronbach alphas where appropriate, and are provided later. Social Competence The three indicators of Social Competence consisted of summary scores from scales measuring Social Confidence, Assertiveness, and Communication Skills. Thirteen items (α = 0.91) measured Social Confidence, or students’ assessments of their confidence in being able to act appropriately in a variety of social situations. For example, items asked participants “How confident are you that you could do well” in situations such as “Making requests or asking favors,” “Asking someone out for a date,” “Receiving a compliment,” and “Saying no to an unfair request” with response options ranging from 1 (not at all confident) to 5 (very confident). Thirteen items (α = 0.81) from the Assertion Inventory (Gambrill and Richey, 1975) were used to assess Assertiveness in a variety of situations. For example, items asked participants how likely would they be to “Express an opinion even though others may disagree with you,” “Take something back to the store if it doesn’t work right,” and “Start a conversation with someone you don’t know” with response options ranging from 1 (definitely would not) to 5 (definitely would ). Four items (α = 0.72) assessed Communication Skills (Epstein et al., 1997). These items assessed the extent to which participants use a variety of techniques to communicate effectively, such as “Talking in a way that is clear and specific” and “Asking questions if someone says something that isn’t clear.” Response categories ranged from 1 (never) to 5 (always). Social Benefit Expectancies of Substance Use Four items (α = 0.72) from the Teenager’s Self-Test: Cigarette Smoking (Centers for Disease Control, 1974) were used to assess Social Benefit Expectancies of Smoking. Items included “Kids who smoke have more friends” and “Smoking cigarettes makes you look cool.” Four similar items (α = 0.72) were created to assess Social Benefit Expectancies of Drinking. Items included “Drinking alcohol

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lets you have more fun” and “Drinking helps you get along with other people at parties.” Response options for all items ranged from 1 (strongly disagree) to 5 (strongly agree). Substance Use A Smoking latent factor had three indicators including the frequency of smoking from 1 (never) to 9 (more than once a day), a dichotomous lifetime smoking variable, and intentions to smoke in the coming year on a scale from 1 (definitely not) to 5 (definitely will). A Drinking latent factor had matching corresponding indicators of frequency, lifetime use, and intentions with the same response options as the smoking items.

Data Analysis Testing of the hypothesized structural models proceeded in a stepwise manner. A confirmatory factor analysis (CFA) model tested the psychometric adequacy of the hypothesized measurement model. Next, a structural equation model (SEM) tested the direct effects of Social Competence on Smoking and Drinking. Finally, a model tested the extent to which the Social Benefit Expectancies of Smoking mediated the relationship between Social Competence and Smoking and whether Social Benefit Expectancies of Drinking mediated the relationship between Social Competence and Drinking. The EQS computer program (Bentler, 1995) was used for the confirmatory and structural analyses. Maximum likelihood estimation was used for all modeling. To account for the skewed distributions of the substance use indicators, robust statistics were computed in testing the models. Robust statistics compute standard errors for model parameters that are correct even if the distributional assumption of multivariate normality is not met. This procedure yields a revised Satorra–Bentler chi-square statistic and a robust Comparative Fit Index (Satorra and Bentler, 1994). In evaluating the overall goodness-of-fit for the CFA and SEM models, the following criteria were used: (1) the Satorra–Bentler robust chi-square p-value, which if p > 0.05 indicates that there are no statistically significant discrepancies between the observed data and the hypothesized model; (2) the Normed Fit Index (NFI; Bentler and Bonett, 1980), which specifies the amount of covariation in the data that is accounted for by the hypothesized model relative to a null model that assumes independence among factors; (3) the Robust Comparative Fit Index (CFI), an index similar to the NFI that adjusts for the sample size (for the NFI and CFI, a cutoff of 0.90 is generally accepted as indicating a good fit, where 1.0 indicates a perfect fit); and (4) the standardized root mean squared residual (SRMR), which should be less than 0.05.

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RESULTS An analysis of substance use prevalence rates revealed that 21% of students reported smoking cigarettes in their lifetime, 5% reported smoking on a monthly basis, and 19% reported that they might smoke in the coming year. In terms of drinking, 50% of students reported drinking alcohol in their lifetime, 3% reported drinking on a monthly basis, and 26% reported that they might drink in the coming year. Confirmatory Factor Analysis As shown in Fig. 1, a CFA model was tested that consisted of 5 latent factors, with each latent factor containing 3 to 4 indicators. The Social Competence latent factor consisted of summary score indicators from the Social Confidence, Assertiveness, and Communication Skills measures; the Social Benefit Expectancies of Smoking and of Drinking latent factors each had 4 single-item indicators; and the Smoking and Drinking latent factors each had 3 single-item indicators. Factor loadings for the CFA were statistically significant ( ps < 0.0001)

Fig. 1. Confirmatory factor analysis model of social competence, social benefit expectancies of smoking and drinking, and smoking and drinking. Note: All factor loadings are statistically significant, p < 0.001.

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Griffin et al. Table I. Correlations Among Latent Factors From Confirmatory Factor Analysis

1. Social Competence 2. Social Benefit Expectancies of Smoking 3. Social Benefit Expectancies of Drinking 4. Smoking 5. Drinking

1

2

3

4

5

— −0.366 −0.275 −0.199 −0.164

— 0.780 0.542 0.416

— 0.461 0.492

— 0.770

—

Note. All correlations are significant at p < 0.001.

and in the expected direction, indicating that the measurement model was properly specified. According to the goodness-of-fit criteria, the fit of the CFA model was adequate, Satorra–Bentler χ 2 (109, N = 1,568) = 805.7, p < 0.001, NFI = 0.937, Robust CFI = 0.918, SRMR = 0.043.6 The latent factor intercorrelations from the CFA model are shown in Table I. All factors were moderately to strongly intercorrelated, and the patterns of intercorrelations were in the expected directions. In summary, the CFA analysis demonstrated that the measurement model was adequate, with high factor loadings for all indicator variables and good fit indices. Structural Equation Models To test the hypothesis that the effects of Social Competence on Smoking and Drinking are mediated by the Social Benefit Expectancies of Smoking and of Drinking, 2 separate SEMs were tested. As outlined by Baron and Kenny (1986), mediation can be established by showing a direct effect of a predictor on an outcome, a direct effect of the predictor on the hypothesized mediator, a direct effect of the mediator on the outcome, and a decrease in the effect of the predictor on the outcome when the mediator is added to the model. First, a direct effect model tested the influence of Social Competence on Smoking and Drinking. As shown in Fig. 2, this model showed a protective effect of Social Competence on both Smoking (β = −0.20, p < 0.001) and Drinking (β = −0.16, p < 0.001). The model provided a good fit to the data, Satorra– Bentler χ 2 (24, N = 1568) = 321.6, p < 0.001, NFI = 0.944, Robust CFI = 0.907, SRMR = 0.046. A second model tested the extent to which Social Benefit Expectancies of Smoking mediated the effects of Social Competence on Smoking and Social Benefit Expectancies of Drinking mediated the effects of Social Competence on Drinking. As shown in Fig. 3, this model included one exogenous latent factor (Social Competence), two potential mediating latent factors (Social 6 The chi-square p-value is often used to evaluate whether there are statistically significant discrepancies

between the observed data and the hypothesized model. Although the chi-square p-value was significant in this model, indicating that additional models could be fit to the data, this is not uncommon with large models and large sample sizes (e.g., Marsh et al., 1988).

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Fig. 2. Structural model of the direct effects of social competence on smoking and drinking. Note: ∗ p < 0.001.

Fig. 3. Structural model of the mediated effects of social competence on smoking and drinking through social benefit expectancies of use. Note: ∗ p < 0.001.

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Benefit Expectancies of Smoking and Social Benefit Expectancies of Drinking), and the two outcome factors of Smoking and Drinking. The model provided a good fit to the data, Satorra–Bentler χ 2 (111, N = 1568) = 817.0, p < 0.001, NFI = 0.936; Robust CFI = 0.918, SRMR = 0.045. Furthermore, all criteria for establishing mediation were met in that (a) Social Competence had a direct effect on both the Social Benefit Expectancies of Smoking (β = −0.37, p < 0.001) and the Social Benefit Expectancies of Drinking (β = −0.28, p < 0.001); (b) the Social Benefit Expectancies of Smoking had a direct effect on Smoking (β = 0.53, p < 0.001) and the Social Benefit Expectancies of Drinking had a direct effect on Drinking (β = 0.46, p < 0.001); and (c) the previously significant direct effect of Social Competence on Smoking became nonsignificant (β = −0.01, ns) with the addition of Social Benefit Expectancies of Smoking, and the previously significant direct effect of Social Competence on Drinking became nonsignificant (β = −0.05, ns) with the addition of Social Benefit Expectancies of Drinking (these previously significant paths are shown as dotted lines in Fig. 3). DISCUSSION The present study examined social competence skills and social benefit expectancies of smoking and drinking as predictors of adolescent substance use in a sample of rural youth. While previous research has shown that social competence is associated with less adolescent substance use, few studies have investigated the mediating mechanisms by which these constructs may be related. Findings from the present study indicated that social competence had a protective effect on smoking and drinking because youth who were more socially confident, assertive, and had better communication skills were less likely to believe that there were important social benefits associated with smoking and drinking. These findings partially replicate those of a previous study of inner-city minority youth that found that a more general construct of competence was protective in terms of subsequent smoking because youth with better decision-making and personal efficacy skills perceived fewer social benefits of smoking (Epstein et al., 2000). The findings from the present study replicate and extend these earlier results by showing that a more narrowly focused construct of social competence skills provides a protective effect via social benefit expectancies of substance use in a different sample (rural vs. urban) using different measures of competence and with outcomes of alcohol use as well as smoking. Thus, it appears that the relationships among competence, social benefit expectancies, and substance use are robust. Another implication of the present findings is that social competence is protective for reasons that go beyond refusal skills. Socially competent youth appear to believe that substance use would not serve a meaningful social purpose in their lives. The literature on adolescent social competence, social activity, and drug use expectancies and behavior illustrate that the relationships among these variables

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are complex. On the one hand, social activity and the ability to garner social support from peers and adults may serve as an essential protective factor, reducing susceptibility to the forces that promote substance use and other problem behaviors. On the other hand, specific social skills such as assertiveness have been found to be positively associated with youth alcohol use (Goldberg and Botvin, 1993; Wills et al., 1989) and smoking (Carvajal et al., 2000). In addition, while studies show that alcohol expectancies are a key predictor of youth drinking (e.g., Simons-Morton et al., 1999), the relationship between expectancies and use may be reciprocal, nonlinear, or interactive in nature (Grube and Agostinelli, 1999; Smith et al., 1995). By showing that poorly socially competent youth engage in substance use in part because they may expect certain social benefits from use, the findings from the present study may help to shed some light on these complex relationships. Further research is needed to distinguish the circumstances under which social competence is protective versus associated with increased risk. The present findings are consistent with the idea that an essential developmental task of adolescence is self-definition (Erikson, 1968). Of course, not all attempts at self-definition will be sanctioned by the larger society. Research has shown that youth who engage in delinquent behavior often see doing so a means of attaining a “possible self” (Oyserman and Saltz, 1993). Youth with poor social competence may find it more difficult to establish an identity, and accepting drug offers from peers engaging in substance use may be an attempt to socially define oneself. Conversely, highly competent youth may be less tempted and better able to withstand peer pressure to engage in problem behaviors because they can use their successes in developmental tasks to envision future goals, possibilities, and future “selves” (Masterpasqua, 1989). These youth may be better prepared to achieve self-definition in more adaptive ways, and able to work effectively toward conventional goals. Implications for Prevention Refusal or resistance skills training is a common approach to substance abuse prevention. This approach teaches young people how to recognize, handle, and avoid situations in which they are likely to experience peer pressure to use substances (Schinke et al., 1991). Project DARE, or Drug Abuse Resistance Education, is probably the most popular school-based drug education program based on the refusal skills model of substance abuse prevention. Despite the popularity of DARE, several recent rigorous evaluation studies of DARE have shown that DARE has little or no impact on drug use behaviors, particularly beyond the initial posttest assessment (Clayton et al., 1996; Ennett et al., 1994; Lynam et al., 1999; Rosenbaum and Hanson, 1998). Although the reasons for the lack of DARE’s impact are unclear, one possibility is that its focus on resistance skills is too narrow.

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Prevention programs that focus more broadly on social and personal competence enhancement as well as refusal skills training target a broader array of risk and protective factors (Botvin and Griffin, 2000). These competence enhancement approaches teach adolescents a combination of resistance skills and a variety of social and personal competence skills in an attempt to reduce intrapersonal motivations to smoke, drink, or use illicit drugs. Rigorous evaluation studies have shown that drug abuse prevention approaches emphasizing competence enhancement are effective and that effects can last until the end of high school (e.g., Botvin et al., 1995, 2000). The success of this prevention approach suggests that it is important for programs to focus more broadly on enhancing social and personal competence rather than focusing solely or primarily on refusal skills training. Social skills training for substance abuse prevention in adolescents may reduce expectations of social benefits of engaging in substance use, and also may have the additional benefit of generalizing to several other areas of everyday adolescent functioning (Pentz, 1983). Several limitations of this study should be noted. First, because this was a school-based study that relied on students’ self-reports, the significant relationships among variables may partly reflect shared method variance. Second, it was a cross-sectional study, limiting the ability to infer causation. Third, the age range of participants was limited because only 7th grade students were included in the sample. Because young people at this age may particularly be influenced by substance use behavior and attitudes of friends and family (e.g., Jackson et al., 1998), the findings of the present study may not generalize to older youth. Fourth, several important predictors of adolescent drug use were not included in the model, such as peer influences. Nevertheless, the final model was derived from theory and the findings are parsimonious. Future research should attempt to identify the circumstances in which social competence is associated with adolescent substance use and the processes by which poorly competent youth turn to substance use over time. Prevention studies should investigate the extent to which various types of social skills training can protect youth with poor social competence from problem behaviors. REFERENCES Baron, R. M., and Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J. Person. Soc. Psychol. 51: 1173–1182. Bentler, P. M. (1995). EQS structural equations program manual. Encino, CA: Multivariate Software. Blyth, D. A., Simmons, R. G., and Carlton-Ford, S. (1983). The adjustment of early adolescents to school transitions. J. Early Adolesc. 3: 105–120. Botvin, G. J. (2000). Preventing drug abuse in schools: Social and competence enhancement approaches targeting individual-level etiologic factors. Addict. Behav. 25: 887–897. Botvin, G. J., Baker, E., Dusenbury, L. D., Botvin, E. M., and Diaz, T. (1995). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. JAMA 273: 1106–1112. Botvin, G. J., and Griffin, K. W. (2000). Preventing substance use and abuse. In Minke, K., and Bear, G. (eds.), Preventing School Problems—Promoting School Success: Strategies and

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