Factors Associated With Levels of Risky Drinking in Adolescent Alcohol Users in Taiwan: A Secondary Data Analysis

台灣青少年飲酒行為危險類型相關因素－次級資料分析

10.1097/jnr.0000000000000151

洪兆嘉(Chao-Chia Hung)；張新儀(Hsin-Yi Chang)；江宜珍(Yi-Chen Chiang)；吳文琪(Wen-Chi Wu)；李蘭(Lee-Lan Yen)

adolescents ； drinking risk levels ； social influences ； 青少年 ； 飲酒行為危險程度 ； 社會影響

The Journal of Nursing Research

25卷2期（2017 / 04 / 01）

163 - 172

英文

Background: Drinking is largely viewed as a socialized behavior; however, our understanding of factors associated with levels of risky drinking is limited in cultures where underage drinking is relatively unacceptable. Purpose: The aims of this study were to define the different levels associated with risky drinking and to examine the factors that are associated with these levels. Methods: We used data from the Child and Adolescent Behavior in Long-Term Evolution project. Of the 2184 students who participated in the 2006 Child & Adolescent Behavior in Long- Term Evolution survey, 1591 self-reported prior use of alcohol and had complete questionnaire data that could be used in secondary data analysis. The main study variables that were used in this study to assess levels of risky drinking included frequency of drinking, amount of drinking, and frequency of intoxication. We used ordinal logistic regression to analyze the relationships between levels of risky drinking and associated factors. Results: In the study sample, 9.55%were classified with high-risk drinking behavior, 22.51% were classified with medium-risk drinking behavior, and 67.94%were classified with low-risk drinking behavior. Having a mother or peers who used alcohol, being encouraged to consume alcohol by older adults or peers, high alcohol availability, high positive alcohol expectancies, low negative alcohol expectancies, and low alcohol refusal efficacy were all associated with higher levels of risky drinking. Conclusions/Implications for Practice: Decreasing the availability of alcohol, developing appropriate alcohol expectancies, and increasing alcohol refusal skills may help decrease the development of high-risk drinking behavior in adolescents. Our study furthers the understanding of underage alcohol use in societies with low alcohol consumption.

背景　飲酒是一種社會化行為，在未成年飲酒行為相對較不被接受的文化裡，對飲酒行為危險程度的相關因素了解非常有限。目的　本研究主要目的是確認曾飲酒的學生於九年級時飲酒行為危險程度及其相關因素。方法　研究利用兒童及青少年行為之長期發展研究計畫（Child & Adolescent Behaviors in Long-term Evolution）調查資料，進行次級資料分析。共有2184名九年級學生參與2006年的調查，其中1591名學生自述曾飲酒。主要研究變項是由飲酒頻率、飲酒量及酒醉頻率所分組而成的飲酒行為危險程度，利用序位邏輯斯迴歸分析探討與飲酒行為危險程度有關的因素。結果　研究結果顯示，9.55%的學生屬於高危險飲酒行為、22.51%的學生屬於中危險性飲酒行為、67.94%的學生屬於低危險性飲酒行為。結果顯示，母親飲酒、同儕飲酒，長輩或同儕勸酒，酒品可獲性愈高，正向飲酒結果期望愈高，負向飲酒結果期望愈低，拒酒效能愈低，都會提升青少年飲酒行為危險程度。結論／實務應用　降低酒品可獲性，建立青少年正確的飲酒結果期望，及增強拒酒的信心可有效降低青少年飲酒行為的危險程度。本研究結果有助於對低飲酒社會未成年飲酒行為的了解。

1. Ariza Cardenal, C.,Nebot Adell, M.(2000).Factors associated with problematic alcohol consumption in schoolchildren.The Journal of Adolescent Health,27(6),425-433.
2. Austin, E. W.,Chen, M. J.,Grube, J. W.(2006).How does alcohol advertising influence underage drinking? The role of desirability, identification and skepticism.The Journal of Adolescent Health,38(4),376-384.
3. Bandura, A.(1986).Social foundations of thought and action: A social cognitive theory.Englewood Cliffs, NJ:Prentice-Hall.
4. Barnes, G. M.,Reifman, A. S.,Farrell, M. P.,Dintcheff, B. A.(2000).The effects of parenting on the development of adolescent alcohol misuse: A six-wave latent growth model.Journal of Marriage and the Family,62,175-186.
5. Callas, P. W.,Flynn, B. S.,Worden, J. K.(2004).Potentially modifiable psychosocial factors associated with alcohol use during early adolescence.Addictive Behaviors,29(8),1503-1515.
6. Cameron, C. A.,Stritzke, W. G.,Durkin, K.(2003).Alcohol expectancies in late childhood: An ambivalence perspective on transitions toward alcohol use.Journal of Child Psychology and Psychiatry,44(5),687-698.
7. Colder, C. R.,Chassin, L.(1999).The psychosocial characteristics of alcohol users versus problem users: Data from a study of adolescents at risk.Development and Psychopathology,11(2),321-348.
8. Dauber, S.,Hogue, A.,Paulson, J. F.,Leiferman, J. A.(2009).Typologies of alcohol use inWhite and African American adolescent girls.Substance Use & Misuse,44(8),1121-1141.
9. Dent, C. W.,Grube, J. W.,Biglan, A.(2005).Community level alcohol availability and enforcement of possession laws as predictors of youth drinking.Preventive Medicine,40(3),355-362.
10. Duncan, S. C.,Duncan, T. E.,Strycker, L. A.(2006).Alcohol use from ages 9 to 16: A cohort-sequential latent growth model.Drug and Alcohol Dependence,81(1),71-81.
11. Elder, R. W.,Shults, R. A.,Swahn, M. H.,Strife, B. J.,Ryan, G. W.(2004).Alcohol-related emergency department visits among people ages 13 to 25 years.Journal of Studies on Alcohol,65(3),297-300.
12. Gilles, D. M.,Turk, C. L.,Fresco, D. M.(2006).Social anxiety, alcohol expectancies, and self-efficacy as predictors of heavy drinking in college students.Addictive Behaviors,31(3),388-398.
13. Hung, C. C.,Chiang, Y. C.,Chang, H. Y.,Yen, L. L.(2011).Path of socialization and cognitive factors' effects on adolescents' alcohol use in Taiwan.Addictive Behaviors,36(8),807-813.
14. Hung, C. C.,Yen, L. L.,Wu, W. C.(2009).Association of parents' alcohol use and family interaction with the initiation of alcohol use by sixth graders: A preliminary study in Taiwan.BMC Public Health,9,172.
15. Jackson, N.,Denny, S.,Sheridan, J.,Fleming, T.,Clark, T.,Teevale, T.,Ameratunga, S.(2014).Predictors of drinking patterns in adolescence: A latent class analysis.Drug and Alcohol Dependence,135,133-139.
16. Kann, L.,Kinchen, S.,Shanklin, S. L.,Flint, K. H.,Kawkins, J.,Harris, W. A.,Centers for Disease Control and Prevention (CDC)(2014).Youth risk behavior surveillance-United States, 2013.Morbidity and Mortality Weekly Report,63(Suppl. 4),1-168.
17. Karam, E.,Kypri, K.,Salamoun, M.(2007).Alcohol use among college students: An international perspective.Current Opinion in Psychiatry,20(3),213-221.
18. Komro, K. A.,Maldonado-Molina, M. M.,Tobler, A. L.,Bonds, J. R.,Muller, K. E.(2007).Effects of home access and availability of alcohol on young adolescents' alcohol use.Addiction,102(10),1597-1608.
19. Koning, I.M.,Engels, R. C.,Verdurmen, J. E.,Vollebergh, W. A.(2010).Alcohol-specific socialization practices and alcohol use in Dutch early adolescents.Journal of Adolescence,33(1),93-100.
20. Li, F.,Duncan, T. E.,Hops, H.(2001).Examining developmental trajectories in adolescent alcohol use using piecewise growth mixture modeling analysis.Journal of Studies on Alcohol,62(2),199-210.
21. Lundborg, P.(2002).Young people and alcohol: An econometric analysis.Addiction,97(12),1573-1582.
22. Nash, S. G.,McQueen, A.,Bray, J. H.(2005).Pathways to adolescent alcohol use: Family environment, peer influence, and parental expectations.The Journal of Adolescent Health,37(1),19-28.
23. Osler, M.,Nordentoft, M.,Andersen, A. M.(2006).Childhood social environment and risk of drug and alcohol abuse in a cohort of Danish men born in 1953.American Journal of Epidemiology,163(7),654-661.
24. Paschall, M. J.,Grube, J. W.,Black, C.,Ringwalt, C. L.(2007).Is commercial alcohol availability related to adolescent alcohol sources and alcohol use? Findings from a multi-level study.The Journal of Adolescent Health,41(2),168-174.
25. Reboussin, B. A.,Song, E. Y.,Shrestha, A.,Lohman, K. K.,Wolfson, M.(2006).A latent class analysis of underage problem drinking: Evidence from a community sample of 16-20 year olds.Drug and Alcohol Dependence,83(3),199-209.
26. Robins, L. N.(Ed.),Rutter, M.(Ed.)(1990).Straight and deviant pathways from childhood to adulthood.New York, NY:Cambridge University Press.
27. Sartor, C. E.,Lynskey, M. T.,Heath, A. C.,Jacob, T.,True, W.(2007).The role of childhood risk factors in initiation of alcohol use and progression to alcohol dependence.Addiction,102(2),216-225.
28. Steinhausen, H. C.,Metzke, C. W.(2003).The validity of adolescent types of alcohol use.Journal of Child Psychology and Psychiatry,44(5),677-686.
29. Trucco, E. M.,Colder, C. R.,Wieczorek, W. F.(2011).Vulnerability to peer influence: A moderated mediation study of early adolescent alcohol use initiation.Addictive Behaviors,36(7),729-736.
30. Verdurmen, J.,Monshouwer, K.,van Dorsselaer, S.,ter Bogt, T.,Vollebergh, W.(2005).Alcohol use and mental health in adolescents: Interactions with age and gender-Findings from the Dutch 2001 Health Behaviour in School-Aged Children survey.Journal of Studies on Alcohol,66(5),605-609.
31. Weitzman, E. R.,Nelson, T. F.,Wechsler, H.(2003).Taking up binge drinking in college: The influences of person, social group, and environment.The Journal of Adolescent Health,32(1),26-35.
32. White, H. R.,Johnson, V.,Buyske, S.(2000).Parental modeling and parenting behavior effects on offspring alcohol and cigarette use: A growth curve analysis.Journal of Substance Abuse,12(3),287-310.
33. World Health Organization(2014).Global status report on alcohol and health 2014.
34. Yeh, M. Y.(2006).Factors associated with alcohol consumption, problem drinking, and related consequences among high school students in Taiwan.Psychiatry and Clinical Neurosciences,60(1),46-54.
35. Yen, L. L.,Chen, L.,Lee, S. H.,Hsiao, C.,Pan, L. Y.(2002).Child and adolescent behavior in long-term evolution (CABLE): A school-based health lifestyle study.Promotion & Education,Suppl. 1,33-40.
36. Young, R. M.,Connor, J. P.,Ricciardelli, L. A.,Saunders, J. B.(2006).The role of alcohol expectancy and drinking refusal self-efficacy beliefs in university student drinking.Alcohol and Alcoholism,41(1),70-75.
37. Young, S. Y.,Hansen, C. J.,Gibson, R. L.,Ryan, M. A.(2006).Risky alcohol use, age at onset of drinking, and adverse childhood experiences in young men entering the US Marine Corps.Archives of Pediatrics & Adolescent Medicine,160(12),1207-1214.
38. Zamboanga, B. L.,Horton, N. J.,Leitkowski, L. K.,Wang, S. C.(2006).Do good things come to those who drink? A longitudinal investigation of drinking expectancies and hazardous alcohol use in female college athletes.The Journal of Adolescent Health,39(2),229-236.

1. (2024)。大學院校男生強制性交行為的盛行率、型態、與連續性。教育心理學報，55(4)，745-766。