Alcohol Use Among Latino Adolescents: Neurocognitive and Contextual Explanations of the Immigrant Paradox

Author(s): Bacio, Guadalupe Alvarado | Advisor(s): Ray, Lara A | Abstract: The purpose of the dissertation was to examine the immigrant paradox in relation to alcohol use patterns among Latino youth and test potential neurocognitive and contextual explanations. Specifically, the dissertation analyzed the differences in drinking initiation and alcohol use patterns between non-U.S.-born Latino adolescents and their U.S.-born Latino counterparts. The neurocognitive factors tested included dimensions of impulsivity (i.e. risky decision-making, response inhibition, and delayed discounting) and alcohol use outcome expectancies. The contextual factors examined were association with substance using peers, perceptions of peer norms, different aspects of parental monitoring, and dimensions of familismo. To this end, a study was designed and implemented at a local Los Angeles Unified School District high school during the 2012-2013 academic year. A total of 130 female and male adolescents between ages 14 and 17 who self-identified as Latino participated in the study. Participants completed a series of self-report measures and behavioral tasks that assessed sociodemographic characteristics, patterns of alcohol use, drinking outcome expectancies, risky decision making, response inhibition, delayed reward discounting, peer perceptions of use, association with substance-using peers, aspects of parental monitoring, and dimensions of familismo. Consistent with hypotheses, non-U.S.-born teens were more likely to have started to drink in adolescence, started to drink at a younger age, and were more likely to drink more recently than their non-U.S.-born counterparts. No differences were found in frequency of drinking episodes or number of drinks per drinking occasion. Mediation analyses indicated that perception of peer norms and more favorable evaluations of negative alcohol expectancies helped explain these differences. That is, U.S.-born Latino youth were more likely to believe that a higher proportion of their friends used substances than their non-U.S.-born counterparts and, in turn, reported worse alcohol use outcomes. Similarly, U.S.-born Latino teens evaluated the negative effects of alcohol to be more favorable than non-U.S.-born youth and were as a result more likely to endorse worse alcohol use outcomes. The multi-mediation analyses that simultaneously tested these two potential mediators in one model determined that both peer perception of use by friends and evaluation of negative expectancies were strong explanations of the immigrant paradox in drinking initiation patterns. Results identified that the immigrant paradox is prevalent in patterns of drinking initiation but not in severity of drinking once Latino teens begin using alcohol. Explanations for differences in drinking initiation suggested that both neurocognitive and contextual factors are relevant to understand the immigrant paradox. Both holding favorable valuations of negative alcohol use expectancy outcomes and perception of substance use by friends explained the immigrant paradox in drinking initiation patterns found in this study. Whereas differences in dimensions of impulsivity, association with substance using peers, and family context factors did not help explain the identified differences in drinking, these factors may play a role in influencing or modulating the severity of alcohol use once Latino teens start drinking. Nevertheless, valuations of negative alcohol use expectancy outcomes and perception of substance use by friends are two tractable factors that present opportunities for intervention geared at this underserved group.