Adolescent DecisionMaking About Drug Use

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Adolescent Decision-Making About Drug Use

• Caroline R. Ellermann, PhD, RN
• University of Hawaii at Manoa
• School of Nursing and Dental Hygiene

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• It takes courage to not only make decisions, but
  to live with those decisions afterwards.
• 
  Krzyzewski, M (2000)

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Background

• Limited success in decreasing drug use
• Missing links
• Decision-making process
• Experimentation unexplored, undefined
• Common influencesrationale to group drugs

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Decision-making

• Distinct process (Gage, 1998)
• Complex mental activity to produce judgment
  choice (Bryans McIntosh, 1996)
• Involves alternatives trade-offs (Hollen, 1998)
• Outcomes based on information, choice cognitive
  ability (Gordon, 1996)
• Decisions facilitate action (McCartney, 1997)

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Study Purpose

• To describe decision-making of adolescents who
• experimented with stopped
• alcohol, tobacco other drug use.

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Method

• Grounded theory
• Taped interviews
• Certificate of Confidentiality

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Enrollment criteria

• Age 14 to 18
• Minimum of 5 or 6 times of experimenting
• No drug use in the past six months
• No intent to resume use

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Informants reported use

• Range 6 to 300 times
• Included cigarettes, Beatties, glue, alcohol,
  marijuana, mushrooms, LSD, ecstasy, speed or
  other unknown pills
• Duration 2 months to 4 ½ years

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Basic Social Psychological Process Starting
Stopping

• Influences on drug use
• Decision about drug use
• Drug use
• Outcomes of drug use
• Decision about stopping
• Drug use ends

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Stages of the Basic Social Psychological Process
Starting Stopping

• Exploratory Use
• Purposeful Use
• Intentional Use

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Stages with Sub-categories

•  _________________________________________________
  _______________________
•  
• Stages of the Basic Social Psychological Process
  Starting and Stopping
• __________________________________________________
  ______________________
•  
• Stage One Stage Two Stage Three
• Exploratory Use Purposeful Use Intentional Use
• __________________________________________________
  ______________________
•  
• Influence to use Influence to continue Positive
  consequences
• Influence to not use Going along/Learning Having
  fun/Problem solving
• Curiosity Use fluctuates Use intensifies
• Beginning Positive consequences Enjoying
• Influence to continue Negative
  consequences Getting relief
• Influence to stop Weighing consequences Contradic
  ting enjoying/relief
• Balancing considerations Engagement
  stops Integrating experiences
• Exploration stops Strategies to stop
• Engagement stops
• __________________________________________________
  ______________________

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Research findings

• Distinct, complex process
• Decisions clearly come before action
• Influences on maintaining behavior
• Benefits of use
• Motivation
• Will power
• Social, psychological societal influences
  contributed

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Conceptual links to literature

• Explanatory/descriptive model (Hinds et al.,
  1998)
• Systematic, contradicting belief of unsystematic
  (Bryans MacIntosh)
• Tough decisions prompt irrational action (Nutt,
  1989)

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Family/parent influence

• My mom says dont even try it once, but thats
  kind of not realistic. (Informant 4)
• I would really let my parents down if I
  continued and they found out. I dont want to do
  anything to like hurt my mom. (Informant 8)

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Normative use

• It is what teens do, everyone else is learning
  about it so I just figured I should to.
  (Informant 5)

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Summary

• Decision-making
• Actively present
• Linked to stages of drug use
• Linked to drug experimentation

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Implications

• Base of normative data
• Basis for continued research
• Creates opportunity to improve health promotion
  outcomes

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