Social Ecological Determinants of Substance Use Treatment Entry Among Serious Juvenile Offenders From Adolescence Through Emerging Adulthood.

Purpose: To examine the social-ecological determinants of substance use treatment entry among serious juvenile offenders over a 7 year period. Using the social-ecological framework, relevant predictors of substance use from the literature were used to assess risk (and protective) factors at the individual, parental, peer and neighborhood level.

Method: Serious juvenile offenders (N=1354, M=16.0 years, SD=1.14) were prospectively followed over 7 years (M=23.0 years, SD=1.15). Cox regression with time invariant and time varying predictors was used to predict time to first substance use treatment entry.

Results: Results for each dimension, separately, varied slightly from the full model. In the full model peer delinquency, peer arrests, post-traumatic stress disorder (PTSD), impulse control, temperament, and emotional regulation remained salient risk (and protective) factors for treatment entry.

Conclusion: Associating with more deviant peers and having more of your peers arrested over the 7 year study period was associated with substantial increase in time to treatment entry. Furthermore, one of the strongest risk factors for treatment entry was a PTSD diagnosis. Treatment implications are discussed regarding peer affiliation and PTSD symptomology as well as potential neurological and biological contributors to increased risk for treatment entry.