Research report no.10 2004
Parenting influences on adolescent alcohol use
by Louise Hayes, Diana Smart, John W. Toumbourou and Ann Sanson
9. Integrative synthesis of parenting influences
This review has shown that the aspects of parenting which influence adolescent alcohol use can be separated into two categories. The first comprises parenting behaviours and skills, specifically parental monitoring, parental behaviour management practices, parent-adolescent relationship quality, and parental norms and attitudes. The second sphere of influence comes from the parents' individual characteristics, family characteristics, and broader environmental and cultural influences.
Conceptual model of the role of parents
To summarise the research that has been reviewed, and to provide an overall picture of the role of parents in adolescent alcohol use, a conceptual model has been developed. This model is shown below in Figure 6. This model depicts the main parenting factors and their proximity to adolescent alcohol use as identified in the literature review. It is important to note that this model is conceptual, but does not represent causal (cause and effect) or statistical relationships which will need to be established by future research. To interpret the model, it is necessary to begin with the parenting factors which have the most direct influence on adolescents, and these are depicted closer to the ellipse which represents adolescent alcohol use.
Figure 6. Conceptual model of parenting influences on adolescents' alcohol use
Parental monitoring
The majority of the studies suggested that parental monitoring was the parenting factor with the most direct influence on adolescent alcohol use. Therefore, one strategy for reducing adolescent alcohol use might be to ensure that parents monitor their adolescent more closely. Unfortunately, at this stage, the research has not firmly established which types of interventions are best to increase monitoring. Enhanced monitoring is not likely to occur by simply advising parents to ask more questions about their adolescent's free time, and indeed this increased interrogation is more likely to hinder their monitoring (Hayes 2004). To date, only one experimental trial has been published where improved monitoring has been demonstrated through an intervention (Dishion et al. 2003).
It is sometimes perceived that parental monitoring occurs when parents question their adolescent about free time, and therefore the general advice to parents is often to ask more questions. However, parental monitoring is not merely a matter of parents questioning an adolescent; in fact, repeated questioning can have adverse effects on the parent-adolescent relationship.
Good monitoring occurs at several levels. First, parents begin monitoring before their adolescent goes out, by establishing rules for appropriate behaviours, setting curfews, being interested, and discussing the forthcoming activity. Parents also monitor when their adolescent comes home from free time, and they do this by asking questions (not interrogating), listening to the adolescent, and observing their behaviour. More importantly, parental monitoring is an episodic process - that is, each monitoring episode influences the next occasion of adolescent free time. If an adolescent transgresses on one occasion, parents who monitor well are likely to adapt their monitoring on the next occasion when the adolescent seeks free time. Finally, parental monitoring is not static across adolescence, and marked differences in the levels of parental monitoring have been shown.
Peer influences
Although the influence of peers on adolescent alcohol use was not a major focus of this review, it has been included in the model because, as shown in Section 6, peer influence can be a primary risk factor. In the model, peer alcohol use is depicted in close proximity to adolescent use. There are many studies that have shown that peers have a more important direct influence than parents on ongoing alcohol use. However, other research has taken a wider perspective and suggests that parents influence the selection of peers at the outset. The model indicates the bi-directional nature of parental monitoring, peer influence, and adolescent alcohol use. Each of these three factors continually exert bi-directional influences.
Parental attitudes and values
The conceptual model next draws attention to parental norms for adolescent alcohol use. The research revealed that parents' beliefs about adolescent drinking have an important influence on adolescent use. When parents disapprove of adolescent drinking, adolescents are likely to consume less, and are less likely to engage in binge drinking. Conversely, when parents tolerate or approve of adolescent drinking, young people are more likely to drink and also to binge drink. Additionally, the influence of parental norms and attitudes may not only be direct, but exerted through the influence parents have on the differing social environments in which their adolescents participate. Parental norms and attitudes may be reinforced by other socialising agents, such as teachers, religious leaders, and sports or club leaders. In general the social norms in Australia appear to regard adolescent drinking as "normal" behaviour, and parents report that they feel under pressure to allow their adolescents to use alcohol (Taylor and Carroll 2001). It is also necessary to examine parental norms across several levels, including those which relate to their own adolescents, as well as broader norms regarding peer behaviour, local community, and wider societal norms.
The research on parent and peer influences has shown that adolescents continue to be guided by their parents' goals and values. Within individual parent-adolescent relationships, the longer parents are able to delay the onset of adolescent drinking, the less likely it is that adolescents will drink at high or risky levels. A key role for educators may therefore be to support parents to delay the onset of adolescent alcohol use. Without support parents may not feel confident that they are making the right decision in delaying their adolescents' alcohol use, and may be pressured into acquiescence. Providing education and developing societal norms that discourage adolescents' initiation into alcohol use may be a necessary first step. Some researchers have argued that a change in adolescent drinking patterns requires change at a societal level, rather than just within individual families (Hawkins et al. 1992; Yu 2003). Furthermore, research has suggested that when societal shifts have changed the legal age for alcohol use from 18-21 years, the commonly observed lowering in the incidence of alcohol use among adolescents may reflect an increase in unfavourable attitudes to youth alcohol use on the part of their parents (Yu and Shacket 1998).
Parental behaviour management
Parental behaviour management, as depicted in the conceptual model, covers the skills parents use to shape their adolescents' behaviour. For example, effective parenting involves the discussion of appropriate behaviours and establishment of clear boundaries for acceptable behaviours. Parents also provide logical consequences for misbehaviour; with adolescents this is most likely to be withdrawing material and domestic support services, grounding them or removing privileges. The research, although not extensive, shows that adolescents who denied parental authority were more likely to use alcohol. Furthermore, adolescents who were able to negotiate unsupervised free time were more likely to drink.
The ASSAD data revealed that on occasions when parents actively engaged with their adolescent with regard to alcohol use, and allowed their adolescent to drink in the home, they consumed less than when they drank at friends' homes or elsewhere. From these studies it could be assumed that if parents allow drinking in the home, adolescents might learn responsible use of alcohol. However, this is an assumption that has not been tested. It may be that adolescents drink less when they drink at home because their parents are present (although this has not been clarified as yet), but there is little evidence concerning whether moderation in the home setting translates to moderation in the peer drinking context.
One of the more sophisticated attempts to evaluate a harm minimisation approach to youth drinking has been conducted through the Australian National Drug Research Institute. In this study schools were assigned using a randomised control framework to a drug education program based on harm minimisation. Students exposed to this program demonstrated lower rates of alcohol-related harm over time compared with those in the control condition. Although not solely emphasising this approach, this study demonstrated an advantage for children who delayed the initiation of alcohol use, as well as for children who were supervised when consuming alcohol. One interpretation of the effectiveness of this study might be that an open approach to communication regarding alcohol can help some children to reach a non-use decision (McBride, Midford, Farringdon and Phillips 2000).
The parent-adolescent relationship
A key factor in the conceptual model is the relationship between parent and adolescent. The majority of the research on alcohol use has shown that relationship quality has both a direct and indirect effect on adolescent alcohol use. High quality parental monitoring and behaviour management, plus sharing of values and norms are fundamentally dependent on the existence of a high quality parent-adolescent relationship.
There is a large body of research to show that adolescents who have good relationships with their parents have improved outcomes in many areas, including reduced substance use, better academic achievement, more selfreliance, and lower rates of social and psychological problems (Armsden and Greenberg 1987). In any intervention work with adolescents and parents, it is recommended that the parent-adolescent relationship is the key starting point. Where the parent-adolescent relationship is damaged it is unlikely that an adolescent will respond in interventions that aim to achieve more monitoring, or following of rules, norms and values of the family.
The feedback loops included in the model are essential to understanding how alcohol use influences parents. The research has shown that when an adolescent has begun to use alcohol, this independent adult-like behaviour is likely to set in motion changes in the parental monitoring behaviours, and parental norms for adolescent alcohol use. In some cases, where conflict is high, adolescent alcohol use may have an impact on the parent-adolescent relationship, particularly if parents fear they no longer have an influence on their adolescent.
Parental characteristics
Finally, the model demonstrates that parents' individual characteristics can also influence adolescent alcohol use, but the effect is far more distant. First, parents' regular alcohol use is associated with higher use in adolescents. Second, the research has shown that parental alcoholism and alcohol abuse is related to increased drinking. While these effects may be due to parental modelling of alcohol use, some researchers have proposed that these individual parental factors influence adolescent alcohol use because they change parenting behaviours. That is, parents who are abusing alcohol may be unable to establish a strong relationship with their adolescents, they may have norms that encourage drinking at an early age, and they may be too preoccupied to monitor their adolescents' independent behaviour. The present review supports this argument, and therefore the conceptual model shows that these parenting factors exert their influence by changing the daily parent-adolescent interactions.