Subpopulations of older foster youths with differential risk of diagnosis for alcohol abuse or dependence.
OBJECTIVE
Distinctive combinations of factors are likely to be associated with serious alcohol problems among adolescents about to emancipate from the foster care system and face the difficult transition to independent adulthood. This study identifies particular subpopulations of older foster youths that differ markedly in the probability of a lifetime diagnosis for alcohol abuse or dependence.


METHODS
Classification and regression tree (CART) analysis was applied to a large, representative sample (N = 732) of individuals, 17 years of age or older, placed in the child welfare system for more than 1 year. CART evaluated two exploratory sets of variables for optimal splits into groups distinguished from each other on the criterion of lifetime alcohol-use disorder diagnosis.


RESULTS
Each classification tree yielded four terminal groups with different rates of lifetime alcohol-use disorder diagnosis. Notable groups in the first tree included one characterized by high levels of both delinquency and violence exposure (53% diagnosed) and another that featured lower delinquency but an independent-living placement (21% diagnosed). Notable groups in the second tree included African American adolescents (only 8% diagnosed), White adolescents not close to caregivers (40% diagnosed), and White adolescents closer to caregivers but with a history of psychological abuse (36% diagnosed).


CONCLUSIONS
Analyses incorporating variables that could be comorbid with or symptomatic of alcohol problems, such as delinquency, yielded classifications potentially useful for assessment and service planning. Analyses without such variables identified other factors, such as quality of caregiving relationships and maltreatment, associated with serious alcohol problems, suggesting opportunities for prevention or intervention.
Keller
Thomas E
TE
School of Social Work, Portland State University, Portland, Oregon 97207, USA. kellert@pdx.edu
Blakeslee
Jennifer E
JE
Lemon
Stephenie C
SC
Courtney
Mark E
ME
D000293:Adolescent; D000367:Age Factors; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002669:Child Welfare / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D005581:Foster Home Care / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors