青少年結交偏差同儕類型與成年過度飲酒的關係： 潛在類別分析

Abstract

背景： 青少年結交偏差同儕（Deviant peer affiliation）為物質濫用的重要社會決定因子，但對於成年過度飲酒（Binge drinking）是否具有長期效應仍未確定。本研究目的在探討青少年結交偏差同儕的類型，及其與成年過度飲酒的相關性，並進一步分析其中可能的性別差異。 方法： 分析資料來自「臺灣青少年成長歷程研究」，此為取樣自台灣北部的固定連續樣本研究 (panel study)。當樣本擁有完整之結交偏差同儕（13歲）及過度飲酒資訊（30歲）時，即納入成為本研究之分析樣本，共1,145名。分析方法為「三階段的偏差調整潛在類別分析（3-step bias-adjusted latent class analysis）」，並依序納入近端、遠端的控制變項，以檢驗結交偏差同儕的類別以及與成年過度飲酒的相關性。最後在模型中納入交互作用項，來檢視相關性是否具有性別差異。 結果： 本研究發現四種結交偏差同儕類型：最少偏差同儕組（65.51%）、攻擊性同儕組（18.19%）、逃學暴力同儕組（9.14%）與嚴重偏差同儕組（7.16%）。在同時考慮近端與遠端之控制變項時，相對於「最少偏差同儕」組，研究對象於青少年時期之偏差同儕結交類型若為「攻擊性同儕」 (OR= 2.12, 95% CI: 1.16–3.86) 或「嚴重暴力同儕」 (OR= 2.50, 95% CI: 1.39–4.48)，在成年時期有較高的過度飲酒風險；但「逃學暴力同儕」的影響並不顯著 (OR= 1.13, 95% CI: 0.58–3.86)。此外，不同類型之接交偏差同儕與成年過度飲酒風險之相關性並無性別差異。 結論： 青少年不同類型的結交偏差同儕，對成年過度飲酒的影響有所差異。因此，建議未來在規劃飲酒相關介入策略時，除需早期介入外，並應將不同偏差同儕結交類型的影響納入考量。

Background: Deviant peer affiliation in adolescence is an essential social determinant of substance misuse, but its long-term effect on adult binge drinking remains uncertain. The present study explored the patterns of deviant peer affiliation during adolescence and its connection with binge drinking in adulthood. The potential sex differences were also examined. Method: Data were drawn from a panel study, Taiwan Youth Project (TYP). 1,145 individuals who had complete data on deviant peer affiliation at 13 years old and binge drinking at 30 years old were analyzed. The bias-adjust 3-step latent class analysis was conducted to examine study hypotheses. All models controlled for both proximal and distal covariates. Sex differences were determined by the significance of the interaction terms. Result: Four patterns of deviant peer affiliation were identified: minimal peer-deviance (65.51%), peer-aggression (18.19%), peer truancy with aggression (9.14%), and severe peer deviance (7.16%). Compared to those in the minimal peer-deviance group, adolescents who belonged to the peer-aggression or severe peer-deviance groups showed an increased risk of binge drinking in adulthood (OR= 2.12 and 2.50 respectively). No sex difference was found for the examined associations. Conclusion: Varying patterns of deviant peer affiliation during adolescence have differential effects on subsequent risks of binge drinking. To prevent adult binge drinking, interventions should be implemented early and consider the nature of peer affiliation.