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_{age baseline} = 16.0 years, SD = 1.14) were prospectively followed over 7 years (M_{age Conclusion} = 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.