ADOLESCENTS INSIGHT IN HEAVY DRINKING

Purpose: Because so few adolescents with alcohol problems seek treatme nt, this study examined the factors associated with adolescents' recog nition or insight into having a substance use problem. Method: Data we re extracted from a self-report questionnaire used in an epidemiologic al study of public middle school students on substance abuse in Arkans as. Those drinking heavily were divided into ''admitters'' and ''denie rs'' based on their response to the question of having a substance use problem. Odds ratios were calculated to measure the association of se veral variables with admitting a problem. Results: Of 3395 adolescents , 13.4% (455) met or exceeded our threshold for heavy drinking. Only 1 5.9% (65) of these heavy drinkers acknowledged having a substance use problem. Reporting more types of negative social events related to alc ohol use and scoring higher on a measure of positive alcohol expectanc ies were significantly related to admitting to a substance use problem . Recent health care contact and perceived environmental factors did n ot independently contribute to insight. Conclusions: If these results are generalizable, treatment and educational interventions should emph asize linking alcohol use and negative social consequences. (C) Societ y for Adolescent Medicine, 1998.