Adolescents' and their friends' health-risk behavior: Factors that alter or add to peer influence

Objective: To examine models of risk for adolescent health-risk behavior, i ncluding family dysfunction, social acceptance, and depression as factors t hat may compound or mitigate the associations between adolescents' and peer s' risk behavior. Methods: Participants were 527 adolescents in grades 9-12. Adolescents repo rted on their substance use (cigarette and marijuana use, heavy episodic dr inking), violent behavior (weapon carrying, physical fighting), suicidality (suicidal ideation and attempts), and the health-risk behavior of their fr iends. Results: Adolescents' substance use, violence, and suicidal behavior were r elated to their friends' substance use, deviance, and suicidal behaviors, r espectively. Friends' prosocial behavior was negatively associated with ado lescent violence and substance use. Family dysfunction, social acceptance, and depression altered the magnitude of association between peers' and adol escents' risk behavior. In cumulative risk factor models, rates of adolesce nt health-risk behavior increased twofold with each added risk factor. Conclusions: Results supported both additive and multiplicative models of r isk. Implications for intervention and primary prevention are discussed.