Journal of Pediatric Psychology, Vol. 26, No. 3, 2001, pp. 131-143
© 2001 Society of Pediatric Psychology
Adolescent Peer Crowd Affiliation: Linkages With Health-Risk Behaviors and Close Friendships
1 University of Miami, 2 Yale University, 3 Grayson and Associates, Birmingham, Alabama
All correspondence should be sent to Annette M. La Greca, Department of Psychology, PO Box 249229, University of Miami, Coral Gables, Florida 33124. E-mail: alagreca{at}miami.edu .
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Abstract |
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Objective: To examine adolescents' peer crowd affiliation and its linkages with health-risk behaviors, their friends' health-risk behaviors, the presence of close friends in the same peer crowd, and adolescents' social acceptance.
Methods: We interviewed 250 high school students and identified six categories: popular, jocks, brains, burnouts, nonconformists, or average/other. Adolescents also reported on their health-risk behaviors (including use of cigarettes, alcohol, marijuana and other drugs; risky sexual behaviors; and other risk-taking behaviors), the health-risk behaviors of their friends, the peer crowd affiliation of their closest friends, and their perceived social acceptance.
Results: Burnouts and nonconformists had the highest levels of health-risk behaviors across the areas assessed, the greatest proportions of close friends who engaged in similar behaviors, and relatively low social acceptance from peers. Brains and their friends engaged in extremely low levels of health-risk behaviors. Jocks and populars also showed evidence of selected areas of health risk; these teens also were more socially accepted than others. In general, adolescents' closest friends were highly nested within the same peer crowds.
Conclusions: The findings further our understanding of adolescent behaviors that put them at risk for serious adult onset conditions associated with high rates of morbidity and mortality. We discuss the implications of the findings for developing health promotion efforts for adolescents.
Key words: health-risk behaviors; peer crowds; close friends; adolescents; health promotion.
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Introduction |
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Adolescence is often associated with the development of behaviors that pose a risk to one's health and well-being. Smoking, drug and alcohol use, and risky sexual behaviors (such as unprotected sex) typically begin during the teenage years. According to Irwin (1993
), cigarettes and alcohol
represent the most commonly used drugs with teenagers, with 66% of teens
trying cigarettes and 92% experimenting with alcohol at least one time, often
by age 12. Lifetime prevalence rates for marijuana and cocaine are 47% and
12%, respectively, with 3% of high school seniors using marijuana daily
(Irwin, 1993). Moreover,
recent epidemiological data suggest that approximately 48% of high
school—age students are sexually active, and of these, only about half
use birth control during sexual intercourse
(Centers for Disease Control and Prevention
[CDC], 1997b).
A major concern with adolescents' health-risk behaviors is that they
represent key risk factors for many diseases that contribute to adult
mortality. For example, the leading causes of death in the United States in
1990 included heart disease, cancer, cerebrovascular disease, and HIV
infection (McGinnis, 1994);
all of these are linked to behaviors that typically develop in childhood or
adolescence. Thus, there has been a call for more attention to the development
of health-risk behaviors in adolescents, so that disease-prevention efforts
can begin earlier (Kolbe, Collins, &
Cortese, 1997).
Adolescents' peer culture is believed to play a key role in the development and maintenance of these health-risk behaviors. For example, adolescents report the presence of friends, acquaintances, or siblings in 80% of the occasions when they first experimented with cigarettes, but they report the presence of parents in only 3% of such occasions (Friedman, Lichenstein, & Biglan, 1985). Although adolescents' peer culture is considered to be important in the initiation and maintenance of health-risk behaviors, little research has directly examined the linkages between adolescents' peer group affiliations, their close friendships, and their health-risk behaviors. This was a primary goal of our study.
Peer Crowd Affiliation
Peer crowd affiliation is a key aspect of adolescents' peer culture and was
a primary focus of this study. Adolescents often characterize their peers
through the use of social labels that apply to large groups of adolescents, or
"crowds" (Kinney,
1993). These crowds are reputation-based groups of teens who may
or may not spend large amounts of time together
(Brown, 1989). The labels used
to describe the crowds often reflect the groups' characteristics. For example,
"jocks" are athletic and participate in sports,
"brains" do well in school and enjoy academics,
"burnouts" (a.k.a., "dirts," "freaks," or
"druggies") often get in trouble and skip school,
"populars" (a.k.a., "hotshots" or
"preppies") are social and involved with school activities, and
"nonconformists" (a.k.a, "alternatives") often rebel
against the norm in clothing or ideas. Peer crowds include large groups of
peers, typically greater than 10, who may not actually know each other well
(Brown, 1989). Peer crowd
categories are remarkably consistent across gender, regions, and ethnic groups
(Brown, 1989;
Phillips, Hughes, & Wilkes,
1998).
Although they have been relatively understudied, literature that describes
adolescent peer crowds and their association with health-risk behaviors has
begun to accumulate. Most prominently, peer crowd affiliation has been linked
with adolescents' reports of cigarette smoking and alcohol use
(Brown, 1989;
Brown, Mounts, Lamborn, & Steinberg,
1993; Mosbach & Leventhal,
1988; Sussman et al.,
1990; Urberg,
1992). Typically, deviant peer crowds, such as burnouts or dirts,
are the most likely to smoke and use alcohol
(Mosbach & Leventhal,
1988; Sussman et al.,
1990; Urberg,
1992), whereas brains are the least likely
(Brown, 1989;
Brown et al., 1993). In some
cases, populars or hotshots have also been found to show high rates of smoking
and alcohol use (Moshbach & Leventhal, 1988), although this has not
consistently been the case (Sussman et
al., 1990). However, few studies have examined crowd affiliation
in conjunction with risk-taking behaviors (e.g., doing something on a dare)
that could contribute to nonintentional injuries, or with risky sexual
behaviors (e.g., multiple partners, unprotected sex) that could put an
individual at risk for sexually transmitted diseases (STDs). However, these
other types of risky behaviors likely follow a pattern similar to substance
use (i.e., high among burnouts and low among brains). In fact, one study of
early adolescents (Dolcini & Adler,
1994) did find that brains were less likely to be sexually active
than others.
The first major goal of this study was to extend existing literature by
examining linkages between adolescents' peer crowd affiliations and a wide
range of health-risk behaviors, including cigarette use, alcohol and drug use,
risky sexual behavior, and general risk taking. We focused on high school
students, who are more likely to be sexually active than younger teens.
Specifically, we expected membership in certain deviant peer crowds (e.g.,
burnouts) to be associated with a wide range of health-risk behaviors,
including substance use (cigarettes, alcohol, marijuana, and illegal drugs),
risky sexual behavior, and general risk taking, to a greater extent than
affiliation with other peer crowds, such as jocks or brains. In addition, we
hypothesized that some peer crowds might have selective areas of health risk.
For example, although jocks might be low on substance use (e.g.,
Mosbach & Leventhal,
1988), they might be more sexually active than other teens and
perhaps engage in more risky sexual behaviors. This pattern would be
consistent with the high status accorded to jocks in many high schools (e.g.,
Brown, Eicher, & Petrie,
1986). Also of interest were populars, who have shown elevations
in cigarette and alcohol use in some studies (e.g., Moshbach & Leventhal,
1988); yet popular teens have often been grouped with jocks (e.g.,
Urberg, 1992), who have low
levels of substance use; this could mask the health-risk behaviors that might
be evident among popular teens.
A second goal of this study was to examine linkages between adolescents'
peer crowds and their friends' health- risk behaviors. Presumably, peer crowd
affiliation may be related to adolescents' health-risk behavior because
affiliation with a particular peer crowd is a marker for a shared set of
values with one's peers (Durbin, Darling,
Steinberg, & Brown, 1993). However, peer crowd affiliation may
indicate that adolescents are interacting with (and are friends with) peers
who engage in similar behaviors and who may directly encourage and reward
certain health-risk behaviors (Urberg,
1992). Such information would be critical for developing effective
prevention programs for reducing adolescent health-risk behaviors and
preventing or forestalling the onset of serious adult diseases.
Little is known about the close friends of adolescents from various peer
crowds or their friends' health behaviors. One might expect, however, that
adolescents would have close friends who affiliate with the same peer crowd
and who engage in similar health-risk behaviors. Indeed, Urberg
(1992) suggested that
adolescents perceive greater pressures toward conformity from their close
friends than from their crowd affiliations; she found this was true for
adolescents' smoking. If adolescents' close friends engage in the same
health-risk behaviors that typify the larger peer crowd, it may be exceedingly
difficult for adolescents to change their health-risk behaviors—or their
peer group affiliations—as this may disrupt their close friendships.
Thus, in this study, adolescents reported on the health-risk behaviors of
their close friends, and these behaviors were examined as a function of the
primary adolescent's peer crowd affiliation. Adolescents from crowds that
engaged in high rates of health-risk behaviors were expected to report having
more close friends who also engaged in such behaviors.
Our third and final goal was to evaluate aspects of adolescents' social
adjustment as a function of their peer crowd affiliation. In particular, we
examined: (1) the degree to which adolescents' closest friends were embedded
within the same peer crowd, and (2) adolescents' levels of perceived social
acceptance. First, we expected that a high percentage of adolescents' close
friends would be affiliated with the same peer crowds. Urberg, Degirmencioglu,
Tolson, and Halliday-Scher
(1995) examined the
correspondence between close friendships and peer crowd affiliation, finding
that 39%-47% of mutual best friends were within the same peer crowd. Having
close friends embedded within peer crowds could make it difficult for
adolescents to break away from the influences associated with various peer
crowds.
In addition, we examined whether adolescents' perceived social acceptance varied as a function of peer crowd. Burnouts were expected to report the lowest levels of peer acceptance and populars or jocks the highest levels. Differential social status associated with peer crowds could make it difficult for teens to shift among peer crowds. If so, successful health promotion efforts might need to consider this issue.
In summary, this study examined linkages between adolescents' peer crowd affiliations and (1) health-risk behaviors (including cigarette, alcohol, marijuana, and other drug use; risky sexual behaviors; and risk-taking behaviors), (2) their close friends' health risk-behaviors; (3) the likelihood of having close friends in the same peer crowd, and (4) perceived social acceptance. The study extended prior work by examining a wide range of health-risk behaviors, by evaluating friendship factors that may be embedded within peer crowd affiliation and could contribute to the initiation or maintenance of health-risk behaviors, and by examining patterns of social acceptance associated with peer crowd affiliation.
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Participants
Participants were 101 boys (40.4%) and 149 girls (59.6%) who ranged in age from 15 to 19 years (M = 16.8, SD =.90) and who were enrolled in grades 10 through 12. The adolescents resided in Miami-Dade County, Florida, a large and diverse metropolitan area in southeastern Florida. Adolescents came from predominantly middle-class socioeconomic backgrounds (Hollingshead Social Class: 36.3% Level I, 41.0% Level 2, 15.7% Level III, 4.7% Level IV, 2.3% Level V; M = 47.83, SD = 11.95). The adolescents' ethnic background was representative of the larger metropolitan areas, as follows: 45.6% White, 37.2% Hispanic-American, 12.9% African American or Black, and 4.4% Asian or mixed.
Procedure
Adolescents were recruited as part of a larger study on adolescent peer
adjustment. An unselected community sample of children who had attended one of
three elementary schools in Miami-Dade six years earlier were tracked through
the county public school database. Of the 306 students who were contacted, 250
(82%) agreed to participate and 56 (18%) declined participation. Participating
students did not differ from those who declined to participate with respect to
gender, ethnicity, age, socioeconomic status (SES), or grade. In addition, the
306 students who were contacted were compared to the 184 who were lost to
follow-up (mostly due to with-drawing from the school district). Those lost to
follow-up did not differ in terms of age, ethnicity, SES, or grade; however,
more boys were lost to follow-up than girls (
2 [1] = 6.73,
p <.01). (It is not clear why proportionately fewer boys than
girls remained in the county over the 6-year period. More boys may have
dropped out of school than girls, which may account for this distinction.)
Adolescents were interviewed in their homes by trained research assistants. Written informed consent was obtained from adolescents and their parents. University institutional review board (IRB) approval was obtained for the study. Adolescents completed several measures for this study, including Peer Crowd Questionnaire, the Survey of Risk-Taking Behavior, and the Self-Perception Profile for Adolescents. Confidentiality of the adolescents' responses was stressed. In addition, parents provided background information used to determine SES status and ethnicity of the adolescents.
Measures
Peer Crowd Questionnaire (PCQ). The PCQ was developed from prior
research on adolescents' peer crowds
(Mosbach & Leventhal,
1988), as well as focus groups of local high school graduates
asked to generate names and descriptions of crowds commonly found in their
high schools. Consistent with previous work
(Brown, 1989;
Mosbach & Leventhal,
1988), the following peer crowds were identified: jocks (i.e.,
athletic, being on school team), brains (doing well in school, enjoying
academics), burnouts (skipping school, getting into trouble), populars
(social, involved in many activities, concerned about their image),
nonconformists (rebelling against the norm in clothing or ideas, not
conforming to social ideals), and none/average (no crowd affiliation, or
"just average"). First, adolescents were asked to verify the
presence of these crowds in their school and then to describe any other crowds
existing in their schools. Next, adolescents picked the crowd with which they
most identified and indicated how long they had been a member of that
particular crowd (less than a year, since beginning high school, since middle
school, since elementary school). Finally, to assess close friends' peer crowd
affiliations, adolescents were asked to name up to three of their very best
friends; for each friend named, adolescents were asked to identify that
friend's peer crowd affiliation.
Prior studies have shown that adolescents are accurate in identifying their
place in the peer crowd system. Brown et al.
(1987) found good agreement
between adolescents' and peers' reports of their crowd affiliation (e.g., 75%
of jocks and druggies correctly identified their crowd). In identification of
crowd choices from freaks (burnouts), jocks, hotshots/populars, and regulars
(average), Sussman et al.
(1990) obtained an interrater
reliability of 93% for assigning adolescents to peer crowds.
Health-Risk Behaviors. Adolescents' cigarette smoking, substance
use, risky sexual behavior, and general risk-taking behaviors were assessed
with the Survey of Risk-Taking Behavior (SRTB) (obtained by request from Dr.
La Greca). The SRTB was constructed from items on existing measures of risk
taking and substance use (Jessor, Donovan,
& Costa, 1991; Levine
& Singer, 1988) and sexual behavior
(Biglan et al., 1990) and were
similar to those used by the CDC
(1997b) to assess youth risk
behaviors. Adolescents rated items on Likert scales that assessed the
frequency of each behavior. Responses were converted to standard scores
(M = 0, SD = 1); scores were averaged when more than one
item assessed a particular area (correlations: for alcohol use, r
=.73; for general risky behavior, r =.60; and for unprotected sex,
r =.87; all ps <.0001). Specifically, one item measured
cigarette use ("On average, in the past month, how many cigarettes have
you smoked each day?"); two items assessed alcohol use ("How many
times have you been drunk in the past twelve months?" "How often
in the last 12 months did you drink five or more drinks on a particular
occasion?"); one item measured marijuana use ("On the average, how
many times per month do you use marijuana?"); and two items measured
general risky behavior ("I would do almost anything on a dare,"
"I like to take chances more than other people my age").
Adolescents also listed the number of times in the past year that they used
other drugs (stimulants, psychedelic drugs, cocaine, barbituates,
tranquilizers, heroin, or other illegal drugs). For sexual activity,
adolescents listed "the number of different people they had sexual
intercourse with in the past year"; responses were used to determine if
an adolescent was sexually active in the past year (yes or no) and also to
index their number of partners. For adolescents who reported at least one
sexual partner (n = 107, 42.8%), two items assessed unprotected sex
("In the last year, how often have you used some sort of birth
control?" "In the last year, how often have you or your partner
used a condom or something to prevent a venereal disease?"), and one
item assessed the frequency of casual sex ("In the last 12 months, how
many times have you had intercourse with someone you didn't know very
well?").
Prior work supports the reliability and validity of the SRTB items. For
example, items on unprotected sex had coefficient alphas of.73 and.77 in two
independent samples (Biglan et al.,
1990). Biglan et al. also found that high-risk sexual behavior was
significantly related to antisocial behavior (r =.21), cigarette use
(r =.43), alcohol use (r =.34), and illicit drug use
(r =.39). With the same substance-use items, Jessor et al.
(1991) found
inter-relationships between deviant behavior and substance use (cigarettes,
alcohol, marijuana, other drugs), with correlations ranging from.14 to.53.
Friends' Health Risk Behaviors. The SRTB was modified to evaluate adolescents' friends' behaviors. Adolescents listed up to five of their very best friends. Next, they indicated how many of their best friends engaged in a variety of health-risk behaviors; these were generally the same behaviors as those on the SRTB. The only exception was that, instead of asking about friends' general risk-taking behaviors, adolescents were asked how many of their friends engaged in illegal behavior (i.e., could have gotten into trouble with the police for the things they have done; suggested that you do something against the law) and aggressive/antisocial behavior (ruined or damaged something on purpose that did not belong to them; hit or threatened to hit someone without any real reason). (We could not use items regarding illegal or violent behaviors when asking the adolescents about their own behaviors because the IRB expressed concerns that we might have to report illegalities to local authorities and thus could not promise confidentiality.) For each item, a proportion score was computed (n of friends who engaged in the behavior divided by the total number of close friends); this was then standardized. Thus, z scores were obtained for the proportion of adolescents' close friends who use cigarettes, alcohol, marijuana, or other drugs; who have unprotected or casual sex; and who display illegal or aggressive/antisocial behavior.
Perceptions of Social Acceptance. The Self-Perception Profile for
Adolescents (SPPA; Harter,
1988) assessed adolescents' perceived acceptance; it contains
eight subscales, including one for social acceptance. Scores can range between
1 and 4, with higher scores reflecting more perceived social acceptance.
Harter reported good internal consistency for the SPPA subscales (.74 to.93);
in this study, the internal reliability of the social acceptance subscale
was.82.
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Results |
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Descriptive Statistics
Prevalence of Adolescent Health-Risk Behaviors. To provide a context for the findings, we first examined adolescents' reported prevalence of health-risk behaviors; where available, comparable statistics are noted for the most recent version (1997) of the Youth Risk Behavior Survey (CDC, 1997b
). As expected,
cigarette use and alcohol use were more prevalent than marijuana use and
illicit drugs. Specifically, 59.2% of the adolescents reported having smoked a
cigarette (ever), and 26% reported smoking a cigarette daily for the past 30
days; these data compare to reports that 70% of high school teens have tried
cigarettes and 17% are frequent, current smokers
(CDC, 1997b). For alcohol use,
54% of the sample reported being drunk at least once in the past year, and
40.4% reported having five or more drinks on at least one occasion in the past
year, in comparison to data indicating that 51% of high school students
currently use alcohol (CDC,
1997b). For marijuana, 30% of the teens reported use in the past
year, and 22% in the past month, in comparison to 26% of the CDC sample who
reported current marijuana use. For other drug use, 17.6% of the adolescents
reported some drug use in the past year; in the CDC sample, 8% reported
cocaine use, and 3% reported illegal steroid use.
With regard to sexual activity, 42.8% of the adolescents were sexually
active in the past year, compared with 48% in the CDC sample
(1997b). Sexually active
adolescents reported an average of 2 partners (range = 1-14), 10.3% reported
never using any form of birth control, 10.3% reported never using condoms, and
21.5% reported having casual sex (i.e., with someone they didn't know very
well). Finally, with respect to risk-taking behaviors, 18.4% of the sample
agreed that they would do almost anything on a dare, and 37.2% agreed that
they took more chances than others their age.
In general, boys and girls did not differ in their health-risk behaviors
with the exception that boys reported more alcohol use/drunkenness,
F(1, 249) = 10.68, p <.01, than girls. More boys (50.5%)
were sexually active than girls (36.9%) (2 [1] = 4.50,
p <.05); boys also reported more sexual partners (M =
1.31; SD = 2.2) than girls (M =.56, SD =. 9),
F(1, 246) = 13.76, p <.0001. Among teens who were
sexually active, boys reported having more casual sex, F(1, 105) =
9.47, p <.003, than did girls.
Description of Adolescents' Peer Crowds. Before evaluating
linkages between crowd affiliation and adolescents' health-risk behaviors, we
examined the composition of the peer crowds (see
Table I). Peer crowd
composition did not differ with respect to ethnicity or age. However, girls
were more likely to affiliate with populars than boys, and boys were more
likely to affiliate with jocks and burnouts than girls (2 [5]
= 14.87, p <.05). Similar gender differences have been obtained in
other studies (e.g., Brown et al.,
1993; Sussman et al.,
1990). Rather than combining groups, as has been done (e.g.,
Urberg, 1992), we kept the
crowds separate, because combining crowds may mask group differences in health
behaviors. As a precaution, however, we repeated our analyses, controlling for
gender whenever significant peer crowd differences emerged. None of the
results (below) changed when gender was controlled.
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The peer crowds differed in terms of length (or duration) of crowd
affiliation (2 [20] = 40.95, p <.01; see
Table I). Specifically, brains
reported affiliating with their crowd for the longest time; in fact, 62%
reported affiliating with this crowd as early as elementary school. More than
half the burnouts reported affiliating with this crowd since middle school. In
contrast, most other teens dated their crowd affiliation to middle school or
the beginning of high school.
Peer Crowd Affiliation and Adolescents' Health-Risk Behaviors
Our first goal was to evaluate peer crowd differences in adolescents'
health-risk behaviors. A MANOVA was conducted using the six domains of
health-risk behavior (i.e., cigarette use, alcohol/ drunkenness, marijuana
use, other drug use, general risk-taking behavior, and number of sexual
partners) as the dependent variables. A multivariate effect for peer crowd
(Wilks' F [30, 950] = 3.91, p <.0001) was significant at
a univariate level for five of the six domains (see
Table II for the standardized
means.)
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Follow-up analyses revealed that burnouts were more likely to engage in cigarette use, F(2, 242) = 8.72, p <.0001; alcohol use/drunkenness, F(2, 242) = 7.05, p <.0001; marijuana use F(2, 242) = 12.78, p <.0001); use of "other" substances, F(2, 242) = 11.08, p <.0001, and general risk-taking behavior, F(2, 242) = 6.58, p <.0001, than adolescents in most other peer crowds. For example, 78% of the burnouts smoked daily, 72% were drunk at least three times in the past year, 55% used marijuana at least twice in the past month, 67% used "other drugs" in the past year, 56% were sexually active, 56% agreed that they would do almost anything on a dare, and 67% took more chances than others their age.
Nonconformists' substance use and risk-taking behavior was generally greater than other peer crowds, although lower than the burnouts (see Table II). Specifically, 65% of the nonconformists smoked daily, 41% were drunk at least three times in the past year, 29% used marijuana at least twice in the past month, 29% had used "other drugs" in the past year, 65% were sexually active, 41% agreed that they would do almost anything on a dare, and 53% took more chances than others their age.
In contrast, brains were the least likely teens to engage in health-risk behaviors. None of the brains smoked, 3% were drunk at least three times in the past year, none used marijuana in the past month, 3% had used "other drugs" in the past year, and only 17% were sexually active. In addition, 0% agreed that they would do almost anything on a dare, and 24% took more chances than others their age.
Patterns of health-risk behaviors were less uniform for jocks and populars. Jocks tended to be low on all substance use but above average on general risk-taking behavior; 23% agreed that they would do almost anything on a dare, and 46% agreed that they take more chances than others their age. Although populars were generally low on substance use, they were above average (.5 SD above the mean) on alcohol use/drunkeness, with 44% reported being drunk three or more times in the past year.
In terms of sexual behaviors, chi-square analyses revealed significant
group differences in sexual activity (2 [5] = 16.65,
p <.01). Specifically, nonconformists (65%), jocks (59%), and
burnouts (56%) were more sexually active than average (40%) and popular (38%)
teens; brains were the least sexually active (17%). For number of sexual
partners, no univariate effects of peer crowd were revealed; however, pairwise
differences revealed that burnouts had the most and brains the fewest number
of sexual partners in the past year (Tukey's HSD, df = 244,
p <.05; see Table
II).
Analyses of unprotected sex and casual sex were conducted only for the subset of the sample who reported being sexually active (n = 107); however, no significant group effects were revealed. The means in Table II suggest that burnouts had the highest rates of unprotected sex; in fact, 50% reported that they did not use a condom or some form of birth control when they had sex. Jocks had the highest reports of casual sex; 29% reported having sex with someone they didn't know well in the past year.
In summary, burnouts and nonconformists had the highest rates of health-risk behaviors, and brains the lowest, compared to other groups. However, relatively high rates of alcohol use among populars, and relatively high rates of risk-taking and sexual activity among jocks, were noted.
Peer Crowd Affiliation and Close Friends' Health-Risk Behaviors
Our second goal was to examine whether adolescents from the various peer
crowds reported differences in the proportions of their close friends who
engaged in similar health-risk behaviors. Using adolescents' own peer crowd as
the grouping variable, we conducted a MANOVA using friends' health-risk
behaviors as the set of dependent variables. A multivariate effect for peer
crowd was revealed, Wilks' F(40, 1001) = 2.99, p <.0001,
and univariate effects were obtained for seven of the eight domains: cigarette
use, F(5, 236) = 8.56, p <.0001; alcohol/drunkenness,
F(5, 236) = 5.78, p <.0001; marijuana use, F(5,
236) = 14.00, p <.0001; use of "other" substances,
F(5, 236) = 8.25, p <.0001; unprotected sex,
F(5, 236) = 5.16, p <.0001; casual sex, F(5,
236) = 2.43, p <.0001; and illegal behavior, F (5, 236) =
9.09, p <.0001. No effects were obtained for aggressive/antisocial
behavior, although the means were highest for the nonconformists, burnouts,
and jocks (see Table III).
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Overall, greater proportions of the close friends of burnouts and nonconformists engaged in various forms of substance use and risky sexual behaviors as compared with other crowd members' friends (see Table III). Although burnouts and nonconformists did not differ statistically, the means were consistently higher for the burnouts, suggesting higher proportions of their close friends engaged in high-risk behaviors. As with their own behaviors, brains were the least likely to report having many close friends who engaged in any form of substance use, risky sexual behavior, or illegal behavior.
In addition to these findings, higher proportions of the burnouts' close friends were reported to engage in illegal behavior than the friends of any other peer crowd affiliates. It is also noteworthy that jocks reported a relatively high proportion of friends who engaged in casual sex (see Table III).
Are Adolescents' Closest Friends Embedded Within the Same Peer
Crowds?
Our third study goal was to evaluate aspects of adolescents' social
adjustment as a function of their peer crowd affiliation. Specifically, we
evaluated the match between adolescents' peer crowd affiliation and that of
their closest friends and also examined adolescents' social acceptance as a
function of their crowd affiliation. Table
IV lists the percentage of adolescents within each peer crowd
whose best friends also affiliated with the same crowd. As can be seen,
adolescents were likely to have close friends who affiliated with the same
peer crowd. Overall, 69% reported that their best friend also
affiliated with the same peer crowd, and this did not differ significantly as
a function of adolescents' own crowd affiliation (2 [5] =
3.51, ns). In addition, 82% of adolescents reported that at least
one of their three best friends affiliated with the same crowd; this
percentage also did not vary significantly as a function of the adolescents'
peer crowd affiliation (2 [5] = 2.76, ns).
Interestingly, none of the teens from the highest "risk group,"
the burnouts, reported having a best friend from the lowest "risk
group," the brains. Similarly, no brains reporting having a best friend
who was a burnout.
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With respect to perceptions of social acceptance, a significant univariate effect was obtained for social acceptance, F(5, 244) = 8.64, p <.0001 (see Table I). Follow-up analyses revealed that populars and jocks reported higher levels of social acceptance than adolescents from other peer crowds.
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Discussion |
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Reducing adolescents' health-risk behaviors is an important health promotion goal (Kolbe et al., 1997
). Reducing smoking, alcohol and drug use, and risk-taking
behaviors would not only contribute to improved adolescent health but could
reduce the morbidity and mortality associated with adult-onset diseases, such
as cancer and heart disease (McGinnis,
1994). Reducing rates of unprotected and casual sex may decrease
STDs and early pregnancy. Thus, understanding adolescents' health-risk
behaviors and their associated factors should help to inform health-promotion
and disease-reduction efforts. In this regard, the findings of this study
indicate that certain groups of adolescents display substantially higher rates
of health-risk behaviors than others, that high-risk teens tend to have poor
profiles of health behaviors across a wide area of domains, and that
adolescents' close friends are likely to display similar behaviors and to be
embedded within the same peer crowds.
In this study, burnouts and nonconformists reported the highest rates of
health-risk behaviors across the board. These findings are consistent
with prior work on cigarette and drug use (e.g.,
Mosbach & Leventhal, 1988)
and extend this work to risk-taking behaviors and sexual activity. Burnouts
were primarily male and nonconformists were primarily female, which may
partially account for the higher levels of health-risk behaviors in burnouts
(i.e., alcohol use and risky sexual behaviors were higher in boys than girls
overall). Given the wide range of their health-risk behaviors, however,
adolescents who affiliate with both of these peer crowds would be
important to target for comprehensive prevention efforts. In doing so, it
would be critical to consider these adolescents' friends. Both burnouts and
nonconformists reported that high proportions of their friends engaged in
similar health-risk behaviors, and both groups have close friends who
affiliate with the same peer crowd. Thus, burnouts and nonconformists may have
substantial support from their friends for their health-risk behaviors. These
data strongly suggest that health-promotion efforts for high-risk youths must
take into account peer networks and friendships to have much impact on the
behavior of these high-risk teens. Educational efforts alone (such as
"Just Say No to Drugs") are not likely to affect teens whose best
friendships are interwoven with high levels of health-risk behaviors. Nor
would it be useful to suggest that burnouts or nonconformists change their
peer crowd affiliation. The relatively low social status associated with these
high-risk peer crowds would make it difficult for such teens to shift
affiliation to a higher status crowd. Others (e.g.,
McWhirter, McWhirter, McWhirter, &
McWhirter, 1998) have criticized adolescent health-promotion and
prevention efforts for failing to take into account adolescents' peer
networks—which may normalize, support, and encourage a wide range of
deviant behaviors. The findings of this study strongly support these
observations.
Adolescents who affiliated with the brains stood in contrast to the burnouts and nonconformists, as they had the lowest levels of health-risk behaviors of any group. Across the board, brains had the lowest levels of substance use and sexual activity, and they had few close friends who exhibited health-risk behaviors. In fact, brains rarely had close friends from one of the high-risk peer crowds. These data suggest that brains are the least likely group of teens to be in need of health promotion efforts, at least for the health risks evaluated in this investigation.
In between the extreme-risk groups, however, are the jocks and populars.
Although jocks reported low substance use, they reported high rates of
risk-taking behaviors, had a high proportion of close friends who engaged in
casual sex, and themselves tended to report more casual sex. One implication
of these findings is that efforts to reduce sexually transmitted diseases and
to promote "responsible sexual behavior" among adolescents should
target the jock or athletic groups within high schools. Athletically oriented
teens tend to be sexually active (e.g., 59% were sexually active, compared
with 42% of the teens overall) and may be engaging in risky sexual behaviors;
these teens also view themselves as popular and may have more opportunities to
find sexual partners than other teens. In fact, surveys of high school
athletes (Forman, Dekker, Javors, &
Davison, 1995) have found that male athletes engage in sex at
earlier ages than male nonatheletes. Moreover, among college students, higher
rates of risky sexual behaviors (i.e., more partners, less contraceptive use)
have been observed in athletes than their nonathlete peers
(Nattiv, Puffer, & Green,
1997). Thus, our findings are consistent with these surveys in
suggesting that adolescent jocks may be a high-risk group for STDs. This is
especially worri-some in a community like Miami-Dade County, which has one of
the highest rates of HIV infection in the country
(CDC, 1997a). Given jocks'
relatively high social status, it may also be useful for school-based
prevention efforts to identify jocks who both practice and advocate
"safe sex" and to recruit them as peer models for responsible
sexual behaviors.
Also of concern is the jocks' relatively high rates of risk-taking behaviors, suggesting that they may be at risk for nonintentional injuries, even outside of athletic competition. Baumert, Henderson, and Thompson (1988), recently surveyed 6,800 high school students, finding that athletes reported exceeding the speed limit and riding bikes or motorcycles without helmets more than nonathletes. Thus, injury prevention programs might also target jocks within high schools, as they may represent a high-risk group of teens.
In terms of teens who are part of the popular crowd, and who are
disproportionately female, this is the second study to find that they have
relatively high rates of alcohol use, at least for occasional binge drinking.
Interestingly, unlike the pattern observed for most health-risk behaviors,
populars did not report higher proportions of close friends who drink
than did teens from other crowds, suggesting that populars' support for binge
drinking may come from influences other than close friends. Populars are, by
definition, socially active teens; thus, they may interact with more different
kinds of teens than those from other peer crowds. In fact, populars' drinking
may emerge during party or social occasions, or perhaps when dating, rather
than in the company of close friends. If this is the case, however, it could
also put these teens at risk for STDs, as linkages have been found between
alcohol excess and risky sexual behavior
(Biglan et al., 1990;
O'Hara, Parris, Fichtner, & Oster,
1998). In general, then, these findings suggest that popular teens
may represent a high-risk group for excessive alcohol use and potentially for
related health problems.
In addition to these observations, several general implications can be
drawn from the findings. First, with the exception of the high social-status
teens (populars, jocks), teens' health-risk profiles were either
"generally good" or "generally poor"; that is, levels
of substance use, risk taking, and risky sexual behaviors tended to "go
together." Yet most prevention efforts focus on selected aspects of
health-risk—usually drug use (e.g.,
Ellickson, Bell, & Harrison,
1993) or risky sexual behaviors (e.g.
Boekeloo et al., 1999). Given
that problematic health-risk behaviors cluster together, however, more
comprehensive health-promotion and prevention efforts may be needed.
Second, given the strong connections between teens' health-risk behaviors
and that of their close friends, health-promotion efforts need to consider how
the modality of preventive interventions may affect, or even inadvertently
reinforce, negative peer influences. Dishion, McCord, and Poulin
(1999) have provided
persuasive evidence of iatrogenic effects in peer-group interventions, noting
that interventions that group deviant teens together lead to increases in
substance use and problem behaviors over time. This suggests that the most
at-risk teens, such as burnouts or nonconformists, would benefit most from
prevention strategies that counteract or minimize peer influences.
Specifically, prevention programs should avoid aggregating high-risk
adolescents into intervention groups; rather, deliberate efforts should be
taken to ensure that such youths are separated from their friends during
prevention programs, to minimize the subtle, yet powerful, ways that deviant
peers influence each others' behaviors (see
Dishion et al., 1999). In
addition, involving high-risk teens' parents in the direct monitoring of their
teens' activities may prove beneficial, as parental monitoring has been shown
to counteract adolescents' associations with deviant peers (e.g.,
Brown et al., 1993;
Mason, Cauce, Gonzales, & Hiraga,
1996).
A third implication concerns the "timing" of prevention
programs. Our findings suggest that early prevention, with periodic follow-up,
might be useful. High-risk teens, like the burnouts, reported affiliating with
this crowd since middle school. Because of the addictive properties of many
substances (e.g., cigarettes, alcohol), health-risk behaviors may already be
entrenched by high school. Thus, initiating prevention programs in early
adolescence would be desirable, with continued attention to health-risk
behaviors throughout high school. Positive outcomes associated with
substance-use prevention programs in middle school, without further follow-up,
have not been maintained later on (e.g.,
Shope, Copeland, Kamp, & Lang,
1998).
Finally, substantial interest has emerged in developing HIV/STD prevention
programs for use in primary care settings. To date, such efforts have focused
on screening for sexual activity and education regarding "safe
sex" (e.g., Boekeloo et al.,
1999; Millstein, Igra, &
Gans, 1996), although the impact of such educational efforts has
been short-lived (e.g., Boekeloo et al.,
1999). Our data suggest that screening efforts might be improved
by asking teens about their peer crowd affiliations, so that high-risk youths
can be more readily identified.
Despite the many positive findings, some caveats remain. First, the
findings are based on adolescent report. Adolescents are considered to be the
best informants for their own health-risk behaviors (e.g.,
La Greca & Lemanek, 1996),
and are used by the CDC (1997b)
to monitor youth risk behaviors. However, the similarity between adolescents'
and their friends' behaviors may be influenced by having the adolescents
report on their friends' behaviors. It would be of interest to see if
adolescents' best friends would report similar kinds of behaviors if asked
directly. That was not feasible in this study, as adolescents came from a
large metropolitan area and attended more than 20 different high schools.
Nevertheless, using a school-based methodology that elicits reports directly
from adolescents' friends in school, others have found that adolescents' and
their friends behaviors matched very well in terms of smoking (e.g.,
Eiser, Morgan, Gammage, Brooks, &
Kirby, 1991; Urberg,
1992), as well as alcohol use, spending habits, school
performance, and other attitudes and beliefs (e.g.,
Eiser et al., 1991). Although
additional research is desirable, our data suggest that the pattern of close
friend influence that has been obtained for smoking and some other behaviors
may, in fact, extend to areas such as substance use, risk taking, and risky
sexual behaviors.
Second, although ethnic differences in health-risk behaviors were not a
focus of this study, this is an important direction for the future. In this
study, the peer crowds did not differ in their ethnic representation, in line
with earlier work suggesting that peer crowds are similar across ethnic groups
(Brown, 1989;
Phillips et al., 1998). Within
the peer crowds, however, our samples were too small to meaningfully evaluate
ethnicity as a moderator of the relationship between crowd affiliation and
health-risk behaviors. However, this would be desirable to consider in the
future. Among adults (e.g., Kaplan,
Sallis, & Patterson, 1993), health behaviors vary according to
ethnicity.
Third, the data collected in this study came from one school district in a large metropolitan area and may not generalize to other communities. On the positive side, Miami-Dade County is the fourth largest school district in the United States and represents a diverse student body. Nevertheless, replication of these findings in other communities would be desirable.
Finally, caution should also be used in interpreting the results, as some
of the peer crowds were fairly small. We note that the distribution of
students across peer crowds was similar to that of other studies (e.g.,
Sussman et al., 1990;
Urberg, 1992), with problem
groups such as the burnouts and nonconformists comprising the smallest crowds
and average or regulars the largest. In fact, some investigators have combined
small groups (e.g., burnouts and nonconformists) to increase group sizes
(e.g., Urberg, 1992). However,
use of this strategy in this study would have masked important peer crowd
differences—such as the elevation in populars' alcohol use, or the high
rates of Jocks' risk-taking behaviors and sexual activity. Despite relatively
small cell sizes for some peer crowds, we observed many significant crowd
differences, suggesting that crowd differences may be fairly robust.
The small group sizes proved to be problematic, however, in terms of
documenting peer crowd differences in risky sexual behaviors, despite group
means that appeared substantially different. Because only 42% of the sample
was sexually active, the cell sizes were much smaller for analyses of risky
sexual behaviors. Thus, the trends we observed await confirmation in a larger
sample of sexually active teens. It is also possible that the absence of
significant crowd differences in risky sexual behaviors could be the result of
the wording used for these items. Although the items were drawn from previous
research (e.g., Biglan et al.,
1990), items asked about behaviors in the past year. Shorter time
intervals (i.e., 3 months) may prove more accurate for assessing risky sexual
behavior (see CDC, 1997b).
In conclusion, preventing the initiation or maintenance of health-risk behaviors among adolescents is an important goal, and one that should have a positive impact on adult morbidity and mortality—and, thus, the health of the nation. Given the intertwining of health-risk behaviors and close friendships, it becomes imperative to pay attention to peer factors in developing effective prevention programs for adolescents.
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Acknowledgments |
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Work on this project was supported in part by a grant from the National Institute of Mental Health (RO1-MH48028) awarded to Dr. La Greca. The authors acknowledge the assistance of Nicole Vincent, Nadja Lopez, and Ami Flam Kuttler in this project.
Received September 20, 1999; revision received February 1, 2000; accepted April 28, 2000
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