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Substance Abuse Among American Indians and Alaska Natives: An Integrative Cultural Framework for Advancing Research

  • Blake T. Hilton
  • Hector Betancourt
  • Holly E. R. Morrell
  • Hyo Lee
  • Jared A. Doegey
Original Article

Abstract

Research consistently highlights the high prevalence of substance-related psychopathology in the American Indian/Alaska Native (AIAN) population. Recent epidemiological literature suggests that these trends are not diminishing, despite decades of etiological work and prevention programs. The aim of this article was to examine the literature on risk and protective factors for substance-related psychopathology in the AIAN population from the perspective of Betancourt’s integrative model of culture, psychological processes, and behavior (Betancourt et al. 1993, 2010, 2011). This model specifies the structure of relations among sociostructural (e.g., income and education), cultural (e.g., values and norms), and psychological (e.g., cognition and emotion) factors influencing behavior. Articles were reviewed that identified one or more determinants of substance-related psychopathology in the AIAN population. An analysis of the reviewed articles revealed that the factors investigated in relation to substance-related psychopathology have typically been studied independently of each other. Also, most studies have examined factors that are rather distal from behavior (e.g., sociostructural). Results suggest that research on the interrelations among cultural and psychological, in addition to sociostructural, determinants may enhance our understanding of substance-related psychopathology in this population. To this end, suggestions for future research are derived from results of the studies reviewed. Such theoretically driven research may contribute to more effective interventions and the reduction of substance-related disparities among the AIAN population.

Keywords

American Indian Alaska Native Substance use Substance use disorder Abuse Dependence Predictors Determinants 

Notes

Funding Information

The authors have no funding to report for this paper.

Compliance with Ethical Standards

This material has not been published in whole or in part elsewhere, aside from a doctoral dissertation. The manuscript is not currently being considered for publication in another journal. All authors have been personally and actively involved in substantive work leading to the manuscript.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Blake T. Hilton
    • 1
  • Hector Betancourt
    • 1
  • Holly E. R. Morrell
    • 1
  • Hyo Lee
    • 1
  • Jared A. Doegey
    • 1
  1. 1.Department of PsychologyLoma Linda UniversityLoma LindaUSA

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