Health Problems in University Students: Abuse to Alcohol and Drug - Dissertation Example

?Health Risk Behaviours among Discussion of Theoretical Framework: Alcohol and drug abuse remains a significant health problem among university students in the modern world, especially in developed countries like UK, and its “consequences” can be “acute” and long lasting both in “personal and societal” contexts (Hawkins et al, 1992, p.64). In fact, university students remain under tremendous pressure primarily because of the academic commitments and secondarily because of the anxiety about their future. The environment they live in also exposes them to the possibility of a wide range of influences both within the campus as well as outside of it. Besides, technological advancement in the modern day and the comforts it offers also has an impact on them. Thus, they develop a lot of health risk behaviours that may cause a wide range of negative outcomes on their physical as well as mental health. On an individual level, health risk behaviours cause the person to be less motivated and lead to poor performance in college. On the societal level, these problems cause heavy expenditure in terms of healthcare, failure in education, “mental health services, drug and alcohol treatment and juvenile crime” (p.64). The risk factors for drug abuse can be understood as the “precursors” that induce adolescents and young adults to consume drugs and the risk factors “occur before drug abuse” (p.65). Similarly, university students also tend to indulge in other health risk behaviours such as rash and negligent driving leading to road accidents, aggressive behaviour that entails violence, risky sexual behaviour that causes sexually transmitted diseases (STDs), smoking, unhealthy diet practices as well as leading a sedentary life, without any physical activities. The Parliamentary Advisory Council for Transport Safety (PACTS) has reported that car drivers in the age group of 17 – 20 years tend to involve “six times more likely” in an accident than drivers over “40 years” (Fiander, 2001, p.4). Since university students form the most part of this segment, it can be construed that they are the high risk group. Aggression, which is usually expressed in terms of bullying nature, is also a significant health risk behaviour and it is common in school as well as universities. Evidence suggests that juvenile violence is the “most visible forms of violence” and individuals between “10 and 21 years” are at highest risk of indulging in it (Neto, 2005, p.164). Similar is the case of unprotected sexual behaviours that may contribute to diseases such STDs, AIDS etc. A study by Johnson et al (2001) suggests that there has been a drastic change in the sexual behaviours of UK population in 2000 and despite the awareness programmes, there still exists a “sustained population risk” which indicates the necessity for a “re-appraisal of the effectiveness” of existing programmes and “new approaches” are inevitable for “public health” interventions” (p.1841). This shift in trend of sexual behaviour also reflects on college students, thus, making them also targets of risk. Similarly, research studies point to a high rate of smoking among “college students” and contend that the smoking prevalence for “people aged 20 – 24 is higher at 31%” (Ansari & Stock, 2012, p.705). Another major health risk behaviour among college students is the lack of physical exercises, which is the major cause of “obesity in the UK” (Obesity – A Public Health Crisis, 2010, p.4). The study by Hawkins et al (1992), has recognised these issues as health risk behaviours for young adults, including university students, but points to a dearth in evidence that confirms which risk factors are “more virulent” or to suggest which are “modifiable” or which are “specific to drug abuse” (p.65). Though none of the studies conducted previously recommends an effective “formula” for the prevention of the health risk problems in university students, the findings from the researches do suggest that identifying “potential targets” and taking steps for “preventive intervention” can be an effective strategy for countering the menace of health risk behaviours in adolescents and young adults, who form the major part of students in universities (p.65). In this context, Richard Jessor of Institute of Behavioral Sciences, University of Colorado offers a “social-psychological framework” which includes the domains of biological and genetic factors, “social environment, perceived environment, personality” and “behavior” of adolescents as the contributors to health risk behaviours in youngsters (Jessor, 1992, p.374, 383). Jessor agrees to the traditional notion that adolescent behaviour such as drug abuse, unsafe sex, complicity in crimes and other such conducts can “jeopardize” their future (p.381). However, he rather perceives these as the “outcomes and consequences” of the behaviour and, thus, identifies a “general conceptual framework” that deals with psycho-social “antecedents and determinants” of the health risk behaviours (p.381). He believes that by conceptualising and elaborating on antecedents and determinants, the issue can be addressed by making use of the “orientation of the epidemiology” for identifying the risk factors (p.381). He further identifies four major domains or “sources of variance” that constitute the conceptual framework such as the “social environment, perceived environment, personality and (other) behavior” (p.382). Additionally, he also includes the influence of genetic or biological factors as the fifth domain, which combines with the others to constitute the “web of causation” for health risk behaviours (p.382). Similarly, Hawkins et al also have identified a five domain conceptual framework for health risk behaviours and risk protection factors in their study, which comprise individual, peer, school, family and community (Risk and Protective Factor Framework, n.d., p.1). As can be discerned from the other study of Hawkins et al (1992), which also refers to the evidence from various researches previously conducted on the topic, following are some of the factors that contribute to health risk behaviours, which may also apply to university students: i) Laws or norms that encourage the behaviour ii) Ready availability o alcohol and drugs iii) Poor socio-economic conditions such as poverty and its associated problems iv) Social circumstances such as bad neighbourhood v) Psychological factors of the individual vi) Alcohol behaviour within the family and the attitude of family members vii) Poor or inconsistent family management viii) Conflicts within the family ix) Lack of bonding within the family x) Problem behaviour in early ages that remain unaddressed xi) Failure in studies xii) Lack of commitment to school xiii) Rejection by peers in early school xiv) Companionship with drug using peers xv) Alienation from peer groups and family and rebellious nature xvi) Attitudes and beliefs that favour drug use xvii) Drug use from early ages (p.65, p.81-85). Health Risk Behaviours among University Students The functions of each of the risk factors, interlinks and interplay among them etc, as well as the relationship among health risk behaviours, will be also discussed in the forthcoming paragraphs of this paper. Functions of Each Risk Factor: Introduction: The health risk factors associated with adolescents include “substance use, violence and suicidality” have far-reaching implications not only on the lives of the young adults but also on the society as a whole (Prinstein et al, 2001, p.288). Health risk behaviours in adolescents occur due to their need to subscribe to a specific group so as to emulate a sense of identity and thus they try to “adopt the norms and values” that are common to the group, which clearly explains the influence of neighbourhood and peer community on young adults (Verkooijen, 2006, p.7). Thus, university students may engage in health risk behaviours to identify with prominent groups that engage in health risk behaviours to establish a sense of belonging. Jenson & Fraser (2011) also, quoting Hawkins et al, recognise the “influences” of peer, community, individual, school and family as the risk factors that can cause children and young adults to experience social or health problems (p.10). They further identify the gaps in the previous risk factor models as the absence of “temporal relationships” of the risk factors to the occurrence of health risk behaviours or the “additive or interactive” effects of such risk factors (p.10). Therefore, the current study will examine these aspects with a specific focus on how each risk factor aligns with the other to enhance the chances of health risk behaviours. For example, drunkenness may incite violent behaviour, rash and negligent driving or indiscrete sexual behaviour. Similarly, students may be encouraged to smoke or abuse drugs after a drinking session. In addition, hangover may preclude them from productive physical activities such a jogging, weight training or participating in sports and games activities. Besides, technological advancements and the resultant comforts rather tend to encourage them to lead a sedentary life and they may prefer to do online shopping or banking instead of visiting a physical store or bank for transactions. While the five domains as identified by Hawkins involve risk factors, they also have certain elements that are protective of the risks. This can be evidenced from the fact that some of the researches have suggested that many conspicuously high risk adolescents “did not engage” in such behaviour (p.11). Many researchers agree that the protective factors are “attributes or characteristics” that have the potential to reduce the chances of “undesirable outcome” (p.11). The authors identify protective factors as the “resources – individual or environmental – that minimise the impact of risk” (p.13). Thus, it transpires that positive vibes from the five domains can also have an impact on reducing health risk behaviours and this study will focus on this aspect specifically, with a view to evaluate how these can be aligned into intervention strategies to prevent health risk behaviours in university students. In order to answer the research questions and to extract relevant evidence, this research also envisages conducting of interviews with some of the university students for identifying and assessing the risk factors as well as the protective factors and how students perceive and respond to these. The researcher has already collected data relevant to health risk behaviours through questionnaires. Thus, this research will involve the collection and interpretation of primary data to obtain information directly from the affected population of university students. The advancement in technology and medical science has transformed the understanding of the “developmental processes” in relation to the occurrence and persistence of childhood as well as the wide range of adolescent health risk behaviours problems and, thus, the modern society has recognized the need for “new thinking about policies and programs” to intervene with behaviour problems in young adults (Jenson & Fraser, 2011, p.5). The authors also point to a lack of ample “conceptual models” that can “inform the design and direction” of relevant social policies to reduce the health risk behaviours of adolescents (p.9). Therefore, the current focus needs to be on devising appropriate means of intervention by identifying the causative elements for health risk behaviours in adolescents and preventing them rather than focusing on outcomes and taking curative measures. Under the circumstances, there is a high relevance for the five domain model as postulated by Hawkins as it addresses all the causative elements that encourage health risk behaviours in adolescents. In order to understand the implications of risk and protective factors and their interaction, this study offers a brief evaluation of each aspect of the five domains as under: Individual: (a) Risk Factors: On an individual level, the risk factors may derive from genetic elements, “early onset of drug use,” attitudes, the tendency to remain alienated or being rebellious, and other health risk behaviours that persist into adolescence etc (Hawkins et al, 1992, Table-1). Thus, individuals, who display any of these attributes during childhood, are likely to develop health risk behaviours when reach adolescence. Such health risk behaviours will explicitly manifest in problematic conduct such as aggression, sedentary life, drinking etc. Therefore, identifying such tendencies in children and addressing them at the appropriate stage will help in eliminating the chances of their indulgence with health risk behaviours when they grow up into young adults. (b) Protective Factors: While individual traits of a child has potential risk factors, they also have some inherent protective factors such as resilience, which can be perceived as an “outcome of a process” that considers the child’s level of exposure to risk as well as the presence of the protective factors in him or her (Jenson & Fraser, 2011, p.13). Thus, in the case of high risk children, the protective factors also “exert their influence” on the developmental outcomes of the child (p.13-14). Hence, by recognizing the positive elements in children and those traits, the health risk behaviours can be controlled to a great extent if not totally eliminated. Peers: (a) Risk Factors: The risk factors emerging from peer groups can be perceived in terms of encouragements that university students may receive from a sense of belonging to a particular group. The risk factors include companionship with friends who engage in health risk behaviours both in the academic as well as social settings or the rejection by peers during their “elementary grades” etc (Hawkins et al, 1992, Table-1). Thus, while some students may try alcohol and drugs to acquire a sense of belonging to certain groups, others may indulge in such habits for fear of rejection from peers, which they have already experienced in their early stages of schooling. (b) Protective Factors: While peer group influence poses a threat of encouragement to children for indulging in health risk behaviours, on the other hand, it may also have some protective factors that may dissuade them from such behaviours. The protective factors can be identified as the possibility of peers setting example for others by abstaining from any health risk behaviours and explaining to them the negative impacts of such indulgences. Some children may encourage others to engage in activities such as sports, games or creative arts, which will facilitate a positive environment for students who may otherwise tend to engage in health risk behaviours. Similarly, when one student achieves success in sports, games or other creative arts and wins a price, it may act as an encouragement for others and they may try to imitate such endeavours in their academic career also. Thus, intervention strategies for preventing health risk behaviours in school and university students need to focus on encouraging the positive attitudes in them. Family: (a) Risk Factors: Family exercises a great influence in children’s attitudes and behaviours and, therefore, any negative trend in the family setting can have long lasting repercussions on children’s habits, attitudes and sense of morals and values. Such children will carry any impairment into their later years, especially when they enter university life and actively indulge in health risk behaviours. Family risk factors, according to Hawkins et al (1992), mainly derive from problems such as drug and alcohol behaviours and conflicts within family, “family management practices,” and lack of bonding within the family (Table-1). Studies further suggest that parental monitoring of the activities of their children also has significant influence on “adolescent alcohol use” (Hayes, et al, 2004, p.26). Thus, children whose parents give out the sense that their activities are being monitored will naturally tend to desist from health risk behaviours for fear of getting caught. On the flip side, children who feel that their parents are not aware of their activities will more likely engage in health risk behaviours more frequently. Similarly, children from families where the management is disorderly are likely to indulge in health risk behaviours because they feel that nobody will take notice of their activities. On the other hand, children who lack proper bonding or whose families remain in conflict are more likely to feel alienated and resort to one or more health risk behaviour as a means of seeking solace. (b) Protective Factors: While family can constitute some risk factors, it can also have several protective factors that can create positive environments for children. The main factor is that family can support the children and encourage them to pursue the positive things in life. Besides, families can instil a sense of value, ethics and morals in children and if such traits are properly imbibed in them, it can deter them from indulging in health risk behaviours. Thus, family has great potential in the moulding of an individual’s habits and the effectiveness of family based intervention can be evidenced from the fact that “80 percent” of the youth that has undergone the therapy are found to be “drug free at termination” (Rahdert & Czechowicz, 1995, p.229). Therefore, providing children with a congenial environment in their family setting and identifying as well as sorting out their problems by the family members will help in solving their issues more effectively. University: (a) Risk Factors: Joining college can be an exciting proposition for youngsters but it also offers an array of challenges for them in terms of academic commitments, “developing autonomy,” having to stay away from family etc (Polymerou, 2007, p.4). Thus, students may turn to any of the health risk behaviours as a matter of seeking vent to their problems when they are not able to cope up with the challenges or homesickness. Health risk behaviours may also entail from the need to seek affiliation to a new group of friends who engage in drinking or drug habits, smoking, rash and negligent driving or sexual escapades. Hawkins et al (1992) identifies low academic performance or “school failure” also as the risk factors that may induce students to indulge in health risk behaviours (Table-1). (b) Protective Factors: Universities, while having some elements of risk, also have certain positive aspects that can be protective factors for the students. Those who are intelligent and have resilience will be able to tap the potential that the new surroundings that the universities provide and make the best use of them. Similarly, the new friends in the universities may dissuade the students, who tend to indulge in health risk behaviours. In addition, some of the students who are habitual of drinking or drug abuse, aggressive conduct, or sexually active in an indiscrete manner can seek better avenues that the universities will be able to offer in terms of additional resources in the fields of sports, games and other creative activities. Community: (a) Risk Factors: The risk factors for health risk behaviours in a community may mainly stem from various aspects such as relevant laws prevailing in the society, the “cultural norms,” legal drinking age, economic conditions as well as the availability of opportunities for engaging in such activities (Hawkins, 1992, Table-1). In addition, social influences such as “media personalities” as well as “persuasive advertising appeals” also can contribute to risk factors from the community (Botvin, 2000, p.888). These elements do exercise significant influences on the adolescents and how they perceive health risk behaviours during their university life. (b) Protective Factors: The protective factors from a societal perspective can be perceived as programmes that the community sponsors and puts in place against possible health risk behaviours in adolescents as well as various campaigns that the media and celebrities endorse to create proper awareness in youngsters. Similarly, wherever high risk becomes evident, the authorities must implement laws that can eliminate the chances for young adults to engage in health risk behaviours. Various schemes that focus on economic growth as well as employment opportunities to youth can also be considered as protective factors that the society can offer, because such endeavours will provide younger adults with more avenues to engage in productive activities. Thus, intervention plans and programmes need orientation towards addressing all the risk factors that are involved within the community so that the creative and productive capabilities in youngsters are properly channelled to meaningful engagements. Rationale for Choosing the Theoretical Framework: In order to understand an issue and its impacts, it is necessary to have an understanding of the causative elements and the basic theories as to how these elements contribute to the risk behaviour theoretically. Knowledge of various theories will also facilitate the understanding of the determinants of risk behaviour. In addition, analysing the issues from within a theoretical framework will enable the researcher to identify each causative element and connect it to the risk behaviour by explaining the relationship between risk factors and risk behaviour. The theoretical framework of Richard Jessor seeks to “incorporate adolescent behavior into an epidemiological perspective” on the risk factors (Jessor, 1992, p.381). The framework further offers the specific understanding of various social, economic and psychological factors that cumulatively contribute to the risk behaviours. Moreover, it illustrates the linkage between biological/genetic factors and how it merges with the social environment to develop personalities of individuals. It also shows how the personality so developed plays a role in the indulgence in risk behaviours. This enables the researcher to form clear ideas about the causative elements and their interplay in encouraging risk behaviours in individuals. In addition, the framework identifies protective factors inherent within the genetic aspects of one’s personality and also links it to the protective factors in a person’s environment. The framework further delineates the protective factors in the personality and behaviour of the individual. Thus, Jessor’s framework is the most appropriate for a study of this nature. Why it is the Best for My Study and How It is Going to Influence My Research: The current study focuses not only on identifying the risk behaviour and its causative elements, but also on filling the gaps in the intervention strategies through a focus on protective factors and by strengthening the potential of these characteristics to derive best results for the target population. Thus, it is imperative for the study to consider the theoretical perspectives of the issues and its causes as well as all the protective factors that can be deployed to determine the ways and means to counter the problems. The theoretical framework offered by both Jessor and Hawkins consider not only the illustration of the problems and their causative elements from all aspects of the subjects’ life but also indicate the protective factors inherent in them so as to make it possible for social scientists to evolve the most appropriate and suitable intervention strategies to address the issues. The framework will, therefore, help in a systematic evaluation of the issues through the clear understanding of the influences behind the stemming of the problems in the target population in terms of genetic, environmental and social factors. Such an evaluation can enable the researcher to understand the role of the protective elements in remedying the problems and thus determine the most practical ways and means to address the issue and recommends his suggestions accordingly. Linking to Problem Behaviour Theory, Behaviour of Change and Other Theories: Jessor’s Problem Behaviour Theory is a “systematic, multivariate, social-psychological, conceptual framework” that has derived from the primary concepts of “value and expectation” as well as “anomie” (Costa, 2008). This model seeks to explicate on the “behavioral outcomes such as substance use, deviancy, and risky sexual behaviours” and comprises the three systems of “psychosocial components” such as personality system, perceived environmental system and the behavior system (Zamboanga, Carlo, Raffaelli, 2004, p.254). Personality system refers to values, beliefs and attitudes of an individual as well as his or her “social cognitions” and the perceived environmental system consists of various social influences including the “orientation” as well as “expectations” of family members and peer groups relating to problem behaviours (p.254). On the other hand, behavior system comprises the problems and “conventional behavior structures” that work in “opposition to one another” and include issues such as drug and alcohol abuse, deviance or any other unsafe sexual practices. Thus, it can be evidenced that Jessor’s Problem Behaviour Theory (PBT) also encompasses the same concepts as postulated in the theoretical framework being used for this study. While PBT identifies the problem behaviours as well as the causative elements, the theoretical framework also illustrates the problems, its causes and effects besides stating the protecting factors within the causative elements. On the other hand, the Theory of Planned Behaviour, a widely accepted concept that follows “cognitive approach” for the explanation of behaviours of individuals, centre on people’s “attitudes and beliefs” (Morris et al, 2012, p.5). An apparent link between the framework used for this study and Theory of Planned Behaviour (TPB) can be evidenced from the fact that TPB relies on intention of the individual as the primary factor for behaviour change of an individual, which is a crucial element in the intervention to address risk behaviours. It is relevant that such intention stems from the protective elements in an individual’s personality that is primarily the reflection of values and attitudes of a person. Similarly, the Theory of Reasoned Action (TRA) also focuses on the “behavioural intention” that derives from an individual’s expectancy about the “outcomes” of a particular behaviour (Elder, Guadalupe & Harris, 1999, p.278). This theory also links intention, which again derives from the protective elements in the personality of an individual and his social circumstances like supportive family or peer group, as a primary factor in evolving strategies for intervention Thus, a distinct link can be established between TPB as well as TRA and the framework used for the current study. Cultural Aspects and how it Differs Among Saudi Arabia and Western Countries: As opposed to the Western cultures, where drinking is a traditionally accepted norm, Saudi Arabian culture and religion does not allow drinking. However, this does not preclude the Saudi university students from engaging in other risk behaviours. Evidence suggests a “high prevalence” of heath risk behaviours such as smoking, lack of physical activity and the avoidance of using seat belts while driving in school children as well as their teachers in Saudi Arabia (Taha, 2007, p.7). Similarly, another study attests to prevalence of a high rate of lack of physical activity “sedentary behaviours” and “unhealthy dietary habits” in adolescents, especially females, in Saudi Arabia (Al-Hazzaa et al, 2011, p.12). Due to the cultural orientation of Saudi Arabians, the natural assumption will be that Saudi students, who are residents of the UK, will abstain On the other hand, while culture plays a significant role as a protective factor, research evidence from a study, which has considered Saudi students also, finds an erosion of the “protective effects that accompany heritage practices” in people from other countries, who immigrate to the US (Schwartz, 2010, p.11). Thus, a dominant influence of Western culture can be traced in Saudi Arabians, which makes them more prone to risk behaviours. Conclusion: As can be evidenced from the research studies of Hawkins, Jessor and other researchers, as discussed in the foregoing section of this paper, the risk factors for health risk behaviours among university students emerge from five domains such as individual, peer group, family, university and community. A very significant factor that becomes relevant in this context is that the risk factors have an inter relation among them. Thus, the drug habit within a community may be carried onto the university campus and vice versa. However, on the contrary, the protective factors also have this characteristic and, hence, the protective factors within the university campus may pass onto the community. Therefore, for the intervention programmes to be more effective and to fully optimise their potential the interplay among all these factors needs to be understood and intervention plans devised accordingly. Similarly, the intervention strategies also need to recognize the determinants of risk factors and address them properly for effectively checking the problem of health risk behaviours in university students. On the other hand, there also exists a need to recognize the interplay of the relationship among the health risk behaviours for devising effective intervention strategies. For example, the health risk behaviour of drinking may overlap into other areas such as aggressive conduct, rash and negligent driving, indiscriminate sexual practices or smoking and abuse of drugs. Similarly, over indulgence with alcohol, drugs and sex may preclude students from engaging in physical activities and relegate them to a sedentary life, which may cause health problems such as obesity and other ailments. Thus, the intervention strategies also need to recognize the overlapping trait of the health risk behaviours and orient their focus accordingly to make them effective. It is also essential to evaluate the risk involved in each individual case and address it appropriately for any intervention strategy to be effective. All these health risk behaviours and the dangerous outcomes they entail on individual students as well as the society, pose a grave threat that needs immediate attention. University students are the future of a nation and they have a key role to play both in terms of resourceful talents and responsible citizens. Thus, cohesive and concerted efforts from the community, families and universities by properly evaluating the risk factors, their causative elements and devising as well implementing suitable plans that match the requirements of the specific groups, will go a long way in eliminating the problem from the society. Reference List Al-Hazzaa H. M. et al. 2011. Physical Activity, Sedentary Behaviors and Dietary Habits among Saudi Adolescents Relative to Age, Gender and Religion. International Journal of Behavioral Nutrition and Physical Activity, Vol.6 (140). Retrieved 24 May, 2013, from Ansari, W. E. & Stock, C. 2012. Factors Associated with Smoking, Quit Attempts and Attitudes towards Total Smoking Bans at University: A Survey of Seven Universities in England, Wales and North Ireland. Asian Pacific Journal of Cancer Prevention, Vol.13. Retrieved April 24, 2013, from Costa, F. 2008. Problem Behavior Theory – A Brief Overview. Retrieved May 24, 2013, from Elder, J. P., Guadalupe, X. A., & Harris, S. 1999. Theories and Intervention Approaches to Health Behavior Change in Primary Care. American Journal of Preventive Medicine. Vol.17 (4):pp.275-284. Retrieved May 24, 2013, from Fiander, S. 2001. Anyone can Save a Life: Road Accidents and First Aid. British Red Cross. Retrieved April 24, 2013, from Hawkins, J. D., Catalano, R. F. & Miller, J. Y. 1992. Risk and Protective Factors for Alcohol and Other Drug Problems in Adolescence and Early Adulthood: Implications for Substance Abuse Prevention. Psychological Bulletin, American Psychological Association, Vol.112, No.14. pp. 64-105. Jessor, R. 1992. Health risk behaviours in Adolescence: A Psychological Framework for Understanding and Action. Developmental Review, Vol.12. pp.374-390. Johnson, A. M. et al. 2001. Sexual Behaviour in Britain: Partnership, Practices, and HIV Risk Behaviours. The Lancet, Vol.358. Retrieved April 24, 2013, from Morris, J., Marzano, M., Dandy, N., & O’Brien, N. 2012. Theories and Models of Behaviour and Behaviour Change. Forest Research. Retrieved May 24, 2013, from Obesity – A Public Health Crisis. 2010. Weight Management Centre. Retrieved April 24, 2013, from Risk and Protective Factor Framework. n.d. Retrieved April 21, 2013, from Schwartz et al. 2010. Dimensions of Acculturation: Association with Health Risk Behaviors among College Students from Immigrant Families. American Psychological Association: Journal of Counseling Psychology. Retrieved May 24, 2013, from Taha, A. Z. A. 2007. Prevalence of Risk-Taking Behaviors. Bahrain Medical Bulletin, Vol.29 (4). Retrieved May 24, 2013, from Zamboanga, B. L., Carlo, G. & Raffaelli, M. 2004. Problem Behavior Theory: An Examination of the Behavior Structure System in Latino and Non-Latino College Students. International Journal of Psychology, Vol.38 (2): pp.253-262. Retrieved May 24, 2013, from Read More