INTRODUCTION The effect of socioeconomic status on adolescent substance abuse may be mediated by family socialization practices. However, traditional mediation analysis using a product or difference method is susceptible to bias when assumptions are not addressed. We aimed to use a potential outcomes framework to assess assumptions of exposure-mediator interaction and of no confounding of the results. METHOD We revisited a traditional mediation analysis with a multiple mediator causal mediation approach using data from 17,761 Norwegian young people (13-18 years), 51% female. Data were collected through a print questionnaire. Socioeconomic status was operationalized as parental education and employment status (employed or receiving welfare); drinking behavior as the frequency of alcohol consumption and frequency of intoxication in the past year; and socialization practices as general parenting measures, alcohol-related parental permissiveness, and parent drinking behavior. RESULTS There was no consistent evidence of exposure-mediator interaction. Formal sensitivity analysis of mediator-outcome confounding was not possible in the multiple mediator model, and this analysis supported the hypothesis that socioeconomic status effects on adolescent substance abuse are fully mediated by family socialization practices, with apparently stronger effects in younger age groups observed in plots. CONCLUSION We found that the effect of socioeconomic status on adolescent substance abuse was fully mediated by family socialization practices. While our analysis provides more rigorous support for causal inferences than past work, we could not completely rule out the possibility of unmeasured confounding.

中文翻译：

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测试年轻人饮酒的社会经济地位和家庭社会化假设：因果中介分析。

引言 社会经济地位对青少年药物滥用的影响可能受到家庭社会化实践的调节。然而，如果没有解决假设，使用乘积或差异方法的传统中介分析容易产生偏差。我们旨在使用一个潜在的结果框架来评估暴露-中介相互作用和没有混淆结果的假设。方法 我们使用来自 17,761 名挪威年轻人（13-18 岁）（其中 51% 为女性）的数据，重新审视了采用多中介因果中介方法的传统中介分析。通过印刷问卷收集数据。社会经济地位作为父母教育和就业状况（就业或接受福利）进行操作；饮酒行为为过去一年的饮酒频率和中毒频率；和社会化实践作为一般育儿措施、与酒精有关的父母许可和父母饮酒行为。结果 没有一致的证据表明暴露-介质相互作用。在多重中介模型中不可能对中介结果混杂进行正式的敏感性分析，并且该分析支持这样的假设，即社会经济地位对青少年药物滥用的影响完全由家庭社会化实践介导，在图中观察到的年轻群体的影响明显更强. 结论 我们发现，社会经济地位对青少年药物滥用的影响完全受家庭社会化实践的调节。虽然我们的分析比过去的工作为因果推论提供了更严格的支持，但我们不能完全排除无法测量的混杂的可能性。