Director's Report to the National Advisory Council on Drug Abuse
Epidemiology, Etiology and Prevention Research
Television Viewing and Aggressive Behavior during Adolescence and Adulthood
Television viewing and aggressive behavior were assessed over a 17-year interval in a community sample of 707 individuals. There was a significant association between the amount of time spent watching television during adolescence and early adulthood and the likelihood of subsequent aggressive acts against others. Specifically, researchers reported that 5.7 percent of the study participants who watched less than an hour of TV a day committed a violent act that resulted in serious injury, such as broken bone. Among those who watched one to three hours, 18.4 percent had been violent. Of those who watched more than three hours a day, the rate of aggression was 25.3 percent. This association remained significant after previous aggressive behavior, childhood neglect, family income, neighborhood violence, parental education, and psychiatric disorders were controlled statistically. This study is the first long-term longitudinal study to link television exposure during adolescence and young adulthood to aggressive behaviors in adults. Although this study's design (observational) is potentially limited in its ability to, in its self, establish that a direct causal link between television watching and aggression exist, it does, nonetheless, provide empirical data that adds to the pattern of accumulated evidence that supports the plausibility that television watching is causally connected to future aggressive behaviors. Johnson, J.G., Cohen, P., Smailes, E.M., Kasen, S., and Brook, J.S. Science, 295(5564), pp. 2468-2471, March 29, 2002.
Early Adolescent Marijuana Use: Risks for the Transition to Young Adulthood
This study assessed the relationship of early adolescent marijuana use to performance of developmental tasks integral to the transition to young adulthood. The tasks concerned intimacy, education, and work and social conformity. African American (N = 617) and Puerto Rican (N = 531) youths completed questionnaires in their classrooms. Five years later they were individually interviewed. Logistic regression analysis estimated the increased likelihood that early marijuana users would make an inadequate transition to young adult social roles. Analyses examining the association between early marijuana use and 20 outcome variables found significant relationships for 10 of them: (a) having lower educational and occupational expectations; (b) being suspended or expelled from school, fired from jobs, 'high' at school or work, collecting welfare; and (c) rebelliousness, not participating in productive activities, not attending church, and being an unmarried parent. Marijuana use was not related to any of the intimate relationship measures. These findings emerged with controls on gender, ethnicity, age and mother's education. The authors conclude that among African Americans and Puerto Ricans, early marijuana use predicts less adequate performance on some developmental tasks integral to becoming an independent young adult. Marijuana is not a benign drug and is associated with future risks for the individual and society at large. Brook, J.S., Adams, R.E., Balka, E.B., and Johnson, E. Psychol Med, 32(1), pp. 79-91, January 2002.
Relative Effectiveness of Anti-drug PSAs
Whether an anti-drug media campaign can produce behavior change in the target (i.e., youth) population is a critical question. Such change depends on knowing the extent to which that behavior is influenced by attitudes, norms and beliefs, and whether these can be altered by televised public service announcements (PSAs). This study explores the relative perceived effectiveness of 30 anti-drug PSAs and assesses the extent to which judgments of effectiveness are related to judgments of realism, amount learned, and positive and negative emotional responses. A sample of students in grades 5 through 12 were randomized to 5 experimental (E) conditions to view sets of 6 anti-drug PSAs or a control group that viewed a non-drug-related TV program. Three of the E groups saw ads focused primarily on the negative consequences of using various drugs; the other two E groups saw ads focused on refusal skills. The researchers report wide variation in the perceived effectiveness of the 30 PSAs: 16 were rated as significantly more effective and 6 significantly less effective than the control program. Ratings of effectiveness were highly associated with realism (r = .87), amount learned (r=. 88), and negative emotion (r=. 87). However, the more positive the adolescents' emotional response to the PSA, the less they regarded it as effective (r=-.35; p=. 06). These findings highlight the variation in the effectiveness of ads. While most ads made adolescents less inclined to use drugs, several had little effect and others had negative effects. Moreover, those youth who do not view drug use as risky behavior were least likely to view the ads as effective. These findings suggest that evaluative research is necessary to prevent broadcast of PSAs that could have a negative impact. PSAs should point out the negative consequences of drug use rather than telling adolescents to just say no. Fishbein, M., Hall-Jamieson, K., Zimmer, E., von Haeften I., and Nabi, R. Avoiding the Boomerang: Testing the Relative Effectiveness of Anti-drug Public Service Announcements before a National Campaign. Am. J. Public Health. 99(2) pp. 238-245, 2002.
Having a Teenage Mother is Unrelated To Adolescent's Psychosocial Outcomes
This is a study of psychosocial outcomes of adolescents born to teenage mothers. Adolescents' problem behaviors, psychological well-being, social support, school variables, and sexual behaviors are compared across three groups-those born to mothers 17 or younger, mothers 18-19 years old, and mothers 20 or older. Analyses from two samples of African American adolescents from Maryland and Michigan are reported. The results from both samples indicate that mother's age at birth is unrelated to adolescents' psychosocial outcomes. These two studies add to the limited number of analyses that examine adolescent outcomes for children of teen mothers. The results suggest that efforts to understand social structural determinants of healthy and problematic adolescent development may be more informative than examining the effects of mother's age. They also suggest that teen pregnancy prevention programs may be more effective if they are part of a larger prevention strategy that incorporates social structural change efforts and not only a focus on individual level change. Zimmerman, M.A., Tuttle, L., Kieffer, E., Parker, E., Caldwell, C.H., and Maton, K.I., American Journal of Community Psychology, 29(5), pp. 799-805, 2001.
Treatment Seeking After Onset of Substance Use Disorder
This paper reports results of analyses of survey data on patterns and predictors of treatment seeking after onset of DSM-III-R substance use disorders in three countries. The study utilized population-based survey data from a regional sample in Ontario, Canada, a national sample in the U.S., and local samples in Fresno, California and Mexico City, Mexico. Analyses examined the effects of demographics, symptoms, and types of substances on treatment seeking. Results indicated that between 50% (Ontario) and 85% (Fresno) of people with substance use disorders seek treatment but the time lag between onset and treatment seeking averages ten or more years. Consistent predictors of treatment seeking include: (1) late onset of disorder, (2) recency of cohort, (3) 4 specific dependence symptoms: using larger amounts than intended, unsuccessful attempts to cut down use, tolerance, and withdrawal symptoms, and (4) use versus non-use of cocaine and heroin. Results from this study indicate that treatment seeking has increased in recent years; however, further research is needed to assess whether this is because of increased access, increased demand, increased societal pressures, or other factors. Kessler, R.C., Aguilar-Gaxiola, S., Berglund, P.A., Caraveo-Anduago, J.J., DeWit, D.J., Greenfield, S.F., Kolody, B., Olfson, M. and Vega, W. Patterns and Predictors of Treatment Seeking After Onset of a Substance Use Disorder. Archives of General Psychiatry, 58, pp. 1065-1071, 2001.
Understanding the Differences in Youth Drug Prevalence Rates Produced by the MTF, NHSDA, and YRBS Studies
This paper explores potential reasons for the differences in drug use prevalence rates among youth generated by three nationally representative surveys: The National Household Survey on Drug Abuse (NHSDA), the Monitoring the Future (MTF) survey, and the Youth Risk Behavioral Survey (YRBS). The MTF and YRBS are the most similar of the surveys, being conducted among students in a classroom using self-administered questionnaires. The NHSDA is conducted in the respondent's household, but it has always used self-administered procedures for the drug questions. Nevertheless, the NHSDA generally reports the lowest drug prevalence rates for youth among the three surveys. There are a number of methodological differences across the surveys that cumulatively, probably account for the differences in estimates. Some of the differences appear to be due to telescoping, in that when a calendar was introduced to anchor past 30 day and 12 month time periods in the NHSDA, prevalence rates for illicit drugs were reduced. However, there is substantial similarity in the trends over time among the three surveys, especially for cigarettes, alcohol and cocaine. Many of the estimates generated by the three surveys have overlapping confidence intervals, which suggests the estimates are not statistically significantly different from one another. Harrison, L.D. Understanding the Differences in Youth Drug Prevalence Rates Produced by the MTF, NHSDA, and YRBS Studies. Journal of Drug Issues, 31(3), pp. 665-694, 2001.
Psychiatric and Substance Use Disorder in South Florida: Racial/Ethnic and Gender Contrasts in a Young Adult Cohort
Authors present their findings of a sub-sample (N = 1,803) of students who entered middle school in 1990, and were interviewed between 1998 and 2000. Using the computer-assisted personal interviews, subjects psychiatric and substance use disorders were evaluated using the DSM IV. Investigators found that over 60% of the sample met lifetime criteria for one or more disorders. Childhood conduct and major depressive alcohol abuse disorders were the most prevalent. The rates of affective and anxiety disorders in females were double that in males, however once attention deficit disorders, conduct disorders, and antisocial personality disorders were considered, the gender difference disappeared. Lower rates were reported among African Americans for depressive disorders and substance abuse dependence. Among Hispanics, rates were found to be lower among the foreign born in comparison with their US born counterparts, especially for substance abuse disorders. This study emphasizes the need for prevention efforts in the school setting and the notion that more research needs to be done on the origins of ethnic and nativity differences. Turner, R.J., Gil, A.G. Archives General Psychiatry, 59, pp. 43-50, 2002.
Estimates of Intra-group Dependence for Drug Use and Skill Measures in School Drug Prevention Trials
Group-randomized drug abuse prevention trials customarily designate schools as the unit of assignment to experimental condition; however, students within schools remain the unit of observation. Students nested within schools may show some resemblance based on common (peer) selection or school climate factors (i.e. disciplinary practices, group norms, or rules). Appropriate analyses of any treatment effects must be statistically correct for the magnitude of clustering within these intact social units (i.e., intra-class correlation coefficient [ICC]). There is little reported evidence, however, of variation in ICCs that might occur with studies of racially or geographically diverse populations. The purpose of this study was to generate estimates of intra-group dependence for drug use and psychosocial measures (hypothesized mediators) from three separate drug abuse prevention trials. Clustering for the drug use measures averaged .02 across studies and age groups (range=. 002 to .053) and was equivalently small for the psychosocial measures (averaging .03 across studies and age-groups; range=. 001 to .149). With few exceptions and across different samples, clustering decreased in magnitude over time. Clustering was largest for peer smoking and drinking norms among white, suburban youth and smallest for alcohol expectancies among urban black youth. Scheier, L.M., Griffin, K.W., Doyle, M.M., and Botvin, G.J. Estimates of Intra-group Dependence for Drug Use and Skill Measures in School-Based Drug Abuse Prevention Trials: An Empirical Study of Three Independent Samples. Health Education & Behavior, 29(1), pp. 85-103, 2002.
Prevention - Effects on Developmental Progression in Drug Use
This study examines the plausibility of the gateway hypothesis to account for drug involvement in a sample of middle school students participating in a drug abuse prevention trial. Analyses focused on a single prevention approach to exemplify intervention effects on drug progression. Improvement in social competence reduced multiple drug use in 1- and 2-year follow-ups. Specific program effects disrupted drug progression by decreasing alcohol and cigarette use over 1 year and reducing cigarette use over a 2-year period. Controlling for previous drug use, alcohol was integrally involved in the progression to multiple drug use. Subgroup analyses based on distinctions of pretest use/nonuse of alcohol and cigarettes provided partial support for the gateway hypothesis. However, evidence also supported alternate pathways including cigarette use as a starting point for later alcohol and multiple drug use. Findings underscore the utility of targeting more than one gateway substance to prevent escalation of drug involvement and reinforce the importance of social competence enhancement as an effective deterrent to early-stage drug use. Scheier, L.M., Botvin, G.J., and Griffin, K.W. Preventive Intervention Effects on Developmental Progression in Drug Use: Structural Equation Modeling Analyses Using Longitudinal Data. Prevention Science, 2(2), pp. 91-112, 2001.
Reliability and Validity of a Brief Measure of Sensation Seeking
Sensation seeking is a powerful predictor of a wide array of problem behaviors. High sensation seekers (HSS) are more likely than low sensation seekers (LSS) to engage in risky behaviors and, subsequently are less likely to label them as risky. The widely used measure of sensation seeking, Form V of the Sensation Seeking Scale (SSS-V), however, has several shortcomings including length, forced-choice format and outdated colloquial language. This article reports on 2 studies that tested a brief alternative measure based on the SSS-V, the Brief Sensation Seeking Scale (BSSS) and its reliability and validity as a self-report of sensation seeking. Study 1 was administered in mass-testing sessions and found to have suitable item characteristics and internal consistency of responses to items across age (13-17 years), sex and ethnic categories. Study 2 participants completed the BSSS individually using a computer, and also responded to questions about their perceptions of and experiences with drugs and additional risk and protective factors. Their BSSS scores correlated inversely with negative attitudes toward drug use and positively with actual drug use and the BSSS's sensation seeking measure was a strong predictor of intention to use marijuana in the future. Thus, this new brief measure reliably and predictably measures sensation seeking and related factors. Hoyle, R.H., Stephenson, M.T., Palmgreen, P., Lorch, E.P., and Donohew, R.L. Reliability and Validity of a Brief Measure of Sensation Seeking. Personality and Individual Differences, 32, pp. 401-414, 2002.
Inhalant Abuse Among Three Groups of Adolescents
Analyses involving participants from three ethnic populations over the course of ten years suggest that a number of social and perceptual correlates of inhalant use operate similarly across Mexican American, American Indian, and non-Latino white adolescents. These analyses suggest that peer factors, including peer sanctions, peer use, and peer encouragement, were particularly important, though less so for Mexican American and Indian youth. Increased perception of harm is also correlated with less inhalant use for all groups. These data suggest that the historically higher rates of inhalant use for males as compared to females no longer prevail. Furthermore, for the American Indian sample, for both lifetime and 30-day prevalence, males were less likely to have used inhalants than females. Overall, American Indian adolescents participating in the survey showed decreasing rates of inhalant use over time. Beauvais, F., Wayman J.C., Jumper-Thurman, P., Plested, B., and Helm, H. Inhalant Abuse Among American Indian, Mexican American, and Non-Latino White Adolescents. American Journal of Drug and Alcohol Abuse, 28, pp. 171-187, 2002.
Social Information Processing and Aggression
Social information processing (SIP) patterns were conceptualized in independent domains of process and context and measured through responses to hypothetical vignettes in a stratified sample of 387 children (50% boys; 49% minority) from 4 geographical sites followed from kindergarten through 3rd grade. Analyses supported the within-construct internal consistency, cross-construct discrimination, and multidimensionality of SIP patterns. Contrasts among nested structural equation models indicated that SIP constructs significantly predicted children's aggressive behavior problems as measured by later teacher reports. The findings support the multidimensional construct validity of children's social cognitive patterns and the relevance of SIP patterns in children's aggressive behavior problems. Dodge, K.A., Laird, R., Lochman, J.E., and Zelli, A. Multidimensional Latent-Construct Analysis of Children's Social Information Processing Patterns: Correlations with Aggressive Behavior Problems. Psych. Assessment, 14(1), pp. 60-73, 2002.
Pathways to Externalizing Behavior
The roles of peer rejection in middle childhood and antisocial peer involvement in early adolescence in the development of adolescent externalizing behavior problems were examined using longitudinal, prospective data. Classroom sociometric interviews from ages 6-9 yrs, adolescent reports of peers' behavior at age 13 yrs, and parent, teacher, and adolescent self-reports of externalizing behavior problems from ages 5-14 yrs were available for 400 adolescents. Both early starter and late starter pathways were considered. Results indicate that experiencing peer rejection in elementary school and greater involvement with antisocial peers in early adolescence were correlated, but that these peer relationship experiences may represent 2 different pathways to adolescent externalizing behavior problems. Peer rejection experiences, but not involvement with antisocial peers, predict later externalizing behavior problems when controlling for stability in externalizing behavior. Externalizing problems were most common when rejection was repeatedly experienced. Early externalizing problems did not appear to moderate the relation between peer rejection and later problem behavior. Laird, R.D., Jordan, K.Y., Dodge, K.A., Pettit, G.S., and Bates, J.E. Peer Rejection in Childhood, Involvement with Antisocial Peers in Early Adolescence, and the Development of Externalizing Behavior Problems. Dev. & Psychopathology, 13(2), pp. 337-354, 2001.
Early-Adolescent Risk Factors of Youth Violence Mediate Childhood Risks
Analyses were conducted to assess whether risk factors for youth violence measured at 10 yrs of age influenced later violence directly or indirectly through predictors measured in early adolescence (14 yrs of age). Analyses revealed that many childhood risks--which included teacher-rated hyperactivity/low attention, teacher-rated antisocial behavior, parental attitudes favorable to violence, involvement with antisocial peers, low family income, and availability of drugs in a neighborhood--had strong and persistent effects on later violence. However, mediation effects also were noted for most factors. Male gender and low neighborhood attachment measured at 10 yrs of age were the only 2 risks that appeared not to be mediated partially by predictors at 14 yrs of age. School and peer predictors of violence measured at 14 yrs of age were the strongest mediators of the earlier risk factors. Those predictors consistently added to the explanatory power of each model that was tested. Herrenkohl, T.I., Guo, J., Kosterman, R., Hawkins, J.D., Catalano, R.F., and Smith, B.H. Journal of Early Adolescence, 21(4), pp. 447-469, 2001.
Persistence of Violence In The Transition To Adulthood
Researchers examined violent behavior from ages 13-21 yrs and identified predictors at age 10. Logistic regression was used to assess predictors of developmental patterns of violence. The sample is from a study of 808 youth interviewed annually from age 10 to 16 yrs, and again at ages 18 and 21. Over 28% of the youth in the sample reported nonviolence throughout adolescence and into early adulthood. Most youth (55%) engaged in violence in adolescence but desisted from violence in early adulthood, while 16% persisted in violent behavior at age 21. Violence in adolescence was best predicted by male gender, Asian American ethnicity (a protective factor), childhood fighting, early individual characteristics, and early antisocial influences. Adult persistence of violence was best predicted by male gender, early school achievement (which was protective), and early antisocial influences. Early prosocial development was also protective against violence persistence for females. Implications for prevention are discussed. Kosterman, R., Graham, J.W., Hawkins, J.D., Catalano, R.F., and Herrenkohl, T.I., Violence & Victims,16(4), pp. 355-369, 2001.
Substance Use and Intimate Violence among Incarcerated Males
The purpose of this study was to examine substance use patterns among a sample of incarcerated males who report engaging in levels of intimate violence as well as identifying similarities and differences in demographic, economic status, mental health, criminal justice involvement, relationships, and treatment factors for three groups of incarcerated males - those who report perpetrating low intimate violence; those who report perpetrating moderately intimate violence; and those who report perpetrating extremely intimate violence the year preceding their current incarceration. Findings indicated that low intimate violence group's perpetration consisted almost exclusively of emotional abuse. Moderately intimate violent males and extremely intimate violent males however report not only high rates of emotional abuse but physical abuse as well. The distinction between moderate and extremely violent groups was substantial. Findings also indicated that perpetrators at different levels of violence in this study, did not vary significantly in age, employment history, marital status or race. However, the three groups showed significant differences in three main areas: (1) cocaine and alcohol use patterns (2) stranger violence perpetration and victimization experiences, and (3) emotional discomfort. Implications for substance abuse and mental health treatment interventions and for future research are discussed. Logan, T.K, Walker, R., Staton, M., and Leukefeld, C. Substance Use and Intimate Violence among Incarcerated Males. Journal of Family Violence, 6(2), pp. 93-114, June 2001.
The Drugs-Violence Nexus among American and Canadian Youth
This paper examines the relationship between drug use and violence among representative samples of students in the United States and Ontario, Canada. Canada has significantly lower levels of violent crime than the United States, but students report similar rates of drug use. Using logistic regression analysis, authors found a similar relationship between drug use and violence among adolescents in the two countries. All the drugs considered-cannabis, cocaine, and alcohol binge drinking-are significantly related to violent behavior; whether the perpetrator or the victim. The most noteworthy difference may be that in Ontario, drug use appears to be even more highly correlated with violence than in the United States. Harrison, L.D., Erickson, P.G., Adlaf, E., Freeman, C. The Drugs-Violence Nexus among American and Canadian Youth. Substance Use & Misuse, 36(14), pp. 2065-2086, 2001.
Correlates of Driving Anger
In a survey and a field study involving psychology students at a state university, it was determined that trait driving anger correlated with reports of anger in response to commonly occurring situations on the road. Significant positive correlations were found between trait driving anger and situations where provocation was significant, as in ordinary traffic, rush hour, and when being yelled at by another driver. There was no correlation when provocation was minimal. Moreover, trait driving anger was not correlated with crash rates or moving violations, but trait driving anger correlated with crash-related conditions such as loss of concentration, loss of vehicular control, and close calls. Deffenbacher, J., Lynch, R.S., Oetting, E.R., and Yingling, D.A. Driving Anger: Correlates and a Test of State-Trait Theory. Personality and Individual Differences, 31, pp. 1321-1331, 2001.
Risk and Promotive Effects in the Explanation of Persistent
Serious Delinquency in Boys Risk and promotive effects were investigated as predictors of persistent serious delinquency in male participants of the Pittsburgh Youth Study (R. Loeber, D. P. Farrington, M. Stouthamer-Loeber, & W. B. van Kammen, 1998), living in different neighborhoods. Participants were studied over ages 13-19 years for the oldest sample and 7-13 years for the youngest sample. Risk and promotive effects were studied in 6 domains: child behavior, child attitudes, school and leisure activities, peer behaviors, family functioning, and demographics. Regression models improved when promotive effects were included with risk effects in predicting persistent serious delinquency. Disadvantaged neighborhoods, compared with better neighborhoods, had a higher prevalence of risk effects and a lower prevalence of promotive effects. However, predictive relations between risk and promotive effects and persistent serious delinquency were linear and similar across neighborhood socioeconomic status. Stouthamer-Loeber, M., Loeber, R., Wei, E., Farrington, D.P., and Wikstroem, P-O.H. Journal of Consulting & Clinical Psychology, 70(1), pp. 111-123, 2002.
Test of the Plausibility of Adolescent Substance Use Playing a Causal Role in Developing Adulthood Antisocial Behavior
DSM-IV antisocial personality disorder diagnosis requires that conduct disorder be exhibited before age 15. However, recent studies have reported on men and women without conduct disorder before age 15 but qualified for the adulthood antisocial personality criterion (AAB). This general-population, retrospective study investigated the plausibility of causal relationships between adolescent drug and alcohol misuse (ADAM) and AAB among subgroups who reported childhood-onset conduct problems (CP), adolescent-onset CP, or no more than one conduct problem. Data from the Epidemiological Catchment Area Study (N=8,724) suggested that persons with childhood-onset CP are at much greater risk for AAB than persons with adolescent-onset CP. Nevertheless, large proportions of men and women with AAB had adolescent-onset CP or no CP. Regardless of CP history, being drunk by age 18 or having a drug use-related symptom before age 18 increased AAB risk, even after controlling for having a substance use-related disorder in adulthood. Mechanisms that potentially explain these associations are discussed. Ridenour, T.A, Cottler, L.B, Robins, L.N., Compton, W.M., Spitznagel, E.L., Cunningham-Williams, R.M. Journal of Abnormal Psychology, 111(1), pp. 144-155, 2002.
Workplace Substance Abuse Prevention Training
Supervisor tolerance-responsiveness is defined as the attitudes and behaviors of supervisors associated with either ignoring or taking proactive steps with troubled employees. Two studies examined this construct. The first study used survey methodology to examine supervisor response to and tolerance of coworker substance use in the workplace and ways of interfacing with the Employee Assistance Programs (EAPs). That study suggested that engaging supervisors in a dialogue about tolerance might improve their willingness to become more responsive to employee drug use, and more inclined to refer employees to EAPs. The second study was a randomized control field experiment that assessed a team-oriented training, using a cognitive mapping technique to help improve supervisor responsiveness to employee substance use. Supervisors who received this training showed improvement on several dimensions of responsiveness, including a greater propensity to refer substance-using employees to EAPs, compared to those who received a more didactic/informational training and those in a no-training/control group. Trained supervisors also showed increases in their own help-seeking behavior. Overall, results indicate that while supervisor tolerance of coworker substance use inhibits EAP utilization, it may be possible to address this tolerance using team-oriented prevention training. Bennett, J.B. and Lehman, W.E.K. Supervisor Tolerance-responsiveness to Substance Abuse and Workplace Prevention Training: Use of a Cognitive Mapping Tool Health Education Research, 17, pp. 27-42, 2002.
Treatment for Aggressive Children
This article provides a history and overview of an Anger Coping Program (ACP) for children with a history of aggressive behavior problems. The program uses a cognitive-behavioral approach to address the social-cognitive distortions and deficits of aggressive children. The program structure, its application in residential treatment, and its dissemination are discussed. The ACP has produced significant post-intervention improvements in childrens' behavior and social-cognitive processes. Lochman, J.E., Curry, J.D., Dane, H., and Ellis, M. The Anger Coping Program: An Empirically Supported Treatment for Aggressive Children. Residential Treatment for Children and Youth, 18, pp. 63-73, 2001.
Influence of a Substance-Abuse-Prevention Curriculum on Violence-Related Behavior
The objective of this work was to test the impact of a school-based substance-abuse prevention program, Project Towards No Drug Abuse (TND), on risk for violence. Logistic regression analyses tested whether victimization, perpetration, or weapon carrying differed for intervention students relative to control students within a sample of 850 continuation high school students followed over 12 months. Data indicate a higher risk for victimization (OR=1.57) among male control students. No intervention effect was observed for female students or for perpetration among males. The findings provide limited support for a generalization of TND's preventive effect. Simon, T.R., Sussman, S., Dahlberg, L.L., and Dent, C.W. Influence of a Substance-Abuse-Prevention Curriculum on Violence-Related Behavior. American Journal of Health Behavior, 26(2), pp. 103-110, 2002.
Support for a Social Contextual Model of Delinquency
Three theoretical approaches designed to predict risk for delinquency were examined empirically. Hypotheses derived from these perspectives, an individual difference perspective, a social interactional model, and a social contextual approach, were tested using two independent samples of early adolescents followed over a four-year period. Results from a series of structural equation models suggested that a social contextual approach provided the best fit with the data across both samples and genders. Consistent with this approach, results indicated that a lack of nurturant and involved parenting indirectly predicted delinquency by increasing children's earlier antisocial behavior and deviant peer relationships. Child antisocial behavior also predicted similar decreases in nurturant parenting over time. Both child antisocial behavior and deviant peer affiliations in the fall of eighth grade predicted delinquency one year later. Scaramella, L.V., Conger, R.D., Spoth, R., and Simons, R.L. Evaluation of a Social Contextual Model of Delinquency: A Cross-Study Replication. Child Development, 73(1), pp. 175-195, 2002.
Deviant Peer Association and Aggression toward Female Partner
Deviancy training was examined as a risk factor for physical and psychological aggression toward a female partner among boys and young men in the Oregon Youth Study. Hostile talk about women during videotaped male friendship interaction was hypothesized to indicate a process by which aggression toward women is reinforced within male peer networks. Both antisocial behavior and hostile talk were predicted to be associated with later aggression toward a female partner. Prospective developmental models were tested from 9-10 years of age through young adulthood. Findings indicated that the relation of deviant peer association in adolescence and later aggression toward a partner was mediated by antisocial behavior; observed hostile talk about women with male peers explained additional variance in aggression toward a partner. Capaldi, D.M., Dishion, T.J., Stoolmiller, M., and Yoerger, K. Aggression Toward Female Partners by at-risk Young Men: The Contribution of Male Adolescent Friendships. Developmental Psychology, 37(1), pp. 61-73, 2001.
The First 3 Years of a Prevention Trial With Children at High Risk For Adolescent Conduct Problems
Fast Track is a conduct-problem prevention intervention derived from longitudinal research on how serious and chronic adolescent problem behaviors develop. Over 9,000 kindergarten children at 4 sites in 3 cohorts were screened, 891 were identified as high risk, and randomly assigned to intervention or control groups. Beginning in Grade 1, high-risk children and their parents were asked to participate in a combination of social skills and anger-control training, academic tutoring parent training, and home visiting. A multiyear universal classroom program was delivered to the core schools attended by these high-risk children. By the end of third grade, 37% of the intervention group was determined to be free of serious conduct-problem dysfunction, in contrast with 27% of the control group. Teacher ratings of conduct problems and official records of use of special education resources gave modest effect-size evidence that the intervention was preventing conduct problem behavior at school. Parent ratings provided additional support for prevention of conduct problems at home. Parenting behavior and children's social cognitive skills that had previously emerged as proximal outcomes at the end of the 1st year of intervention continued to show positive effects of the intervention at the end of third grade. Bierman, K.L., Coie, J.D., Dodge, K.A., et al. Evaluation of the First 3 Years of The Fast Track Prevention Trial With Children At High Risk For Adolescent Conduct Problems. Journal of Abnormal Child Psychology, 30 (1), pp. 19-35, 2002.
Predictor Variables Associated with Positive Fast Track Outcomes at Grade 3
Progress has been made in understanding the outcome effects of preventive interventions and treatments designed to reduce children's conduct problems. However, limited research has explored the factors that may affect the degree to which an intervention is likely to benefit particular individuals. This study examines selected child, family, and community baseline characteristics that may predict proximal outcomes from the Fast Track intervention. The primary goal of this study was to examine predictors of outcomes after 3 years of intervention participation, at the end of 3rd grade. Three types of proximal outcomes were examined: parent-rated aggression, teacher-rated oppositional-aggressive behavior, and special education involvement. The relation between 11 risk factors and these 3 outcomes was examined, with separate regression analyses for the intervention and control groups. Moderate evidence of prediction of outcome effects was found, although none of the baseline variables were found to predict all 3 outcomes, and different patterns of prediction emerged for home versus school outcomes. Bierman, K.L., Coie, J.D., Dodge, K.A., et al. Predictor Variables Associated with Positive Fast Track Outcomes at the End of Third Grade. Journal of Abnormal Child Psychology, 30(1), pp. 37-52, 2002.
Stress and Smoking in Adolescence: A Test of Directional Hypotheses
The authors conducted a comparative test of the hypotheses that (a) stress is an etiological factor for smoking and (b) cigarette smoking causes increases in stress. Participants were a sample of 1,364 adolescents, initially surveyed at mean age 12.4 years and followed at 3 yearly intervals. Measures of negative affect, negative life events, and cigarette smoking were obtained at all 4 assessments. Latent growth modeling showed negative affect was related to increase in smoking over time; there was no path from initial smoking to change in negative affect. Comparable results were found for negative life events, with no evidence for reverse causation. Results are discussed with respect to theoretical models of nicotine effects and implications for prevention. Wills, T.A., Sandy, J.M., Yaeger, A.M. Health Psychology, 21(2), pp. 122-130, 2002.
Perceived Discrimination and Early Substance Abuse
This study investigated internalizing and externalizing symptoms as potential mediators of the relationship between perceived discrimination and early substance abuse among 195 American Indian 5th through 8th graders from three reservations that share a common culture. It was found that perceived discrimination increased both internalizing and externalizing symptoms among the youth. Perceived discrimination contributed significantly to internalizing symptoms, particularly among female and younger adolescents, but did not contribute to early onset substance abuse. Instead, perceived discrimination acted through externalizing symptoms to increase its likelihood. That is, American Indian early adolescents who experienced discrimination were likely to respond with anger and delinquent behaviors, which in turn were strongly associated with early substance abuse. Whitbeck L.B., McMorris, B.J., Chen, X., and Stubben, J. Perceived Discrimination and Early Substance Abuse among American Indian Children. Journal of Health and Social Behavior, 42, pp. 405-424, 2001.
Traditional Indian Culture Associated with Academic Success
This research examines factors affecting school success for a sample of 196 5th to 8th grade American Indian children from three reservations in the upper Midwest. The investigators assessed enculturation, a multidimensional construct including involvement with traditional activities, cultural identification, and traditional spirituality. The results indicate that traditional culture, as measured by enculturation, positively affects the academic performance of early adolescent American Indian students when controlling for age, participation in clubs, maternal warmth, and self-esteem. These findings are congruent with the growing literature on the positive effects of traditional culture for American Indian children. Whitbeck, L.B. Hoyt, D.R., Stubben, J.D., and LaFromboise, T. Traditional Culture and Academic Success among American Indian Children in the Upper Midwest. Journal of American Indian Education, 40(2), pp. 48-60, 2001.
Gender Labels and Gender Identity Predict Drug Use
This article examines the intertwined roles of gender labels and gender identity in predicting drug use behaviors and experiences of middle school students in a large, ethnically diverse, southwestern city. Gender labels refers to male vs. female while gender identity refers to a subjective sense of maleness/masculinity or femaleness/femininity. Gender labels by themselves appear to be more salient in explaining differences in self-reported drug use than two of the three gender identity measures examined. Boys used more drugs, used them more frequently and were more likely to use marijuana and hard drugs. However, masculine dominance also is associated with drug use, especially for boys. Such boys report more drug use and exposure. Gender identity measures do not supersede gender labels in predicting drug outcomes. However, labels and identity together are more powerful predictors than separately. Kulis, S., Marsiglia, F.F., and Hecht, M.L. Gender Labels and Gender Identity as Predictors of Drug Use Among Ethnically Diverse Middle School Students. Youth and Society, 33(3), pp. 442-475, 2002.
Predicting Smoking Initiation
In an analysis of 810 children drawn from a longitudinal study of students from a suburban school district in the Pacific Northwest, predictor variables for smoking initiation were assessed in second or third grade and smoking initiation was measured in sixth or seventh grade. Measures of family processes were entered separately into logistic regression models that included controls for household structure and income, parent smoking and peer and child characteristics. Measures of child attachment to parent and parent involvement with the child's school were significantly and negatively associated with smoking initiation. The results suggest that family bonding and parent supportiveness protect youth from early smoking initiation while parent smoking and early childhood antisocial behavior and depression are risk factors for early smoking initiation. Fleming, C.B., Kim, H., Harachi, T.W., and Catalano, R.F. Family Processes for Children in Early Elementary School as Predictors of Smoking Initiation. Journal of Adolescent Health, 30(4), pp. 184-189, 2002.
Family- and Community-Level Factors Predict Parent Support Seeking
This study was designed to elucidate the influences of community- and family-level sociodemographic factors on parent formal and informal support seeking activities. Participants in the study were 1,260 parents of sixth graders from 26 rural communities. Informal support seeking was defined as the frequency with which parents sought parenting information through reading newspaper or magazine articles or talking to friends and relatives. Formal support seeking was defined as participating in support groups for parents, and talking to a family counselor or talking to a religious leader. Findings indicated that at the family level, higher formal support seeking scores were associated with lower household income, being a mother (vs. father), and a greater number of children, while higher informal support seeking was predicted by more parent education and being a mother (vs. father). There was a significant positive effect of community population size on informal parent support seeking. Redmond, C., Spoth, R., and Trudeau, L. Family- and Community-Level Predictors of Parent Support Seeking. Journal of Community Psychology, 30(2), pp.153-171, 2002.
Rural-Urban Differences in Substance Abuse Risk Factors
The authors examined rural-urban differences in cumulative risk for youth substance abuse. Two studies were conducted including samples of midwestern parents interviewed as a part of a state-level needs assessment for prevention program planning purposes (n=339; n=593). A cumulative risk index was constructed using individual and family risk items that have been shown to be associated with adolescent substance use. Rural urban comparisons demonstrated higher levels of cumulative risk among rural youth, which contributes to an explanation of findings from earlier reports of rural-urban differences in substance use. Spoth, R.L., Goldberg, C. Neppl, T., Trudeau, L., and Ramisetty-Mikler, S. Rural-Urban Differences in the Distribution of Parent-Reported Risk Factors for Substance Use Among Young Adolescents. Journal of Substance Abuse, 13, pp. 609-623, 2001.
Family Process Assessment for an African-American Sample
Data from 492 parents and 226 children in the EARLY ALLIANCE (EA) prevention trial were used to explore an assessment of family processes for a sample of African American kindergarten children, their parents, and teachers. Modified versions of the Family Assessment Measure, the Family Adaptability and Cohesion Evaluation Scales, the Family Beliefs Inventory, and the Deviant Beliefs measure were examined for internal consistency. Exploratory and confirmatory factor analyses provided empirical support for a Cohesion factor (cohesion and communication), a Structure factor (support and organization), a Beliefs factor (on family purpose and child development), and a Deviant Beliefs factor. Regression analyses examined the relationship of these measures of family processes to child social and academic competence, problem behavior, and early reading achievement. Family Structure (support and organization), Family and Beliefs were consistently related to parent- and teacher-reported competence and behavioral outcomes. Smith, E.P., Prinz, R.J., Dumas, J.E., and Laughlin, J. Latent Models of Family Processes In African American Families: Relationships to Child Competence, Achievement, and Problem Behavior. J. Marriage & Family, 63(4), pp. 967-980, 2001.
Recruitment and Retention Procedures for Violence Prevention
Participant recruitment and retention problems and strategies of the EARLY ALLIANCE (EA) violence prevention intervention are presented. EA combines home visitation and school-based prevention, and targets entire families in the prevention of child conduct disorder, substance abuse, and school failure. Techniques used to enhance participant recruitment included signing families to a package of programs, presenting EA as a preventive program. Caregivers were directly approached at the beginning of 1st grade, a time when they are particularly motivated to help children. Retention techniques include maintaining flexible schedules, keeping appointments, adhering to procedures, providing support in times of need, and adequately compensating families for their time and inconvenience. Prinz, R.J., Smith, E.P., Dumas, J.E., Laughlin, J.E., White, D.W., and Barron, R. Recruitment and Retention of Participants in Prevention Trials Involving Family-Based Interventions. Am. J. Prev. Med., 20(Suppl1), pp. 31-37, 2001.
Behavior Management to Improve School-Wide Positive Behavior
The Effective Behavior Support program, a consultative approach to assisting middle schools in implementing empirically based school-wide behavior management practices, involved working with school staff to clarify rules, teach appropriate social behavior, increase positive reinforcement for positive behavior, consistently provide mild consequences for rule violation, and monitor data on student behavior. The intervention was evaluated through records of rewards given, discipline referrals, and frequent surveys of students. Where possible, data from the target school were evaluated against data from comparison schools. Results show effects at the target school on increased positive reinforcement for appropriate social behavior and decreased aggressive behavior among students. Discipline referrals were significantly decreased for 7th graders and for harassment among males. Students' perceptions of school safety improved at the target school but not at comparison schools. Students' reports of being physically or verbally attacked the previous day were reduced at the target school as well, but these changes were also seen at the comparison school. Metzler, C.W., Biglan, A., Rusby, J.C., and Sprague, J.R. Evaluation of a Comprehensive Behavior Management Program To Improve School-Wide Positive Behavior Support. Education & Treatment of Children, 24 (4), pp. 448-479, 2001.
Relationship Quality Of Aggressive Children And Their Siblings
Sibling influence on the learning and enactment of aggressive behavior has been consistently demonstrated in studies of sibling relationships. Available evidence suggests that, compared with nonaggressive children's sibling interactions, the sibling interactions of aggressive children are marked by more frequent, intense, and prolonged aggressive behaviors. Although research on normative and aggressive children's sibling interactions has increased recently, a number of limitations in this literature were addressed in this study by: (1) including both an aggressive and nonaggressive comparison group, (2) examining both positive and negative features of sibling relationships, (3) employing a multi method/multi-informant approach to data collection, and (4) utilizing an improved self-report method. In support of their hypotheses and consistent with previous research, results showed that aggressive children's sibling relationships were marked by higher levels of observed conflict and lower levels of self-reported positive features. When gender was examined, results showed that older brother/younger sister dyads were characterized by higher levels of negative features and lower levels of positive features. Aguilar, B., O'Brien, K.M., August, G.J., et al. Relationship Quality of Aggressive Children and Their Siblings: A Multi-Informant, Multi-Measure Investigation. Journal of Abnormal Child Psychology, 29 (6), pp. 479-489, 2001.
Binge Drinking Trajectories from Adolescence to Emerging Adulthood in a High-Risk Sample: Predictors and Substance Abuse Outcomes
This study describes binge-drinking trajectories from adolescence to emerging adulthood in 238 children of alcoholics and 208 controls. Mixture modeling identified three trajectory groups: early-heavy (early onset, high frequency), late moderate (later onset, moderate frequency), and infrequent (early onset, low frequency). Nonbingers were defined a priori. The early-heavy group was characterized by parental alcoholism and antisociality, peer drinking, drug use, and (for boys) high levels of externalizing behavior, but low depression. The infrequent group was elevated in parent alcoholism and (for girls) adolescent depression, whereas the nonbinger and late-moderate groups showed the most favorable adolescent psychosocial variables. All 3 drinking trajectory groups raised risk for later substance abuse or dependence compared with the nonbingers, with the early-heavy group at highest risk. Chassin, L., Pitts, S.C., Prost, J. Journal of Consulting & Clinical Psychology, 70(1), pp. 67-78, 2002.
Moderators of the Relation between Substance Use Level and Problems: Test of a Self-Regulation Model in Middle Adolescence
The authors tested predictions, derived from a self-regulation model, about variables moderating the relationship between level of substance use (tobacco, alcohol, and marijuana) and problems associated with use. Data were from two independent studies of adolescents, with mean ages of 15.4 and 15.5 years (Ns=1,699 and 1,225). Factor analysis indicated correlated dimensions of control problems and conduct problems. Protective moderation was found for variables indexing good self-control; risk-enhancing moderation was found for variables indexing poor self-control. These effects were generally independent of deviance-prone attitudes and externalizing symptomatology. Multiple-group structural modeling indicated moderation occurred for paths from life stress and coping motives and for paths from level to control and conduct problems. Moderation effects were also found for parental variables, peer variables, and academic competence. Wills, T.A., Sandy, J.M., and Yaeger, A.M. Journal of Abnormal Psychology, 111(1), pp. 3-21, 2002.
Developmental Trajectories of Cigarette Use
This study identified developmental trajectories of cigarette smoking from early adolescence into young adulthood, and delineated whether risk factors derived from a social learning-problem behavior framework could differentiate among trajectories. Participants (N=374) were interviewed five times from age 12 until age 30/31. Using growth mixture modeling, three trajectory groups were identified - heavy/regular, occasional/maturing out, and non/experimental smokers. Being a female, having higher disinhibition, receiving lower grades, and more frequent use of alcohol or drugs significantly increased the probability of belonging to a smoking trajectory group compared with being a nonsmoker. Higher disinhibition and receiving lower grades also differentiated regular smokers from the rest of the sample. None of the risk factors distinguished occasional from regular smokers. When models were tested separately by sex, disinhibition, other drug use, and school grades were associated with smoking for both sexes. On the other hand, environmental factors, including socioeconomic status, parent smoking and friend smoking, were related to smoking for females but not for males. Sex differences in developmental trajectories and in smoking behavior among regular smokers were notable. The occasional/maturing out group was made up of more females than males and may relate to women stopping or reducing smoking when they begin to have children. In contrast, women were more likely to start regular smoking earlier than males and being female significantly differentiated smokers from nonsmokers. Future research should examine transitions and turning points from adolescence to adulthood that may affect cessation and escalation differently for males and females. White, H.R., Pandina, R.J., and Chen, P.H. Developmental Trajectories of Cigarette Use from Early Adolescence into Young Adulthood. Drug Alcohol Depend., 65, pp. 167-178, 2002.
Risk Factors Vary According to Substance Use Outcome
This longitudinal study investigated Grade 7 and Grade-10 risk factors for alcohol misuse at Grade 12. Alcohol use was conceptualized as problem-related drinking, high-risk drinking and high consumption. Prospective analyses using two-part models predicted any alcohol misuse and the amount of misuse for over 4,200 participants in the RAND Adolescent Pan Study. Predictor variables were: demographics; substance use and exposure; prodrug attitudes; rebelliousness and deviant behavior; self-esteem; family structure and relations; and grades. Grade-7 predictors of alcohol misuse 5 years later included: early drinking onset; parent drinking; future intentions to drink; cigarette offers; difficulty resisting pressures to smoke; being white; being male; having an older sibling; deviant behavior; and poor grades. By Grade 10, predictors of alcohol misuse 2 years later included: drinking and marijuana use by self and peers; future intentions to drink; difficulty resisting pressures to drink and use marijuana; being male; coming from a disrupted family; and deviant behavior. Somewhat different predictors were identified for problem-related, high-risk and high consumption drinking, emphasizing the importance of investigating multiple dimensions of misuse. Ellickson, P.L., Tucker, J.S., Klein, D.J., and McGuigan, K.A. Journal of Studies on Alcohol, 62(6), pp. 773-782, 2001.
Emotional Distress Both Contributes To And Is Influenced By Cigarette Smoking
Empirical evidence regarding the causal nature of the relationship between emotional distress and tobacco use in male and female adolescents provides support for both the distress-to-use and the use-to-distress hypotheses. Using a cross-lagged model with 3 waves of data from 2,961 adolescents followed into young adulthood, the authors tested the hypothesis that this relationship changes over time. As hypothesized, emotional distress in Grade 10 was associated with increased smoking in Grade 12 for both boys and girls. Smoking in Grade 12 was, in turn, associated with increased emotional distress in young adulthood. The addition of 3 factors (rebelliousness, deviance, and family problems) to the model did not alter the results. Results suggest that the relationship between tobacco use and emotional distress is a dynamic one in which distress initially leads to use but then becomes exacerbated by it over time, Orlando, M., Ellickson, P.L., and Jinnett, K., Journal of Consulting & Clinical Psychology, 69(6), pp. 959-970, 2001.
Predictors of Late-Onset Smoking and Cessation Over 10 Years
Researchers examined predictors of smoking onset and cessation between early and late adolescence (13-18 yrs) and between late adolescence and young adulthood (18-23 yrs). Subjects were 3,056 high school students recruited in 1985. Predictors measured at 13 and 18 yrs included sociodemographic and environmental characteristics, smoking attitudes, bonds with school and problem behavior. Results show that robust predictors of initiation and cessation across the 2 developmental periods included doing poorly in school and prior smoking. Predictors common to 3 of 4 developmental models included being young for grade cohort and intention to smoke. Early deviant behavior and drinking fostered initiation among older teenagers, but problem behavior as an older teenager did not predict young adult initiation. Smokers with few or no high school friends who smoked and felt able to resist smoking pressure at age 18 yrs were more likely to quit by age 23 yrs. Being female predicted initiation by age 18 yrs; being African-American, Hispanic, or Asian inhibited this. The strong association of prior smoking behavior and intentions with later smoking among adolescents and young adults is seen to underscore the importance of early smoking prevention that continues through high school. Ellickson, P.L., McGuigan, K.A., and Klein, D.J., Journal of Adolescent Health, 29(2), pp. 101-108, 2001.
High-Risk Behaviors Associated With Early Smoking
This study compared problem behaviors of 7th grade nonsmokers, experimenters, and smokers at baseline and at 5-yr follow-up. 4,327 7th grade students completed questionnaires concerning academic difficulties, substance use, and delinquent behavior at baseline and at 5-yr follow-up. Subjects were classified as nonsmokers, experimenters, or smokers. Results showed that, compared with nonsmokers, early smokers were 3+ times more likely by 12th grade to regularly use tobacco and marijuana, use hard drugs, sell drugs, have multiple drug problems, drop out of school, and experience early pregnancy and parenthood. These subjects were also at higher risk for low academic achievement and behavioral problems at school, stealing and other delinquent behaviors, and use of predatory and relational violence. Early experimenter subjects were at significantly greater risk for these problems as well, although to a lesser extent than smokers. The higher risk of many of these problems was evident for experimenters and smokers as early as 7th grade. It is concluded that early experimenters and smokers are more likely than nonsmokers to experience various problem behaviors by 12th grade, with many of these problems evident as early as 7th grade. Ellickson, P.L., Tucker, J.S., and Klein, D.J., Journal of Adolescent Health, 28(6), pp. 465-473, 2001.
Inflating GPA In Self-Report Related To Reports of Less Psychological Distress
The purpose of this study was to better understand the implications for using self-reported grade point average (GPA) versus school-record GPA in academic achievement research. The authors examined the degree of accuracy between self-reported and school-record GPA among 679 African American high school students (mean age 15.1 yrs) and studied how the discrepancy between GPA is related to psychological distress, academic beliefs, and problem behaviors. Structural equation modeling was used to examine how the 2 GPA measures are related differently to these outcomes, regardless of their discrepancy. Results show that nearly half the youths interviewed over reported their GPAs by at least 2 half grades. Youth who over reported their GPAs also reported less psychological distress, more successful academic beliefs, and fewer problem behaviors. Self-reported GPA was associated with all 3 sets of variables, but school-record GPA was associated with only problem behaviors. The findings suggest that it may be useful for researchers to consider how different measures of GPA may influence their results. Zimmerman, M.A., Caldwell, C.H., and Bernat, D.H., Journal of Applied Social Psychology, 32(1), pp. 86-109, 2002.
Primary Mental Disorders are Significant Predictors of First Onset of Subsequent Substance User Disorders
Kessler and colleagues present results of analyses of patterns of comorbidity between mental disorders and substance use disorders utilizing data from seven epidemiologic surveys carried out in six countries including the U.S., Canada, Brazil, Mexico, Germany and the Netherlands. Results are consistent across the surveys in showing that strong comorbidities exist between mental disorders and substance use disorders, that mental disorders are typically temporally primary and that primary mental disorders are significant predictors of the first subsequent onset of substance use disorders. Only active mental disorders, not remitted disorders, predict subsequent substance use, problems, and dependence. These findings suggest that there is something about the mental disorders themselves rather than about determinants of these disorders, that promotes substance disorders. Further analyses revealed that mental disorders are less powerful predictors of first drug use than of progressing from use to problem use and from problem use to dependence. Simulations suggest that primary mental disorders are associated with 54.7% of all drug dependence among men and 47.8% among women in these surveys. Conduct disorder and adult antisocial behavior are responsible for these cases among men, while anxiety disorders and mood disorders are also important among women. The authors conclude that the study results suggest that early interventions to treat mental disorders might be effective in reducing the number of people who would otherwise become dependent on drugs. Kessler, R.C., Aguilar-Gaxiola, S., Andrade, L., Bijl, R., Borges, G., Caraveo-Anduaga, J., DeWit, D., Kolody, B., Merikangas, K., Molnar, B., Vega, W., Walters, E., Wittchen, H. and Ustun, T. Mental-Substance Cormorbidities in the ICPE Surveys. Psychiatria Fennica, 32(supplement 2), pp. 62-79, 2001.
Exploring Why Heroin Epidemics Occur in Different Groups
As part of a project to explain heroin use trends, Agar and colleague develop and explore the concept of "open marginality" to highlight how different groups impacted by heroin epidemics have a common historical experience. Analysis of the literature on the history of drug epidemics in the U.S. together with the authors' work on two heroin epidemics in the Baltimore region demonstrate the diversity of groups who have been "at risk" over the years. Agar's approach is to integrate political, socioeconomic and cultural factors within an historical framework. Analysis of cases shows that such groups experience a rapid and unexpected change, such that a gap between expectations and reality opens up, a gap that is taken up in national public discourse. The paper presents the concept of "open marginality" as part of a broader working theory to explain drug trends that the authors hope will enhance our ability to forecast and thus anticipate (and potentially prevent) new drug use trends. Agar, M. and Reisinger, H.S. Open Marginality: Heroin Epidemics in Different Groups. Journal of Drug Issues, 31(3), pp. 729-746, 2001.
Using Trend Theory to Explain Heroin Use Trends
Trend theory is developed by the authors in an effort to integrate histories of populations and distribution systems to explain the key epidemiological question: why do these people in this place at this time experience a rapid increase in heroin use? The theory grows out of work on heroin trends in the Baltimore metropolitan area, specifically on epidemics among urban African-Americans in the 1960s and among suburban white youth in the 1990s. The authors describe trend theory as an example of agent-based adaptive models characteristic of complexity theory and draw on the heroin epidemic studies to illustrate how the model works. Agar, M., and Reisinger, H.S. Using Trend Theory to Explain Heroin Use Trends. Journal of Psychoactive Drugs, 33(3), pp. 203-210, 2001.
Intergenerational Transmission of Risks for Problem Behavior
The intergenerational transmission of risk factors for problem behaviors was examined across three generations. Two hundred fifty-four 2-year-old toddlers, one or two of their parents, and one grandmother of each toddler were studied. Grandmothers and parents were individually interviewed. Data were analyzed for the male and female toddlers combined. Correlations and hierarchical multiple regression analyses were performed. Findings indicate that the grandmother-parent relationship, parental personality attributes, marital harmony, and drug use and the parent-toddler relationship, predict the toddlers' behavior. The investigation provides evidence for a longitudinal, intergenerational process whereby the grandmother-parent relationship and the parents' personality and behavioral attributes are transmitted across generations through their association with the parent-child relationship. Brook, J.S., Whiteman, M., and Zheng, L. Journal of Abnormal Child Psychology, 30(1), pp. 65-76, February 2002.
Childhood Adversities Associated with Risk for Eating Disorders or Weight Problems during Adolescence or Early Adulthood
This community-based prospective longitudinal study was conducted to investigate the association between childhood adversities and problems with eating or weight during adolescence and early adulthood. A sample of 782 mothers and their offspring were interviewed during the childhood, adolescence, and early adulthood of the offspring. Childhood maltreatment, eating problems, environmental risk factors, temperament, maladaptive parental behavior, and parental psychopathology were assessed during childhood and adolescence. Eating disorders and problems with eating or weight in the offspring were assessed during adolescence and early adulthood. A wide range of childhood adversities were associated with elevated risk for eating disorders and problems with eating or weight during adolescence and early adulthood after the effects of age, childhood eating problems, difficult childhood temperament, parental psychopathology, and co-occurring childhood adversities were controlled statistically. Numerous unique associations were found between specific childhood adversities and specific types of problems with eating or weight, and different patterns of association were obtained among the male and female subjects. Maladaptive paternal behavior was uniquely associated with risk for eating disorders in offspring after the effects of maladaptive maternal behavior, childhood maltreatment, and other co-occurring childhood adversities were controlled statistically. The authors conclude that childhood adversities may contribute to greater risk for the development of eating disorders and problems with eating and weight that persist into early adulthood. Maladaptive paternal behavior may play a particularly important role in the development of eating disorders in offspring. Johnson, J.G., Cohen, P., Kasen, S., and Brook, J.S. Am J Psychiatry, 159(3), pp. 394-400, March 2002.
Adolescent Life Events as Predictors of Adult Depression
Among adults, life events predict future episodes of major depression as well as a range of anxiety disorders. While studies have begun to examine this issue in adolescents, few studies rely upon prospective epidemiological designs to document relationships between adolescent life events and adult major depression. A sample of 776 young people living in Upstate New York received DSM-based psychiatric assessments and an assessment of life events in 1986. Psychopathology was again assessed in 1992. This study examined the predictive relationship between life events in 1986 and depression as well as anxiety in 1992, controlling for depression/anxiety in 1986. Results show that adolescent life events predicted an increased risk for major depression diagnosis in adulthood. When analyzed continuously, an association emerged with symptoms of major depression as well as with symptoms of generalized anxiety disorder. However, this association with generalized anxiety disorder was limited to females. Pine, D.S., Cohen, P., Johnson, J.G., and Brook, J.S. J Affect Disord, 68(1), pp. 49-57, February 2002.
Gender Differences in Juvenile Arrestees' Drug Use, Self-Reported Dependence, and Perceived Need for Treatment
The authors examined gender differences in drug use, self-reported dependence, and perceived need for treatment in a national sample of juvenile arrestees and detainees between the ages of nine and 18 years. A sample of 4,644 boys and girls, drawn from the Juvenile Drug Use Forecasting Survey from 1992 to 1995, was matched by sex within each of seven sites by survey year. In anonymous interviews, respondents were asked about their living arrangements, drug use, and need for drug treatment. Questions about drug use covered marijuana, cocaine, crack, heroin, crystal methamphetamine, amphetamines, and phencyclidine (PCP). Logistic regression was used to identify significant predictors of drug dependence and perceived need for treatment. Results showed that girls were significantly more likely than boys to report dependence but were no more likely to report a need for treatment. Among those who reported current, frequent drug use, girls were significantly less likely than boys to report a need for treatment. Girls who reported having more severe drug problems were more likely than their male counterparts to report dependence and a need for treatment. The authors conclude that clinicians should assess and reduce barriers to treatment perceived by girls in particular to engage them in services before their drug use escalates. Kim, J.Y., and Fendrich, M. Psychiatr Serv, 53(1), pp. 70-75, January 2002.
Sex-Specific Predictors of Suicidality Among Runaway Youth
This study examined predictors of suicidality (ideation and attempts) among 348 adolescent runways (197 boys; 56% African American; Mean age = 16) using sex-specific models that tested the impact of the three domains of the Social Action Model: individual characteristics, interpersonal influences, and life events. Twenty-five percent of the girls and 14% of the boys had attempted suicide at least once. Male suicidality was mainly predicted by individual characteristics: identifying as gay, emotional distress, fewer conduct problems, and avoidant reasons for drug use. The interpersonal influence of suicidal friends also predicted suicidality. Variables from all three domains influenced girls: individual characteristics of lower age, lower self-esteem, and emotional distress; interpersonal influence of suicidal friends; and life events of having lived on the streets and assaults. Findings suggest some sex-specific interventions, but decreasing emotional distress and lessening the influence of suicidal friends may be useful for both boys and girls. Leslie, M.B., Stein, J.A., and Rotheram-Borus, M.J. J Clin Child Psychol, 31(1), pp. 27-40, March 2002.
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