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Director's Report to the National Advisory Council on Drug Abuse - February, 2004

Research Findings - Prevention Research

Children's Proactive and Reactive Aggressive Behaviors Can be Manipulated

Reactive aggression includes hostile, "hot-blooded" and defensive behavior, generally directed at someone or something perceived as a threat. Proactive aggression is generally goal related, involves unemotional and "cold-blooded" behavior that is oriented toward power or dominance, and involves little physiological arousal. This study assessed the effectiveness of two behavior manipulations for the purpose of differentially lowering reactive and proactive aggression in children. Fifty males between the ages of 10 and 12 were selected to play pinball in competition for points against an unknown peer whose responses were actually controlled by the experimenter. Participants could exhibit different levels of aggression towards the unknown peer by : 1) sending an annoying noise; 2) interfering with the opponent's game; or 3) offering a pro-social behavior. After playing five rounds, participants were randomly assigned to two groups: 1) reactive anger manipulation group, where trained instructors helped participants to practice distraction and relaxation techniques and alternative behaviors to aggression; or 2) positive instrumental manipulation group, where trained instructors provided rewards and reinforcement for not using proactive aggression, emphasizing the importance of team-work, taking turns, and noninterference. Then the participants played pinball for another five rounds. Results indicate that positive instrumental manipulation significantly lowered aggressive responses for both reactive and proactive behavior in children. Reactive anger manipulation did not produce similar effects. Phillips, N.C., and Lochman, J.E. Experimentally Manipulated Change in Children's Proactive and Reactive Aggressive Behavior. Aggressive Behavior, 29, pp. 215-227, 2003.

Large-Scale Trial of Revised Project ALERT

Project ALERT was originally designed to use interactive teaching methods to motivate middle-school students against using drugs, and to give them the skills they need to translate that motivation into effective resistance behavior. The initial evaluation of Project ALERT found that the program effectively prevented or reduced both cigarette and marijuana use among eighth-grade students, although committed cigarette smokers did not reduce or stop smoking. Project ALERT also had a modest initial impact on alcohol use, but this disappeared by 8th grade. In an effort to improve the program's effectiveness and generalizability, Project ALERT was revised to focus primarily on smoking cessation and alcohol use, and involve parents in substance-use prevention. The revised version of this program was tested in a randomized trial including a wide variety of schools in urban, small-town, and rural Midwestern communities. The revised version of the curriculum produced the following effects: 1) significant reductions in cigarette initiation (ever use), current use (use in past month), and regular use (weekly use); 2) significant reduction in marijuana initiation, and moderate but nonsignificant reductions in current and regular marijuana use; and 3) nonsignificant reductions on alcohol initiation and current use. Ellickson, P. L., Daniel F., McCaffrey, Ghosh-Dastidar, B. and Longshore, D.L. New Inroads in Preventing Adolescent Drug Use: Results from a Large-Scale Trial of Project ALERT in Middle Schools. American Journal of Public Health, 93(11), pp. 1830-1836, 2003.

Extent of National Awareness for Principles of School Prevention Effectiveness

The U.S. Department of Education's Principles of Effectiveness require recipients of Safe and Drug-Free Schools and Community Act funds to: 1) base drug and violence prevention programming on needs assessment data; 2) develop measurable program goals and objectives; 3) implement programs for which there is research evidence of effectiveness; and 4) periodically evaluate programs relative to their goals and objectives. A survey of school personnel showed that levels of awareness of these principles were relatively low at both school district (59.6% or 95% CI = 56.7%-62.5%) and individual school (22.3% or 95% CI = 20.2% - 24.4%) levels. Therefore greater communication about these principles to school districts is needed, and in turn, this should increase communication between school districts and school-level substance use and prevention staff. Simmons-Rudolph, A.P., Ennett, S.T., Ringwalt, C.L., Rohrback, L.A., and Vincus, A.A. The Principles of Effectiveness: Early Awareness and Plans for Implementation in a National Sample of Public Schools and Their Districts. Journal of School Health, 73, pp. 181-185, 2003.

Factors Associated with Teachers' Adherence to Prevention Curricula

Teachers' fidelity in implementing substance use prevention curricula is widely considered desirable, and is linked empirically to prevention effectiveness. Factors pertinent to teachers' adherence to curriculum guides were explored using data from a nationally representative sample of 1905 substance use prevention teachers in the nation's public and private schools. Results suggest that about one-fifth of the teachers did not use a curriculum guide at all; while only 15% reported that they followed one very closely. Adherence was positively associated with: 1) teachers' discretion in their coverage of prevention lessons; 2) beliefs concerning the effectiveness of the most recent training they received and the curricula they taught; and 3) their principal's level of support for substance use prevention. The authors conclude that some degree of curriculum adaptation is inevitable, but adherence to curriculum guides may be improved through teacher training. Ringwalt, C.L., Ennett, S.T., Johnson, R., Rohrbach, L.A., Simons-Rudolph, A. P., Vincus, A.A. and Thorne, J. Factors Associated with Fidelity to Substance Use Prevention Curriculum Guides. Health Education and Behavior, 30, pp. 375-391, 2003.

Relevant Biological Background Knowledge Enables Children to Learn About the Mechanisms of Drug Action

To prevent early drug and alcohol experimentation, experts suggest that prevention efforts should be initiated in elementary school. However, there has been little systematic assessment of the knowledge that elementary school-aged children need in order to understand the risks associated with substance abuse. This study sought to determine whether children are better able to learn about the physiological mechanisms of drug action if they have relevant biological background knowledge than if they do not. The participants were 363 third- to sixth-grade students from 24 classrooms in four Catholic schools in an ethnically diverse metropolitan area who were enrolled in a study of the efficacy of a drug-education curriculum designed to teach a causally coherent explanation of how alcohol and cocaine effect behavior. All children took pre- and posttests designed to measure knowledge about alcohol and cocaine, attitudes and intentions toward their use, and knowledge of the brain and circulatory system. The children were randomly assigned to four small groups within same-grade groupings, and one researcher was randomly assigned to oversee each group. The groups received one of four curricula: (1) basic theory of drug action, (2) biologically enhanced version of the theory, (3) version confronting smoking myths, or (4) control group. Results indicated that biological knowledge was greater among older students, but on the whole, elementary school-aged children may not have sufficient grasp of general biological information to apply it to a specific case like the circulation of drugs. Nevertheless, biological knowledge, especially knowledge of the brain's controlling functions, was positively associated with greater endorsement of central theories of drug action. Most importantly, the hypothesis that relevant biological knowledge would be associated with both concurrent drug knowledge and gains in drug knowledge following exposure to a drug and alcohol education curriculum was supported. Sigelman, C.K., Bridges, L.J., Sorongon, A.G., Rinehart, C.S., Brewster, A.B., and Wirtz, P. Biological Background Knowledge and Learning From a Drug and Alcohol Education Program. The Journal of Genetic Psychology, 164(2), pp. 133-152, 2003.

Prevention Program Slows Increases in Drug Use and Delinquency

This is a study of outcomes of the Preparing for the Drug Free Years Program (PDFY), a universal family-based prevention intervention proven to be effective in previous studies. This study extends prior research on the program, which has predominantly addressed process outcomes and intervention efficacy with regard to specific substances, by examining growth over time in polysubstance use and non-drug delinquency. Latent growth curve modeling was used to analyze 5 waves of data collected from 429 rural adolescents. Results showed that adolescents assigned to the PDFY condition had a slower rate of linear increase over time in both substance use and delinquency compared with adolescents assigned to the control condition. Moreover, pretest level of delinquency was a reliable, positive predictor of growth in substance use, whereas pretest level of substance use did not predict growth in delinquency. Mason, W.A., Kosterman, R., Hawkins, J.D., Haggerty, K.P., and Spoth, R.L. Reducing Adolescents' Growth in Substance Use and Delinquency: Randomized Trial Effects of a Parent-Training Prevention Intervention. Prevention Science, 4(3), pp. 203-212, 2003.

Both Physiological and Social-Cognitive Processes Should be Addressed in Clinical Interventions with Aggressive Boys

Physiological and social-cognitive correlates of aggression were examined in an In vivo laboratory provocation situation. Fifty-one male participants (age 9 to 13) were selected based on teacher aggression screening, ranging from normative to high levels. A provocation was induced by the experimenter communicating a threat from an unseen "peer" in the laboratory. Bivariate linear regression analyses showed that aggression significantly predicted heart rate at both pre- and post-induction, and aggression significantly predicted attributions of intent following the provocation. Results indicated that aggression was a significant predictor of changes in hostile attribution and heart rate following the threat induction. A positive correlation was also found between heart rate change and attribution change. The findings suggest that both physiological and social-cognitive processes should be addressed in clinical interventions with aggressive children. Williams, S.C. and Lochman, J.E. Aggressive and Nonaggressive Boys' Physiological and Cognitive Processes in Response to Peer Provocations. Journal of Clinical Child and Adolescent Psychology, 32(4), pp. 568-576, 2003.

Curriculum Found To Be Effective, Culturally Grounded Approach to Prevention

The authors present findings from an effectiveness study of a school-base drug abuse prevention intervention developed for culturally diverse, urban middle school students. The 'keepin' it R.E.A.L.' curriculum consists of 10 lessons promoting antidrug norms and teaching resistance skills and other social skills, reinforced by booster activities and a media campaign. Three versions of the intervention were delivered: Mexican American, combined African American and European American, and Multicultural. The investigators hypothesized that: 1) the three culturally-grounded interventions would influence anti-drug attitudes and reduce drug use compared to the standard or existing intervention and 2) the greater the cultural matching between student background and intervention condition, the stronger the effect of the program (cultural matching hypothesis). Thirty-five middle schools were randomly assigned to 1 of the 3 versions or to the control group. A total of 6,035 students completed baseline and follow-up interviews over a two-year period. Analyses utilizing a generalized estimating equations approach suggest that the intervention was effective, with significant effects on gateway drug use as well as norms, attitudes, and resistance strategies. There was little support for the cultural matching hypothesis. Contrasts suggested that the Mexican American and Multicultural versions impacted the most outcomes. Hecht, M.L., Marsiglia, F.F., Elek, E., Wagstaff, D.A., Kulis, S., Dustman, P., and Miller-Day, M. Culturally Grounded Substance Use Prevention: An Evaluation of the keepin' it R.E.A.L. Curriculum. Prevention Science, 4(4), pp. 233-248, 2003.

Pairing Aggressive and Nonaggressive Children in Strategic Peer Affiliation is Effective

During a 6-week summer school program 118 second graders participated in a program that incorporated strategic peer affiliation (a "buddy system") to assess the impact of pairing moderately aggressive children (the targets of the intervention) and nonaggressive children. All participants were observed playing foosball with their buddies and with aggressive and nonaggressive non-buddies as teammates. Aggressive children had lower levels of disruptive behavior when their teammate was nonaggressive, regardless of whether the teammate was a buddy. Nonaggressive children showed elevated disruptive behavior when playing with an aggressive non-buddy, but not when playing with an aggressive buddy. The highest level of aggressive behavior was seen in pairs of aggressive teammates who were friends. One year later, no increase in peer-rated aggressive behavior was found in either group. Results suggest that unidirectional peer influence is possible and that strategic peer affiliation can be an effective intervention that does not put nonaggressive children at risk for acquiring undesired behaviors. Hektner, J.M., August, G.J., and Realmuto, G.M. Effects of Pairing Aggressive and Nonaggressive Children in Strategic Peer Affiliation. Journal of Abnormal Child Psychology, 31(4), pp. 399-412, 2003.

Gateway Communications are Ineffective in Anti-Marijuana Campaigns

Successful anti-marijuana messages can be hypothesized to have two types of effects: persuasion effects that result in change in people's beliefs about using marijuana, and priming effects, that strengthen the correlation between beliefs and associated variables such as attitude toward and intention to use a drug. This study examined different sets of anti-drug advertisements for persuasion and priming effects focusing on the effectiveness of the gateway argument in anti-marijuana interventions. The belief that marijuana is a gateway to other drugs was selected since it often is endorsed by campaign planning officials and health educators. A sample of 418 middle and high school students was randomly assigned to a control video or one of three intervention conditions two of which included the gateway message in either an explicit or implicit way. Results did not support the use of the gateway belief in anti-marijuana interventions. No clear persuasion or priming effects were found for any of the ad sequences. In fact, in comparison to the control condition, adolescents in the explicit gateway condition tended to agree less with the gateway message and displayed weaker correlations between anti-marijuana beliefs and their attitude toward marijuana use. For most youth there was no room for the ads to lower intentions to use marijuana since they did not intend to use. For higher risk youth many of whom presumably had used marijuana but had not gone on to use other drugs, the gateway message runs counter to their experience and is rejected. These results suggest that the gateway message should not be used in anti-drug interventions. Yzer, M.C., Cappella, J.N, Fishbein, M., Hornik R. and Ahern, R.K. The Effectiveness of Gateway Communications in Anti-Marijuana Campaigns. Journal of Health Communication, 8(2), pp. 129-143, 2003.

Predictors of Early Sexual Risk in High Risk Youth

This longitudinal study assessed the characteristics that predicted the timing of first sexual intercourse in a high-risk sample of adolescents between the ages of 11 and 14. A high-risk community sample was recruited through advertisement and a telephone interview with parents, who were asked to reported on their child's current risk factors, such as low grades, suspected drug use, and aggression. Youth were eligible to participate in the study if parents reported the presence of at least four risk factors. Following recruitment, families participated in a 2-3 hour assessment involving questionnaires, structured interviews, and a family assessment task. Following the assessment, participants were administered brief telephone interviews. The analyses were conducted with 162 adolescents who were virgins at baseline and for whom it was possible to determine the date of first sexual intercourse. The modal age of first intercourse was 14. Pubertal status, externalizing ratings, delinquency, substance use, monitoring, and deviant-peer involvement were univariate predictors of age of first sexual intercourse, whereas deviant-peer involvement was the sole predictor in the multivariate analysis. These results suggest that precocious sexual initiation can be understood using models of the etiology of other problem behavior and that deviant-peer involvement is a particularly salient dimension of this trajectory. French, D. and Dishion, T.J. Predictors of Early Initiation of Sexual Intercourse Among High-Risk Adolescents. Journal of Early Adolescence, 23(3), pp. 295-315, 2003.

The Potential Role of Deviant Talk in Adolescent Antisocial Behavior

Deviant talk in adolescent friendships has been previously found to predict escalation in substance use, delinquency, and violence. The current paper extends past work on deviant talk by examining its dynamic, self-organizing properties. From the direct observations of peer interactions, a simple measure was developed that indicated whether, as an interaction unfolded, deviant talk bouts became longer in duration, indicating an "attractor state" according to dynamic systems principles. Participants included 102 high-risk adolescents and their friends. A time series of the duration of each successive deviant talk bout over the course of an interaction was created for all dyads. Slope values were derived from the time-series and used as an index of attractor strength. As hypothesized, the attractor index predicted serious authority conflict (arrests, school expulsion) and drug abuse three years later, after controlling for problem behavior, family coercion, and deviant peer associations. The findings suggest that the process by which adolescents become increasingly absorbed in deviant talk is an important underlying mechanism in the development of serious antisocial behavior. Granic, I. and Dishion, T.J. Deviant Talk in Adolescent Friendships: A Step Toward Measuring a Pathogenic Attractor Process. Social Development, 12(3), pp. 314-334, 2003.

Predictors of Smoking Among Rural Adolescents

This study investigated a model of social and cognitive cross-sectional predictors of smoking, with a focus on rural adolescents. Gender-specific differences in etiology were examined by testing the same model separately for boys and girls. Seventh graders (N=1,673) residing in northeastern Iowa self-reported smoking, peer smoking norms, adult smoking norms, drug refusal assertiveness, drug refusal techniques, life skills, prosmoking attitudes, risk-taking tendency, and family management practices. Data were collected during a class period in 36 junior high schools. Peer smoking norms, adult smoking norms, drug refusal assertiveness, drug refusal techniques, prosmoking attitudes, and risk-taking tendency were associated with smoking. Notably, family management skills and life skills were associated with current smoking for girls only. Based on the results of the present study and on previous research, smoking prevention programs for rural adolescents should incorporate normative education, drug refusal training, parent skills training, and competence enhancement skills training, strategies that have been successful with urban and suburban populations. Epstein, J.A., Botvin, G.J., and Spoth, R. Predicting Smoking among Rural Adolescents: Social and Cognitive Processes. Nicotine and Tobacco Research, 5, pp. 485-491, 2003.

Cognitive Predictors of Children's Attitudes Toward Alcohol and Cocaine

Using a multi-ethnic sample of 217 elementary school children, this study looked at age-related differences in attitudes and intentions regarding alcohol and cocaine use. It also examined possible cognitive underpinnings of these attitudes and intentions, such as basic familiarity with each substance, expectancies about short-term psychological and behavioral effects, beliefs about long-term health effects, and causal understanding of drug action. Findings revealed that as they get older, children increasingly report familiarity with alcohol and cocaine and they understand that their effects are in large part brain-mediated rather than due to a drug's direct effects on peripheral parts of the body. Although older children were more likely than younger children to endorse positive expectancy statements about alcohol and cocaine, negative expectancies prevailed at all ages and did not weaken with age. The knowledge, belief, and understanding variables examined in this study were associated with attitudes toward cocaine use, but not alcohol. Structural equation modeling involving these variables revealed that cognitive predictors had no significant indirect associations with cocaine use intentions through attitudes. Instead, cognitions predicted attitudes and attitudes, in turn, predicted intentions of cocaine use. Whereas most studies have emphasized associations between expectancies and attitudes toward drug use, this study suggests that other sorts of cognitions deserve further exploration. The findings also suggest that it may be beneficial to supplement drug prevention efforts with an approach that targets general knowledge about drugs, knowledge of drugs' long-term effects, and causal understanding of how drugs alter brain functioning. Bridges, L.J., Sigelman, C.K., Brewster, A.B., Leach, D.B., Mack, K.L., Rinehart, C.S., and Sorongon, A.G. Cognitive Predictors of Children's Attitudes Toward Alcohol and Cocaine. Journal of Child and Adolescent Substance Abuse, 12(3), pp. 19-44, 2003.

Young Adults with Attention-Deficit/Hyperactivity Disorder and Conduct Disorder are at Unique Risk for Drug Dependence

Prior research examining relations among attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), and substance abuse has suggested that CD fully accounts for relationships between ADHD and substance abuse. This study tested an alternate theory that ADHD and CD interact to produce substance use problems. The 481 participants were part of a 10- to 12-year longitudinal study of the etiological pathways to substance use and psychopathology. Results indicated that college aged youth with a history of a greater number of symptoms of both hyperactivity-impulsivity-inattention (HIA) and conduct problems (CP) when they were younger had the highest rates of marijuana and hard drug use dependence symptoms. Interestingly, youth with higher HIA and lower CP symptoms often had the lowest rates of substance use and dependence symptoms, suggesting that HIA, in the absence of CP, may serve as a protective factor. This subtype is often characterized by relatively low levels of impulsivity and an anxious, shy or socially withdrawn personality style, which could account for the low levels of substance use. The only substance to which HIA was uniquely related after controlling for the overlap between ADHD and CD was tobacco. Since stimulant medications are the most effective medical treatment for reducing symptoms of HIA, the authors speculate that individuals with HIA may use the socially acceptable stimulant drug nicotine as a way to decrease their HIA symptoms. As a whole, these study findings support the hypothesis that there may be unique characteristics, such as impulsivity, executive deficits or peer rejection, that are associated with HIA-CP that impose a particularly high risk for antisocial behavior, substance use and dependence. Flory, K., Milich, R., Lynam, D.R., Leukefeld, C., and Clayton, R. Relation Between Childhood Disruptive Behavior Disorders and Substance Use and Dependence Symptoms in Young Adulthood: Individuals With Symptoms of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder Are Uniquely at Risk. Psychology of Addictive Behaviors, 17(2), pp. 151-158, 2003.

The Associations of Social Self-Control, Personality Disorders, and Demographics With Drug Use Among High-Risk Youth

A 10-item self-report measure of social self-control was examined for its association with substance use, controlling for its associations with 12 personality disorder indices and 4 demographic variables among a sample of 1,050 high-risk youth. Social self-control was found to be associated with 30-day cigarette smoking, alcohol use, marijuana use, and hard drug use, controlling for these other variables. The most consistent concurrent predictors of substance use were male gender, antisocial personality disorder, and social self-control. These results highlight the importance of social self-control as a unique concurrent predictor of substance use and suggest that social self-control skill training is relevant in substance abuse prevention programming. Sussman, S., McCuller, W.J., and Dent, C.W. Implications for Social Self-Control Training. Addictive Behaviors, 28(6), pp. 1159-1166, 2003.

Callous/Unemotional Traits are Related to Social-Cognitive Problems in Adjudicated Youths

Callous/unemotional (C/U) and impulsivity/conduct problems (I/CP) in youth may be associated with psychopathic traits. This study sought to clarify the nature of these two factors, and examine their relation with social-cognitive problems in incarcerated adolescents. Self-report measures and archival data were collected from one hundred sixty- nine male and female adjudicated youth to assess their psychopathic traits, emotional distress, behavioral dysregulation, social-cognitive processes, and delinquency severity. Analyses demonstrated that the I/CP factor is associated with increased levels of dysregulated behavior, while the C/U dimension is related to deficits in empathy. Also, C/U traits were associated with an increased focus on the positive aspects of aggression and a decreased focus on the negative aspects of hostile acts. Findings remained after controlling for demographic characteristics, abuse history, intellectual abilities, and delinquency severity. Results provide support for the two-dimensional nature of psychopathology in youth and suggest that C/U traits are associated with lower emotional distress and a specific social information-processing pattern. Pardini, D.A., Lochman, J.E., and Frick, P.J. Callous/Unemotional Traits and Social Cognitive Processes in Adjudicated Youth. Journal of American Academy of Child and Adolescent Psychiatry, 42, pp. 364-371, 2003.

Flexibility in Parent Child Interactions Peaks During the Adolescent Transition

This family research study (n=149) was designed to test how parent-child interaction trajectories, measured through observation, changed over three periods of time: 1) preadolescence (ages 9-12), the adolescent transition (13-14), and after the adolescent transition (ages 15-18). The authors hypothesized that preadolescent parent-child interactions would be very stable in nature and would become much more unstable during the transition period. These unstable patterns were expected to restabilize after the transition period. Patterns were documented and analyzed using a new dynamic systems methodology called "state space grids." Participants in the study were a subsample of boys involved in the Oregon Youth Study who completed all five waves of data collection in that study. The boy and one or two parents were videotaped engaging in problem solving discussions over two high conflict family issues. The problem solving sessions were coded using the Family Process Code to categorize behavior into 1 of 25 content codes and 1 of 6 valance or affect codes. This analysis focused on the valance codes, which were collapsed into four groups. The findings strongly supported the hypothesis that the early adolescent transition involves increased behavioral flexibility in interaction style between these boys and their parents. Granic, I., Hollenstein, T., Dishion, T.J., and Patterson, G.R. Longitudinal Analysis of Flexibility and Reorganization in Early Adolescence: A Dynamic Systems Study of Family Interactions. Developmental Psychology, 39(3), pp. 606-617, 2003.

Longitudinal Relations Among Depression, Stress, And Coping In High Risk Youth

The structural relationships among risk and protective factors were examined in a sample of 646 continuation high school students. Depression predicted more perceived stress but was not a unique predictor of anger coping, seeking social support, or substance use. Perceived stress increased seeking social support, which subsequently decreased the use of anger coping. This suggests that social support may be a means of prevention for adolescents. Anger coping behaviors were significant in sustaining depression and perceived stress, and in increasing hard drug use over time. Analyses of moderators of this effect indicated that there was no difference in the stress-coping depression relationship between Latinos and Caucasians. However, the relationship among perceived stress, anger coping, and depression was stronger for female than for male adolescents. Galaif, E.R., Sussman, S., Chou, C.P., and Wills, T.A., Longitudinal Relations Among Depression, Stress, and Coping in High Risk Youth. Journal of Youth and Adolescence, 32(4), pp. 243-258, 2003.

Mixed Outcomes after 3 Years of a Multifaceted Prevention Program for Disruptive Elementary School Children

This study examined predictors and outcomes of attendance in two standard components of a multifaceted preventive intervention aimed at children with early-onset disruptive behavior after 3 years of intervention. Mean rate of attendance in the Family Program, but not the Summer School Program, differed by level of child disruptiveness (i.e., the grouping variable). Predictors of attendance (SES, single-parent status, child IQ) did not differ across high- and low-disruptive groups. However, level of child disruptiveness moderated academic achievement and aggression outcomes, but not social competence. Higher attendance in the Summer Program was associated with higher child social competence at Year 3 for all children. For academic achievement, higher attendance in the Summer Program was associated with higher scores for mild/moderately disruptive children and lower scores for highly disruptive children in Year 3. Higher attendance in the Family Program was associated with lower aggression scores for mild/moderately disruptive children. Findings highlight the importance of matching intervention components to the assessed or expressed needs of client subgroups. August, G.J., Egan, E.A., Realmuto, G.M., and Hektner, J.M. Parceling Component Effects of a Multifaceted Prevention Program for Disruptive Elementary School Children. Journal of Abnormal Child Psychology, 31(5), pp. 515-527, 2003.

Project Towards No Drug Abuse: Two-Year Outcomes of a Trial That Compares Health Educator Delivery To Self-Instruction

This paper describes the 2-year follow-up of a 12-session version of an indicated drug abuse prevention program, Project Towards No Drug Abuse (TND). Self-instruction programming often is used to help youth who are at high risk for dropout and drug abuse to complete their high school education. However, a health educator-led program is much more interactive. In this study the effects of self-instruction versus health educator-led versions of this curriculum were examined. Eighteen schools were randomly assigned by block to one of three conditions-standard care (control), health educator-led classroom program, and self-instruction classroom program. Subjects were followed up 1 and 2 years later. Two-year results are reported here. Results showed that the self-instruction program produced no behavioral effects relative to the standard care control condition. The 2-year follow-up results indicated maintenance of program effects on cigarette smoking and hard drug use in the health educator-led version. It was concluded that Project TND shows maintenance of effects on some drugs 2 years after program implementation, when most youth were young adults. More work is needed to learn how to maintain effects across substances. Continued exploration of modalities of implementation may be helpful. Sussman, S., Sun, P., McCuller, W.J., and Dent, C.W. Preventive Medicine, 37(2), pp. 155-162, 2003.

Family-Based Interventions for Substance Use and Misuse Prevention

Because "substance abuse" is a "family disease" of lifestyle, including both genetic and family environmental causes, effective family strengthening prevention programs should be included in all comprehensive substance abuse prevention activities. This article presents reviews of causal models of substance use and evidence-based practices. National searches by the authors suggest that there is sufficient research evidence to support broad dissemination of five highly effective family strengthening approaches (e.g. behavioral parent training, family skills training, in-home family support, brief family therapy, and family education). Additionally, family approaches have average effect sizes two to nine times larger than child-only prevention approaches. Comprehensive prevention programs combining both approaches produced much larger effect sizes. Kumpfer, K.L., Alvarado, R., and Whiteside, H.O. Family-based Interventions for Substance Use and Misuse Prevention. Substance Abuse and Misuse, 38(11-13), pp. 1759-1787, 2003.

The Development of the Driver's Angry Thoughts Questionnaire

Angry, aggressive drivers are a significant psychological and health hazard on the road. This study was undertaken to develop a measure of angry thinking while driving and to provide initial reliability and validity data. The questionnaire under evaluation, the Driver's Angry Thoughts Questionnaire (DATQ), includes 88 thoughts people have when angry while driving, generated from 248 college students. Investigators also measured the propensity to become angry when driving, expression of anger behind the wheel, driving habits, hostile automatic thoughts, and trait anger. Factor analysis identified five forms of driving-related angry cognitions: Judgmental/Disbelieving Thinking, Pejorative Labeling/Verbally Aggressive Thinking, Revenge/Retaliatory Thinking, Physically Aggressive Thinking, and Coping Self-Instruction. Pejorative labeling/verbally aggressive, physically aggressive, and revengeful/retaliatory thinking correlated positively with each other and with driving anger, expressing driving anger, aggression on the road, and risky driving behavior. Coping self-instruction tended to correlate negatively with these variables. Judgmental/disbelieving thinking correlated positively with other forms of angry thinking but correlated only somewhat with other variables (e.g., expression of anger). Driving-related angry thoughts, except coping self-instruction, correlated positively with general hostile automatic thoughts. The analyses supported the validity of the measure. Deffenbacher, J.L., Petrilli, R.T., Lynch, R.S., Oetting, E.R., and Swaim, R.C. The Driver's Angry Thoughts Questionnaire: A Measure of Angry Cognitions When Driving. Cognitive Therapy and Research, 27(4), pp. 383-402, 2003.

Developing and Testing an Objective Measure of Message Sensation Value

Effective targeting of high sensation-seeking adolescents, who are most at risk for drug abuse, requires creation of high sensation value messages. Previous research has focused on subjective reactions of receivers as the primary way to define message sensation value (MSV). In contrast, this study treats message sensation value as the formal and content features (audio, visual and format) of a message that contribute to subjective message sensation evaluations. Study goals were to: (1) identify message design features that would aid in the development of effective prevention messages targeting high sensation seekers; (2) develop an objective measure of message sensation value based on formal and content features of messages; and (3) determine whether high message sensation value messages were associated with higher subjective evaluations of message sensation value. A total of 418 undergraduates each viewed 10 public service announcements (PSAs) selected at random from a pool of 109 PSAs that had been previously coded for message sensation value. As hypothesized, the data analysis found that perceived MSV is at least in part a product of the formal and content features of a PSA. Morgan, S.E., Palmgreen, P., Stephenson, M.T., Hoyle, R.H., and Lorch, E.P. Associations Between Message Features and Subjective Evaluations of the Sensation Value of Antidrug Public Service Announcements. Journal of Communication, 53(3), pp. 512-526, 2003.

Pilot Study Findings of a Preventive Intervention with African American Families

The authors report the results of a pilot of the Strengthening Families Program: For Parents and Youth 10-14 with a sample of African American families with young adolescents (n=110). This study was undertaken to address the gap in knowledge regarding the efficacy of substance use prevention programs with African American populations. Participants were randomized to an intervention and a waitlist control group. Outcome data were collected from all participants by telephone survey before and after the six weekly 2-hour intervention sessions, then once more after the program was offered to the waitlist control group. Implementation feasibility clearly was demonstrated and observer ratings showed high adherence to the intervention protocol. Trial findings showed positive results for intervention-targeted child behaviors, such as setting goals and managing stress. The intervention did not have effects on targeted parenting skills expected to mediate child skill-building. Spoth, R., Guyll, M., Chao, W., and Molgaard, V. Exploratory Study of a Preventive Intervention with General Population African American Families. Journal of Early Adolescence, 23(4), pp. 435-468, 2003.

The Role of Assertiveness and Decision Making in Early Adolescent Substance Initiation

This study examined the mediating processes linking individual rights assertiveness and decision-making to early adolescent substance initiation, along with the moderating effect of gender on those processes. Individual rights assertiveness was defined as learned, goal-oriented behavior that increases the likelihood that personal needs will be met. Decision-making skills were defined as active strategies to gather information, with pros and cons and choose appropriate actions. Self-report measures were collected from a non-treatment cohort of rural, young adolescents participating in a prevention trial (N=357). Analyses were conducted to test mediational models across three waves of data collected over a period of 18 months. Results indicated that individual rights assertiveness and decision-making had indirect effects on substance initiation through effects on negative outcome expectancies and refusal intentions. Gender differences were found in both the average level and the pattern of relationships among the variables. For girls, refusal intentions were negatively associated with later substance initiation. For boys, early levels of substance initiation were negatively associated with later levels of negative expectancies and refusal intentions. Trudeau, L., Lillehoj, C., Spoth, R., and Redmond, C. The Role of Assertiveness and Decision Making in Early Adolescent Substance Initiation: Mediating Processes. Journal of Research on Adolescence, 13(3), pp. 301-328, 2003.

Development of A Culturally Grounded Prevention Approach

Research has shown that students respond more favorably to drug prevention programs when they see their culture and themselves represented in the prevention message. Additionally, studies highlight important ethnic differences in drug behaviors and attitudes, indicating that students' ethnic culture should be considered in the creation of prevention programs. Still there are few effective, culturally grounded programs like the 'keepin' it R.E.A.L.' curriculum, designed for ethnically diverse seventh grade students residing in a large southwestern city. This curriculum was developed by incorporating several theoretical perspectives such as Communication Competence Theory, Narrative Theory, and the Focus Theory of Norms and culturally grounding through the use of youths narratives that reflect their local, youth, and ethnic cultures. This descriptive paper illustrates the process of curriculum design, focusing on the methods used to ensure cultural grounding. Gosin, M., Marsiglia, F.F., and Hecht, M.L. Keepin' it R.E.A.L.: A Drug Resistance Curriculum Tailored to the Strengths and Needs of Pre-Adolescents of the Southwest. Journal of Drug Education, 33(2), pp. 119-142, 2003.

School-based Programs for Social, Emotional and Academic Development

A comprehensive mission for schools is to educate students to be informed, responsible, socially skilled, healthy, caring, and contributing citizens. To support this mission a growing number of school-based prevention and youth development programs have been developed. However, the impact of these programs is limited because of insufficient coordination with other components of school operations and inattention to implementation and evaluation factors necessary for strong program impact and sustainability. Widespread implementation of beneficial prevention programming requires development of research-based, comprehensive school reform models that improve social, health, and academic outcomes; educational policies that demand accountability for fostering children's full development; professional development that prepares and supports educators to implement programs effectively; and systematic monitoring and evaluation to guide school improvement. Greenberg, M. T., Weissberg, R.P., O'Brien, M.U., Zins, J.E., Fredericks, L., Resnik, H., and Elias M.J. Enhancing School-Based Prevention and Youth Development Through Coordinated Social, Emotional, and Academic Learning. American Psychologist, 58(6-7), pp. 466-474, 2003.

Substance Abuse Among Very Young Juvenile Offenders

Although the relationship between delinquency and substance use in adolescence is well documented, less is known about substance-use initiation in childhood for juvenile delinquent populations. This study examined early substance initiation in childhood as reported by adolescents who were incarcerated for juvenile offenses (93 males, 96 females; 58% African American, 42% European American). Youth were individually interviewed using an adapted version of substance-related questions from the National Household Survey on Drug Abuse. Juvenile justice system records were reviewed to characterize offense histories. A majority of males and females reported using at least one substance (other than cigarettes) such as alcohol, marijuana, or inhalants by age 13. Alcohol use reportedly occurred by age 10 for 17% of the youth. For a substantial portion, early initiation turned into frequent early use. For example, 32% of the males and 39% of the females reported drinking alcoholic beverages at a frequency of at least several times per month by age 13. Limited evidence related early substance initiation with subsequent substance abuse. Offense status is related to early substance initiation for females but not males. Early substance use is a significant problem among youth who end up in the juvenile justice system. Prinz, R.J., and Kerns, S.E.U. Early Substance Use by Juvenile Offenders. Child Psychiatry and Human Development, 33(4), pp. 263-277, 2003.

Problem Behavior Screening in First Grade

First grade teacher ratings of aggressive, hyperactive-inattentive, and low levels of pro-social behaviors made unique contributions to the prediction of school outcomes (measured 2 years later) for 755 children. Person-oriented analyses compared the predictive utility of 5 screening strategies based on child problem profiles to identify children at-risk for school problems. Children with elevations in any 1 of the 3 behavior problem dimensions were identified as "at-risk". A broad screening strategy used with these children showed lower specificity than other measures, but superior sensitivity, odds ratios, and overall accuracy in the prediction of school outcomes than the other screening strategies that were more narrowly focused or were based on a total problem score. Flanagan, K.S., Bierman, K.L., and Kam, C.M. Identifying At-Risk Children at School Entry: The Usefulness of Multi-Behavioral Problem Profiles. Journal of Clinical Child and Adolescent Psychology, 32(3), pp. 396-407, 2003.

Parent Knowledge about Monitoring Behavior and Adolescent Delinquency

Links between parental monitoring-relevant knowledge and adolescent delinquent behavior were tested for correlated rates of developmental change and reciprocal associations. For 4 years beginning at age 14, adolescents (N = 396) reported on their delinquent behavior and on their parents' knowledge of their whereabouts and activities. Parents completed measures of their adolescents' delinquent behavior. Parent monitoring-relevant knowledge was negatively correlated with delinquent behaviors at baseline. Increases over time in parent monitoring knowledge were associated with decreases in parent-reported delinquent behavior. Reciprocal associations indicate that low levels of parental knowledge predict increases in delinquent behavior and that high levels of delinquent behavior predict decreases in parent knowledge. Both youth-driven and parent-driven processes may account for the correlated developmental changes and reciprocal associations. Laird, R.D., Pettit, G.S., Bates, J.E., and Dodge, K.A. Parents' Monitoring-Relevant Knowledge and Adolescents' Delinquent Behavior: Evidence of Correlated Developmental Changes and Reciprocal Influences. Child Development, 74(3), pp. 752-768, 2003.


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