Risk Factors for Adolescent Suicide and Suicidal Behavior: Mental and Substance Abuse Disorders,Family Environmental Factors,and Life Stress

This review focuses on psychopathologic risk factors for adolescent suicide and suicidal behavior, namely, affective, disruptive, substance abuse, psychotic, and personality disorders. The interaction of psychopathology with age and gender is discussed. The role of family environmental risk factors and stress events in suicide and suicidal behavior, both alone, and in interaction with psychopathology are reviewed. Research reviewed will include psychological; autopsy studies, longitudinal studies examining predictors of suicide, and epidemiologic studies of suicide attempts.     

Religious Faith and Substance Problems in Undergraduate College Students: A Replication

The present study examined the relations between religious faith and alcohol and drug problems in undergraduate college students at a large public university in the Southeastern United States. The Santa Clara Strength of Religious Faith Questionnaire—Short Form and the Alcohol Problems and Drug Problems scales of the Personality Assessment Inventory were given to 303 undergraduate students. Findings indicated that religious faith was inversely associated with drug and alcohol problems in both males and females. Implications of these findings are discussed.     

Family Dynamics and Substance Abuse: A Preliminary Study

The authors discuss family patterns of interaction that are thought to contribute to the maintenance of substance abuse. Preliminary research findings pertaining to the interaction patterns are also presented. The data suggest that these families are often highly interdependent, that in about 50% of the cases they ideally desire some sort of triangulation between parents and offspring, and that in about 50% of the cases they have or are working toward a hierarchical reversal. Therefore, in addition to evaluating characteristics of the substance abuser, the authors recommend that counselors consider the nature of relationships within the client's family of origin.     

Gender Roles,Suicide Attempts,and Substance Abuse

In this article, the focus is on a comparison of suicide attempts and substance abuse in the United States. It is argued that suicide attempts and substance abuse may function as psychologically equivalent but gender-specialized forms of self-injurious behaviors. Possible explanations for the gender segregation of suicide attempts and substance abuse are reviewed, and the benefits of crossover theories and treatments are presented.     

Assessing Religious Faith in Medical Patients: Cross-Validation of the Santa Clara Strength of Religious Faith Questionnaire

Growing attention has focused on the relationship between religiosity and health outcomes. However, research has been constrained by the limited availability of measures suitable for use with medical patients. This study examined the psychometric properties of the Santa Clara Strength of Religious Faith Questionnaire (SCSORF) in two well-defined samples of medical patients, representing a range of illness severity: 1) 175 women seen at a gynecology clinic; and 2) 104 cancer patients treated at a bone marrow transplantation program. Evidence for convergent validity was demonstrated by moderately high correlations with other measures of religious involvement. Divergent validity was demonstrated by small associations with social desirability. The measure was not strongly associated with demographic background or medical variables. Modest correlations with conceptually-related measures commonly used in health research (e.g., social support, optimism, existential meaning, purpose in life) further supported the divergent validity of the instrument. Results suggest that this may be a useful, concise measure for assessing religious involvement in medical patients.     

A Protective Factors Model for Alcohol Abuse and Suicide Prevention Among Alaska Native Youth

This study provides an empirical test of a culturally grounded theoretical model for prevention of alcohol abuse and suicide risk with Alaska Native youth, using a promising set of culturally appropriate measures for the study of the process of change and outcome. This model is derived from qualitative work that generated an heuristic model of protective factors from alcohol (Allen et al. in J Prev Interv Commun 32:41–59, 2006; Mohatt et al. in Am J Commun Psychol 33:263–273, 2004a; Harm Reduct 1, 2004b). Participants included 413 rural Alaska Native youth ages 12–18 who assisted in testing a predictive model of Reasons for Life and Reflective Processes about alcohol abuse consequences as co-occurring outcomes. Specific individual, family, peer, and community level protective factor variables predicted these outcomes. Results suggest prominent roles for these predictor variables as intermediate prevention strategy target variables in a theoretical model for a multilevel intervention. The model guides understanding of underlying change processes in an intervention to increase the ultimate outcome variables of Reasons for Life and Reflective Processes regarding the consequences of alcohol abuse.     

Classification of Co-occurring Depression and Substance Abuse Symptoms Predicts Suicide Attempts in Adolescents

Although both depression and substance use have been found to contribute to suicide attempts, the synergistic impact of these disorders has not been fully explored. Additionally, the impact of subthreshold presentations of these disorders has not been researched. We utilized the Quadrant Model of Classification (a matrix of severity of two disorders) to assess for suicide attempt risk among adolescents. Logistic regression was used to examine the impact of co-occurring disorder classification on suicide risk attempts. Results indicate that quadrant classification had a dramatic impact on suicide attempt risk, with individuals with high severity co-occurring disorders at greatest risk.     

Substance Abuse in Middle Eastern Adolescents Living in Two Different Countries: Spiritual,Cultural, Family and Personal Factors

It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the USA and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the USA increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.     

SHORES: A Practical Mnemonic for Suicide Protective Factors

Guidelines for addressing and managing client suicide risk include discussing and conceptualizing protective factors. Counselors should be able to recall and discuss suicide protective factors that are applicable across client populations. SHORES, a suicide protective factors mnemonic that is supported by the literature, has applications for risk assessment and crisis intervention across settings, preventative care, strengths‐based management, and counselor training. A case example and discussion serve to illustrate the wide‐ranging application of SHORES in counseling practice.     

Relationship of Mental Health and Illness in Substance Abuse Patients

This study examined the latent structure of a number of measures of mental health (MH) and mental illness (MI) in substance use disorder outpatients to determine whether they represent two independent dimensions, as Keyes (2005) found in a community sample. Seven aspects of MI assessed were assessed - optimism, personal meaning, spirituality/religiosity, social support, positive mood, hope, and vitality. MI was assessed with two measures of negative psychological moods/states, a measure of antisociality, and the Addiction Severity Index's recent psychiatric and family-social problem scores. Correlational and exploratory factor analyses revealed that MH and MI appear to reflect two independent, but correlated, constructs. However, optimism and social support had relatively high loadings on both factors. Antisociality and the family-social problem score failed to load significantly on the MI factor. Confirmatory factor analysis supported the existence of two obliquely related, negatively correlated dimensions. Study findings, although generally supporting the independence of MH and MI, suggest that the specific answers to this question may be influenced by the constructs and assessments used to measure them.     

Self‐Efficacy Among Adults in Substance Abuse Treatment: The Role of Religious Coping

In substance abuse treatment, general self‐efficacy and religiousness are factors that may support positive outcomes. The authors surveyed clients receiving substance abuse treatment (N = 121) and found that religious coping predicted general self‐efficacy scores. Clinical implications are discussed.     

Incarcerated Mothers: Mutual Support Groups Aimed at Reducing Substance Abuse Relapse and Recidivism

Interventions to reduce relapse and recidivism for the increasing number of mothers incarcerated for illicit drug use are needed to prevent maternal/child separation and high public expenditures. This paper describes mutual support groups for women inmates aimed at strengthening family coping skills, especially communication, anger management, and parenting skills. Qualitative data collected during the group sessions indicated that the healing support of shared experiences, stories, poetry, and staying in the present were identified as spiritually uplifting. Problem solving and improved family interactions constituted additional themes extracted from the qualitative data. Future plans include including quantitative outcome measures of success.     

Risk and Protective Processes Predicting Rural African American Young Men's Substance Abuse

Informed by a life course perspective, this study tested a cascade model linking harsh, unresponsive parenting during childhood to young African American men's substance abuse via precocious transitions, economic instability, and future orientation. The moderating influence of community disadvantage and romantic partner support on the hypothesized pathways was also examined. At the baseline, the sample included 505 African American men between ages 19 and 22 years from high‐poverty rural communities. Follow‐up data were collected 18 months after baseline. Using structural equation modeling, we identified harsh, unresponsive parenting influenced precocious transitions in adolescence, which in turn increased economic instability during young adulthood. Economic instability was associated with a reduction in future orientation, a proximal influence on increases in substance abuse. Also, residence in a disadvantaged community amplified the influence of precocious transitions on economic instability and the influence of economic instability on future orientation. Involvement with supportive romantic partnership evinced a protective effect, attenuating the influence of precocious transitions on economic instability and the influence of economic instability on a future orientation. This study expands understanding of young adults’ substance abuse by demonstrating the risk and protective processes linking substance abuse to developmental factors across childhood, adolescence, and young adulthood.     

Religious Faith and Psychosocial Adaptation among Stroke Patients in Kuwait: A Mixed Method Study

Religious faith is central to life for Muslim patients in Kuwait, so it may influence adaptation and rehabilitation. This study explored quantitative associations among religious faith, self-efficacy, and life satisfaction in 40 female stroke patients and explored the influence of religion within stroke rehabilitation through qualitative interviews with 12 health professionals. The quantitative measure of religious faith did not relate to life satisfaction or self-efficacy in stroke patients. However, the health professionals described religious coping as influencing adaptation post-stroke. Fatalistic beliefs were thought to have mixed influences on rehabilitation. Measuring religious faith among Muslims through a standardized scale is debated. The qualitative accounts suggest that religious beliefs need to be acknowledged in stroke rehabilitation in Kuwait.     

Understanding Adolescent Substance Abuse: Prevalence,Risk Factors,and Clinical Implications

From a developmental perspective, adolescence is a time of gaining independence, experimentation, and taking risks. One area of experimentation associated with adolescence is substance use. For counselors working with adolescents who use or abuse substances, or both, it is important to understand the scope of the problem and ways to effectively work with this population. This article provides counselors with current information on adolescent substance abuse and suggestions for clinical work.     

影响当代中国人宗教信仰倾向的几个因素辨析

在我国特殊的社会文化背景下,性别、年龄、文化程度等常见自变量对民众宗教信仰倾向的影响呈现出复杂、多样的特征.本文以零点调查的全国抽样数据为基础,对上述问题进行了深入分析,揭示出重大社会事件这一显著影响因素,进而指出意识形态与泛神文化共同构成了民众宗教信仰倾向形成的重要背景.     

Childhood Sexual Abuse and Suicidal Ideation Among Bipolar Patients: Existential But Not Religious Well‐Being as a Protective Factor

Individuals diagnosed with bipolar disorder (BD) are at an increased risk of Suicidal ideation, attempts, and death. Moreover, a strong association exists between childhood sexual abuse (CSA) and suicidal ideation among individuals with BD. Yet growing evidence suggests that existential well‐being (EWB) may be a protective factor against suicidality. In this study, adult BD patients (N = 112) provided data on CSA, religious well‐being (RWB; spiritual life in relation to God), EWB (purpose/meaning in life), and suicidal ideation. Participants were between 19 and 65 years of age. The majority was female and described their race/ethnicity as African American. Results indicated that CSA was negatively associated with EWB and was not related to RWB. Further, EWB mediated the association between CSA and suicidal ideation, whereas RWB did not. Having meaning/purpose in life may serve as a protective factor against suicidal ideation among individuals with BD who experienced CSA, whereas having a relationship/belief in God may not serve the same function.     

Codependency,Perceived Interparental Conflict,and Substance Abuse in the Family of Origin

Codependency has been found to originate in many different environments, namely the family of origin. The most popularly researched environment is the family of origin that exhibits substance abuse. However, little research has clearly demonstrated that codependency is most prevalent in children of substance abusers. Previous research has not examined how codependency is correlated with perceived interparental conflict. This study examined the relationships among codependency, interparental conflict, and substance abuse in the family of origin. Results of this study found that codependency in adulthood was related to perceived interparental conflict in the family of origin, but was not related to the family of origin that exhibited substance abuse.     

Statistical Effects of Religious Participation and Marriage on Substance Use and Abuse in Racial and Ethnic Minorities

Substance use and abuse, which includes alcohol use, alcohol dependence, drug use, and drug dependence, inflicts a substantial toll on Americans. Although studies have demonstrated the protective effect of social support, such as religious participation and via marriage, understanding their influence on racial and ethnic minorities is limited. Thus, the aim of this study is to assess the impact of social support on substance use and abuse in racial and ethnic minorities. The Collaborative Psychiatric Epidemiology Surveys, sponsored by the National Institute of Mental Health, a repository of race, ethnicity, and mental health data, was leveraged to develop four models using multivariate analysis, specifically logistic regression to estimate the probability of meeting the criteria for substance use and abuse. Racial and ethnic minorities were found to have lower rates of substance use and abuse compared to Whites, and foreign-born individuals were consistently less likely to use or abuse substances compared to American-born minorities. Mental health conditions were highly associated with substance use and abuse, and social support by way of religious participation and marriage was protective against substance use and abuse. In racial and ethnic minorities, nativity and social support were protective against substance use and abuse; however, these protective factors did not completely eliminate risk. Thus, although race and ethnicity are important to understanding health outcomes and health behaviors, such as substance use and abuse, it is the intersection of multiple factors, representing internal and external forces, which may be more informative and offer a more comprehensive picture of the landscape influencing drug and alcohol use and dependence. Targeted interventions should consider leveraging religious spaces and bilingual materials when attempting to reach racial and ethnic minorities.