Child psychopathology risk factors for drug abuse: overview.

Introduces the special section on Child Psychopathology Risk Factors for Substance Use Disorders. This article summarizes important principles, the current literature, contributions to this section, and issues for future research. Psychopathological conditions are strongly associated with substance use disorders, and some childhood psychopathological conditions may constitute precursors to this comorbidity. Conduct disorder constitutes a strong risk factor for substance use disorders, and bipolar disorder, although more rare, may also constitute a significant risk. Data for other child psychiatric conditions are mixed or lacking; however, important subgroups may be at risk and merit further attention. Underlying characteristics, such as temperament and self-regulation, merit further study as possible explanatory variables. Such studies hold the key for targeting and improving preventive and therapeutic interventions.     

Identification and impact of risk and protective factors for drug use among urban African American adolescents.

Identified 10 risk and 12 protective factors associated with drug use among African American 8th graders (N = 994) in an urban school system. Regression analyses identified 7 risk and 7 protective factors with minimal overlap. The total number of risk factors was significantly related to the prevalence of use for cigarettes, beer or wine, liquor, marijuana, and a composite measure of drug use. The Protective Factor Index (PFI) was a significant moderator of the relation between risk and use of beer or wine, liquor, marijuana, and the composite measure. Longitudinal analyses of data on 650 students across the transition from middle to high school indicated that the sum of risk factors predicted changes in all drug use categories except the composite. The PFI significantly predicted changes in beer or wine, liquor, and composite drug use over this 1-year period. It also moderated risk for cigarette use, but not for other drugs. Results replicated prior studies and highlighted the importance of protective factors such as adaptive functioning in school and family influences.     

Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention.

The authors suggest that the most promising route to effective strategies for the prevention of adolescent alcohol and other drug problems is through a risk-focused approach. This approach requires the identification of risk factors for drug abuse, identification of methods by which risk factors have been effectively addressed, and application of these methods to appropriate high-risk and general population samples in controlled studies. The authors review risk and protective factors for drug abuse, assess a number of approaches for drug abuse prevention potential with high-risk groups, and make recommendations for research and practice.     

Minority adolescents and substance use risk/protective factors: a focus on inhalant use

Despite the fact that inhalant use is a growing problem among youth in the United States, relatively little attention has been paid to the demographic and social factors related to its use. This study used data from a household survey of adolescents in Washington state, and found that race/ethnicity was a strong predictor of lifetime prevalence of inhalant use, with Native-American youth being particularly likely to use inhalants. Comparing the age at initiation of inhalant use to other legal and illegal substances, we found that cigarettes and inhalants showed the lowest age at initiation. We conducted logistic regressions on lifetime prevalence of inhalant use, and compared these models to other substances. In general, we found that attachment to parents. parents' drug use, and school attachment were strong predictors of lifetime use of marijuana, alcohol, and inhalants. However, while peer drug use was a strong predictor of marijuana and alcohol use, it was not a significant predictor of adolescents' use of inhalants. Our final set of analyses included inhalant use in regression models predicting other problem behaviors: these analyses demonstrated that inhalant use was a strong predictor of involvement in problem behavior.     

Characteristics of children of alcoholics: putative risk factors, substance use and abuse, and psychopathology.

A sample of 253 children of alcoholics (COAs) and 237 children of nonalcoholics (non-COAs) were compared on alcohol and drug use, psychopathology, cognitive ability, and personality. COAs reported more alcohol and drug problems, stronger alcohol expectancies, higher levels of behavioral undercontrol and neuroticism, and more psychiatric distress in relation to non-COAs. They also evidenced lower academic achievement and less verbal ability than non-COAs. COAs were given Diagnostic Interview Schedule alcohol diagnoses more frequently than non-COAs. The relation between paternal alcoholism and offspring alcohol involvement was mediated by behavioral undercontrol and alcohol expectancies. Although gender differences were found, there were few Gender X Family History interactions; the effects of family history of alcoholism were similar for men and women. When gender effects were found, they showed greater family history effects for women.     

Genetic influences on the association between personality risk factors and alcohol use and abuse

The authors assessed the association of 2 personality dimensions with use and abuse of alcohol in 1,320 twin pairs concordantly reporting nonabstinence at age 18.5 years. The 2 alcohol outcomes differentially relate to the 2 personality dimensions: Alcohol-related problems correlate more highly with social deviance than with excitement seeking (ES), and alcohol consumption correlates more highly with ES than with social deviance. Biometric models fit to the data identified similar patterns in genetic covariance, although differences were more evident in genetic correlations between social deviance and alcohol outcomes than in those for ES. Results suggest that genetic influences underlie the association of personality with alcohol use and subsequent problems and illustrate the utility of informative twin analyses in exploring links between genes, personality, and behavior disorder.     

Risk and protective factors in adolescents' drug use, and differences by age and sex

Adolescents' drug use has huge social and personal implications, so it is essential to identify risk and protective factors. In this research, the CTCYS was used with 2440 adolescents to detect risk and protective factors for drug use in the community, family, school and peers/individual; differences in risk and protective factors by age and sex; and relationships between risk and protective factors and substance use. Protective factors are high. Risk factors are high in the community, the school and the individual. Older adolescents have more risks and less protection than the youngest; and there are sex differences, because males have less protection and more risks. The risk factors more closely related to drug use are availability of drugs in the community, family attitudes favourable to drug use, family history of antisocial behaviour, early start and use of drugs by friends, perceived risk and attitudes favourable to drug use. In the protective factors, the role played by social skills for alcohol use is important.     

2005 Shneidman Award Address. Integratively assessing risk and protective factors for adolescent suicide

This article briefly reviews key issues in adolescent suicide risk assessment and proposes that assessing risk and protective factors in combination has the best probability of informing the field's understanding of this complex problem. Several newer measures are described along with summaries of their psychometric properties. A recommended protocol utilizing 4 developmentally appropriate, valid, and reliable self-report measures is suggested as a parsimonious way of gathering information on the range of risk and protective factors. Finally, a novel approach of employing short-term longitudinal studies to test models of adolescent suicide attempts is described along with a rationale for not focusing research efforts on completed suicide. Implications of this approach for prevention efforts conclude the article.     

A prospective study of memory for child sexual abuse: new findings relevant to the repressed-memory controversy

Previous research indicates that many adults (nearly 40%) fail to report their own documented child sexual abuse (CSA) when asked about their childhood experiences. These controversial results could reflect lack of consciously accessible recollection, thus bolstering claims that traumatic memories may be repressed. In the present study, 175 individuals with documented CSA histories were interviewed regarding their childhood trauma. Unlike in previous studies, the majority of participants (81%) in our study reported the documented abuse. Older age when the abuse ended, maternal support following disclosure of the abuse, and more severe abuse were associated with an increased likelihood of disclosure. Ethnicity and dissociation also played a role. Failure to report CSA should not necessarily be interpreted as evidence that the abuse is inaccessible to memory, although inaccessibility or forgetting cannot be ruled out in a subset of cases.     

Eating pathology in female gymnasts: Potential risk and protective factors

Although participation in sports that emphasize aestheticism, such as women's gymnastics, are associated with higher rates of eating pathology, little is known about the risk and protective factors involved in this process. We established and tested a model proposing that body surveillance and body shame are processes by which pubertal development and training may uniquely contribute to pathological eating by sampling 100 competitive female gymnasts via questionnaires. We further tested whether self-esteem moderated several model relationships. Results demonstrated that pubertal development was associated with higher levels of body surveillance, body shame and disordered eating; whereas greater time spent training was associated with lower levels of body shame and disordered eating. Finally higher self-esteem was associated with lower levels of disordered eating, less body surveillance, and less body shame. Potential risk and protective factors for the development of eating pathology in female gymnasts are discussed.     

Multiple drug use and dietary restraint in a Mr. Universe competitor: psychobiological effects.

A male bodybuilder was assessed for 20 weeks before, during, and after an international competition. Preparation included high-doses of three anabolic steroids, several nonsteroid drugs including synthetic growth hormone, prolonged training, and a severely reduced diet. Aggression and many other negative moods peaked precompetition, when these factors were most extreme.     

Risk factors for drug use in urban adolescents: Identification and cross-validation

Examined the relationship between 26 dichotomous risk factors and drug use in derivation (N = 1,352) and cross-validation (N = 1,309) samples of seventh graders in the public school system of a large southeastern city. The majority of students was African American, many came from low-income, single parent families. A total of 20 risk factors representing a variety of variables was significantly related to at least one category of drug use in both samples. Regression analyses identified a subset of 11 risk factors with minimum overlap. The simple sum of these 11 risk factors was significantly associated with prevalence of use for cigarettes, beer and wine, hard liquor, marijuana, and other drugs. The total number of risk factors also showed a curvilinear relationship with the frequency of 30-day use for each category of drug. Theoretical and practical implications of these findings are discussed.     

The reliability of a computer interview for drug use/abuse information

A computer interview was developed to collect information about drug use/abuse from high school students. Responses to this interview were compared with those obtained from an identical paper-and-pencil questionnaire given to the same students, in counterbalanced order. Results were comparable for the two methods, but missing data and logically inconsistent answers obtained with the paper-and-pencil questionnaire were not possible with the computer interview. The overwhelming majority of respondents preferred the computer interview as a means of data collection.     

Psychological distress and resilience as risk and protective factors of psychoactive substance use among Chinese nonengaged youth

Nonengaged youth (NEY) are those who have neither been working nor studying for a prolonged period of time. They are at risk of psychoactive substance use, but relevant studies are scarce. Based on a population‐based telephone survey and referrals, we anonymously interviewed 479 Hong Kong Chinese NEY aged 15–24 years. Of them, 14.8–23.7% reported moderate to severe depression, anxiety, and stress. Moreover, one fourth of the participants (24.8%; n = 119) had used psychoactive substances. Adjusted analyses showed that these three psychological distress variables were positively associated with, while resilience was negatively associated with, both ever‐use of psychoactive substances and intention to use such substances in the next 12 months. Loneliness was associated only with intention to use psychoactive substances. The mediating role of psychological distress was shown: Anxiety significantly mediated the association between resilience and ever‐use of psychoactive substances, whereas depression mediated that between resilience and behavioural intention. Resilience was not a significant moderator on the relationship between psychological distress and ever‐use of psychoactive substance use or behavioural intention to use those substances. The findings suggest that anti‐drug interventions should outreach NEY and should include mental health support as well as building up resilience, as NEY are prone to psychological distress that increases risk of substance use.     

Behavioral economics of drug self-administration and drug abuse policy.

The concepts of behavioral economics have proven useful for understanding the environmental control of overall levels of responding for a variety of commodities, including reinforcement by drug self-administration. These general concepts are summarized for application to the analysis of drug-reinforced behavior and proposed as the basis for future applications. This behavioral agenda includes the assessment of abuse liability, the assay of drug-reinforcer interactions, the design of drug abuse interventions, and the formulation of drug abuse public policy. These separate domains of investigation are described as part of an overall strategy for designing model projects to control drug use and testing public policy initiatives.     

Intimate partner physical abuse perpetration and victimization risk factors: A meta-analytic review

Evidence from 85 studies was examined to identify risk factors most strongly related to intimate partner physical abuse perpetration and victimization. The studies produced 308 distinct effect sizes. These effect sizes were then used to calculate composite effect sizes for 16 perpetration and 9 victimization risk factors. Large effect sizes were found between perpetration of physical abuse and five risk factors (emotional abuse, forced sex, illicit drug use, attitudes condoning marital violence, and marital satisfaction). Moderate effect sizes were calculated between perpetration of physical abuse and six risk factors (traditional sex-role ideology, anger/hostility, history of partner abuse, alcohol use, depression, and career/life stress). A large effect size was calculated between physical violence victimization and the victim using violence toward her partner. Moderate effect sizes were calculated between female physical violence victimization and depression and fear of future abuse.     

Family risk factors and adolescent substance use: moderation effects for temperament dimensions

This research tested for moderation in the relation of family risk factors (parent-child conflict, family life events, and parental substance use) to adolescent substance use (tobacco, alcohol, and marijuana). A sample of 1,810 participants was surveyed at the mean age of 11.5 years and followed with 2 yearly assessments. Temperament dimensions were assessed with the Revised Dimensions of Temperament Survey and the Emotionality, Activity, and Sociability Inventory. Multiple-group latent growth analyses indicated moderation occurred through (a) alteration of effects of parental variables on the adolescent substance use intercept and on the peer substance use intercept and slope and (b) alteration of the effect of the peer substance use intercept on the adolescent substance use slope. The impact of parental risk factors was decreased among participants with higher task attentional orientation and positive emotionality (resilience effect) and was increased among participants with higher activity level and negative emotionality (vulnerability effect). Results from self-report data were corroborated by independent teacher reports.     

History of military service and the risk of suicidal ideation: findings from the 2008 national survey on drug use and health

Studies of completed suicide by history of military service have produced inconsistent findings; no representative population‐based study has compared the risk of nonfatal suicidal behavior among veterans with risk among nonveterans. The objective of this study was to examine whether male veterans of the U.S. military are at heightened risk of suicidal ideation, compared with males who never served in the U.S. military. A total of 17,641 adult men completed the 2008 National Survey on Drug Use and Health (NSDUH). Subjects provided information about history of ever having served in the U.S. armed forces, past suicidal ideation, alcohol and drug abuse and dependence, measures of psychological distress, and sociodemographic data. Overall, men who had ever served in the armed forces were no more likely than men who had never served to report having seriously considered suicide over the prior 12 months. Military status was not differentially associated with other known suicide risk factors assessed by NSDUH, including psychiatric disorders. Our findings suggest that evidence‐based suicide prevention strategies applicable to the general population should be employed to reduce suicide risk among the veteran population as well.