Adolescent alcohol and substance abuse: parent and peer effects

There has been considerable research into the effects of peer and parent drug usage on substance abuse by the adolescent. A correlation has been shown to exist between parent usage and increased adolescent substance usage. The parental attitude toward illicit substance use has been positively correlated with adolescent substance use. Once the adolescent starts using illicit drugs, the influence of parents decreases, and the peer influence increases. The research provides further support to Kandel's theory of stages of substance use. In addition, it provides support to the theory that adolescent substance usage is learned, in part, by modeling and imitation. The results are not as conclusive in predicting personality characteristics of the adolescent and parental influence that predate adolescent substance abuse.     

Factors affecting agreement between severely mentally ill alcohol abusers' and collaterals' reports of alcohol and other substance abuse.

This study examined subject-collateral reports of alcohol use among a sample of 167 dually diagnosed individuals seeking outpatient treatment at a community mental health clinic. All subjects met Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for a schizophrenia-spectrum or bipolar disorder and for alcohol abuse or dependence. Subjects were recruited within 2 weeks of treatment entry and completed measures of cognitive functioning, alcohol dependence severity, psychiatric symptoms, and quantity and frequency of substance use over the previous 60 days using the Timeline Follow-Back interview (L. C. Sobell & M. B. Sobell, 1996). They also provided a urine sample, which was screened for recent drug use. Collateral interviews were conducted by phone and included an assessment of the subject's alcohol and drug use over the same 60-day period. Collaterals also reported their confidence in the accuracy of their reports. Overall, the results indicated generally poor subject-collateral agreement. However, subject-collateral agreement appeared better for those individuals (n = 97) with negative urine drug screens. The most consistent predictor of subject-collateral discrepancy scores was subjects' recent drug use. Recommendations for enhancing the validity of self-reports of substance use in a severely mentally ill population are discussed.     

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.     

Psychometric, diurnal, and electrophysiological correlates of activation.

Several studies were performed using Thayer's Activation-Deactivation Adjective Check List (AD-ACL). Factor analysis of college students' scores identified a single activation factor representing a continuum ranging from sleep through wakefulness. Next, changes over the diurnal cycle in activation factor scores were demonstrated. One-week test-retest reliability was also investigated. Finally, activation scores were related to pulse rate, respiration rate, and skin resistance level under passive and active conditions. Correlations between factor scores and electrophysiological measures were higher than were intercorrelations of electrophysiological measures, indicating that scores on this revised activation factor represent a valid measure of phenomenological bodily activation level.     

Selective attentional delays and attentional capture among simultaneous visual onset elements

Visual discrimination and detection responses to a single stimulus presented simultaneously with noise stimuli are slower and less accurate than are responses to a single stimulus presented alone. This occurs even though the location of the relevant stimulus (target) is known or visually indicated with stimuli onset. Results showed that noise elements delay focal attending and processing of a target. Furthermore, precuing the target location reduces, and can eliminate, target processing delays. Processing delays were not due to response competition or to random attentional capture by noise. It is suggested that simultaneous stimuli are perceived initially as a single object, and delays in processing a single stimulus are due to difficulties in perceptually segregating this stimulus from noise. Precuing is assumed to facilitate this segregation process.     

Object onset and parvocellular guidance of attentional allocation

The parvocellular visual pathway in the primate brain is known to be involved with the processing of color. However, a subject of debate is whether an abrupt change in color, conveyed via this pathway, is capable of automatically attracting attention. It has been shown that the appearance of new objects defined solely by color is indeed capable of modulating attention. However, given evidence suggesting that the visual system is particularly sensitive to new onsets, it is unclear to what extent such results reflect effects of color change per se, rather than effects of object onset. We assessed attentional capture by color change that occurred as a result of either new objects appearing or already-present "old" objects changing color. Results showed that although new object onsets accrued attention, changing the color of old objects did not. We conclude that abrupt color change per se is not sufficient to capture attention.     

Prediction of drug and alcohol abuse in hospitalized adolescents: comparisons by gender and substance type

The authors examined psychosocial correlates of drug and alcohol abuse in 462 hospitalized adolescents, and the extent to which these associations may be affected by gender or by substance type. Participants completed a battery of psychometrically-sound, self-report measures of psychological functioning, environmental stress, drug abuse, and alcohol abuse. Four multiple regression analyses were conducted to determine the joint and independent predictors of drug abuse and alcohol abuse, for males and for females. Multiple regression analysis revealed that seven variables--age, depression, impulsivity, low self-esteem, delinquent predisposition, low peer insecurity, and history of child abuse--jointly predicted both drug and alcohol abuse, for both males and females. However, several differences were found with respect to which variables made independent contributions to the predictive models--with only delinquent predisposition making a significant independent contribution for all four conditions. We found distinct patterns of psychosocial predictor variables for drug and alcohol abuse, as well as distinct patterns for males and females. These results may reflect differing risk factors for drug abuse and alcohol abuse in adolescent psychiatric patients--and differing risk factors for males and females. Such differences have potential implications for prevention and treatment.     

Psychometric and related deficits in preventive alcohol intervention programming.

The 1991 study by Collins and Cellucci ignores some important research principles needed for sound educational inquiry. Psychometric properties of evaluation instruments cannot be omitted from even field tests of small scale. Selected other omissions need review since other researchers may replicate such errors.     

A cross-validation of MMPI-2 substance abuse scales.

We evaluated the efficacy of the Addiction Potential Scale (APS) and the Addiction Acknowledgement Scale (AAS), two new scales designed to assess substance abuse problems with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), in samples from settings different from those used in their development. Results replicate earlier findings that both scales discriminate between psychiatric and substance abuse samples and do so more effectively than other substance abuse scales designed for use with the MMPI and carried over to the MMPI-2. Results also suggest that APS may be more resistant than AAS to response distortion.     

Prevention education and substance abuse treatment

Relapse prevention is influenced by a number of variables including stress and negative mood states, motivation and commitment to abstinence, social support, physiological factors, withdrawal symptoms, and a repertoire of cognitive and behavioral strategies utilized in responding to the relapse process. Diverse theoretical approaches have emphasized conditioning models as well as information processing, cognitive and affective components of treatment, cognitive and behavioral coping responses, and a variety of other procedures. Outcome studies related to treatment have failed to consistently support the effectiveness of several of these components. To overcomes this, the authors advocate a single subject design in the study of these approaches. This article emphasizes the role of relapse prevention, and training and education in facilitating long-term abstinence, particularly with those intervention methods that are based on social learning theory and cognitive-behavioral models.     

Protection and vulnerability processes relevant for early onset of substance use: a test among African American children.

This research tested predictions from a self-regulation model of factors relevant for early onset of tobacco and alcohol use with a community sample of 889 African American children (mean age = 10.5 years). Criterion variables were peer substance use, willingness to use substances, and resistance efficacy (intention to refuse substance offers). Structural modeling indicated effects of temperament dimensions were mediated through self-control and risk-taking constructs, which were related to school involvement, life events, and perceived vulnerability to harmful effects of substances. Peer use was predicted by life events, poor self-control, and parent-child conflict; willingness was predicted by life events, risk taking, and (inversely) parental support; and resistance efficacy was predicted by perceived vulnerability and (inversely) poor self-control. Findings are discussed with reference to theoretical models of early protection and vulnerability processes.     

Psychometric properties and correlates of three computer aversion scales

Investigators have employed a variety of constructs and measures to examine individuals’ discomfort with computer use. Models and instruments for measuring constructs such as computer anxiety, computer phobia, and computer aversion have been employed to investigate negative reactions that slow individuals’ acceptance and useful application of computers. Using a large college student sample, we sought to compare the psychometric properties of three computer aversion scales and to investigate their relationships to gender, age, cognitive abilities, and experience with computer use. The results indicated good reliability, good validity coefficients, and similar factor structures for the scales. Younger students, female students, and students with lower mathematical skills and less computer experience were more likely to experience discomfort with computers. Implications include the possibility that if software and hardware alter subjects’ expectations about the difficulty of completing tasks, individual differences in computer aversion are likely to become a source of additional unexplained variance. Such differences must be heeded in software design and in the design of experimental research involving computers as stimulus controllers and response recorders.     

Maternal employment and early adolescent substance use.

Research stimulated by increases in maternal employment has focused primarily on children, even though mothers of adolescents are more likely to be employed. It is adolescents who experience developmental changes that promote participation in adult behaviors in advance of their abilities. This study investigated the effects of maternal employment on the use of alcohol, cigarettes, marijuana, and other substances by early adolescents. A sample of ninth-grade students responded to a 48-item survey about their substance use behavior. A comparison of maternal employment patterns (full-time vs. part-time/not employed outside the home) indicated no significant differences in substance use behavior. These results confirmed and extended the growing literature regarding the nonharmful effects of maternal employment on adolescent adjustment and behavior.     

Treatment of co-occurring child maltreatment and substance abuse

Despite high prevalence and severe negative consequences of child maltreatment (e.g., Brown, G. R., & Anderson, B., (1991). Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 148, 55–61; Jaudes, P. K., Ekwo, E., & Van Voorhis, J.V., (1995). Association of drug abuse and child abuse. Child Abuse and Neglect, 19, 1065–1075; Murphy, J. M., Jellinek, M., Quinn, D., Smith, G., & Goshkom, M., (1991). Substance abuse and serious child mistreatment: Prevalence, risk, and outcome in a court sample. Child Abuse and Neglect, 15, 197—211), the treatment of perpetrators and victims of child abuse and neglect remains grossly understudied (Behl, L. E., Conyngham, H. A., & May, P. F., (2003). Trends in child maltreatment literature. Child Abuse and Neglect, 27, 215–229). More than half of parentes founded for the abuse and neglect of their children have evidenced drug abuse, yet no treatments have been validated that concurrently address these problems. The reciprocal interaction between substance abuse and child maltreatment supports the need to concurrently treat these problems. This article illustrates the relationship between child maltreatment and parental substance abuse and proposes a behavioral model to explain the reciprocal influence of drug abuse and child maltreatment. A behavioral treatment plan that is designed to concurrently address drug abuse and child abuse is proposed and suggestions are made for future directions in this area.     

Distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility

A large percentage of individuals who enter residential substance abuse treatment drop out before completing treatment. Given that early treatment dropout places individuals at an increased risk for relapse, identifying the mechanisms underlying treatment dropout would have several important theoretical and clinical implications. In the current study, the authors examined levels of psychological and physical distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. In a sample of 122 individuals entering a residential substance abuse treatment facility, level of psychological distress tolerance was predictive of early treatment dropout above and beyond relevant self-report variables. There was no relationship between physical distress tolerance and early treatment dropout. Implications for future studies and treatment development or modification are discussed.     

Substance abuse in borderline personality disorder: clinical and etiological correlates.

This work examines differences between female borderline patients with and without substance abuse problems and between borderline patients from different treatment settings. A total of 64 female borderline patients were recruited from mental health services (n = 34) and addiction treatment services (n = 20); 35 had a substance abuse problem. Patient groups were compared with regard to both clinical and etiological factors using multivariate analysis of variance for 47 continuous variables and logistic regression for 15 dichotomous variables. Borderline patients with substance abuse problems reported less hostility, suspicion, and anger but more anxiety, insufficiency, and suicide attempts. Patients from addiction treatment services reported less avoidant and more antisocial behavior. The differences between borderline patients with and without substance abuse problems are limited in number and size. Therefore, there is no empirical justification for the exclusion of borderline patients with substance abuse problems from general treatment services or clinical trials.     

Cultural context and substance abuse in Hispanic adolescents

Much emphasis has been placed on the significant substance abuse problem being faced by Hispanic as well as other minority youth in the United States. However, little research has focused on the relative importance of culturally determined factors in the development of substance abuse in Hispanic youths. In this study, we propose an approach to measuring cultural factors through the activity orientations that youths endorse. We studied over 4000 Mexican-American and Mexican youths living along the U.S.-Mexico border with respect to their recent drug use, problem drug use, depressive symptomatology, and their activity orientation. While culturally related activity orientation does significantly increase risk for substance abuse, we found that symptoms of distress/depression and sociodemographic factors exerted a stronger effect on these youths.