Reducing drug and alcohol use and improving well-being for Indigenous and non-Indigenous Australians using the Community Reinforcement Approach: A feasibility and acceptability study

There is a lack of evidence of effective and appropriate drug and alcohol treatment for Aboriginal and Torres Strait Islander peoples. This paper contributes to addressing the evidence gap by examining the feasibility and acceptability and conducting a pre/post-evaluation of the Aboriginal-adapted Community Reinforcement Approach (CRA) delivered in New South Wales, Australia. Aboriginal and non-Aboriginal clients (n = 55) received tailored CRA delivery between March and November 2013. Compared to the original US version, tailored CRA had reduced technical language, reduced number of treatment sessions, and the addition of group delivery option. An Australian training manual with local case studies was developed. Alcohol, Smoking and Substance Involvement Test (ASSIST), Kessler-5 (K-5) and the Growth Empowerment Measure were used. 58% of participants were followed-up at 3 months. Tailored CRA was feasible to deliver in a rural, community-based health setting, and rated by clients as highly effective and acceptable. CRA was associated with statistically significant reductions in the use of alcohol, tobacco, cannabis, amphetamine and over the counter medication, and levels of psychological distress, and an increase in levels of empowerment for Aboriginal and non-Aboriginal clients. This study provides evidence for the feasibility and acceptability of an Aboriginal-adapted psychological intervention addressing drug, alcohol and mental health outcomes.     

Social anxiety and problematic cannabis use: evaluating the moderating role of stress reactivity and perceived coping

Despite epidemiological reports indicating an association between social anxiety disorder (SAD) and cannabis use disorders (CUD), there is a paucity of research exploring the nature of this relationship. The present investigation examined potential moderators of this relationship that are consistent with a tension-reduction model of addiction. Specifically, physiological reactivity to stress and perceived coping with stress were evaluated as moderators of the relation between symptoms of SAD and CUD. Physiological (SCR) and subjective (perceived coping) responses to unpredictable white noise bursts were collected from non-clinical participants (n=123). Lifetime symptoms of CUD and anxiety disorders were assessed using a structured diagnostic interview. CUD symptomatology was associated with symptoms of SAD but not with symptoms of any other anxiety disorder. Only perceived coping to unpredictable stimuli moderated the relationship between SAD and CUD symptoms. Findings are discussed in the context of tension-reduction models of co-occurring social anxiety and problematic cannabis use.     

The relation of methamphetamine use and violence: A critical review

Methamphetamine (MA), a psychostimulant drug, was first produced in Germany and Japan in the late 1800s. MA use and trafficking have been a problem since the 1970s in the United States (U.S.) [National Drug Intelligence Center (NDIC). (2006). National Drug Threat Assessment 2006. Retrieved March 18, 2006 from http://www.usdoj.gov.ndic/pubs11/18862/MA.htm] and have increased in recent years [Office of Applied Studies (OAS). (September 16, 2005). The National Survey on Drug Use and Health report: Methamphetamine use, abuse, and dependence: 2002, 2003, and 2004. Rockville, MD: Substance Abuse and Mental Health Services Administration]. MA is associated with violent behavior yet the nature of this relation remains poorly understood, largely due to methodological shortcomings. The present paper critically examines the empirical literature on MA use and its relation to violence. Methodological issues and challenges are discussed and suggestions for future research are provided.     

Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention

A large and growing empirical literature reveals a robust relationship between alcohol use and the occurrence of intimate partner violence (IPV). However, the role of alcohol use and intoxication in episodes of IPV, particularly with respect to alcohol's potential causal or facilitative function in the occurrence of partner aggression, remains a source of much controversy and considerable debate. The purpose of this review is to (a) describe briefly IPV and the types of behaviors subsumed under this label, (b) examine evidence for the link between alcohol use and IPV, (c) explicate factors (e.g., antisocial personality disorder) that may moderate this relationship, and (d) discuss the primary conceptual models put forth to explain this association. Recommendations for interventions that consider the relationship between alcohol use and IPV are also provided.     

Social support, coping, life events, and posttraumatic stress symptoms among former peacekeepers: a prospective study

This study examined both cross-sectionally and longitudinally the relationship between social support, coping strategies, additional stressful life events, and symptoms of posttraumatic stress disorder (PTSD) among Dutch former peacekeeping soldiers. Two groups of peacekeepers were investigated: 311 peacekeepers who participated in the peacekeeping operation in Lebanon between 1979 and 1985, and 499 peacekeepers who were deployed after 1990. These peacekeepers completed a questionnaire in 1996 and again in 1998. The results show that more negative social contacts and fewer positive social contacts were associated with more PTSD symptom severity. More use of the coping strategies ‘wishful thinking’ and ‘accepting responsibility’ was related to more PTSD symptoms. Conversely, more planful problem solving and seeking social support was related to less PTSD symptom severity. In addition, a bilateral relationship was found between additional stressful life events and PTSD symptom severity. The results indicate that social support and coping strategies may be valuable aspects of prevention and intervention programs.     

Social anxiety,disengagement coping,and alcohol-use behaviors among adolescents

Background and Objectives: Although research indicates that social anxiety (SA) is associated with problematic drinking, few studies have examined these relations among adolescents, and all alcohol-related assessments have been retrospective. Socially anxious youth may be at risk to drink in an effort to manage negative affectivity, and a proclivity toward disengagement coping (e.g. avoidance of aversive stimuli) may enhance the desire to drink and learning of coping-related use. Design: Adding to research addressing adolescent SA and alcohol use, the current study examined (1) proportional drinking motives (subscale scores divided by the sum of all subscales), (2) current desire to drink in a socially relevant environment (introduction to research laboratory), and (3) the indirect effect of retrospectively reported disengagement in social stress contexts on proportional coping motives and desire to drink. Method: Participants were 70 community-recruited adolescents who reported recent alcohol use. Level of SA, disengagement coping, drinking motives, and desire to drink following laboratory introduction were assessed. Results: Proclivity toward disengagement in prior socially stressful contexts accounted for significant variance in the positive relations between SA and both proportional coping motives and current desire to drink. Conclusions: These data complement existing work. Continued efforts in building developmentally sensitive models of alcohol use are needed.     

Alcohol use and dating violence among college students

IntroductionNumerous studies have focused on the association of dating violence (DV) and alcohol use. However, little research has as yet assessed their co-occurrence in short timeframes.ObjectiveThis study aims to investigate alcohol use in the two hours preceding DV and in the two hours following DV.MethodCollege students (n = 649, 71% females, mean age = 19.8) reported their experience of DV and their hazardous drinking on self-administered questionnaires. They also reported their alcohol use in the two hours preceding – as well as following – a specific DV event (i.e. insult between dating partners).ResultsChi-square tests outline that alcohol use in the two hours preceding an insult is associated with alcohol use in the two hours following an insult. Regressions show that higher scores of hazardous drinking puts students at risk of insulting or being insulted in a context of alcohol use.ConclusionThe findings can contribute to DV prevention programs among college students.     

Personality traits as predictors of trauma-related coping self-efficacy: A three-wave prospective study

Aim of the present three-wave study was to examine to what extent personality traits and general self-efficacy measured before exposure to a potentially traumatic event (PTE) prospectively predict coping self-efficacy (CSE) perceptions, and to test whether outcomes are biased by the timing of assessment of personality traits. The study was conducted within a large probability-based multi-wave representative internet panel in the Netherlands (N^total = 1154).ResultsFindings for both personality assessments (2009, 2011) were similar. Among respondents with low levels of PTSD-symptomatology, higher levels of emotional stability and agreeableness were associated with higher levels of CSE, while among those with relatively high levels of PTSD-symptomatology emotional stability alone was independently predictive of CSE. After adding personality traits to the model, general self-efficacy, demographic and event-related variables were not predictive of CSE, with the exception of time since the event for the high-symptoms group.ConclusionsEmotional stability most strongly and systematically predicts CSE following PTE’s, regardless of the moment it was assessed. Agreeableness is only predictive of CSE among those with low levels of PTSD-symptomatology. Timing of assessment of personality did not influence results. In sum the personality traits emotional stability and agreeableness provide (limited) information on CSE levels among adults following PTE’s.     

Ways of coping with excessive drug use in the family: A provisional typology based on the accounts of 50 close relatives

This paper outlines an eight-fold typology of coping actions based upon a qualitative analysis of the accounts provided by 50 close relatives of people with drug problems. In a number of different ways relatives draw attention to the contrasts between these distinguishable ways of coping. Emphasis is placed upon the provisional nature of this typology and upon the compromises between, and combinations of, ways of coping that are often used by relatives in practice. Different ways of coping represent alternative choices for relatives, often explicitly expressed by them as difficult dilemmas. Links are suggested between the ways of coping identified here and those discussed in the literature on coping with other disorders and disabilities in the family, with ways of coping described in the general literature on coping with stress, and with types of social action appearing in general models of interpersonal behaviour. Implications for counselling close relatives of people with drug problems are also outlined.     

The Effects of Cumulative Risks and Promotive Factors on Urban Adolescent Alcohol and Other Drug Use: A Longitudinal Study of Resiliency

Resiliency theory provides a conceptual framework for studying why some youth exposed to risk factors do not develop the negative behaviors they predict. The purpose of this study was to test compensatory and protective models of resiliency in a longitudinal sample of urban adolescents (80% African American). The data were from Years 1 (9th grade) and 4 (12th grade). The study examined effects of cumulative risk and promotive factors on adolescent polydrug use including alcohol, tobacco and marijuana. Cumulative measures of risk/promotive factors represented individual characteristics, peer influence, and parental/familial influences. After controlling for demographics, results of multiple regression of polydrug use support the compensatory model of resiliency both cross-sectionally and longitudinally. Promotive factors were also found to have compensatory effects on change in adolescent polydrug use. The protective model of resiliency evidenced cross-sectionally was not supported in longitudinal analysis. The findings support resiliency theory and the use of cumulative risk/promotive measures in resiliency research. Implications focused on utilizing multiple assets and resources in prevention programming are discussed.     

Evidence for a curvilinear dose-response relationship between avoidance coping and drug use problems among women who experience intimate partner violence

Women who experience intimate partner violence (IPV) are at heightened risk for drug use problems. While prevailing models of drug use suggest that IPV-exposed women use drugs in an effort to escape or avoid negative affect, a dearth of literature has examined the role of avoidance coping in drug use problems within this population. Given recent suggestions that flexible, situationally appropriate use of avoidance coping may be adaptive, particularly when confronted with highly stressful situations, we hypothesized that avoidance coping and drug use problems would demonstrate a curvilinear, U-shaped dose-response relationship. Participants were 147 community-recruited women experiencing IPV. Consistent with our hypotheses, moderate levels of avoidance coping were associated with lower levels of drug use problems, whereas high and low levels of avoidance coping were associated with higher levels of drug use problems. Findings highlight the complex relationship between avoidance coping and drug use problems and suggest that avoidance coping, when used in moderation, may be an adaptive strategy for coping with relational conflict among women who experience IPV.     

The association between religiosity and alcohol use: the mediating role of meaning in life and media exposure

We examined whether meaning in life and exposure to media mediate the association between religiosity and alcohol use among members of the Jewish-orthodox community in Israel. One hundred and ten young adult men self-identified as orthodox (n?=?57) or secular (n?=?53) participated in the study. Participants completed self-report measures designed to assess meaning in life, media exposure, alcohol use, and craving. Our findings show that orthodox participants consumed less alcohol and reported less alcohol craving compared to their secular counterparts. Importantly, search for meaning in life and media exposure mediated the relationship between religiosity and alcohol craving. Our findings suggest that religion provides a sense of meaning that serves as a protective factor against alcohol craving, supporting existential theories. Furthermore, our studies show that practices that are associated with a religious lifestyle such as low exposure to mass media also serve as protective factors for alcohol use and craving.     

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.     

A path analysis of stress appraisals, emotions, coping, and performance satisfaction among athletes

Objectives

In this study we examined athletes’ stress appraisals, emotions, coping, and performance satisfaction ratings using a path analysis model. This is the first study to explore all of these constructs in a single study and provides a more holistic examination of the overall stressful experience that athletes encounter.

Design

Cross-sectional.

Methods

Participants were 557 athletes, aged between 18 and 64 years (M age = 22.28 years, SD = 5.72), who completed a pre-competition measure of stress appraisals and emotions. Participants also completed a coping questionnaire and a subjective performance measure after competing, with regards to how they coped during competition and how satisfied they were with their performance.

Results

Path analysis revealed that appraisals of uncontrollable-by-self, stressfulness, and centrality were positively associated with the relational meaning threat appraisals. Threat appraisals were associated with unpleasant emotions, prior to competition, and pre-ceded distraction- and disengagement-oriented coping. The pre-competition appraisals of controllable-by-self, centrality, controllable-by-others, and stressfulness were associated with challenge relational meanings, which in turn were linked to task-oriented coping during competition. Task-oriented coping was positively related to superior subjective performance.

Conclusions

Our findings support the notion that stress appraisals, emotions, and coping are highly related constructs that are also associated with performance satisfaction.     

Prevalence and correlates of substance use among school children in six African countries

An increasing trend of noncommunicable diseases is a worldwide phenomenon, also including the developing countries. Few studies focus on adolescents' substance use in relation to mental distress and protective factors in African countries. The purpose of this study was to assess the prevalence and correlates (mental distress and protective factors) of substance use among school-going adolescents in six African countries. The sample included 20,765 students aged from 13 to 15 years from six African countries (Kenya, Namibia, Swaziland, Uganda, Zambia, Zimbabwe), chosen by a two-stage cluster sample design to represent all students in grades 6, 7, 8, 9, and 10 in each country. The measure used was part of the Global School-Based Health Survey (GSHS) questionnaire, including various domains of health behaviour. Results indicate a prevalence of 12.6% tobacco use (past month), 6.6% risky alcohol use (two or more per day for at least 20 days or more in the past month), and 10.5% of illicit drug use (three or more times ever) in school-going adolescents in six African countries. School truancy, loneliness, sleeping problems, sadness, suicidal ideation, suicide plans, and poverty were associated with substance use (tobacco, alcohol, illicit drugs), while school attendance and parental supervision and connectedness were protective factors for substance use, and peer support protective for tobacco use. It is concluded that tobacco use, risky drinking and illicit drug use were common, clustered together and were associated with school truancy, mental distress, and lack of parental and peer support among adolescent African school children. These findings stress the need for early and integrated prevention programmes.     

Posttraumatic stress severity is associated with coping motives for alcohol use among in-patient and community recruited adolescents

Background and Objectives: A growing body of work suggests individuals with more severe post-traumatic stress symptoms (PTSS) are at higher risk for developing problematic alcohol use outcomes. Extending work from the adult literature, the present study was the first to examine the extent to which PTSS is related to drinking motives for alcohol use in both clinical and non-clinical samples of adolescents.

Design: Hierarchical regression analyses were used to predict coping motives for alcohol use from PTSS, above and beyond demographic variables, alcohol use frequency, and other alcohol use motives.

Methods: Trauma-exposed adolescents before entering treatment (Sample 1 n?=?41) and recruited from the local community (Sample 2 n?=?55) self-reported on PTSS and alcohol use motives.

Results: PTSS positively predicted coping motives for alcohol use after controlling for age, gender, and alcohol use frequency.

Conclusions: The current study highlights the need to consider both PTSS severity, as well as underlying cognitive mechanisms (e.g., motives), to better understand the etiology of problematic alcohol use among trauma-exposed youth. Future work focused on clarifying the trajectory of alcohol use motives and problems as a function of PTSS is needed.     

Exercise based interventions for alcohol use disorder: A comment on motivational aspects of participation

Exercise based treatment for alcohol use disorders have shown an impact on mental health (e.g., depression or anxiety), and alcohol outcomes (e.g., craving or abstinence). However, there is a lack of information on the role of motivational aspects of participation in the process of designing exercise interventions for alcohol use disorder. This study aims to examine: (1) whether motivational aspects are taken into account when the type and delivery method of exercise interventions are chosen; (2) whether motivational aspects are taken into account post intervention; and (3) whether there are different traditions regarding payment for participants. A systematic search was conducted to identify eligible studies in order to investigate the impact of motivational aspects including payment for participation. Twelve samples including ten to 620 participants were investigated. Participants were predominantly male and in their 40s, ranging from 20 to 69 years. Aerobic exercise (running, walking, fitness) either in a group or individual condition is the most frequently used exercise form. Two studies included ball games or cycling, while only one study offered the opportunity to choose between a wide range of sports. Motivational aspects are mentioned explicitly in half of the studies, mostly with regard to adherence to participation and social integration as the reason for using a group condition. Achievement is mentioned in two studies but not explicitly with regard to planning the intervention design. Five studies include payment for participation in exercise. Findings of the present study identify that motivational aspects for participation are rarely involved in the planning of an exercise intervention. With regard to the specific psychosocial vulnerability of an alcohol use disorder population, this should be an important aspect of further research studies.     

Cessation of alcohol and drug use among adolescents: A social learning model

This investigation tests the ability of Akers’ (1977) social learning theory of deviance to account for the cessation of alcohol or drug use among adolescents. For each of five substances, two‐group discriminant function analyses showed that social learning variables were successful in discriminating adolescents who ceased using from their counterparts who continued to use. Peer associations were generally most discriminating with normative definitions and social rewards or punishments also contributing to differentiation. Positive or negative effects of the substances as well as imitation bore little relationship to cessation. Social learning theory was as explanatory for stronger drugs as it was for alcohol and marijuana. Policy and program implications are suggested.