Comorbidity of substance dependence and depression: role of life stress and self-efficacy in sustaining abstinence.

The authors examined life stress and self-efficacy as predictors of time to relapse for 113 adults with comorbid major depressive disorder and alcohol and/or substance dependence in a randomized clinical trial comparing 2 psychotherapy interventions (integrated cognitive- behavioral therapy and 12-step facilitation therapy). Life stress, self-efficacy, and substance use were assessed at treatment entry, 12 weeks (mid-treatment), and 24 weeks (end of treatment). Time to relapse was defined as the number of days from treatment initiation until first alcohol and/or drug use. Half of the sample relapsed within the study period of 24 weeks. There was no significant difference between treatment groups. Individuals experiencing life stressors were more likely to relapse early than those not experiencing life stressors. Lower self-efficacy also predicted earlier relapse. Chronic stress levels and self-efficacy were stable across time for most individuals. In contrast, acute stress events occurred at differing times, and survival analyses provided evidence of heightened relapse risk in the month following acute stressors. The interaction of self-efficacy and life stress was not significant. The results highlight the significance of life stress and self-efficacy as predictors of early relapse.     

The impact of self-efficacy and implementation intentions-based interventions on fruit and vegetable intake among adults

This study tested the effect of interventions designed for people who do not eat yet the recommended daily fruit and vegetable intake (FVI) but have a positive intention to do so. Adults (N?=?163) aged 20–65 were randomised into four groups: implementation intentions (II group), self-efficacy (SE group), combination of II?+?SE group) and a control group receiving written information on nutrition. Study variables were measured at baseline, post-intervention and at 3-month follow-up. At follow-up, compared to the control group, FVI increased significantly in the II and II?+?SE groups (1.5 and 1.9 servings per day, respectively). Most psychosocial variables significantly increased compared to the control group, with the exception of SE for vegetable intake (VI). Moreover, at 3-month follow-up, change in FVI was mediated by changes in fruit intake (FI) intention and VI action planning. In conclusion, II interventions were efficient to increase FVI, with or without consideration for the development of SE. Thus, future studies should favour the adoption of this approach to bridge the intention–behaviour gap for FVI.     

The impact of self-efficacy and implementation intentions-based interventions on fruit and vegetable intake among adults

This study tested the effect of interventions designed for people who do not eat yet the recommended daily fruit and vegetable intake (FVI) but have a positive intention to do so. Adults (N?=?163) aged 20-65 were randomised into four groups: implementation intentions (II group), self-efficacy (SE group), combination of II?+?SE group) and a control group receiving written information on nutrition. Study variables were measured at baseline, post-intervention and at 3-month follow-up. At follow-up, compared to the control group, FVI increased significantly in the II and II?+?SE groups (1.5 and 1.9 servings per day, respectively). Most psychosocial variables significantly increased compared to the control group, with the exception of SE for vegetable intake (VI). Moreover, at 3-month follow-up, change in FVI was mediated by changes in fruit intake (FI) intention and VI action planning. In conclusion, II interventions were efficient to increase FVI, with or without consideration for the development of SE. Thus, future studies should favour the adoption of this approach to bridge the intention-behaviour gap for FVI.     

The impact of continuing care adherence on environmental risks, substance use, and substance-related problems following adolescent residential treatment.

The effectiveness of adolescent treatment to reduce substance use has been demonstrated by a number of different literature reviews, yet longer term outcome studies have suggested that continued alcohol and other drug use is common. Participation in continuing care services and reductions in environmental risk factors (e.g., peer substance use or alcohol or drug use in the home) have both been found to be associated with improved posttreatment substance use. The authors conducted Path analysis to examine the experimental direct effect of the Assertive Continuing Care Protocol (S. H. Godley, M. D. Godley, & M. L. Dennis, 2001) on general continuing care adherence following residential treatment and the protocol's indirect effect (via general continuing care adherence) on social and environmental risk factors, as well as subsequent substance use and substance-related problems. Supporting previous findings, the final model indicates that greater adherence to continuing care is associated with reductions in environmental risk, which in turn is associated with reduced adolescent substance use and substance-related problems 9 months after discharge from residential treatment.     

Negotiator confidence: The impact of self-efficacy on tactics and outcomes

In a series of four studies, we examined whether and how negotiators’ task-related self-efficacy affects their performance. In the first two studies, we identified two theoretically meaningful self-efficacy constructs—distributive self-efficacy (DSE) and integrative self-efficacy (ISE)—and provided evidence of construct validity. In the third study, task-congruent self-efficacy was positively associated with negotiators’ self-reports of tactical decision-making. In the fourth study, we measured negotiators’ tactics and found that ISE and DSE affected negotiators’ initial choice of tactics. We conclude that ISE and DSE predisposes negotiators to select certain tactics, which then guide the course of the negotiation, and, ultimately, affect the quality of deals.     

The impact of posttraumatic growth,transformational leadership,and self-efficacy on PTSD and depression symptom severity among combat Veterans

Previous research has established self-efficacy as essential to postdeployment adjustment among Veterans, and perceived transformational leadership is well known for its positive effects on follower outcomes across contexts. However, little is known regarding how transformational leadership may relate to posttraumatic growth and self-efficacy in fostering psychological wellbeing among combat Veterans. The purpose of this study was to examine the role of transformational leadership in predicting posttraumatic stress disorder (PTSD) and depression symptoms among combat Veterans, as well as how posttraumatic growth and postdeployment coping self-efficacy may influence these relations. The study sample consisted of 130 combat Veterans recruited from a university, Veterans Affairs medical center, and the greater community. Path analysis based on bootstrapped resampling revealed postdeployment coping self-efficacy and perceived transformational leadership as predictors of lower PTSD and depression symptom severity. In addition, mediation modeling revealed that postdeployment coping self-efficacy mediated the relation between transformational leadership and both PTSD and depression, while posttraumatic growth did not predict PTSD symptoms. These findings may aid in the prediction of PTSD and depression symptoms among Veterans, which may then influence pre-deployment leadership training among military personnel as well as clinical treatment protocols for Veterans.     

The association between heroin use and anxiety sensitivity among inner-city individuals in residential drug use treatment

The current study represents an initial investigation of the association between heroin use and anxiety sensitivity (AS). Within a sample of 172 inner-city treatment seeking drug users, AS was compared across past year (1) heroin users with no crack/cocaine use (n=12); (2) crack/cocaine users with no heroin use (n=66); (3) users of both heroin and crack/cocaine (n=45); and (4) individuals with no use of heroin or crack/cocaine (n=49). Consistent with expectations, primary heroin users evidenced higher levels of AS than all other groups, with these differences also evidenced for the physical and social subscales. Differences in AS total score and physical subscale score persisted after controlling for demographic variables, depressive symptoms, and primary use of drugs other than heroin and crack/cocaine including alcohol, nicotine, marijuana, and hallucinogens. Findings suggest a unique relationship between AS and heroin, and set the stage for future work explicating the direction of the observed association.     

The influence of self-efficacy on alcohol use among American Indians

The influence of self-efficacy (general and substance use) on alcohol use among 114 American Indian and Native Alaskan adults was examined. Analysis of variance was performed to assess differences between alcohol use groups (nonuse, low use, and medium-high use). Low general self-efficacy (GSE) was associated with higher alcohol use. High substance use self-efficacy (SSE) was associated with higher alcohol use. Moreover, low GSE was associated with higher SSE. Results indicate that alcohol use may be in response to feelings of powerlessness within one's life and may be sustained by perceived feelings of control over use. The study suggests that the concept of self-efficacy appears to relate to empowerment issues and, as such, would have important applications for use with minority individuals.     

Anxiety sensitivity: a unique predictor of dropout among inner-city heroin and crack/cocaine users in residential substance use treatment

The present study examined the extent to which anxiety sensitivity (AS) at treatment entry was related to prospective treatment dropout among 182 crack/cocaine and/or heroin-dependent patients in a substance use residential treatment facility in Northeast Washington, DC. Results indicated that AS incrementally and prospectively predicted treatment dropout after controlling for the variance accounted for by demographics and other drug use variables, legal obligation to treatment (i.e., court-ordered vs. self-referred), alcohol use frequency, and depressive symptoms. Findings are discussed in relation to the role of AS in treatment dropout and substance use problems more generally.     

The impact of religious behaviours on the health and well-being of emerging adults

Emerging adulthood is a life stage in which the frequency of religious behaviours often wanes while the risk of mental illness, substance abuse, and risky sexual behaviour increases. The current study explores the role that religious behaviours might play in mitigating these risks among college-attending emerging adults. Survey data were collected on religious service attendance, prayer and meditation, substance use, sexual activity, and life satisfaction. Results revealed a significant effect for religious service attendance on substance use and sexual behaviour and for the frequency of prayer/meditation on life satisfaction, marijuana use, and sexual intercourse. Group comparisons revealed that emerging adults who participated in religious activities reported lower rates of substance use, less sexual behaviour, and greater satisfaction with life. Limitations and suggestions for future research are discussed.     

Identifying two potential mechanisms for changes in alcohol use among college-attending and non-college-attending emerging adults

This study tested whether pro-alcohol peer influences and prosocial involvement account for increases in drinking during the transition into emerging adulthood and whether these mechanisms differ depending on college attendance and/or moving away from home. The authors used structural equation modeling of prospective data from 825 young men and women. For 4 groups defined by college and residential status, more drinking in the spring of 12th grade predicted more pro-alcohol peer influences the following fall, and more pro-alcohol peer influences in the fall predicted increases in drinking the following spring. Going to college while living at home was a protective factor against increases in drinking and selection of pro-alcohol peer involvements. Prosocial involvement (measured by involvement in religious activities and volunteer work) was not significantly related to post-high school drinking except among college students living away from home. Prevention efforts should focus on (a) reducing opportunities for heavy drinking for college and noncollege emerging adults as they leave home and (b) increasing prosocial involvement among college students not living at home.     

Temperamental and environmental risk factors for borderline personality disorder among inner-city substance users in residential treatment

Borderline Personality Disorder (BPD) is widely considered the result of biological vulnerability and environmental adversity. Despite growing evidence for the role of several temperamental and environmental risk factors in the development of BPD, the unique contribution of each to the development of this disorder remains unclear. Furthermore, the extent to which these factors are associated with BPD among underserved and diverse populations is unknown. The current study examined the temperamental and environmental factors uniquely associated with BPD among a sample of 93 inner-city individuals receiving residential substance use treatment. Results indicate that BPD was associated with higher impulsivity and emotional instability/vulnerability, lower well-being, and several interpersonal manifestations of positive and negative temperament (i.e., greater alienation and lower achievement and social closeness). BPD was also associated with several forms of childhood maltreatment, including emotional and physical abuse and neglect. However, only emotional instability or vulnerability, impulsivity, and emotional abuse emerged as unique predictors of BPD status.     

The impact of supervisory mentoring on personal learning and career outcomes: The dual moderating effect of self-efficacy

Using survey data from 226 employees and their supervisors in four manufacturing companies in China, we found that employee self-efficacy has a dual moderating effect on the impact of supervisory mentoring on subordinate career outcomes. Path analytic tests of mediated moderation suggested that self-efficacy moderates the mediated effects of supervisory mentoring on job performance and career satisfaction through personal learning such that the mediated effect on job performance is stronger when employees have higher self-efficacy, but the mediated effect on career satisfaction is stronger when they have lower self-efficacy.     

The relationship between self-efficacy and depression in adolescents

This study examined the self-efficacy status of depressed versus nondepressed adolescents. As predicted, self-efficacy was negatively correlated with depression. A three-way interaction of Sex x Age x Level of Depression suggested separate analyses for males and females. Regression analysis revealed age-related changes in the dependence of depression scores on general, academic, physical and social self-efficacy status. It was concluded that self-efficacy has an important relationship with adolescent depression. The implications of these findings are discussed.     

Effects of homophobic name‐calling and verbal sexual harassment on substance use among young adults

Verbal aggression victimization, such as homophobic name‐calling, has been linked to heavier substance use among young people, but little longitudinal research has examined how different types of victimization may affect substance use or whether certain psychosocial factors moderate these risks. In a diverse cohort (N = 2,663), latent transition analysis was used to model heterogeneity in victimization (age 19) and substance use (age 20). Four victimization (high victimization, homophobic name‐calling only, verbal sexual harassment only, and low victimization) and three substance use (poly‐substance use, alcohol, and cannabis only, low all) classes were identified. The high victimization and homophobic name‐calling only classes had the highest probabilities of transitioning into the poly‐substance use class, and the high victimization class had the highest probability of transitioning into the alcohol and cannabis only class. The probability of transitioning into the low all substance use class was highest in the low victimization class and lowest in the high victimization class. For the high victimization class, greater depressive symptoms increased the odds, and better peer relationship quality decreased the odds, of transitioning into the poly‐substance use and alcohol and cannabis only classes. For the homophobic name‐calling only class, greater depressive symptoms increased the odds of transitioning into the poly‐substance use class. Homophobic name‐calling, alone or in combination with verbal sexual harassment, is a risk factor for escalating substance use in young adulthood, especially among victims with depressive symptoms.     

Effects of diversion on adults with co-occurring mental illness and substance use: outcomes from a national multi-site study

This quasi-experimental non-equivalent comparison group study examines outcomes for participants in eight programs conducting criminal justice diversion for people with co-occurring serious mental illness and substance use disorders compared with jail detainees eligible for diversion, but who were processed through standard criminal justice methods without diversion. Nearly 2000 participants were interviewed at baseline, and 1500 at 3 month and 1300 at 12 month follow-up to baseline. In these interviews, outcome measures of re-arrest, mental health functioning, substance abuse, quality of life, and service utilization were obtained. Those diverted were more likely to have received mental health counseling, mental health medication, and mental health hospitalization than those not enrolled in a diversion program, but were equally likely to have received substance abuse counseling. Overall, the differences in proportions receiving services between the two groups were small, even when these differences were statistically significant. The effect associated with diversion differed somewhat across the individual sites. However, overall cross-site pooled analyses revealed no outcome differences between groups on measures of mental health symptoms, substance use, criminal justice recidivism, or quality of life. Although the immediate benefit of diversion as an access mechanism to community treatment is indicated in pooled cross-site results, such access was driven by more coercive (pre-booking and court) models and results suggest that effecting substantially greater access to services or services use did not occur. The findings also suggest that mental health, substance abuse, and criminal justice outcomes remain dependent on the treatment intervention received, perhaps moderated by type of diversion intervention, rather than on a generic and initial diversion event.     

Racial identification, racial discrimination, and substance use vulnerability among African American young adults

Two studies examined racial identity (RI) as a protective factor against substance use cognitions among African American young adults who either envisioned or experienced racial discrimination. In Study 1, participants envisioned a discrimination or nondiscrimination scenario, and then their willingness to use drugs and an indirect measure of substance use were assessed. Discrimination was associated with higher levels of use cognitions among participants with low levels of RI. In Study 2, participants were excluded or included in an online game (Cyberball) by White peers and then engaged in an RI-affirmation or control writing task. Participants attributed this exclusion to racial discrimination. Excluded participants who did not affirm their RI reported the highest levels of substance use cognitions, especially if they had engaged in higher levels of previous substance use. These findings highlight the importance of RI among Black young adults and the impact of discrimination on health behaviors.     

A test of the relations between avoidance of panic-related situations and substance use, substance dependence, and depression among subclinical panickers

The hypotheses that among subclinical panickers, avoidance of panic-related situations would be associated with elevated substance use levels and increased likelihood of lifetime diagnoses of substance dependence and major depressive disorder (MDD) were tested. Findings confirmed that panic-related avoidance was associated with an elevated likelihood of lifetime diagnoses of nicotine and alcohol dependence as well as MDD, but not drug dependence. Panic avoidance was also related to relatively greater daily levels of cigarette and alcohol use.     

Experimental evaluation of self-efficacy treatment on technical/scientific career outcomes

A technology education programme designed to provide mastery experiences described in self-efficacy theory and predicted to improve career decision-making was evaluated. Seventh- and eighth-grade students (N = 169) were stratified by grade level and randomly assigned either to a published technology education programme or to control curricula. Over a 7-week period, the experimental programme attempted to foster exploration and performance accomplishments in the students' choice of three (out of 21 possible) technical and scientific careers. Pre- and post-test instruments assessed technical/scientific self-efficacy and career interest. No treatment effects were found. However, an experimental demand measure showed greater valuing of the technology education programme. Implications and suggested improvements to the treatment are discussed.