The Relationship Between Perceptions of Neighborhood Characteristics and Substance Use Among Urban African American Adolescents

Although the neighborhood microsystem is recognized as an important domain for adolescent development, relative to the family and peer contexts, neighborhood factors have been understudied in relation to adolescent substance abuse. In addition, recent research suggests that risk factors for adolescent substance use may differ for African Americans when compared to Caucasian youth. This study investigated the association between perceived neighborhood disorganization and later substance use, as well as possible mediators of that association, among a community sample of urban African American adolescents. Perceptions of neighborhood disorganization (i.e., violence/safety and drug activity) in grade 7 were associated with increased tobacco, alcohol, and marijuana use in grade 9. For females, this association was mediated by attitudes about drug use and perceptions of drug harmfulness. Findings highlight the importance of neighborhood contextual variables for African American substance use. Implications and directions for future research are presented.     

The Structure of Problem and Positive Behavior Among American Indian Adolescents: Gender and Community Differences

Using Problem-Behavior Theory as a framework, the latent structure of problem and positive behaviors was examined within a sample of 1,894 American Indian adolescents. Support was found for a two-factor second-order structure in which problem behaviors (antisocial behavior, alcohol use, drug use, and risky sexual behavior) and positive behaviors (school success, cultural activities, competencies, and community-mindedness) represented two relatively uncorrelated aspects of behavior. Hierarchical multiple regressions demonstrated that the positive behaviors construct contributed significant incremental construct validity in the statistical prediction of psychosocial outcomes, over and above the problem behaviors. In addition, the fit of the structure was examined across gender and the four participating communities. The importance of the inclusion of positive behaviors is discussed from the standpoint of both prevention/promotion activities and the communities' perceptions. Further recommendations are made for deeper understandings of community concerns and strengths in conducting preventive/promotive research efforts.     

Urban American Indian Youth Spirituality and Religion: A Latent Class Analysis

This article explores the interconnected spiritual, religious, and cultural worlds of the majority of American Indian (AI) youth who live in urban areas: their patterns of involvement in religion and Native spirituality and associated well‐being. Latent class analysis of data from 205 AI middle school students identified five distinctive classes using survey measures of religious affiliation, attendance at services, adherence to Christian and traditional spiritual beliefs, Native spirituality, and Native cultural practices. Two classes were Christian groups: one attending Christian churches and following Christian beliefs but uninvolved with Native beliefs, spirituality, or cultural practices; and a nominal Christian group affiliated with but not attending church and unattached to belief systems. Two groups followed Native beliefs and spiritual practices, one affiliated with the Native American Church and another unaffiliated with any church. The fifth, nonreligious group, had no religious affiliation, followed neither Christian nor traditional beliefs, and was uninvolved in Native spirituality and cultural practices. The two groups embracing AI spirituality reported better academic performance, more reservation contact, higher AI enculturation, and stronger bicultural orientations.     

Psychological Trauma Among American Indian Families: A Two-Generation Study

The findings presented in this article come from a two-generation study exploring the psychological impact of trauma among American Indian/Alaskan Native (AI/AN) families and its perceived relationship to substance abuse across generations. Psychological traumas and stressors found to be pervasive across generations included physical and sexual abuse as well as persistent discrimination and racism, such as fear of having children removed from the home. A noteworthy finding was a decrease in reports of childhood traumas across the two generations within this sample. Implications and recommendations for clinicians and researchers working with AI populations are discussed in light of the findings.     

Mental Health Conditions and Substance Use Among American Indians From Eastern Tribes

This study examined the differences in mental health and substance use by gender and across education levels of 634 American Indians from 4 eastern tribes. Multivariate analysis of variance indicated that men self‐rated significantly better mental health but binge drank and used illicit drugs more often compared with women. Participants with a post–high school degree had significantly better mental health than those without a high school diploma. As education increased, cigarette smoking significantly decreased. Implications for culturally appropriate interventions are discussed. Este estudio examinó las diferencias en salud mental y abuso de sustancias entre distintos sexos y niveles de educación de 634 indios americanos de 4 tribus del este. El análisis multivariante de la varianza indicó que los hombres autoevaluaron su salud mental como significativamente mejor, pero consumían alcohol en exceso y usaban drogas ilícitas con más frecuencia que las mujeres. Los participantes con un grado superior a la enseñanza secundaria tenían una salud mental significativamente mejor que aquellos que no terminaron la enseñanza secundaria. A niveles educativos mayores, la incidencia de fumadores disminuyó significativamente. Se discuten implicaciones para intervenciones culturalmente apropiadas.     

Substance Use and Psychological Adjustment in Homeless Adolescents: A Test of Three Models

Three models of adolescent substance use, the deviance-prone, affect-regulation, and normative development models, were assessed regarding their ability to predict the substance use of a high-risk homeless adolescent sample with high rates of deviance, depression, and substance use. Hierarchical multiple regression analyses that included tests for curvilinear and gender interaction effects were performed. Results supported the deviance-prone model most strongly, with delinquency but not aggressive behavior predicting substance use. The affect-regulation model received support for females but not for males. With respect to the normative development model, results did not indicate that moderate substance users were better off than abstainers in terms of negative affect or interpersonal relationships.     

The Role of Parents and Peers in Early Adolescent Substance Use: An Examination of Mediating and Moderating Effects

We examined several models representing the relations among parenting practices, family structure, peer pressure, and drug use in a sample of 443 seventh graders. The setting was an urban school system serving a high percentage of African American students from low-income families. Analyses using structural equation modeling supported a mediation model in which both peer pressure and parenting practices had direct effects on drug use, with peer pressure mediating the influence of parenting. Within this model, family structure had a significant direct effect on parenting, however, contrary to hypotheses, children from two-parent families were more likely to report that they received adequate parenting than were children from single-parent extended families. Several gender differences were also found. Peer pressure was more highly related to drug use for girls than for boys, and the relation between parenting and peer pressure was stronger for boys. Examination of a model that included moderator effects revealed that the relation between peer pressure and drug use increased as a function of poor parenting. Results of our study underscore the importance of drug prevention efforts focused on parenting practices.     

Psychiatric Disorders Associated with Substance Use Among Children and Adolescents: Findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study

The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit substance use and substance use (SUD) and other psychiatric disorders were investigated among 1,285 randomly selected children and adolescents, aged 9 to 18, and their parents, from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Logistic regressions indicated that daily cigarette smoking, weekly alcohol consumption, and any illicit substance use in the past year were each independently associated with an elevated likelihood of diagnosis with SUD and other psychiatric disorders (anxiety, mood, or disruptive behavior disorders), controlling for sociodemographic characteristics (age, gender, ethnicity, family income). The associations between the use of specific substances and specific psychiatric disorders varied as a function of gender.     

The Structure of Negative Self-Statements in Children and Adolescents: A Confirmatory Factor-Analytic Approach

The aim of this study was to examine the nature and organization of a range of negative self-statements in children and adolescents, using a structural equations/confirmatory factor-analytic approach. A community sample of 978 children aged 7-16 years completed a questionnaire about the frequency with which they experienced a broad range of negative automatic thoughts. The outcome of comparative modeling provided strongest support for a model in which 4 distinct cognitive factors were all related to a single higher order factor. The 4 lower order factors related to cognitions on social threat, physical threat, personal failure, and hostility. The pattern of results was consistent across age and gender. Results were consistent with assumptions of cognitive specificity models of psychopathology, on the latent structure of automatic thoughts in children and adolescents.     

The Network Constellation of Personality and Substance Use: Evolution from Early to Late Adolescence

There is a well-established link between substance use and four personality traits of anxiety–sensitivity, hopelessness, impulsivity, and sensation-seeking. However, construct-level models of personality may conceal indicator-level personality–outcome associations. The current study aims to investigate evolution of the network constellation of personality and cannabis/alcohol use from early to late adolescence. Data comes from the longitudinal Co-Venture cohort (N = 3800). Personality indicators, measured by Substance Use Risk Profile Scale (SURPS) items, and the frequency of cannabis/alcohol use were assessed at four consecutive years (13–17 years old). Network constellations of the SURPS items and cannabis/alcohol use were estimated using Bayesian Gaussian graphical models at four time points. Results highlighted the age-specific associations between personality indicators and substance use. The positive role of the sensation-seeking trait (e.g. attitude towards transgression) was constant, whereas the positive role of hopelessness indicators (e.g. not being enthusiastic about future) and the negative role of anxiety–sensitivity indicators (e.g. fear of having unusual body sensations) were more prominent at early adolescence. The current study provides a novel perspective on the network structure of personality and substance use in adolescence and suggests substance-specific and age-adjusted targets in intervention efforts. © 2020 European Association of Personality Psychology     

The Initial Efficacy of Stand-Alone DBT Skills Training for Treating Impulsivity Among Individuals With Alcohol and Other Substance Use Disorders

Impulsivity is considered a core feature of substance use disorders (SUDs), including personological (i.e., negative urgency, positive urgency, lack of premeditation) and neuropsychological (i.e., cognitive and motor disinhibition, impulsive choice) dimensions. Dialectical Behavior Therapy Skills Training (DBT-ST) as a stand-alone treatment is an effective intervention for alcohol use disorder (AUD) and other SUDs. However, there are no studies that have investigated changes in impulsivity levels during a DBT-ST program, especially testing the therapeutic effects of DBT skills. Twenty-nine patients with AUD and other SUDs were admitted to a 3-month DBT-ST program. Self-report (i.e., UPPS-P) and computerized neuropsychological (i.e., Attentional Network test; Go/No-Go task; Iowa Gambling Task) measures of impulsivity were administered at the beginning and end of the DBT-ST. Distress tolerance (DTS), mindfulness (MAAS, FFMQ) and emotion regulation (DERS) were also assessed pre- and post-intervention. The study included two age- and gender-matched control groups: (a) untreated patients with SUDs (N = 29); (b) healthy controls (HCs) (N = 29). Twenty-four (82.7%) patients concluded the DBT-ST program. Emotion-based forms of impulsivity significantly improved during the program. At the end of treatment, impulsivity levels were significantly lower than those of untreated patients with SUDs and they were not significantly different from HCs. Cognitive disinhibition significantly decreased during the treatment. The improvement in impulsivity was explained by pre- posttreatment changes in distress tolerance, mindfulness and emotion regulation. Motor disinhibition did not improve during the treatment. These findings supported the initial efficacy of the DBT-ST program for addressing different features of impulsivity among individuals with AUD and other SUDs. Future follow-up studies should demonstrate the role of impulsivity domains in long-term relapse prevention.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Linking Childhood Maltreatment to Substance Use in College Students: The Mediating Role of Self-Worth Contingencies

This study investigated the link between childhood maltreatment and substance use, focusing on examining contingencies of self-worth (CSWs) as mediators among college students (N?=?513). Structural equation modeling indicated that childhood sexual abuse among females was related to lower God's love CSW, which in turn was related to higher levels of cigarette, marijuana, and other illicit drug use, supporting the mediational role of God's love CSW. Correlational analyses demonstrated that, for both male and female students, external contingency of appearance was related to higher substance use, whereas internal contingencies of God's love and virtue were related to lower substance use. The findings highlight the protective role of internal CSWs in substance use among females with childhood sexual abuse.