Preventing and reducing substance use among institutionalized adolescents

The Residential Student Assistance Program, serving high-risk, multiproblem, inner-city, primarily African-American and Latino youth, was evaluated for its ability to prevent and decrease alcohol and other drug use. Participants were drawn from several adolescent residential facilities: three foster care sites for abused, neglected, orphaned, or troubled adolescents, a nonsecure facility for adjudicated juvenile offenders, a treatment center for teens with severe psychiatric problems, and a locked county correctional facility. In addition, comparison groups were employed. A 5th-year outcome evaluation documented the program's effectiveness in both preventing and reducing substance use among participants, with impact related to program dosage. Qualitative process data clarified and strengthened confidence in the quantitative outcomes.     

Life-style and substance use among male African American urban adolescents: A cluster analytic approach

Cluster analyzed four variables: school attendance, employment, church attendance, and delinquency, to develop life-style profiles. Data from 218 African-American urban adolescents were used in the study. Five meaningful clusters were retained and subjected to criterion validity analyses using measures of spirituality, participation in a voluntary organization, self-esteem, and friend's substance use. The five clusters were then compared on cigarette, alcohol, marijuana, and hard drug use. The results suggest that a life-style that includes an adaptive compensatory behavior component may be more adaptive than a life-style that does not include compensatory behavior. For example, youths who left high school before graduation but were involved in church reported less alcohol and substance use than youths who left school and were not involved in any meaningful instrumental activity. Implications for intervention and future research on high-risk behaviors are discussed.     

Psychosocial correlates of substance use behaviors among African American youth

Cross-sectional data were collected on substance use behaviors and potential correlates in 1,494 African American students enrolled in grades 5-12 in eight schools in a central Alabama school district. Using a risk and asset framework, self-reported recent alcohol, cigarette, and marijuana use were analyzed by identifying and measuring levels of influence, including individual, family, and school. For alcohol and marijuana use, recurrent risk factors were age, being hit by a parent, affiliation with gangs, and a tolerant attitude of peers toward drug use. For cigarette use, risk factors were peer-oriented: associations with gangs or cohorts holding lenient attitudes about substance use. For all substances, salient asset factors were academic achievement and parental monitoring. Findings suggest that efforts to reduce substance use behaviors should be directed at adolescents in terms of academic achievement and grade level as well as their social environments. For the latter, peer/family risks and family/school assets should be the foci for programs to minimize the short- and long-term consequences of these behaviors. Hence, the emphasis should be placed on modeling attitudes, preventing gang and family violence, encouraging parental supervision, and building positive teacher-student interactions.     

Reasons for substance use among people with psychotic disorders: method triangulation approach

Substance use disorders (SUD) are common among people with psychotic disorders and are associated with many negative consequences. Understanding the reasons for substance use in this population may allow for the development of more effective prevention and intervention strategies. We examined reasons for tobacco, alcohol, or cannabis use among people with psychotic disorders. Sixty-four participants with a diagnosed psychotic disorder completed a self-report reasons for use questionnaire. A subset of eight participants completed semi-structured qualitative interviews. Both the qualitative and quantitative data indicated that reasons for use of tobacco, alcohol, and cannabis differed considerably. Tobacco was primarily used for coping motives, alcohol for social motives, and cannabis for pleasure enhancement motives. Prevention and intervention strategies targeting coexisting psychotic disorders and SUD may improve in effectiveness if they address the perceived beneficial effects of tobacco use, the strong social pressures influencing alcohol use and if they encourage cannabis users to seek alternative pleasurable activities.     

Correlations for perceived family environmental factors with substance use among adolescents in South Africa

Perceived family environmental factors were used to predict self-reported use of substances (drugs or alcohol) among adolescents in South Africa. 435 high school students (ages 15 to 19 years, M=17.2 yr., SD=1.34) answered a questionnaire which included questions on demographic variables, the Family Environmental Scale, and questions on substances used (drugs or alcohol). Logistic regression analysis indicated that scores on family conflict and low family moral-religious emphasis were significantly associated with drug use (57.9% of the variance was accounted for) and use of alcohol (62.3% of the variance was accounted for). Programmes for the reduction of substance use among adolescents should include activities designed to reduce family conflict and strengthen family moral-religious emphasis.     

Personality scores and licit and illicit substance use

The effects of personality structure on subsequent substance use was examined. Data were collected from 841 men from Zürich questioned twice at the age of 19 and 22 about drug use and personality. Multiple regression and canonical correlation analysis methodology indicated a significant relationship between personality and subsequent substance use. Illicit drug consumption was positively related to the personality scale Depressiveness and negatively to Dominance and Excitability, cigarette consumption correlated with Nervousness and Sociability and alcohol consumption was related to Nervousness, Depressiveness and Sociability. The association of illicit drug use with Emotional Lability decreased when cigarette and alcohol consumption was included in the analysis. The cannabis users described themselves less neurotic than the consumers of alcohol and cigarettes.     

Oral contraceptive use among African American adolescents: Individual and community influences

Side effects of oral contraceptives are a noteworthy problem, particularly among low-income young women who reside in inner-city communities. The problem may be compounded by inadequate family planning services, particularly when such services are provided by general medical practices with high volumes of clients. This study examined the prevalence and correlates of pill-related side effects, with particular attention to the role of clinic characteristics. Participants were 177 pregnant and parenting African American adolescents and young women (average age=18.34). The experience of a pill-related side effect was the most frequently cited barrier to birth control use, and it was significantly related to contraceptive behavior. Finally, although participants attending comprehensive clinics experienced more barriers to medical service use than those attending neighborhood clinics, they reported fewer problems with pill-related side effects and better psychological functioning. Implications for future research and policy are discussed. This study was completed with the assistance of grants from the Illinois Department of Alcoholism and Substance Abuse, the National Institute of Child Health and Human Development, and the Office of Research on Women's Health to Jean Rhodes. Portions of this paper were presented at the 1993 Biennial Meeting of the Society for Community Research and Action, Williamsburg, Virginia. The authors gratefully acknowledge the assistance of Julian Rappaport, Joel Meyers, Hope Landrine, Lori Ebert, the Reverend Annette Collins, Margaret Daniels, Khya Lawrence, and the professionals and participants at the service settings.     

Personality and substance use in Japanese adolescents: The Japanese version of Substance Use Risk Profile Scale

Substance Use Risk Profile Scale (SURPS; Conrod & Woicik, 2002) measures four risk personality dimensions related to substance use; anxiety sensitivity (AS), hopelessness (H), sensation seeking (SS), impulsivity (IMP). The aim of this study is to develop the Japanese version of Substance Use Risk Profile Scale (SURPS-J) and to probe the reliability and validity of this scale to the Japanese context. This study consists of the test of the factor analysis (Study 1; N = 462), the reliability (Study 2; N = 64), and the validity (Study 3; N = 182). Our findings are as below; Study 1 showed the conformed factorial structure of SURPS-J and Study 2 revealed the good test–retest reliability. Additionally, Study 3 demonstrated the adequate validity of SURPS-J and its sensitivity in identifying risky drinking motivations and lifetime tobacco and alcohol use. Results showed that high H individuals are likely to experience smoking under the personal and collective situations, while high SS and IMP individuals are prone to drink alcohol under the collective situation. Additionally, high AS individuals are prone to drink by virtue of negative reinforcement motives and high SS and IMP drink by reason of all drinking reinforcement motives.     

Heroes and heroines among American adolescents

Based upon the analysis of questionnaire responses of 1092 high school students, an attempt was made to assess the type of heroes and heroines most often chosen. The major findings are that high school students have more heroes than heroines, that they have an approximately equal number of personal heroes and heroines, and that the preference for heroes is not altered when the sex or race of the respondents is considered. The findings are explained both by the greater numbers of males than females in public professional roles and by the greater salience of male than female professional role models. Implications of the possible effects of hero and heroine choices for sex-role identification are discussed.     

Personality characteristics of a community sample of adolescents with conduct disorders

The Millon Adolescent Personality Inventory (MAPI) was used to compare the personality styles, expressed concerns, and behavioral correlates of a community sample of conduct-disordered (n = 13) and non-conduct-disordered (n = 137) adolescents. Structured interviews with adolescents and parents were used to classify subjects using DSM-III criteria. Significant differences were found between groups. Conduct-disordered youth reported being very critical, harsh, and not respectful of others. They tended to seek out the unpredictable and to be moody and pessimistic. They expressed a lack of confidence in school performance and dissatisfaction with family life. These results support the usefulness of self-report measurements with troubled adolescents in general, and the validity of the MAPI in particular. Implications for diagnosis and treatment are discussed.     

Peer isolation and drug use among white non-Hispanic and Mexican American adolescents.

The social-emotional characteristics and drug-use patterns of adolescents who reported having no friends (i.e., isolates) were compared to those of adolescents in drug-using and non-drug-using peer groups. Adolescents who did not have drug-using peers reported the lowest drug use and those with drug-using peers had the highest drug use, with adolescents who were isolated falling in between. Isolated youth reported more shyness, greater feelings of alienation, and lower social acceptance than did those in the other groups. Isolated youth also reported more anger and depression than did youth with non-drug-using peers, but less anger and equivalent depression when compared to adolescents with drug-using peers. Results are discussed in terms of social-emotional characteristics of isolated youth and risk/protective factors.     

Coping and psychological distress for men with substance use disorders

Coping with stress is a major focus for chemically dependent persons in relapse prevention programs. The relationships among coping and psychological distress were investigated in 71 men with substance use disorders, at both pre—and post-treatment. It was predicted that low task-oriented coping, high emotion-oriented coping, and high avoidance-oriented coping would predict psychological distress (e.g., anxiety and depression). It was also expected that use of task-oriented coping would increase following treatment and that use of emotion-oriented coping and avoidance-oriented coping, and reported levels of psychological distress would all decrease following treatment. Participants completed the Coping Inventory for Stressful Situations and the General Health Questionnaire, took part in an intensive treatment program (e.g., relaxation, drug education, stress management) and completed these questionnaires again following treatment. Results indicated that high emotion-oriented coping predicted hypochondriasis, anxiety and depression. Task-oriented and avoidance-oriented coping did not predict psychological distress, although task-oriented coping was negatively related to hypochondriasis, anxiety and depression. The results regarding change in coping styles and levels of psychological distress were as hypothesized, except that avoidance-oriented coping did not significantly change following treatment. Theoretical and practical implications of the research are discussed.     

Coping and psychological distress for men with substance use disorders

Coping with stress is a major focus for chemically dependent persons in relapse prevention programs. The relationships among coping and psychological distress were investigated in 71 men with substance use disorders, at both pre—and post-treatment. It was predicted that low task-oriented coping, high emotion-oriented coping, and high avoidance-oriented coping would predict psychological distress (e.g., anxiety and depression). It was also expected that use of task-oriented coping would increase following treatment and that use of emotion-oriented coping and avoidance-oriented coping, and reported levels of psychological distress would all decrease following treatment. Participants completed the Coping Inventory for Stressful Situations and the General Health Questionnaire, took part in an intensive treatment program (e.g., relaxation, drug education, stress management) and completed these questionnaires again following treatment. Results indicated that high emotion-oriented coping predicted hypochondriasis, anxiety and depression. Task-oriented and avoidance-oriented coping did not predict psychological distress, although task-oriented coping was negatively related to hypochondriasis, anxiety and depression. The results regarding change in coping styles and levels of psychological distress were as hypothesized, except that avoidance-oriented coping did not significantly change following treatment. Theoretical and practical implications of the research are discussed.     

Exploration of the prevalence and correlates of substance use among sheltered adolescents in South Korea

Substance use among sheltered adolescents is very serious in South Korea--a nation in the process of rapid industrialization and urbanization. However, few studies have investigated substance use among the adolescents which is a growing concern of the changing society of this nation. This study examined the prevalence of substance use and explored risk factors that predict substance abuse by sheltered adolescents. Through a questionnaire survey of sheltered adolescents, data on substance use and the risk factors were collected. The sample of the adolescents included 44 (33.3%) males and 88 (67.2%) females; their mean age was 15.8 years (SD = 1.62). The results of a logistic regression analysis showed that alcohol expectancy, physical abuse, and peer pressure were all statistically significantly associated with substance abuse. Findings on the critical issues are expected to lead to the development of urgently needed prevention programs for the high-risk adolescents in South Korea.     

Brain functions associated with verbal working memory tasks among young males with alcohol use disorders

This study aimed to investigate the differences in brain functions during verbal working memory between individuals with alcohol use disorders (AUD) and normal controls. fMRI was used to scan brain activations associated with verbal working memory while participants performed 2-back and 0-back tasks. A total of 21 young male college students participated in the study. Eleven of those who clinically met the criteria for AUD were assigned to the AUD group, whereas ten demographically similar subjects who were social drinkers but not AUD were assigned to the normal control group. The AUD group showed less activation in bilateral frontal and precentral, left superior temporal, left superior parietal, and left cerebellar cortex during the 2-back task relative to 0-back task compared to the normal control group. In contrast, the control group showed less activation only in the right uncus than the AUD group. These results suggest that subjects with AUD present abnormality in brain functioning during verbal working memory.     

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.     

Clinical utility of the Cross-Cultural (Chinese) Personality Assessment Inventory (CPAI-2) in the assessment of substance use disorders among Chinese men

This study examined the clinical utility of the Cross-Cultural (Chinese) Personality Inventory (CPAI-2) in differentiating the personality characteristics of Chinese men with substance use disorders from other psychiatric patients and normal control participants. The CPAI-2 profile of 121 Chinese men with substance use disorders was contrasted with that of a matched psychiatric comparison group (n = 172) and a normal comparison group (n = 187). Multivariate analyses of variance and logistic regression results supported the utility of the CPAI-2 clinical scales, especially Pathological Dependence, Antisocial Behavior, and Depression, for assessing substance use disorders. The Pathological Dependence scale (cutoff T score of 64) achieved good sensitivity and specificity. Apart from the universal personality traits related to neuroticism, conscientiousness, and agreeableness found in Western studies, the indigenously derived CPAI-2 personality scales, including Family Orientation and Harmony, highlighted deficits in social adjustment and interpersonal relationship as important cultural features in the personality characteristics of these participants. The study provided a cross-cultural extension to research on the relationship between personality and substance use disorders and could assist clinicians in considering culturally relevant treatment approaches.     

Predicting substance use behavior among South African adolescents: The role of leisure experiences across time

Using seven waves of data, collected twice a year from the 8th through the 11th grades in a low-resource community in Cape Town, South Africa, we aimed to describe the developmental trends in three specific leisure experiences (leisure boredom, new leisure interests, and healthy leisure) and substance use (cigarettes, alcohol, and marijuana) behaviors and to investigate the ways in which changes in leisure experiences predict changes in substance use behaviors over time. Results indicated that adolescents' substance use increased significantly across adolescence, but that leisure experiences remained fairly stable over time. We also found that adolescent leisure experiences predicted baseline substance use and that changes in leisure experiences predicted changes in substance use behaviors over time, with leisure boredom emerging as the most consistent and strongest predictor of alcohol, cigarette, and marijuana use. Implications for interventions that target time use and leisure experiences are discussed.