Directed forgetting of trauma cues in adults reporting repressed or recovered memories of childhood sexual abuse

An item-cuing directed forgetting task was used to investigate whether women reporting repressed (n = 13) or recovered (n = 13) memories of childhood sexual abuse (CSA) exhibit an avoidant encoding style (and resultant impaired memory) for trauma cues relative to women reporting no CSA experience (n = 15). All participants viewed intermixed trauma (e.g., molested), positive (e.g., confident), and categorized neutral (e.g., mailbox) words on a computer screen and were instructed either to remember or to forget each word. The results provided no support for the hypothesis that people reporting either repressed or recovered memories of CSA are especially adept at forgetting words related to trauma. These groups recalled words they were instructed to remember more often than words they were instructed to forget regardless of whether they were trauma related.     

Substance use in lesbian, gay, and bisexual populations: an update on empirical research and implications for treatment

Historically, substance use problems were thought to be more prevalent in lesbian, gay, and bisexual (LGB) populations, and correcting skewed perceptions about substance abuse among LGB individuals is critically important. This review provides an update on empirical evidence on LGB substance use patterns and treatment outcome, with specific focus on clinical implications of findings. Compared to earlier studies, the recent research included in this review has used more sophisticated methodologies and more representative samples, and also has investigated multiple dimensions of sexual orientation in relation to substance use patterns. Findings from recent research suggest that lesbians and bisexual women are at greater risk for alcohol and drug use disorders and related problems, and that gay and bisexual men are at greater risk for illicit drug use and related problems. Several sociocultural factors have emerged as correlates of substance use patterns in LGB populations (e.g., affiliation with gay culture, HIV status), and several demographic characteristics (e.g., female, older age) do not appear to be as robust of protective factors against substance abuse for LGB individuals compared to heterosexual populations. Bisexual identity and/or behavior in particular seem to be related to increased risk for substance abuse. In terms of treatment outcome, limitations of extant research prevent conclusions about the relative impact of LGB-specific interventions, and further research that includes women and uses more equivalent comparison interventions is needed. Clinical implications of research findings are discussed for case identification, selection of treatment goals (e.g., moderation vs. abstinence), targets for intervention, and specific treatment modalities.     

Five-factor measure of borderline personality traits

This study provides psychometric data for a new self-report measure of borderline personality traits from the perspective of the Five-factor model (FFM) of general personality. Subscales were constructed in an undergraduate sample (n = 109) to assess maladaptive variants of 12 FFM traits (e.g., Affective Dysregulation as a maladaptive variant of FFM Vulnerability). On the basis of data from a second undergraduate sample (n = 111), the Five Factor Borderline Inventory (FFBI) subscales were shown to have good internal consistency, convergent, discriminant, and incremental validity. These psychometric results were replicated in a clinical sample of female residents at a substance abuse treatment facility (n = 94).     

Characteristics of suicide attempters in a Slovenian high school population

The study was carried out on a representative sample of Slovenian high school students (n = 3687) of whom 238 (137 girls and 101 boys) have already attempted suicide. Both suicide attempters and nonattempters were assessed by a questionnaire consisting of Zung's (1965) Depression Scale, Rosenberg's (1965) Self-Esteem Scale, sociodemographic data, information on suicide attempt, suicide ideation, family relations, and substance abuse. Statistical analyses indicated that groups differed in the levels of self-esteem, emotional reaction to family problems, running away from home, and substance abuse. The differences in the level of depression, frequency of suicide ideation, family suicide occurrence, smoking, and alcohol use were significant.     

Substance use and abuse among children and teenagers

During the past several years, there has been a renewed national concern about drug abuse, culminating in the current "war on drugs." In this review, we emphasize that even though child or teenage drug use is an individual behavior, it is embedded in a sociocultural context that strongly determines its character and manifestations. Our focus is on psychoactive substances both licit (cigarettes and alcohol) and illicit (e.g., cannabis and cocaine). We feel that it is critical to draw a distinction between use and abuse of drugs and to do so from a multidimensional perspective that includes aspects of the stimulus (drug), organism (individual), response, and consequences. Our selective review of substance use and abuse among children and adolescents covers epidemiology (patterns and extent of drug use), etiology (what generates substance use), prevention (how to limit drug use), treatment (interventions with drug users), and consequences (effects and outcomes of youthful drug use).     

CANTAB explicit memory is less impaired in addicted schizophrenia patients

It has been suggested that in order to sustain the lifestyle of substance abuse, addicted schizophrenia patients would have less negative symptoms, better social skills, and less cognitive impairments. Mounting evidence supports the first two assumptions, but data lack regarding cognition in dual diagnosis schizophrenia. Seventy-six schizophrenia outpatients (DSM-IV) were divided into two groups: with (n = 44) and without (n = 32) a substance use disorder. Motor speed and visuo-spatial explicit memory were investigated using CANTAB. As expected, dual diagnosis patients showed a better cognitive performance. Our results suggest either that substance abuse relieves the cognitive deficits of schizophrenia or that the patients with less cognitive deficits are more prone to substance abuse.     

Natural Mentors, Mental Health, and Risk Behaviors: A Longitudinal Analysis of African American Adolescents Transitioning into Adulthood

Patterns of substance use are examined in a sample of over 1,200 youth in a non-metropolitan region of New England. Self-reported history and frequency of alcohol, tobacco, marijuana, inhalants, pain medications, and other hard drug use was assessed for 9th and 10th grade students. Latent class analyses identified four patterns of substance use: non-users (22%), alcohol experimenters (38%), occasional polysubstance users (29%), and frequent polysubstance users (10%). Contextual risk and protective factors in the individual, family, peer, and community domains predicted substance use patterns. Youth report of peer substance use had the largest effects on substance use class membership. Other individual characteristics (e.g., gender, antisocial behavior, academic performance, perceived harm from use), family characteristics (e.g., parental drinking, parental disapproval of youth use), and community characteristics (e.g., availability of substances) demonstrated consistent effects on substance use classes. Implications for prevention are discussed from a social-ecological perspective.     

Gender typing,importance of multiple roles,and mental health consequences for women

The present study examined the interactive influence of gender role typing and multiple role involvement with regard to specific mental health concerns among middle-class Caucasian women. As with previous research, depression and anxiety proved to be a function of gender role typing (feminine-typed and undifferentiated women displayed greater depression and anxiety relative to masculine-typed or androgynous women) with no differences attributable to multiple role involvement. For substance abuse, however, an interaction effect was obtained. Gender-typed (both masculine and feminine) women striving to excel across multiple roles engaged in greater substance abuse than women not gender typed (androgynous and undifferentiated); indeed, the latter displayed low risk comparable to women not similarly striving at multiple roles regardless of gender typing. A similar interaction previously has been reported with regard to disordered eating. These findings suggest that the lack of gender typing for women may enable them to cope more effectively with the conflicting demands of multiple roles and thereby reduce certain health risk behaviors (e.g., disordered eating and substance abuse), but that other mental health concerns (e.g., depression and anxiety) may not be similarly affected.     

Profiles of Chronic Illness Knowledge in a Community Sample of American Adults

The author identified profiles of chronic illness knowledge (i.e., heart disease, cancer, diabetes) in a community sample of American adults and examined the effect of sociodemographic influences on relations of illness knowledge to health practices and well-being. Participants were 181 women and 120 men who completed measures of illness knowledge, sociodemographics, personal health practices (e.g., diet, exercise, substance abuse, adaptive healthcare use), well-being (e.g., self-rated physical health, depression, social support), and perceived illness risk. Two-step cluster analyses performed on random subsets of the sample identified three levels of illness knowledge: low, medium, and high. Knowledge groups were differentiated on most measures of health practices, well-being and perceived illness risk. However, effects were substantially attenuated after controlling for differences in age and SES. Findings indicate that age and other sociodemographic factors are related not only to levels of illness knowledge but also to the application of knowledge in relation to health practices and well-being.     

Delinquency,substance abuse,and risk taking in middle-class adolescents

Risk-taking attitudes are strong predictors of delinquency and substance abuse among male and female middle-class adolescents. Risk-taking measures make strong and independent contributions to predicting self-reported delinquency and drug and alcohol use, even taking into account bonding to family and school and attitudes toward one's religious faith and employment. A measure of involvement with a delinquent peer group also predicts delinquency and drug and alcohol use. Moreover, those adolescents who are more likely to be involved in delinquent activity, or to be heavier users of substances, are less likely to turn to parents or formal helpers (e.g., counselors, teachers, etc.), and more likely to turn to peers for help. Delinquency and substance abuse prevention programs should take into account adolescent risk taking and should affect peer group norms if they are to be effective.     

Psychometric vs. attentional correlates of early onset alcohol and substance abuse

Adolescent inpatients with a diagnosis of alcohol abuse (n=28), nonalcohol substance abuse disorders (n=15), or psychiatric disorders without substance abuse (n=46) were examined on measures of attentional, intellectual, and personality functioning. High scores on a personality measure, the Substance Abuse Proclivity Scale (SAP), was the best predictor of substance abuse in general. Alcohol abusers were differentiated from other substance abusers by their increased impairment on the Continuous Performance Test. Adolescents with alcohol abuse did not manifest the types of cognitive impairments associated with chronic alcoholism. These data suggest that certain attentional impairments may be associated with early onset alcohol abuse and that earlier conceptions of the role of attentional impairments in risk prediction for alcohol abuse are supported.This research was supported by the Four Winds Foundation.     

Reciprocal relations between adolescent substance use and delinquency: a longitudinal latent variable analysis

Reciprocal relations between self-reported substance use and delinquency were examined through the analysis of 4-wave panel data collected from 1,218 high school students. A longitudinal, latent-variable framework was used to investigate interrelationships between changing patterns of generalized involvement in these 2 problem behaviors, while simultaneously accounting for specificity in drug use (e.g., marijuana use) and delinquency (e.g., theft). Analyses revealed that a model of bidirectional effects between polysubstance use and general delinquency was plausible for boys but not for girls. For boys, the effect of delinquency on substance use was small but consistent over time, whereas the effect of substance use on delinquency was larger but restricted to the earlier waves of the study. Implications for the question of whether or not substance use and delinquency have causal connections are discussed.     

The Coping Self-Efficacy Scale: Psychometric properties in an outpatient sample of active duty military personnel

ABSTRACT

Active duty military service members endure a unique constellation of stressors while deployed or at home. Yet, assessment of protective factors against these stressors among active duty service members represents an under studied area. The present study advances the assessment of protective factors through the psychometric evaluation of the Coping Self-Efficacy Scale (CSES) in a clinical sample of military service members in mental health or substance abuse treatment (n = 200). Cross-sectional data were drawn from military medical records and a supplemental self-report questionnaire. Data extracted included demographic (e.g., sex, age), military characteristics (e.g., rank, years in service), physical health and mental health (e.g., anxiety, depression), and coping self-efficacy. Findings suggest a 3-factor (i.e., problem-focused coping, thought-stopping, and getting social support) CSES structure with acceptable internal consistency. Further, there were small-to-moderate associations with physical and mental health outcomes, providing evidence of construct validity. There were few significant associations with military-related characteristics. Finally, controlling for covariates, thought-stopping beliefs explained unique variance in suicide-related behaviors. Together, findings support the use of the CSES to measure coping-related beliefs in military service members. Recommendations are offered for future research and practice with active duty service members.     

The Influence of Posttreatment Mutual Help Group Participation on the Friendship Networks of Substance Abuse Patients

The effect of 12-step mutual help groups (e.g., Narcotics Anonymous) on members' friendship networks has received little attention. This 1-year longitudinal study examined such effects in a sample of 2,337 male substance abuse inpatients, 57.7% of whom became significantly involved in 12-step activities (e.g., reading program literature, attending meetings) after treatment. An a priori model of the interplay of 12-step involvement and friendship networks was tested using structural equation modeling, and found to have excellent fit to the data. Twelve-step group involvement after treatment predicted better general friendship characteristics (e.g., number of close friends) and substance abuse-specific friendship characteristics (e.g., proportion of friends who abstain from drugs and alcohol) at follow-up. Results are discussed in terms of how mutual help group involvement benefits patients and how the self-help group evaluation paradigm should be broadened.     

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.     

Reward sensitivity and substance abuse in middle school and high school students

In this study, the authors investigated the relation between reward and punishment sensitivity and adolescent substance use. The sample (N = 216; 130 girls, 85 boys) was drawn from high school and middle school students enrolled in a Midwestern suburban school district. Participants completed a substance use questionnaire and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (R. Torrubia, C. Avila, J. Molto, & X. Caseras, 2001). For 13 of 15 types of substance abuse, students with high reward sensitivity and low punishment sensitivity showed the highest levels of use. This finding supports the hypothesis of an interaction effect between reward sensitivity and punishment sensitivity and suggests that individuals who are high in reward sensitivity but low in sensitivity to punishment may be at a higher risk for substance abuse.     

Smokers discount their drug of abuse in the same way as other consumable rewards

Recent research shows that drug abusers discount delayed monetary rewards more than nonabusers do, and they discount delayed substances of abuse (e.g., drugs) more than delayed money. Furthermore, non-drug-abusers discount food and substances of abuse (e.g., alcohol), more than money. Here, we compare the delay and probability discounting of money with that of a directly consumable reward (chocolate) and with that of a substance of abuse (cigarettes), in a drug-using population (smokers). In line with previous research, we found in two experiments that delay discounting differentiated between smokers and nonsmokers, and between money and a nonabused directly consumable reward (chocolate). In addition, our results show that there appears to be no difference in the extent to which smokers discount their abused substance compared to another directly consumable reward. These findings support the contention that drugs and food are part of the same category of primary reinforcers, whereas money is discounted differently, as a conditioned reinforcer.     

Risk Factors for Suicidality Among a Nationally Representative Sample of High School Students

Using the 2005 Youth Risk Behavior Surveillance data (n = 13,917) of high school students, we examined the association between four domains of risk factors (alcohol/drug use, aggression, HIV risk‐related behaviors, and health problems) and indicators of suicidality (considering a suicide attempt, making a plan to attempt suicide, and actually attempting suicide). Logistic regressions showed that drug use (e.g., recent smoking, drinking before 13), victimization (e.g., threatened at school, hit by girl/boyfriend), risky sexual behavior (e.g., forced to have sex, used a condom) and two health problems (health as fair/poor, has disability/health problem) were associated with all three indicators of suicidality. These findings suggest that programs to prevent alcohol/drug use, address aggression, promote safety, and prevent unsafe sexual practices may also prevent suicidality.     

Pathways to Adolescent Substance Use Among Sexually Abused Girls

This study examined the link between childhood sexual abuse and adolescent substance use among girls, and evaluated depressive self-concept and behavioral under-control (BUC) as pathways to substance use for sexually abused girls. Participants (n = 150) were drawn from a longitudinal study of the impact of domestic violence on the lives of women and children. Structural equation modeling revealed that girls childhood sexual abuse was associated prospectively with their later substance use. This relationship persisted when age, co-occurring forms of child abuse (physical, exposure to domestic violence), childhood depression and aggression, family income, maternal substance use, and parenting practices were controlled. Behavioral under-control mediated the relationship between childhood sexual abuse and later substance use, but depressive self-concept did not. Implications, limitations, and directions for future research are discussed.     

Self-punishment as a regulation strategy in borderline personality disorder

Studies using the Thought Control Questionnaire (TCQ; Wells & Davies, 1994) suggest that the tendency to use self-punishment (e.g., shouting at oneself) in order to control unpleasant internal experiences (e.g., cognitive and emotional) is associated with psychopathology. To evaluate the role of self-punishment in borderline personality disorder (BPD), we first examined whether TCQ scales, including Self-Punishment, were different among adults with BPD (n = 31) when compared to those with other personality disorders (OPD; n = 24), elevated symptoms of major depressive disorder (MDD; n = 24), and healthy controls (n = 105). Findings indicated that Self-Punishment was elevated in the BPD group relative to other groups. Next, Self-Punishment was examined as a potential mediator in the relationship between negative affectivity and BPD symptom severity in all participants. Results indicated that Self-Punishment did not mediate this relationship, but did account for significant variance in BPD symptoms over and above negative affectivity. Implications and future research directions are discussed.