The Double Bind of Siblings in Adolescent Substance Abuse Treatment

Siblings have been found to be perhaps the greatest source of social risk for adolescent substance abuse, particularly when the relationship is close. But, close sibling relationships are also linked to an array of important developmental and lifelong protective benefits. Sibling closeness simultaneously poses considerable risks and benefits. These conflicting findings suggest opposite treatment directions, or a “double bind” for practice. That sibling closeness risks contagion suggests treatment that aims to decrease sibling closeness. On the other hand, the many lifelong and protective benefits of close sibling relationships suggests increasing sibling closeness when possible. Family-based treatment is recommended for adolescent substance abuse, but offers little explicit direction for involving siblings in general, and none for this double bind. This paper untangles and translates the extant literature into preliminary practice guidelines; the Sibling Substance Abuse Treatment Matrix. Important variations related to gender, and age-spacing are considered. Implications for future research and practice are discussed.     

Why young people do not kill themselves: the reasons for living inventory for adolescents

Assessed the reliability, validity, and predictive power of a new measure, the Reasons for Living Inventory for Adolescents (RFL-A; Osman et al., 1998). A group of 206 (101 boys and 105 girls) adolescent psychiatric inpatients completed the RFL-A, Minnesota Multiphasic Personality Inventory for Adolescents (Butcher et al., 1992), and a packet of self-report measures. Additional information about the patients including diagnosis and suicide status were obtained from their medical records. It was determined that the RFL-A is a valid and reliable measure of adolescent suicide risk potential. Additionally, the RFL-A possesses better predictive power than the Beck Hopelessness Scale (Beck, Weissman, Lester, & Trexler, 1974). A discussion of the clinical and research utility of the RFL-A is included along with suggestions for future research.     

Factor structure and psychometric characteristics of the beck depression inventory-II

The present study evaluated the factor structure and psychometric properties of the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996) in the nonclinical sample of 230 young adults. The BDI-II is a revised version of the BDI-IA. We evaluated the fit of three alternative models to the sample data, using confirmatory factor analysis. Results provided support for the fit of the oblique three-factor model. The BDI-II and factor scales had satisfactory coefficient alpha indices. We obtained gender differences on the BDI-II item, total, and factor scale scores. We examined the relations of the BDI-II with demographic variables and with other self-report measures of social desirability, anxiety, depression, stress, and self-esteem. We also examined the issue of whether specific self-report measures of anxiety and depression assess separate or different constructs. We discuss the limitations of the present study.     

The social phobia and anxiety inventory: Further validation in two nonclinical samples

The Social Phobia and Anxiety Inventory (SPAI) has been developed to assess specific symptoms of social phobia and agoraphobia. Although the SPAI was developed with both clinical and nonclinical populations, research with this measure is currently focused primarily on clinical samples. We examined the factor structure and psychometric properties of the SPAI in adult community and college undergraduate samples. We found that single-sample and multisample confirmatory factor analyses provided support for extending use of the correlated two-factor SPAI subscales to our nonclinical samples. In addition, we found evidence for the internal consistency reliability of the SPAI subscales in both samples. Limitations and suggestions for future research are discussed.     

The Social Phobia and Social Interaction Anxiety Scales: Evaluation of Psychometric Properties

The present investigations examined the factor structure and psychometric properties of two new self-report measures of social phobia, the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS). A confirmatory factor analysis in Study I provided support for the fit of a two-factor model of the SIAS and SPS. Internal consistency estimates were high for the original two scales with a sample of 200 undergraduates. Also, using an item parceling procedure, the obtained internal consistency reliability indices for each parcel were acceptable. Results of the CFA in Study II provided support for the factorial stability of the model identified in Study I. Furthermore, multisample analyses showed invariant patterns for factor loadings and factor correlations across 138 men and 272 women. Gender differences were not observed in the mean SIAS and SPS scale and item scores. Both scales correlated negatively and significantly with measures of social desirability. Concurrent validity was established for the scales. The SPS was less specific than the SIAS to symptoms of social phobia.     

The beck anxiety inventory: Psychometric properties in a community population

This study presents data on the norms and psychometric properties of the Beck Anxiety Inventory (BAI), using a sample of 225 community adult volunteers. Maximum-likelihood confirmatory factor analyses of previously published models of the BAI: a two-factor model and a five-factor model, showed that the fit of each model was unacceptable. Also, the fit of the single-factor model was poor. Exploratory principal-components analyses with varimax and oblique rotations suggested four BAI components within this sample. Satisfactory levels of reliability were established for the BAI subscales. Finally, the relations between the BAI total and subscale scores and a related measure of anxiety and with another self-report measure of psychological distress were examined.This paper was presented at the 27th Annual Convention of the Association for Advancement of Behavior Therapy, Atlanta, Georgia, November 1993.     

Cognitive behavioral therapy for panic disorder and comorbidity: more of the same or less of more?

This study compared the effects of a higher dose of cognitive behavioral therapy (CBT) for panic disorder versus CBT for panic disorder combined with "straying" to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic disorder and agoraphobia or CBT that simultaneously addressed panic disorder and agoraphobia and, to a lesser degree, the most severe comorbid condition. Results indicated a significant reduction in panic disorder severity and a decline in severity of comorbid diagnoses across both treatment conditions. However, individuals receiving CBT focused only on panic disorder were more likely to meet high end-state functioning at post-treatment, even in intent-to-treat analyses, and report zero panic attacks at the 1-year follow-up, although this effect was not retained in intent-to-treat analyses. At follow-up, CBT focused only on panic disorder yielded more substantial improvement in the most severe baseline comorbid condition, although not in intent-to-treat analyses, and a greater proportion of individuals in this treatment condition were rated as having no comorbid diagnoses, even in intent-to-treat analyses. These findings raise the possibility that remaining focused on CBT for panic disorder may be more beneficial for both principal and comorbid diagnoses than combining CBT for panic disorder with 'straying' to CBT for comorbid disorders.     

The relations of parental autonomy support to cultural internalization and well-being of immigrants and sojourners

Previous research has demonstrated that autonomy support is one particularly effective means of promoting internalization and fostering well-being. The present study sought to determine if this would also be the case with regards to culture by testing the relation of perceived parental autonomy support to the cultural internalization and well-being of multicultural students. In Study 1, 105 multicultural participants living in Canada were more likely to have fully internalized their host and heritage cultures and to have higher self-reported well-being when they reported that their parents were autonomy supportive. In Study 2, 125 Chinese-Malaysians sojourners were also more likely to have fully internalized their heritage culture and indicated higher well-being when they perceived their parents as autonomy supportive. In both studies, heritage cultural internalization was also associated with higher well-being.