Facilitating Adolescent Well‐Being: A Review of the Challenges and Opportunities and the Beneficial Roles of Parents,Schools, Neighborhoods,and Policymakers

Adolescents face exceptional challenges and opportunities that may have a lifelong impact on their consumption and personal and societal well‐being. Parents, community members (schools and neighborhoods), and policymakers play major roles in shaping adolescents and influencing their engagement in consumption behaviors that are either developmentally problematic (e.g., drug use and unhealthy eating) or developmentally constructive (e.g., academic pursuits and extracurricular activities). In this article, we discuss two main topics: (a) the challenges and opportunities that characterize adolescence, based primarily on research in epidemiology and neuroscience, and (b) the ways that parents, community members, and policymakers can facilitate positive adolescent development, based on research from many disciplines including marketing, psychology, sociology, communications, public health, and education. Our goal is to summarize the latest scientific findings that can be used by various stakeholders to help adolescents navigate this turbulent period and become well‐adjusted, thriving adults.     

At-Risk for Diabetes: Coping with the News

This study assessed 37 children's and 38 adults', as well as their family members' (39 mothers and 26 spouses), coping responses to the news that they (or a loved one) were islet-cell antibody positive (ICA+) and at risk for type 1 diabetes. The Ways of Coping Checklist (WCC) was administered 4 months after ICA+ notification and at follow-up 10 months later. Participants' state anxiety was measured a few days after ICA+ notification and again 4 months later, at the time of the initial WCC administration. Children's coping strategies differed from those of adults, and mothers' coping strategies differed from spouses'. Initial state anxiety in response to ICA+ notification was related to how participants subsequently coped with the news. Coping, in turn, was related to maintenance of state anxiety over time.     

Behavioral perspectives on the neuroscience of drug addiction

Neuroscientific approaches to drug addiction traditionally have been based on the premise that addiction is a process that results from brain changes that in turn result from chronic administration of drugs of abuse. An alternative approach views drug addiction as a behavioral disorder in which drugs function as preeminent reinforcers. Although there is a fundamental discrepancy between these two approaches, the emerging neuroscience of reinforcement and choice behavior eventually may shed light on the brain mechanisms involved in excessive drug use. Behavioral scientists could assist in this understanding by devoting more attention to the assessment of differences in the reinforcing strength of drugs and by attempting to develop and validate behavioral models of addiction.     

The Beck Anxiety Inventory in Older Adults With Generalized Anxiety Disorder

The authors investigated the psychometric properties of the Beck Anxiety Inventory (BAI) in a sample of 75 older generalized anxiety disorder (GAD) patients and a comparison group of 32 older adults without significant psychopathology. Internal consistency was above .80, and the BAI showed evidence of convergent validity in both groups. Evidence for discriminant validity with respect to measures of depression was weaker. Two items, fearing the worst and nervousness, correctly distinguished 86.5% of patients with GAD and 93.8% of the normal controls. Medical comorbidity was associated with somatic but not cognitive anxiety symptoms in the normal older sample. Overall, results indicate the limitations of the BAI in assessing anxiety symptoms in older adults and suggest the need for use of an instrument focusing on cognitive aspects of anxiety.     

A call to restructure the drug development process: Government over-regulation and non-innovative late stage (Phase III) clinical trials are major obstacles to advances in health care

The history of drug/vaccine development has included major advances guided primarily by risk/benefit analyses concerning the innovative agent, not by evidence-based clinical trials (Phase I–IV). Because the approval for new drugs is hindered under the present process, the system requires restructuring. The Phase I/II study period should be more flexible, using the “environment of knowledge” about the new agent, plus risk/benefit assessments. Phase III, as presently constructed, does not add new adverse events data, it provides a narrower profile of drug efficacy than properly done Phase II studies, and placebo-controlled trials continue to raise unresolved ethical and social issues. Phase III studies should be abandoned for most drugs, and substituted with properly powered Phase II doseranging studies plus careful post-marketing surveillance. Phase III should be a penalty for poor drug development, not a regulatory requirement. To accomplish efficient drug development, greater cooperation between pharmaceutical companies and governments in developing clinical trials is needed rather than over-regulation. These changes will synchronize the drug development and regulatory process with the current rapid drug discovery process, reduce drug development time and cost, and improve patient care. The author is Adjunct Professor of Medicine, Weill Medical College of Cornell University, New York, New York, USA.     

Young Indigenous Australians' Sexually Transmitted Infection Prevention Practices: A Community‐based Participatory Research Project

National surveillance data indicate marked differences between Indigenous and other Australians in the prevalence of many sexually transmitted infections (STIs). Young Indigenous people bear a particularly high burden of these infections. A collaboration of university researchers, Indigenous health workers and young Indigenous people conducted 45 field interviews to examine how young Indigenous Australians keep themselves healthy and protected against STIs. Our findings emphasise the complexity of health behaviours, where individuals are rarely always ‘risky’ or always ‘safe’, as well as subtle gender differences in health practices. Preventive strategies employed by the young people were contingent on beliefs and knowledge about sexual partners, the type of relationship, the context of the sexual encounter and access to condoms. Tangible strengths such as young Indigenous people's commitments to condoms and STI screening should be celebrated and bolstered to enhance their ability to protect themselves against adverse health outcomes and enhance their resilience against STIs. Focusing on strengths helps to counter the deficit model of health commonly deployed in Indigenous health research and draws attention to health issues facing young Indigenous people and their communities, without reinforcing negative stereotypes or focusing solely on individual risk behaviour. We provide concrete recommendations for health promotion and education. Copyright © 2011 John Wiley & Sons, Ltd.     

Personality and Substance Use in Midlife: Conscientiousness as a Moderator and the Effects of Trait Change

Personality traits predict substance use in adolescence, but less is known about prospective substance use in middle age and beyond. Moreover, there is growing interest in how personality change and the multiplicative effects among personality traits relate to substance use. Participants included approximately 4000 adults aged 25-74 who participated in two waves of the Midlife in the US (MIDUS) study. Higher levels of neuroticism, extraversion, openness, and lower levels of conscientiousness and agreeableness predicted longitudinal substance use. Increases in neuroticism and openness predicted increased substance use while increases in conscientiousness and agreeableness predicted decreased substance use. Higher levels of conscientiousness moderated two of the other trait main effects. Personality, trait change, and interactions among traits reliably forecasted 10-year substance-use behaviors.     

Brief Counseling for Alcohol Misuse Among Trauma Patients: Two Interventions and Influence of Baseline Use

This study examined whether baseline trauma patient characteristics and randomized participation in 1 of 2 brief interventions predicted changes in alcohol use at 6 months postintervention. Higher total Alcohol Use Disorders Identification Test (AUDIT) scores predicted greater changes, and specific AUDIT items were significant predictors.     

Development and psychometric evaluation of a rapid intimate partner violence perpetration screening tool

Current methods of identifying intimate partner violence (IPV) perpetration rely upon lengthy screening instruments, partner injury, and legal involvement. There exist no viable, brief screening tools to facilitate the rapid and early identification of IPV perpetration. The development of a brief IPV screening tool would reduce participant burden and compensation in research as well as aid in self‐identification and appropriate consultation for treatment. Three samples were recruited and administered an IPV assessment measure. Receiver Operating Characteristic (ROC) curve analyses were used to determine a critical subset of items that could be rapidly administered and used to accurately detect physical IPV perpetrators. A set of four items emerged that were capable of differentiating between partner violent and nonviolent participants in Samples 1 (the Area Under the ROC Curve (AUC) = .95, SE = .02), 2 (AUC = .98, SE =.01), and 3 (AUC = .94, SE = .04). Internal consistency of the screening items was acceptable across samples and the scores on the screening tool were significantly associated in the expected direction with all assessed risk factors for IPV. Initial evaluation of the rapid IPV perpetration screening tool suggests that it may help satisfy the growing need to quickly determine research eligibility and to help college students self‐identify risk, offering objective data upon which to base the decision for follow‐up consultation.