Adolescent Substance Use: Preliminary Examinations of School and Neighborhood Context

In considering the influences of microsystems on adolescent substance use, familial and peer contexts have received the most extensive attention in the research literature. School and neighborhood settings, however, are other developmental contexts that may exert specific influences on adolescent substance use. In many instances, school settings are organized to provide educational services to students who share similar educational abilities and behavioral repertoires. The resulting segregation of students into these settings may result in different school norms for substance use. Similarly, neighborhood resources, including models for substance use and drug sales involvement, may play an important role in adolescent substance use. We briefly review literature examining contextual influences on adolescent substance use, and present results from two preliminary studies examining the contribution of school and neighborhood context to adolescent substance use. In the first investigation, we examine the impact of familial, peer, and school contexts on adolescent substance use. Respondents were 283 students (ages 13 to 18) from regular and special education classrooms in six schools. Although peer and parental contexts were important predictors of substance use, school norms for drug use accounted for variance in adolescent use beyond that explained by peer and parental norms. Data from a second study of 114 adolescents (mean age = 15) examines neighborhood contributions to adolescent substance use. In this sample, neighborhood indices did not contribute to our understanding of adolescent substance use. Implications for prevention are presented.     

心算加工年老化及其机制研究

以１７２名２０－７９岁成人为被式对心算加工的年老化过程及其机制进行了研究。任务为连续减法心算,依难度分为５种：１０００－１,１０００－３,１０００－１３及１０００－１７。结果表明,年龄与心算难度存在明显的交互作用,且随着年龄增加,不同难度心算效率均以幂函数形式降低。     

心算活动机制的研究

心算是一种重要的思维活动,是认知心理学的研究主题之一。心算活动具有明显的问题大小效应,其加工过程与工作记忆和长时记忆存在密切关系。此外,对心算的加工机制进行跨学科（认知心理学、神经科学等）的综合研究,是今后心算研究的主要方向。     

心算加工年老化及其机制研究

以172名20－79岁成人为被试对心算加工的年老化过程及其机制进行了研究。任务为连续减法心算,依难度分为5种：1000－1、1000－3、1000－7、1000－13及1000－17。结果表明,年龄与心算难度存在明显的交互作用,且随着年龄增加,不同难度心算效率均以幂函数形式降低。结构方程建模分析发现心算加工年老化过程存在两个中介作用因子,即速度因子和非速度因子,且速度因子对非速度因子存在明显的正效应。     

The Role of Schools in Outcomes for Youth: Implications for Children's Mental Health Services Research

We explore the role of schools in children's mental health services research. Recent literature has suggested that schools play an important role in delivering services to children and adolescents with emotional and behavioral problems. Research in services research, though, has taken a fairly narrow view of which dimensions of school environments are relevant for inclusion in studies. We suggest that a broader view of school environments is appropriate and potentially beneficial to the field. Using Bronfenbrenner's ecological model as a guide, we conceptualize schools as microsystems. Such an approach suggests that all aspects of school environments (treatment as well as non-treatment) are likely to influence many of the outcomes that children's mental health services research frequently targets (e.g., behavioral problems, problematic peer relationships, academic achievement, school attendance). We review literature from a variety of disciplines to suggest relevant features of schools, with particular attention to the role of peer dynamics within schools. We conclude with implications of this expanded conceptualization of schools for children's mental health services research.     

Applying Utilization Management Principles to a Comprehensive Service System for Children with Emotional and Behavioral Disorders and Their Families: A Feasibility Study

The Comprehensive Services Act for At Risk Youth and Families of Virginia (CSA), is a service, funding, and organizational reform initiative designed to improve the provision of child centered and family focused services within a community setting. We conducted this study in order to assess the feasibility of applying utilization management principles to the CSA in order to improve the appropriateness, quality, and cost effectiveness of this service delivery system. Data were gathered through focus groups, surveys, clinical profiling, and analysis of costs, and service utilization. While overall program costs increased since inception of the program, the costs per child served rose less than the rate of inflation. CSA appeared to be serving children with a high degree of emotional and behavioral difficulties. There was considerable variation among localities in placement patterns. A majority of survey and focus group respondents were willing to consider the application of utilization management principles to the CSA as long as decision making remained within localities. We concluded that there is a constructive role for utilization management approaches to improve the appropriateness and quality of services as well as enhancing efficiency in child mental health.     

The Strengths and Limitations of Case Record Reviews in Examining Family Preservation Outcome Formulation and Treatment Planning

Much debate has centered on what are reasonable outcomes of the short-term intensive family preservation services (IFPS). However, little attention has been given to how therapists actually formulate outcomes in their practices. The files of 98 families who used IFPS were reviewed to determine how therapists formulated outcomes and whether formulated outcomes varied by service sector (child welfare or mental health) and child age. It was found that formulated outcomes in mental health were more likely than those in child welfare to have a child focus and an interpersonal locus. Variation in outcome formulation in child welfare by child age was found, with outcomes of younger children more likely to be parent-focused than were outcomes of older children. The issues pointed out by these findings are discussed. Since case records are a potential data source for researchers, the paper concludes with a discussion of the strengths and limitations of case record reviews for research purposes.     

A Comparison of Three Methods of Teaching Skin Self-Examinations

Skin self-examinations are essential for the early identification and treatment of skin cancers. However, little is known about the most effective methods for teaching skin cancer detection and skin self-examination. This study compared three skin cancer education methods that are commonly used in the primary care setting: viewing a videotape, reading brochures, and one-on-one instruction from a nurse practitioner. One hundred forty-three young adults were randomly assigned to one of the four conditions (educational intervention or wait list) and completed measures of skin cancer knowledge, ability to visually discriminate cancerous versus noncancerous skin growths, and behavioral ability to perform a skin self-examination immediately (Time 1) and 3 weeks (Time 2) after the educational intervention. Results showed that participants across all educational interventions had significantly higher skin cancer knowledge compared to those in the wait-list control group, and these knowledge scores were maintained for 3 weeks. Participants in the brochure condition scored significantly higher than participants in all other conditions on an observational measure of skin self-examination. Demographic variables, such as gender and ethnicity, were not found to be related to performance on any of the dependent measures. These findings provide preliminary evidence that knowledge of skin cancer may be enhanced through a variety of educational techniques and that written materials (e.g., brochures) may represent the minimal intervention level necessary for teaching adults how to perform thorough skin self-examinations.     

A History of the Association of Medical School Psychologists

While psychologists have been active faculty members in medical schools for over 85 years, they lacked organization on the national level until 1981. This history traces the background of psychology's involvement in medical schools, landmark events that affected the discipline, and progress since formal organization has occurred. Office of the Senior Vice President and Provost     

Inequalities in Health and Intergenerational Equity

In the popular folklore three-score-years-and-ten is treated as a fair innings for people, and thereby serves as an informal reference point for judgements about distributive justice within a community. But length of life alone is an insufficient basis for such judgements - a person's health-related quality-of-life also needs to be taken into account. If one of the objectives of public policy is to reduce inequalities in lifetime health, it will be demonstrated that this is very likely to require systematic discrimination against the older members of a community. The notion of community solidatity will also be tested, because a decision will need to be made as to whether the same fair innings applies to all members of the community, or whether some are entitled to more than others. The strength of the fair innings principle is that it brings these issues to the fore in a systematic way which should ais their resolition in a practical context.