Best Practices Start With Screening: A Closer Look at Screening,Brief Intervention,and Referral to Treatment in Adolescent,Military, and LGBTQ Populations

Screening, brief intervention, and referral to treatment (SBIRT) is a flexible, evidence‐based approach to assessing risk and providing brief interventions for individuals with alcohol use disorders. This article identifies 3 diverse populations that could benefit from universal screening—a foundation of SBIRT—and provides resources and support for implementation across a broad range of settings.     

Sexual Coercion,Trauma, and Sex Work in Justice-Involved Women with Substance Use Disorders

Sexual victimization is associated with mental health problems, trauma, substance use, and incarceration. We recruited 200 formerly incarcerated women with substance use disorders in Chicago. We examined whether empowerment moderates relationships between trauma symptoms, trading sex, and being forced to have sex. There was a significant 3-way interaction among sexual coercion, trading, and empowerment scores on trauma symptoms. For women who have not traded sex, lower levels of empowerment were associated with a larger difference in trauma symptoms between women who have been coerced or traded sex. For women who had been coerced, lower levels of empowerment were associated with a larger difference in trauma symptomatology between those who have traded sex or not. Promoting empowerment in sexually traumatized women might reduce the harm that results from being victimized. Furthermore, providing interventions that educate women regarding gender and cultural roles could help women avoid situations that result in exploitation.     

School Substance Use Norms and Racial Composition Moderate Parental and Peer Influences on Adolescent Substance Use

Parental and peer influences on adolescent substance use have been well demonstrated. However, limited research has examined how parental and peer influences vary across school contexts. This study used a multilevel approach to examine the effects of school substance use norms and school racial composition in predicting adolescent substance use (a composite measure of alcohol, tobacco, and marijuana use) and in moderating parental and peer influences on adolescent substance use. A total of 14,346 adolescents from 34 schools in a mid‐western county completed surveys electronically at school. Analyses were conducted using hierarchical linear modeling. Results indicated that school‐level disapproval against substance use and percentage of minority students at school were negatively associated with adolescent substance use. School‐level disapproval moderated the association between peer substance use and adolescent substance use, with the association being stronger when school‐level disapproval was lower. School racial composition moderated the influence of parental disapproval and peer substance use on adolescent substance use. Specifically, both the association between parental disapproval and adolescent substance use and the association between peer substance use and adolescent substance use were weaker for adolescents who attended schools with higher percentages of minority students. Findings highlighted the importance of considering the role of school contexts, in conjunction with parental and peer influences, in understanding adolescent substance use.     

The Role of Parents and Peers in Early Adolescent Substance Use: An Examination of Mediating and Moderating Effects

We examined several models representing the relations among parenting practices, family structure, peer pressure, and drug use in a sample of 443 seventh graders. The setting was an urban school system serving a high percentage of African American students from low-income families. Analyses using structural equation modeling supported a mediation model in which both peer pressure and parenting practices had direct effects on drug use, with peer pressure mediating the influence of parenting. Within this model, family structure had a significant direct effect on parenting, however, contrary to hypotheses, children from two-parent families were more likely to report that they received adequate parenting than were children from single-parent extended families. Several gender differences were also found. Peer pressure was more highly related to drug use for girls than for boys, and the relation between parenting and peer pressure was stronger for boys. Examination of a model that included moderator effects revealed that the relation between peer pressure and drug use increased as a function of poor parenting. Results of our study underscore the importance of drug prevention efforts focused on parenting practices.     

遗传、环境和青少年的吸烟饮酒行为：芬兰双生子研究的回溯与前瞻

本文介绍的两个“芬兰双生子（Finn Twin）”研究是对10个出生组的青少年双生子及其家庭的长期跟踪研究。本文概述了这两个项目对遗传与环境的关联和互动对吸烟饮酒行为影响的研究。这些研究的结果提示个体差异对吸烟饮酒行为的长期变动的影响受到兄弟姐妹互动、同伴互动以及父母教养方式的调节。环境对吸烟饮酒的影响主要表现在学校、居住社区与家庭环境的差异上。环境与遗传影响的程度和持久度有城乡差异。遗传的影响受居住社区的制约。多阶段模型的分析揭示了遗传与环境的互动对这些行为的演变（从试吸试饮到发展到滥用）的动态的影响,遗传似乎对吸烟饮酒的共同轨迹更有影响。这些结果对今后本项目对这约1万对芬兰成年双生子的分子遗传学研究提供了有益的线索     

A Study of Clinical Supervision Techniques and Training in Substance Abuse Treatment

Data from 57 clinical supervisors in licensed substance abuse treatment programs indicate that 28% had completed formal graduate course work in clinical supervision and 33% were professionally licensed or certified. Findings raise concerns about the scope and quality of clinical supervision available to substance abuse counselors.     

Examination of the Relationship Between PTSD and Distress Tolerance in a Sample of Male Veterans With Comorbid Substance Use Disorders

Distress tolerance (DT), the perceived or actual ability to tolerate negative emotional or physical states, is inversely related to posttraumatic stress disorder (PTSD) symptoms in civilian, community samples. No studies to date have examined the relationship between DT and PTSD in clinical samples of veterans with a comorbid diagnosis of PTSD and a substance use disorder (SUD). Thus, the present study examined the relationship between DT and PTSD in a sample of predominately African American, male veterans (n = 75) diagnosed with comorbid PTSD and SUD (according to a structured clinical interview). Results of hierarchical linear regression models indicated that DT was inversely related to total PTSD symptom severity score, above and beyond depressive symptoms and SUD severity. Of the 4 symptom clusters, DT was inversely associated with intrusions and hyperarousal. These findings are discussed in light of previous work with civilian samples. Determining whether treatment incorporating DT skills would be useful for veterans undergoing PTSD treatment should be evaluated.     

Emotion Dysregulation in Comorbid Posttraumatic Stress Disorder and Substance Use Disorders: A Narrative Review

Co-occurrence of substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) is extremely common and is associated with elevated dropout and relapse rates. Given that PTSD/SUD co-occurrence rates among veterans have been found to be as high as 55?75%, it is important to identify mechanisms that may affect the interplay of both disorders. Emotion dysregulation (ED) presents a candidate mechanism that may underlie poor treatment response in co-occurring PTSD/SUD. This article proposes a transdiagnostic emotion regulation framework that considers ED conceptualized as a combination of low ability to tolerate emotional distress (low distress tolerance) and difficulties in the goal-directed use of emotion regulation strategies as a key risk factor in co-occurring PTSD/SUD. The authors review empirical findings from self-report and laboratory-based studies of ED in PTSD. They describe psychological explanations of the emotion-substance relationship and review studies documenting ED in SUDs and in co-occurring PTSD/SUD. The literature on ED in PTSD/SUD suggests that (a) patients with PTSD may resort to substances to cope with trauma-related symptoms due to ED, and (b) ED may maintain SUD symptoms and interfere with psychological treatment. Longitudinal studies on bidirectional relationships between ED and substance use in PTSD are needed, particularly research examining the course of ED in PTSD patients who use substances versus those who do not.     

《神农本草经》的道家养生思想与汉画像石中的羽人仙药图

以<神农本草经>中的道家养生思想,结合汉画像石中的羽人仙药图,说明秦汉时期道家养生思想对<神农本草经>的渗透与影响,以及<神农本草经>道家养生思想对后世本草方剂学的重要影响.     

《周易》与中国象科学

本文通过对《周易》和古希腊哲学的比较,说明中西方在传统认识上,由于时空选择不同,从而形成了两种科学。西方的传统认识,以空间为主,时间为辅.空间统摄时间。中国的认识传统,以时间为主,空间为辅,时间统摄空间.因此,前者认识世界着重在“体”,后者则着重在“象”,对“象”层面的认识为“象科学”,主要采用自然整体方法和意象方法.象的实质是“气”.“气”是时间属性占优势的物质存在,与空间属性占优势的实物和物理场不同,构成世界的另一半,中医学是象科学的代表.中医学的突破,定将带来象科学的复兴,对人类的未来和健康发展具有关键意义。