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.     

Acquisition of Related and Unrelated Factual Information Delivered by a Teacher Within an Inclusive Setting

Two secondary students with moderate disabilities (one per classroom) attended Advanced English classes with peers without disabilities in a rural high school. In additional to conducting planned daily instruction, each English teacher also systematically presented three sets of information (two facts per set) to each student with disabilities during the course of the class using a parallel treatments design. Each set of information included a fact related to the English class (e.g., Begin each sentence with a capital letter.) and a fact not related to the English class (e.g., The governor of Kentucky is Paul Patton.). The special education teacher conducted daily probe sessions to document acquisition. Of the six facts presented to each student with disabilities, one student acquired two related facts and one unrelated fact, while the other student acquired two related and two unrelated facts. This investigation implies that students who are fully included can acquire information presented by the regular classroom teacher during the course of a typical class and that teachers can facilitate learning by planning to present such information in a systematic fashion.     

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.     

Comorbidity in schizophrenia: A prognostic study of personality disorders in recovered and non-recovered schizophrenia patients

Symptoms and outcome in schizophrenia are heterogeneous. Part of the variation in outcome might be due to the coexistence of other forms of psychopathology. In the present study the prevalence of personality disorders in a group of recovered and non-recovered schizophrenia patients was focused to examine the prognostic implications of comorbidity for the outcome of the disorder. The results showed no significant differences in prevalence of personality disorders in the two groups at first admission to the hospital, but the difference at the time of interview was close to significance. Emotional and conduct difficulties in adolescence were significantly more prevalent in the non-recovered group. Schizoid features and emotional and conduct disorders in childhood were also more often reported among the non-recovered subjects. The results confirm that comorbidity contributes to the variation in outcome for schizophrenia patients, but does not confirm its prognostic significance.     

AUGMENTING SIMPLIFIED HABIT REVERSAL IN THE TREATMENT OF ORAL-DIGITAL HABITS EXHIBITED BY INDIVIDUALS WITH MENTAL RETARDATION

We investigated whether a simplified habit reversal treatment eliminates fingernail biting and related oral-digital habits exhibited by individuals with mild to moderate mental retardation. Although simplified habit reversal did little to decrease the target behaviors for 3 of 4 participants, simplified habit reversal plus additional treatment procedures decreased the behavior to near-zero levels for all participants. These procedures included remote prompting, remote contingencies involving differential reinforcement plus response cost, and differential reinforcement of nail growth. Limitations of habit reversal for individuals with mental retardation along with directions for future research involving therapist-mediated treatment procedures, particularly those involving remote prompting and remote contingencies, are discussed.     

A case study of behavioral assessment and treatment of insect phobia

We assessed the academic performance of a 14-year-old boy with insect phobia in the context of feared stimuli. The dependent measure was math calculation rate across three conditions that varied therapist statements about the presence of crickets and the actual presence of live crickets. Subsequent treatment consisted of graduated exposure and contingent rewards for math problem completion. Assessment results indicated that the boy's performance was consistently low in the presence of live crickets but not when he was spuriously informed that crickets were present (the primary referral concern). Treatment results indicated no effect from exposure alone and a dramatic effect when exposure was combined with contingent rewards.     

Found in Translation: Late Bilinguals Do Automatically Activate Their Native Language When They Are Not Using It

In their paper “Do Bilinguals Automatically Activate Their Native Language When They Are Not Using it?”, Costa, Pannunzi, Deco, and Pickering (Cognitive Science, 2017) proposed a reinterpretation of Thierry and Wu's (2004, 2007) finding of native language‐based (Chinese, L1) ERP effects when they tested Chinese–English late bilinguals exclusively in their second language (English, L2). Using simulations in a six‐node Hebbian learning model (three L1 nodes, three L2 nodes), Costa et al. suggested that form overlaps in L1 between otherwise unrelated words create a persistent relationship between their L2 translations. In this scenario, words in the nascent L2 lexicon overlapping in their L1 translations would become linked during learning because of the form overlap in L1; once the L2 words are learned, the direct link between them would be sufficient to generate robust, apparently “L1‐mediated” priming without requiring any activation of L1 translations. Costa et al. contend that links between L2 words remain beyond the learning phase, even after links to L1 representations have been severed, and thus that their model affords an alternative account to (but not a rebuttal of) Thierry and Wu's claim of language non‐selective activation—or automatic activation of translation equivalents—in late bilinguals. In this response, we build on Costa et al.'s original simulation code, showing that it can only reproduce L1‐independent priming when implementing the L1 disconnection in their particular way. By contrast, when severing inter‐language connections bidirectionally, their model fails to retain any sizeable influence of L1 form overlap on L2 activations. The model is not the theory, however, and we discuss several issues that would need to be addressed in further attempts to model language non‐selective activation in late bilinguals.     

Distress tolerance but not impulsivity predicts outcome in concurrent treatment for posttraumatic stress disorder and substance use disorder

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly co-occur. Emerging research suggests that both distress tolerance and impulsivity may underlie this comorbidity. However, to our knowledge no studies have examined whether these 2 constructs predict outcome in PTSD-SUD treatment. The current study investigated whether pretreatment distress tolerance and impulsivity predicted posttreatment PTSD and cravings severity in a sample of 70 Veterans receiving concurrent treatment for PTSD and SUD in a residential day treatment program. Veterans completed measures of symptom severity before and after treatment. Results demonstrated that pretreatment distress tolerance predicted posttreatment PTSD severity while controlling for pretreatment PTSD. By contrast, pretreatment impulsivity was not predictive of posttreatment PTSD while controlling for pretreatment values. Neither distress tolerance nor impulsivity predicted posttreatment cravings severity. The findings support the notion that distress tolerance may help to explain the co-occurrence of PTSD and SUD and suggest that targeting this construct in PTSD-SUD treatment may be important for successful outcomes.