Integrated Treatment Programmes for Mothers with Substance Use Problems: A Systematic Review and Meta-analysis of Interventions to Prevent Out-of-home Child Placements

Approximately half of mothers receiving substance use treatment are involved with childcare proceedings. This review aims to determine whether integrated treatment programmes for mothers with substance use problems are effective in preventing out-of-home placement (temporally/permanent) and influencing other maternal factors such as patterns of substance use, treatment completion and parenting behaviours. Six trials were identified—two randomised controlled trials and four non-randomised controlled studies. The pooled sample of participants was 1717. The results showed that mothers who participated in integrated treatment programmes were significantly less likely to have the children removed from their care (Odds Ratio (OR)?=?0.40, 95% CI?=?0.27, 0.61), more likely to complete substance use treatment (OR?=?3.01, 95% CI?=?1.79, 5.06), and more likely to reduce their alcohol consumption (Standardised Mean Difference (SMD)?=??0.40, 95% Cl?=??0.78, ?0.01) and drug use (SMD?=??0.30, 95% CI?=??0.53, ?0.07). However, non-significant reductions were observed for parent–child conflict (SMD?=??0.35, 95% CI?=??0.72, 0.03) and child abuse risk (SMD?=??0.03, 95% CI?=??0.36, 0.31). While the findings from this review suggest that mothers involved in integrated treatment programmes could potentially be less likely to experience out-of-home child placements and more likely to improve substance use treatment outcomes, little evidence exists for the effectiveness of these interventions. Further research, particularly high-quality RCTs, is required to demonstrate and persuade health and public policy on the far-reaching value of the integrated approaches.

     

Adolescent Precursors of Intensity of Marijuana and Other Illicit Drug Use Among Adult Initiators

This study examined (a) adolescent psychosocial risk factors for frequency (intensity) of marijuana use and for other illicit drug use among those who started using these drugs in early adulthood (adult initiators) and (b) the protective role of parent-adolescent relations in reducing or preventing drug use when adolescents enter early adulthood. The study's participants were male and female youth from a longitudinal prospective study. The participants' mean ages were 17 and 22 years at late adolescence and early adulthood, respectively. Independent measures assessed personality, parental, peer, and self-drug-use factors during late adolescence; dependent measures assessed frequency of marijuana use and other illicit drug use during early adulthood for initiators of the respective drug categories. The authors found that intensity of marijuana use was directly associated with the personality, parental, and self-drug-use domains and indirectly associated with the peer domain. Intensity of other illicit drug use was directly associated with personality and self-drug use. Analyses also revealed that some parent-adolescent relations factors buffered the effects of risk factors for both marijuana and other illicit drug-use intensity, whereas others enhanced the effects of protective factors against other illicit drug-use intensity. The results indicate that there are both commonalities and differences in precursors of marijuana and other illicit drug-use intensity among initiators of these drugs during early adulthood.     

Implications of Pro‐ and Counterattitudinal Information Exposure for Affective Polarization

The American electorate is characterized by political polarization, and especially by increasingly negative affective responses toward opposing party members. To what extent might this be attributed to exposure to information reinforcing individuals' partisan identity versus information representing the views of partisan opponents? And is this a uniquely American phenomenon? This study uses survey data collected immediately following recent national elections in two countries, the United States and Israel, to address these questions. Results across the two nations are generally consistent, and indicate that pro‐ and counterattitudinal information exposure has distinct influences on perceptions of and attitudes toward members of opposing parties, despite numerous cross‐cultural differences. We discuss implications in light of recent evidence about partisans' tendency to engage in selective exposure.     

Influence of value predispositions,interpersonal contact,and mediated exposure on public attitudes toward homosexuals in Singapore

This national survey tracks changes in Singaporeans' attitudes toward lesbians and gay men (ATLG) and examines value predispositions, interpersonal contact, and mediated exposure as predictors of ATLG and acceptance of homosexuals. The study replicates and extends research done previously and addresses temporal shifts in values and views. Findings indicate that the relatively small positive change in ATLG from 2005 to 2010 was mainly due to values and demographic factors. The addition of several new predictive variables increased the variance explained for why people hold certain ATLG and their acceptance. Conformity to norms, intrinsic religiosity, Western orientation, interpersonal contact, and mediated exposure were significantly associated with both ATLG and acceptance of homosexuals. Perception of homosexuality as a choice was significantly associated with ATLG but not with acceptance of homosexuals. Asian orientation and extrinsic religiosity showed no significant association with either dependent variable. The findings are discussed in the context of a multicultural Asian society and future directions for research.     

Capturing focused attention

When attention is diffuse, as in a visual search task, an abrupt onset almost invariably succeeds in capturing attention. But if attention had been cued in advance to a different location, the same onset may then fail to capture attention (Theeuwes, 1991; Yantis and Jonides, 1990). In previous demonstrations, the onset appeared frequently. This may have diminished the onset's novelty, which in turn could have affected its potency in capturing attention. The question we asked was whether preserving the onset's novelty could enhance its capacity in capturing attention, even when attention had been prioritized elsewhere. As in Theeuwes's (1991) study, observers were cued to the target location with a 100%-predictive central arrow cue. The frequency with which visual transients were introduced was varied across experiments. When the onset stimulus appeared frequently (Experiment 1), it indeed failed to capture attention. But when its appearance was relatively infrequent (Experiment 2), capture effects were clearly observed. In Experiment 3, the target appeared in one location throughout the experiment. This would have improved target localization, but an infrequently appearing onset stimulus still successfully captured attention.     

Frontal theta power linked to neuroticism and avoidance

Approach–avoidance conflict is thought to generate negative affective bias, mediated by theta rhythms. This process is distinct from, and adds to, the effects of simple aversive input. We assessed this distinction by holding gain constant and increasing loss value so that conflict and simple aversion peaked in the conflict (gain equals loss) and loss (net loss) conditions, respectively. Right frontal areas showed increases in both conflict- and loss-induced theta power. However, loss, but not conflict, power was correlated with avoidance and neuroticism, showing a Gender x Hemisphere interaction. We concluded that multiple aversive processes converge in lateral frontal networks and that individual differences in theta response in these networks may reflect differences in behavioural and emotional reactivity to aversive events.     

Stopping,goal-conflict,trait anxiety and frontal rhythmic power in the stop-signal task

The medial right frontal cortex is implicated in fast stopping of an initiated motor action in the stop-signal task (SST). To assess whether this region is also involved in the slower behavioural inhibition induced by goal conflict, we tested for effects of goal conflict (when stop and go tendencies are balanced) on low-frequency rhythms in the SST. Stop trials were divided, according to the delays at which the stop signal occurred, into short-, intermediate-, and long-delay trials. Consistent with goal-conflict processing, intermediate-delay trials were associated with greater 7–8 Hz EEG power than short- or long-delay trials at medial right frontal sites (Fz, F4, and F8). At F8, 7–8 Hz power was linked to high trait anxiety and neuroticism. A separate 4–7 Hz power increase was also seen in stop, relative to go, trials, but this was independent of delay, was maximal at the central midline site Cz, and predicted faster stopping. Together with previous data on the SST, these results suggest that the right frontal region could be involved in multiple inhibition mechanisms. We propose a hierarchical model of the control of stopping that integrates the literature on the neural control of fast motor stopping with that on slower, motive-directed behavioural inhibition.     

Capturing focused attention

When attention is diffuse, as in a visual search task, an abrupt onset almost invariably succeeds in capturing attention. But if attention had been cued in advance to a different location, the same onset may then fail to capture attention (Theeuwes, 1991; Yantis & Jonides, 1990). In previous demonstrations, the onset appeared frequently. This may have diminished the onset’s novelty, which in turn could have affected its potency in capturing attention. The question we asked was whether preserving the onset’s novelty could enhance its capacity in capturing attention, even when attention had been prioritized elsewhere. As in Theeuwes’s (1991) study, observers were cued to the target location with a 100%-predictive central arrow cue. The frequency with which visual transients were introduced was varied across experiments. When the onset stimulus appeared frequently (Experiment 1), it indeed failed to capture attention. But when its appearance was relatively infrequent (Experiment 2), capture effects were clearly observed. In Experiment 3, the target appeared in one location throughout the experiment. This would have improved target localization, but an infrequently appearing onset stimulus still successfully captured attention.