A Dual-Process Discrete-Time Survival Analysis Model: Application to the Gateway Drug Hypothesis

The gateway drug model is a popular conceptualization of a progression most substance-users are hypothesized to follow as they try different legal and illegal drugs. Most forms of the gateway hypothesis are that "softer" drugs lead to "harder," illicit drugs. However, the gateway hypothesis has been notably difficult to directly test - i.e., to test as competing hypotheses in a single model that licit drug use might lead to illicit drug use or the reverse. This article presents a novel statistical technique, dual-process discrete-time survival analysis, which enables this comparison. This method uses mixture-modeling software to estimate two concurrent time-to-event processes and their effects on each other. Using this method, support for the gateway hypothesis in the National Longitudinal Survey of Youth 1997 was weak. However, this paper was not designed as a strong test of causal direction but more as a technical demonstration, and suffered from certain technological limitations. Both these limitations and future directions are discussed.     

Long Term Outcomes to Family Caregiver Empowerment

The Vanderbilt Caregiver Empowerment Project evaluated a training program designed to enhance empowerment of caregiver and their subsequent involvement in the mental health treatment of their children. The intervention utilized a multi-component parent training curriculum that was designed to enhance: (a) knowledge of the service system; (b) skills needed to interact with the mental health system; and (c) the caregiver' s mental health services self-efficacy designed to improve caregivers beliefs in their ability to collaborate with service providers. The resulting increased empowerment was hypothesized to increase caretaker involvement, which should affect service use and ultimately the mental health status of the child. A randomized design was used to test the effectiveness of this model with caregivers of children receiving mental health services. The results one-year after the training replicated the intermediate outcomes of the project conducted 3-months after the training. The initial training continued to significantly influence the parent's knowledge and mental health services self-efficacy. However, the intervention had no effect on caregiver involvement in treatment, service use or the mental health status of the children.     

Effects of Facebook Maintenance Behaviors on Partners’ Experience of Love

This study collected data from 75 heterosexual couples. Partners self-reported their own Facebook behaviors as well as their perceptions of their partner’s Facebook behaviors. Partners also completed the Partner Relationship Quality Components inventory. Analyses used a pairwise data set according to the Actor Partner Interdependence Model. Confirmatory factor analysis demonstrated that two factors explained 59 % of the variance regarding Facebook behaviors: Partner Facebook Maintenance (PFM) and Actor Facebook Maintenance (AFM). Two structural equation models were created, one proposing that PFM and AFM would predict Actor Love and Partner Love when controlling for length of relationship, relationship status, and gender, the other proposing that Actor Love and Partner Love would predict PFM and AFM. Overall analysis indicates good model fit for both models. These results suggest that partners who perceive higher levels of love in their relationship actually participate in less Facebook Maintenance behaviors, and couples who engage in more Facebook Maintenance behaviors experience less love in the relationship. Implications for couples and therapists are discussed.     

An Assessment of Risk Understanding in Hispanic Genetic Counseling Patients

This study sought to identify if differences existed in risk comprehension and risk format understanding between genetic counseling patients of Hispanic and Caucasian ethnicity. A total of 107 questionnaires were collected, 56 from Hispanic patients, and 51 from Caucasian controls. Of the total population 41.1% (44/107) could not demonstrate sufficient risk understanding, which was 71.4% (40/56) of Hispanics and 7.8% (4/51) of Caucasians. Fractions were the best-understood format for all participants. However, both Hispanics and Caucasians had difficulties with the percentage risk format. Discrepancies were also noted in qualitative word format understanding. Awareness of differences in risk comprehension may affect the selection of counseling techniques and strategies utilized by genetic counselors when educating patients about risk related information.     

A Brief,Hospital-Initiated Motivational Interviewing and Acceptance and Commitment Therapy Intervention to Link Postpartum Mothers Who Use Illicit Drugs With Treatment and Reproductive Care: A Case Report

Maternal substance use during the prenatal period often results in infants with compromised health outcomes. The American College of Obstetrics and Gynecology recommends screening, brief motivational interviewing, and referral to existing treatment for women who use illicit substances prenatally. However, many of these women do not present for prenatal care and are not identified as using substances until delivery of their infants, many of whom are admitted to the neonatal intensive care unit (ICU). We describe a case from a novel, hospital-initiated intervention study, Moms in ACTion (MIACT) that combines motivational interviewing (MI) and acceptance and commitment therapy (ACT) to target new mothers with an infant in the neonatal ICU who screen positive for illicit substance use prenatally or at delivery. The MIACT program consists of an adaptive intervention that includes up to three sessions. Initiation of substance use treatment and reproductive care via a gynecological visit are the primary targets of the intervention. Urine samples were collected at 2- and 6-month follow-up visits. The participant successfully completed the program, achieved both treatment outcomes, and had negative urine drug screens at follow-up visits. Improvements in readiness to change and psychological flexibility were also observed. The present case report of a new mother who used substances demonstrated feasibility for combining MI and ACT treatments and the potential for MIACT to increase treatment and contraception initiation, ultimately preventing future substance-exposed pregnancies.     

Culturally Competent Family Therapy with Latino/Anglo-American Adolescents: Facilitating Identity Formation

On two occasions separated by one year, Chinese adolescents (N = 2,758) responded to instruments measuring their perceived parent-adolescent trust (i.e., paternal trust of the child and the child's trust of the parent) and other dimensions of parent-child relational qualities (satisfaction with parental control, readiness to communicate with the parent, and global satisfaction with the parent-child relationship). Results showed that perceived parent-adolescent trust was concurrently and longitudinally related to other dimensions of parent-child relational qualities. Multiple regression analyses suggest that the relations between perceived parent-adolescent trust and different dimensions of parent-child relational qualities over time were bidirectional in nature. Relative to perceived paternal trust of the adolescent child, adolescent child's trust of their parents exerted a stronger influence on different dimensions of parent-adolescent relational qualities, particularly in the father-adolescent dyad. While the influence of the child's readiness to communicate with the parents on parent-adolescent trust was weak in the father-adolescent dyad, the influence of global satisfaction with the parent-adolescent relationship on parent-adolescent trust was weak in the mother-adolescent dyad. The implications of the present findings on parent education and family therapy are discussed.     

Word comprehension mediates the link between gesture and word production: Examining language development in infant siblings of children with autism spectrum disorder

Children's gesture production precedes and predicts language development, but the pathways linking these domains are unclear. It is possible that gesture production assists in children's developing word comprehension, which in turn supports expressive vocabulary acquisition. The present study examines this mediation pathway in a population with variability in early communicative abilities—the younger siblings of children with autism spectrum disorder (ASD; high‐risk infants, HR). Participants included 92 HR infants and 28 infants at low risk (LR) for ASD. A primary caregiver completed the MacArthur‐Bates Communicative Development Inventory (Fenson, et al., 1993) at 12, 14, and 18 months, and HR infants received a diagnostic evaluation for ASD at 36 months. Word comprehension at 14 months mediated the relationship between 12‐month gesture and 18‐month word production in LR and HR infants (ab = 0.263; p < 0.01). For LR infants and HR infants with no diagnosis or language delay, gesture was strongly associated with word comprehension (as = 0.666; 0.646; 0.561; ps < 0.01). However, this relationship did not hold for infants later diagnosed with ASD (a = 0.073; p = 0.840). This finding adds to a growing literature suggesting that children with ASD learn language differently. Furthermore, this study provides an initial step toward testing the developmental pathways by which infants transition from early actions and gestures to expressive language.     

Dynamics of the dyad: How mothers and infants co-construct interaction spaces during object play

Studies of dyadic interaction often examine infants’ social exchanges with their caregivers in settings that constrain their physical properties (e.g., infant posture, fixed seating location for infants and adults). Methodological decisions about the physical arrangements of interaction, however, may limit our ability to understand how posture and position shape them. Here we focused on these embodied properties of dyadic interaction in the context of object play. We followed 30 mother–infant dyads across the first year of life (at 3, 6, 9, and 12 months) and observed them during 5 min of play with a standard set of toys. Using an interval-based coding system, we measured developmental change in infant posture, how mothers and infants positioned themselves relative to one another, and how they populated interaction spaces with objects. Results showed that mother–infant dyads co-constructed interaction spaces and that the contributions of each partner changed across development. Dyads progressively adopted a broader spatial co-orientation during play (e.g., positioned at right angles) across the first year. Moreover, advances in infants’ postural skills, particularly increases in the use of independent sitting in real time, uniquely predicted change in dyadic co-orientation and infants’ actions with objects, independent of age. Taken together, we show that the embodied properties of dyadic object play help determine how interactions are physically organized and unfold, both in real time and across the first year of life.     

A Dual-Process Discrete-Time Survival Analysis Model: Application to the Gateway Drug Hypothesis

The gateway drug model is a popular conceptualization of a progression most substance users are hypothesized to follow as they try different legal and illegal drugs. Most forms of the gateway hypothesis are that “softer” drugs lead to “harder,” illicit drugs. However, the gateway hypothesis has been notably difficult to directly test—that is, to test as competing hypotheses in a single model that licit drug use might lead to illicit drug use or the reverse. This article presents a novel statistical technique, dual-process discrete-time survival analysis, which enables this comparison. This method uses mixture-modeling software to estimate 2 concurrent time-to-event processes and their effects on each other. Using this method, support for the gateway hypothesis in the National Longitudinal Survey of Youth, 1997, was weak. However, this article was not designed as a strong test of causal direction but more as a technical demonstration and suffered from certain technological limitations. Both these limitations and future directions are discussed.