A longitudinal grouping analysis of adolescent substance use escalation and de-escalation.

Although studies have explored the predictors of changes in rank ordering of adolescent substance use over time, little research has specifically examined the predictors of substance use escalation and de-escalation. The present study tested whether social influences, individual differences, and symptomatology predicted substance use escalation and de-escalation over a 9-month period in a community sample of adolescents (n?=?390). Peer substance use, negative affectivity, externalizing symptoms, and internalizing symptoms prospectively predicted substance use escalation. Only peer substance use and parental control predicted de-escalation. Results provide support for the assertion that social influences, individual differences, and symptomatology predict substance use escalation and de-escalation but suggest that the relations differ for alcohol use versus illicit substance use and for the prediction of escalation versus de-escalation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between adolescent substance use and young adult internalizing symptoms: Findings from a high-risk longitudinal sample.

The present study examined the role of adolescent substance use and its antecedent behavioral and familial risk factors in the prediction of young adult internalizing symptoms 10 years later, using a community sample of children of alcoholics (n = 194) and demographically matched controls (n = 209). Using growth curve modeling, the authors found that initial levels of adolescent alcohol and drug use (μage = 13) and growth in drug use during adolescence predicted higher levels of internalizing symptoms in young adulthood, even after including in the models shared risk factors for both internalizing symptoms and adolescent substance use. These effects remained significant after including concurrent substance use in adulthood, suggesting that adolescent substance use exerts a long-term impact on young adult internalizing symptoms over and above the effects of persistent substance use over time. The present investigation further revealed that initial levels of alcohol and drug use in adolescence mediate the relation between parental alcoholism and young adult internalizing symptoms. Findings provide evidence for the long-term effects of adolescent substance use on young adult functioning and can help inform both etiological and prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The substance use system: social and neighborhood environments associated with substance use and misuse

Substance use theory and practice have traditionally focused on individuals who misuse substances or who are at risk for substance misuse, but this emphasis is shifting. The present study views both substance use and misuse systematically, assessing the relationships between the physical and social environments and substance use and misuse in dynamic interplay. This substance use system was examined through a survey of approximately 10,000 persons, aged 22-44, from primarily inner-city neighborhoods in the United States. Individual indicators such as race, sex, age, socioeconomic status, education, and religious service attendance relate to both the physical and interpersonal environments, even when each is controlled for the others. Qualities of both environments are strongly associated with substance dependency, even after individual indicators are controlled. These findings suggest the difficulty of bringing about change in drug and alcohol use without fundamental change in the environments where use takes place.     

The utility of locus of control for predicting adolescent substance use

Structural equation modelling (SEM) was used to examine the utility of locus of control (LOC) for predicting adolescent substance use. As part of a larger three-wave cohort-sequential study (1983-1989), 155 secondary school-based adolescents completed questionnaires on substance use, personality characteristics, family/peer influences, and health behaviors. Latent variable indicators were developed from the Nowicki-Strickland Personal Reaction Survey and substance use survey items. LOC was a weak predictor of substance use. In two instances were relationships significant: (a) 7th grade LOC predicted 11th grade alcohol use; and, (b) 9th grade LOC correlated with 11th grade cannabis use. Small samples precluded analysis of gender and social class effects. SEM with panel data offers a methodological approach for examining the explanatory capability of LOC.     

Measuring risks and outcomes in substance use disorders prevention research.

Assessment planning in substance use disorder prevention research entails the identification of measurement domains and the selection of corresponding instruments needed to fulfill specific project goals. The study design, developmental periods examined, feasibility constraints, and anticipated statistical analyses are important considerations in optimally designing the assessment protocol. As a conceptual framework to organize the domains considered here as examples, the multifactorial model of complex disorders with elaborations emphasized by the discipline of developmental psychopathology is applied. Risks reviewed include family history, childhood maltreatment, peer relationships, and psychopathology. The substance involvement dimensions germane as outcomes include substance type, consumption quantity and frequency, and substance-related problems. Comprehensive diachronic evaluation over critical developmental periods provides the technical foundation for etiology and intervention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways from proactive and reactive aggression to substance use.

Childhood aggression is a known risk factor for adolescent substance use; however, aggression is a complex construct, and developmental researchers have identified a variety of subdimensions that may be germane to substance use. Very little research has examined risk pathways from subdimensions of aggression. The current study examined a developmental model and tested whether childhood proactive aggression, reactive aggression, or both were related to the development of substance use in adolescence in a sample of 126 children (mean age at initial assessment = 10.4 years, SD = 0.51). Peer rejection and peer delinquency were examined as potential mediators of these relations. The findings suggest that proactive aggression was indirectly associated with substance use through peer delinquency. Reactive aggression was also indirectly associated with substance use through a complex mediational chain, such that high levels of reactive aggression were associated with high levels of peer rejection, which in turn were associated with peer delinquency (p = .06), which subsequently predicted substance use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical outcomes of an integrated treatment for depression and substance use disorders.

The authors compared longitudinal treatment outcomes for depressed substance-dependent veterans (N = 206) assigned to integrated cognitive–behavioral therapy plus standard pharmacotherapy (ICBT + P) or 12-step facilitation therapy plus standard pharmacotherapy (TSF + P). Drug and alcohol involvement and depressive symptomology were measured at intake and at 3-month intervals during treatment and up to 1 year posttreatment. Participants in both treatment conditions showed decreased depression and substance use from intake. ICBT + P participants maintained improvements in substance involvement over time, whereas TSF + P participants had more rapid increases in use in the months following treatment. Decreases in depressive symptoms were more pronounced for TSF + P than ICBT + P in the 6 months posttreatment. Within both treatment groups, higher attendance was associated with improved substance use and depression outcomes over time. Initial levels of depressive symptomology had a complex predictive relationship with long-term depression outcomes. Early treatment response predicted long-term substance use outcomes for a portion of the sample. Although both treatments were associated with improvements in substance use and depression, ICBT + P may lead to more stable substance use reductions compared with TSF + P. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood and personality-based models of substance use.

Mood and personality-based vulnerabilities have been extensively examined in patients with substance use disorders, but their relevance as models of etiology remains to be fully investigated. The present investigation examined mood and personality-based models of substance use in a nonclinical sample of young adults. Two-hundred and twelve individuals were assessed for personality and clinical characteristics and participated in computerized ambulatory monitoring of mood states and substance use over a 1-week period. Personality factors were strong predictors of substance use frequency over the previous 30 days, as well as of substance use in daily life using ambulatory monitoring. A linear increase was also observed in the intensity of novelty seeking and antisocial personality traits as a function of the social deviance of substances used. However, mood disorder history was related only to the use of illicit drugs other than cannabis, and fluctuations in mood states did not prospectively predict daily use of substances in a manner consistent with self-medication. Moreover, there was little evidence that personality characteristics moderated relations between mood states and substance use in daily life. The relevance of results for mood and personality models of substance use etiology is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disordered eating and substance use in an epidemiological sample: II. Associations within families.

This study investigated familial associations of disordered eating (DE) with substance use and substance use disorders (SU/SUDs) in a community-based sample of 620 adolescent girls, their 310 mothers, and 299 fathers. Female participants completed structured interviews of lifetime anorexia nervosa, bulimia nervosa, binge eating disorder, and SU/SUD; daughters also completed a self-report measure of current DE attitudes and behaviors. Fathers completed interviews assessing lifetime SUD. Evaluation of independent and combined associations of mothers' bulimic eating disturbance (ED) and parents' SUDs with daughters' DE/EDs and SU/SUDs revealed links between mothers' ED and daughters' DE but no relationship between EDs and SU/SUDs across generations. These results suggest that these problems are not cross-transmitted within families and suggest that the addiction model of eating disorders may be simplistic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation of parent alcoholism to adolescent substance use: A longitudinal follow-up study.

The current study tested parent alcoholism effects on growth curves of adolescent substance use and examined whether parent and peer influences, temperamental emotionality and sociability, and stress and negative affect could explain parent alcoholism effects. Longitudinal latent growth curve modeling showed that adolescents with alcoholic fathers, boys, and adolescents with drug-using peers had steeper growth in substance use over time than did adolescents without alcoholic fathers, girls, and adolescents without drug-using peers. Data were consistent with father's monitoring and stress as possible mediators of paternal alcoholism effects. However, the direct effects of paternal alcoholism on substance use growth remained significant even after including the hypothesized mediators in the model. This suggests that other (unmeasured) mediators are necessary to fully explain paternal alcoholism risk for adolescents' escalating substance use over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of change in adolescent substance use and symptomatology: Impact of paternal and maternal substance use disorders.

The effects of paternal and maternal substance use disorders (SUDs) on trajectories of change in adolescent offspring nicotine, alcohol, and drug use and symptomatology were investigated in a population-based sample of adolescent twins (N = 1,514). Adolescent and parental substance phenotypes were assessed when most adolescents were 11 years old, with 2 assessments of adolescents approximately every 3 years thereafter. Growth curves were fit using hierarchical linear modeling. Results indicated acceleration of substance involvement during adolescence, particularly for boys. Paternal and maternal SUD were each associated with more extreme trajectories. There was evidence for an additive, rather than interactive, combined parental effect. Findings help clarify the impact of paternal and maternal SUD on the development of substance involvement during adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of peers on young adult substance use.

Data collected from 294 young adults, ages 19 to 25, and both a same- and an opposite-gender best friend or mate across 3 annual assessments were analyzed to examine the similarity to and influence of the peer on the young adult's substance use. The authors found similarity across time between both peers and the young adult in cigarette use, alcohol use, binge drinking, and, in most cases, marijuana use. In prospective analyses, peer use predicted young adult cigarette use, binge drinking, and problem use by the young adults. Results were generally consistent across gender and for both same- and opposite-gender peers. Findings emphasize peer influence contribution to young adult substance use and suggest the design of interventions that involve both young adults and their peers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance use escalation and substance use restraint among adolescent children of alcoholics.

Assessed the escalations in substance use over 3 yrs among 246 adolescent children of alcoholics (COAs) and 208 controls (aged 10.5–15.5 yrs). Older COAs showed the steepest escalations in drug use. Younger COAs whose fathers had continuing alcohol-related consequences showed the greatest escalations in alcohol use. Ss' beliefs about drinking restraint were related to their alcohol and drug use. Those whose alcoholic fathers had no continuing alcohol-related consequences showed the strongest relations between substance use and self-control reasons for limiting drinking, perceived risk for future drug problems, and seeing the negative effects of alcohol on someone else. These adolescents may be deterred from substance use escalations because of particular parental characteristics (e.g., mild forms of paternal alcoholism) or because of their beliefs about substance use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accuracy and bias in adolescents' perceptions of friends' substance use.

This study tested competing hypotheses related to the false consensus effect and pluralistic ignorance by examining the accuracy and bias of adolescents' perceptions of peer substance use and the effects of their own substance use, gender, and age on perceptions of peer behavior. Two samples (ns = 163 and 2,194) that collected data on peer nominations, perceptions of peer substance use, and self-reports of substance use were used in analyses. Results from both samples provided evidence supporting the false consensus effect, that is, adolescents' reports of their friends' substance use were biased in the direction of their own use. Users and nonusers did not differ in accuracy of perceptions; however, across all substances and samples, they differed significantly in bias. Substance users displayed nearly perfect liberal bias, assuming their friends also used substances. Nonusers displayed an opposite, conservative bias, assuming their friends did not use substances. Gender and age differences in bias also were observed, with older adolescents and girls having more liberal biases than younger adolescents and boys. Results suggest the importance of differentiating the effects of actual and perceived peer substance use. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Physical and mental comorbidity of substance use disorders in psychiatric consultations. European Consultation-Liaison Workgroup

Comorbidity of substance use disorders with physical and mental disorders was investigated among 1249 consecutive psychiatric consultation patients admitted to six general hospitals in Finland. Of the patients 354 (28%) were diagnosed with substance use disorders (ICD-10), of which 22% were due to use of at least two different types of psychoactive substances. Alcohol dependence (117/226) in male patients and acute drug intoxication (49/128) at a similar rate as alcohol dependence (44/128) in female patients were the most common clinical conditions. With few exceptions, all substance use disorders were comorbid and in 63% of affected patients comprised a "triple diagnosis" (i.e., physical, mental, and substance use diagnoses concurrently). Poisonings and personality disorders in both sexes, digestive system diseases in men, and injuries in women were related to substance use disorders. Conclusions for service provision were: (1) the high level of co-occurrence of physical and mental disorders with substance use disorders calls for comprehensive, multi-disciplinary assessment of any substance use problems ascertained in psychiatric consultations; (2) poisoning with substance use involvement and mental comorbidity was the most common combined clinical condition justifying provision of addiction psychiatric emergency consultations in general hospitals; (3) polydrug use indicating severe problems and complex treatment needs should be identified; and (4) psychiatric referrals of patients with physical alcohol-related disorders should be ensured in general hospitals.     

Personality and substance use disorders: A prospective study.

The personality systems of Cloninger (as measured by the Tridimensional Personality Questionnaire [TPQ]) and Eysenck (as measured by the Eysenck Personality Questionnaire [EPQ]) both have been linked to substance use and abuse. The current study examined the predictive utility of both systems for substance use disorder (SUD) diagnoses, both cross-sectionally and prospectively. Participants (N?=?489 at baseline) completed the EPQ and TPQ and were assessed via structured diagnostic interview at baseline and 6 years later (N?=?457 at follow-up). Both the EPQ and TPQ scales demonstrated bivariate cross-sectional and prospective associations with SUDs. Within each system, those dimensions marking a broad impulsive sensation-seeking or behavioral disinhibition trait were the best predictors prospectively, although the 2 systems were differentially sensitive to specific diagnoses. These relations remained significant even with autoregressivity, other concurrent SUD diagnoses, and multiple personality dimensions statistically controlled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pubertal maturation and early substance use risks among African American children.

Using 2 waves of longitudinal data collected from approximately 870 African American adolescents, this study examined (a) changes in early risk factors for substance use during transition to early adolescence, including perceived prototypes of substance-using peers, willingness and intention to use substances, number of substance-using peers, and youths' own actual substance use; (b) the relationship between pubertal timing and these substance use risks; and (c) the interaction between pubertal timing and peer substance use in predicting the risks. Results showed that, first, risks for substance use increased, particularly among girls, during the transition to early adolescence. Children's prototypic images of substance users became increasingly favorable during this transitional period; a greater number of them were willing and intended to use substances during the transition to early adolescence; and an increased number of early adolescents and their friends began to use substances. Second, these changes were significantly more likely to occur among early maturing girls. Third, early physical maturation interacted with peer substance use to affect these changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations of delinquency to adolescent substance use and problem use: A prospective study.

Although studies have indicated that delinquency predicts adolescent substance use, little research has examined whether it predicts problem use or has explored the mechanisms by which it relates to problem use. Accordingly, this study tested the nature of the relations between delinquency and problem use over a 1-year interval in adolescents who had been treated for substance abuse. Results show that delinquency moderated the relation between consumption and problem use, with high-delinquent teens showing consistently elevated levels of use-related problems across all levels of substance use and nondelinquent teens showing a stronger correspondence between use levels and problems. Results support the assertion that antisocial pathology fosters problem substance use. Implications for treatment and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-coded indirect memory associations in a brief school-based intervention for substance use suspensions.

This study assessed the concurrent validity of self-generated and self-coded substance use associations for marijuana and alcohol use. Grades seven to twelve students were assessed as part of a brief intervention program in lieu of suspension for substance use infractions in school. During the cognitive assessment, students generated memory associations to probes for high-risk situations and desirable outcomes. Later, the participant rated their responses according to categories including both non-risk and substance use. Three different coding methods were compared: (1) conservative codes using clearly unambiguous responses, (2) liberal scores adding ambiguous, but likely responses, and (3) self-coded. Self-coded scores were higher, had stronger correlations with substance use, and were better predictors of substance use and problems than either conservative or liberal coded scores. These findings suggest that self-coding may be used to improve concurrent validity, decrease ambiguities in coding, and reduce the cost of measuring memory associations. The present method promises a cost effective and valid measure of indirect substance use cognitions that can be readily adapted for interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Employee substance use and on-the-job behaviors.

Substance use and job behaviors were assessed in a sample of municipal employees from a large city in the southwestern United States. Job behaviors included psychological and physical withdrawal, positive work behaviors, and antagonistic work behaviors. Employees who reported substance use at or away from work were found to more frequently engage in withdrawal activities and antagonistic work behaviors than did nonusers, although users and nonusers did not differ on positive work behaviors. Hierarchical regression models were tested to determine whether substance use contributed unique variance to the prediction of job behaviors after controlling for variance associated with personal and job background domains. Substance use added unique variance to the prediction of psychological and physical withdrawal behaviors but not to positive or antagonistic work behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)