Demographic, individual, and interpersonal predictors of adolescent alcohol and marijuana use following treatment.

A vulnerability model of adolescent substance abuse treatment outcome provided the basis for selection of demographic, individual, interpersonal, and treatment factors to predict the follow-up use of alcohol and marijuana in a sample of 225 adolescents (aged 12–18 yrs) with psychoactive substance use disorders. Pretreatment levels of sibling substance use and aftercare participation predicted alcohol and marijuana use during the first 6 mo posttreatment. Pretreatment levels of deviant behavior also predicted the use of marijuana at 6-mo follow-up. Peer substance use at intake and 6-mo posttreatment both predicted substance use frequency outcomes at 12-mo follow-up. Alcohol and marijuana use frequencies at 6-mo follow-up also predicted continued use for these substances throughout the remainder of the 1st posttreatment year. Shorter treatment length and being male were risk factors for alcohol use during the 2nd half of the 1st posttreatment year. Elevated psychological substance dependence at 6-mo follow-up was a unique risk factor for subsequent marijuana use. Findings support conceptual models that attempt to explain adolescent substance abuse treatment outcome in terms of relationships among demographic, individual, interpersonal, and treatment factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recent-onset ecstasy use: Association with deviant behaviors and psychiatric comorbidity.

Background: Despite increases in ecstasy (MDMA) use in the United States, little is known about characteristics linked with recent-onset ecstasy use, especially psychiatric symptoms and deviant behaviors. Aims: To test whether individuals with high levels of other drug use are more likely to be recent-onset ecstasy users; to test whether psychiatric symptoms in adults are associated with recent-onset ecstasy use; to explore the association between recent-onset ecstasy use and concomitant deviant behaviors in adolescents and adults. Methods: Data from the 2001 National Survey on Drug Use and Health. Findings: Recent-onset ecstasy use was significantly more likely to occur among adolescents and adults (18-34 years old) who engaged in deviant behaviors during the past year as compared with those who did not engage in deviant behaviors during the past year. Higher levels of deviancy indicated a higher likelihood of being a recent-onset ecstasy user, and associations were strongest with nonviolent deviant behaviors such as selling illegal drugs and stealing. Associations between deviant behaviors and recent-onset ecstasy use were similar in strength to associations between deviant behaviors and recent-onset cocaine and marijuana use, respectively. Adults who had past-year psychiatric symptoms (both depressive and panic symptoms) were twice as likely to be recent-onset ecstasy users as compared with those without past-year psychiatric symptoms. Greater levels of drug involvement increased the odds of being a recent-onset ecstasy user. Conclusion: Recent-onset ecstasy use seems to be associated with a range of other behavioral problems and may reflect one aspect of a larger problem behavior syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Associations of marijuana use and sex-related marijuana expectancies with HIV/STD risk behavior in high-risk adolescents.

Multiple studies suggest an association of marijuana use with increased rates of sexual risk behavior and sexually transmitted diseases (STDs). Most studies have focused on global associations of marijuana use with sexual risk outcomes and few have examined relevant cognitive variables. Adolescents in the juvenile justice system are at elevated risk for HIV/STDs and preliminary evidence suggests that marijuana is a potentially important cofactor for sexual risk behavior in this population. This study evaluated global, situational and event-level associations of marijuana use and sex-related marijuana expectancies with sexual risk outcomes in a large, racially diverse sample of adjudicated youth (n = 656, 66% male, mean age = 16.7 years). Cross-sectional and prospective analyses identified associations of marijuana use and dependence symptoms with sexual risk outcomes, including lower frequency of condom use and higher STD incidence. Stronger sex-related marijuana expectancies predicted greater intentions for and frequency of marijuana use in sexual situations. In event-level analyses that controlled for alcohol, marijuana use predicted a significantly decreased likelihood of condom use; this association was moderated by sex-related marijuana expectancies. Mediation analyses suggested that behavioral intentions partly accounted for the prospective association of expectancies with marijuana use before sex. These results provide further evidence that marijuana use is a potentially important cofactor for HIV/STD transmission in high-risk adolescents and suggest that cognitive factors could be important for characterizing this association. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivational enhancement therapy for adolescent marijuana users: A preliminary randomized controlled trial.

This study's aims were (a) to investigate the feasibility of a school-based motivational enhancement therapy (MET) intervention in voluntarily attracting adolescents who smoke marijuana regularly but who are not seeking formal treatment and (b) to evaluate the efficacy of the intervention in reducing marijuana use. Ninety-seven adolescents who had used marijuana at least 9 times in the past month were randomly assigned to either an immediate 2-session MET intervention or to a 3-month delay condition. Two thirds of the sample characterized themselves as in the precontemplation or contemplation stages of change regarding marijuana use. Participants' marijuana use and associated negative consequences were assessed at baseline and at a 3-month follow-up. Analyses revealed that both groups significantly reduced marijuana use at the 3-month follow-up ( p = .001); however, no between-group differences were observed. Despite the absence of a clear effect of MET, this study demonstrated that adolescents could be attracted to participate in a voluntary marijuana intervention that holds promise for reducing problematic levels of marijuana use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations between anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations to coping and conformity marijuana use motives among young adult marijuana users.

The present investigation examines anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations in relation to Coping and Conformity marijuana use motives among a sample of young adult marijuana users (n = 135; 46.7% women; Mage = 20.45, SD = 5.0). After controlling for current marijuana use frequency (past 30 days), daily cigarette smoking rate, average volume of alcohol used over the past year, negative affectivity, and other marijuana use motives, anxiety sensitivity was significantly and uniquely associated with Coping and Conformity motives for marijuana use. Distress tolerance evidenced significant and unique incremental relations to Coping motives, whereas fear reactivity to bodily sensations was unrelated to any marijuana use motive. These results provide novel information related to the role of emotional sensitivity and tolerance factors as they pertain to specific types of motives for marijuana use among young adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance use diagnosis within a community sample of adults: Distinction, comorbidity, and progression over time.

Practicing psychologists conceptualize, assess, and treat clients who use substances in different ways. Using longitudinal data from a multiethnic community sample of 470 adults, the authors examine patterns of abuse and dependence on alcohol, marijuana, and cocaine. Men were significantly more abusive, dependent, and polysubstance dependent on all drugs than women. A large percentage of drug abusers, and over 1/3 with drug dependence, remitted without formal treatment. However, early severe problems with cocaine increased later alcohol problems. Traditional disease progression and drug use acquisition models are not supported. Psychologists should incorporate the natural course of substance use into treatment and prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marijuana use and panic psychopathology among a representative sample of adults.

This study examined the relations between marijuana use and panic attacks and panic disorder using a large representative survey of adults (N = 5,672; 53% women; Mage = 45.05 years, SD = 17.9) conducted in the United States (Kessler et al., 2004). After adjusting for sociodemographic variables (age, marital status, income, education, race, and sex) and the presence of a lifetime substance use disorder, lifetime marijuana use was significantly associated with increased odds of a lifetime panic attack history. Lifetime marijuana use also was significantly associated with an increased risk of current (past-year) panic attacks; however, this relation was not significant when controlling for nicotine dependence. Lifetime marijuana use was significantly associated with increased odds of a lifetime diagnosis of panic disorder as well as a current (past-year) diagnosis of panic disorder. Current (past-year) marijuana use was significantly associated with both lifetime and current panic attacks, but not current or lifetime panic disorder. Results are discussed in relation to the novel information they offer in regard to understanding the putative marijuana use–panic psychopathology association(s). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marijuana use and treatment outcome in cocaine-dependent patients.

Marijuana use was assessed in 186 people seeking treatment for cocaine dependence. Comparisons were made between clients who did and did not report using marijuana and between marijuana users who did and did not meet diagnostic criteria for marijuana dependence. The relationship between marijuana use and treatment outcome was also explored. A high rate of current marijuana use (59%) was observed at intake, and the majority of the marijuana users (74%) used marijuana at some point during treatment. Marijuana use at intake was associated with increased psychosocial impairment and substance-use severity. However, no significant adverse relations were observed between marijuana use at intake or during treatment and treatment outcome. Such functional independence may have important implications for addressing marijuana use during treatment for cocaine dependence. These findings should be interpreted with caution pending replication in prospective studies and with other treatment approaches. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concordance among biological, interview, and self-report measures of drug use among African American and Hispanic adolescents referred for drug abuse treatment.

This study examined the concordance among urine assays, interview measures, and self-report measures of marijuana and cocaine use among 190 drug-abusing/dependent African American and Hispanic adolescents and their families at 3 assessment points of an 18-month randomized clinical trial study. Results demonstrated concordance among urine assays, a calendar method self-report measure (Timeline Follow Back [TLFB]), and a noncalendar method self-report measure (Adolescent Drug Abuse Diagnosis Scale). Diagnostic criteria of marijuana and cocaine abuse/dependence from a clinical structured interview (Diagnostic Interview Schedule for Children [DISC]) also converged, albeit weakly, with self-report measures. Adolescent and parent reports on DISC marijuana abuse/dependence diagnostic criteria were related; however, collateral findings for DISC cocaine abuse/dependence diagnostic criteria were equivocal. Differences in concordance among biological and self-report cocaine use measures were found for baseline TLFB assessments among African American participants. Implications for future use and refinement of adolescent drug use assessments are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Young-adult malt liquor drinkers: Prediction of alcohol problems and marijuana use.

Malt liquor (ML) is a cheap, high alcohol content beverage that is marketed to appeal to young adults. Findings from the few published studies of ML use suggest that it may be associated with excessive drinking, alcohol problems, and the use of illicit drugs. The authors conducted separate hierarchical multiple regressions to examine the role of ML use and psychosocial variables (e.g., personality, ML motives) in alcohol-related problems and marijuana use. Demographic characteristics served as controls. The sample consisted of 639 (456 men, 183 women) young adults (M = 22.9 years, SD = 4.2) who regularly (≥40 oz/week) consumed ML. ML use significantly and positively predicted alcohol problems, ML-specific problems, and marijuana use, above and beyond their associations with typical alcohol use. Marijuana was the illicit drug of choice, and 46% reported concurrent use of marijuana and ML. Those who concurrently used ML and marijuana began drinking at a younger age and reported more substance use (particularly marijuana) and more alcohol-related problems than did nonconcurrent users. These results suggest that ML use may represent a risk for alcohol problems and marijuana use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk and vulnerability for marijuana use problems: The role of affect dysregulation.

This study examined the moderating effects of impulsivity and affect lability on relations between marijuana use frequency and use consequences. From a sample of 592 undergraduates, 300 marijuana users completed a survey that assessed marijuana problems and the hypothesized risk and vulnerability factors. Affective variables were significantly associated with increased marijuana problems above and beyond the effects of gender and lifetime use frequency. A hypothesized vulnerability mechanism, whereby impulsivity strengthened the relationship between use frequency and marijuana problems, was observed. The findings support the hypothesis that affect dysregulation enhances risk for marijuana problems among young adults who use marijuana. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk factors for adolescent substance abuse and dependence: Data from a national sample.

A national household probability sample of 4,023 adolescents aged 12 to 17 years was interviewed by telephone about substance use, victimization experiences, familial substance use, and posttraumatic reactions to identify risk factors for Diagnostic and Statistical Manual of Mental Disorders- (4th ed.; American Psychiatric Association, 1994) defined substance abuse/dependence. Age and ethnicity data were available for 3,907 participants. Major findings were (a) adolescents who had been physically assaulted, who had been sexually assaulted, who had witnessed violence, or who had family members with alcohol or drug use problems had increased risk for current substance abuse/dependence; (b) posttraumatic stress disorder independently increased risk of marijuana and hard drug abuse/dependence; and (c) when effects of other variables were controlled, African Americans, but not Hispanics or Native Americans, were at approximately 1/3 the risk of substance abuse/dependence as Caucasians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expectancy change and adolescents' intentions to use marijuana.

Drug prevention campaigns commonly seek to change outcome expectancies associated with substance use, but the effects of violating such expectancies are rarely considered. This study details an application of the expectancy violation framework in a real world context by investigating whether changes in marijuana expectations are associated with subsequent future marijuana intentions. A cohort of adolescents (N = 1,344; age range = 12?18 years) from the National Survey of Parents and Youth was analyzed via secondary analysis. Nonusers at baseline were assessed 1 year later. Changes in expectancies were significantly associated with changes in intentions (p     

Adolescent modeling of parent substance use: The moderating effect of the relationship with the parent.

This study examined a hypothesis derived from social learning theory, that adolescents would be more likely to model the substance use of each parent if they had a relatively good relationship with the parent than if their relationship with that parent was relatively poor. Data from 657 adolescents (51% female; 11 to 15 years of age at the 1st assessment), 357 fathers, and 633 mothers across a 6-year assessment period were used for these analyses. As hypothesized, all adolescents modeled mother's cigarette use and father's marijuana use, older adolescents modeled mother's marijuana use and younger girls and older boys modeled father's alcohol use if they had a relatively good or moderate relationship with that parent but did not model their parent's use if the relationship with that parent was relatively poor. Caution is noted in assuming that relatively good relationships with a parent are always protective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood victimization and illicit drug use in middle adulthood.

Using a prospective cohort design, the authors examined in this study whether childhood victimization increases the risk for illicit drug use and related problems in middle adulthood. Court-documented cases of childhood physical and sexual abuse and neglect and matched controls (N = 892) were first assessed as young adults (mean age = 29 years) during 1989-1995 and again in middle adulthood (mean age = 40 years) during 2000-2002. In middle adulthood, abused and neglected individuals were about 1.5 times more likely than controls to report using any illicit drug (in particular, marijuana) during the past year and reported use of a greater number of illicit drugs and more substance-use-related problems compared with controls. The current results reveal the long-term impact of childhood victimization on drug use in middle adulthood. These new results reinforce the need for targeted interventions with abused and neglected children, adolescents, and adults, and particularly for women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward the DSM-V: The Withdrawal-Gate Model versus the DSM-IV in the diagnosis of alcohol abuse and dependence.

The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) classifies as dependent many cases of mild alcohol problems. DSM-IV diagnoses have modest relationships with predictive and some concurrent validators and often improperly sequence the onset of abuse vs dependence, perhaps due to insufficient emphasis on physiological features. Testing reliability, syndrome prevalence, syndrome sequencing, and concurrent and predictive validity, this study contrasted the DSM-IV with the Withdrawal-Gate Model (WGM), in which alcohol withdrawal is necessary and sufficient for the dependence diagnosis. Clinical samples of adults (baseline n?=?318) and adolescents (baselinen?=?214) meeting abuse or dependence were assessed for DSM-IV alcohol symptoms and external measures of problem severity and reinterviewed at 6 (adults) and 12 mo (adults and adolescents). Among DSM-IV dependent cases, the WGM shifted 32% of adults and 80% of adolescents to the abuse category, making both categories more symptomatically severe, but had a negligible effect on prevalence of total alcohol diagnoses. The WGM was more reliable than the DSM-IV and temporally sequenced abuse before dependence in a greater number of cases. The WGM was superior to the DSM-IV in concurrent and predictive validity on most measures. Future diagnostic systems may be more reliable and valid if they require evidence of withdrawal for substance dependence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adult marijuana users seeking treatment.

In an effort to study the efficacy of attracting and intervening with adult marijuana users, 290 men and 92 women were screened for participation in a treatment-outcome study focused on marijuana cessation. The well-educated, self-referred sample reported using marijuana on 79 of the past 90 days before testing. Indices of the severity of marijuana abuse and general psychopathology were in the clinical range for a majority of Ss. Ss who did not report evidence of alcohol or other drug abuse (n?=?144) reported less severe consequences of marijuana use and experienced less general psychological distress than Ss who also reported lifetime (n?=?165) or current abuse (n?=?73) of other substances in addition to marijuana. The findings indicate the need for clinical research targeting adults who are dependent on marijuana. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Growth response of human coronary smooth muscle cells to angiotensin II and influence of angiotensin AT1 receptor blockade

BACKGROUND: Adolescents and young adults are four times more likely to be victims of sexual assault than women in all other age groups. In the vast majority of these cases, the perpetrator is an acquaintance of the victim. Date rape is a subset of acquaintance rape where nonconsensual sex occurs between two people who are in a romantic relationship. METHODS: We conducted a MEDLINE and Current Concepts search for articles relating to date rape and then systematically reviewed all relevant articles. RESULTS: Lifetime prevalence of date or acquaintance rape ranges from 13% to 27% among college-age women and 20% to a high of 68% among adolescents. Demographic characteristics that increase vulnerability to date rape include younger age at first date, early sexual activity, earlier age of menarche, a past history of sexual abuse or prior sexual victimization, and being more accepting of rape myths and violence toward women. Other risk factors include date-specific behaviors such as who initiated, who paid expenses, who drove, date location and activity, as well as the use of alcohol or illicit drugs such as flunitrazepam (Rohypnol). Alcohol use that occurs within the context of the date can lead to: the misinterpretation of friendly cues as sexual invitations, diminished coping responses, and the female's inability to ward off a potential attack. CONCLUSIONS: Longitudinal research designs are needed to further our understanding of sexual violence among adolescents and young adults and the most effective ways to eliminate it. Understanding and comparing research findings would be easier if consensus regarding the definitions of date rape, sexual aggression, and sexual assault was obtained. Finally, primary and secondary date and acquaintance rape prevention programs must be developed and systematically evaluated.     

Adolescents' thoughts about abstinence curb the return of marijuana use during and after treatment.

Despite evidence showing that readiness to change substance use predicts reductions in substance use among treated adolescents, there is little research on changes in thoughts about abstinence and marijuana use during and after treatment. The current study tested whether time-varying changes in adolescents’ motivation to abstain and perceived difficulty to abstain from marijuana use hinder the return of regular marijuana use during and after treatment. Monthly data on thoughts about abstinence, marijuana use, and treatment utilization were collected over 6 months from 142 adolescents recruited from intensive outpatient substance use treatment. Results indicated that higher motivation to abstain (but not perceived difficulty) predicted fewer days of marijuana use, over and above the individual’s average trajectory of marijuana use, the initial severity of marijuana involvement, and the effects of treatment utilization. Moreover, past-month marijuana use influenced both motivation to abstain and perceived difficulty to abstain. Findings highlight the importance of abstinence-related cognitions as a target of intervention during and after treatment and underscore the importance of considering recovery from substance use disorders as a dynamic process of change over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)