Brief Family Intervention Effects on Adolescent Substance Initiation: School-Level Growth Curve Analyses 6 Years Following Baseline.

This study examines the effects of 2 brief family-focused interventions on the trajectories of substance initiation over a period of 6 years following a baseline assessment. The 2 interventions, designed for general-population families of adolescents, were the 7-session Iowa Strengthening Families Program (ISFP) (Molgaard & Spoth, 2001) and the 5-session Preparing for the Drug Free Years Program (PDFY) (Catalano, Kosterman, Haggerty, Hawkins, & Spoth, 1999). Thirty-three rural public schools were randomly assigned to the ISFP, the PDFY, or a minimal-contact control condition. The authors evaluated the curvilinear growth observed in school-level measures of initiation using a logistic growth curve analysis. Alcohol and tobacco composite use indices-as well as lifetime use of alcohol, cigarettes, and marijuana-and lifetime drunkenness, were examined. Significant intervention-control differences were observed, indicating favorable delays in initiation in the intervention groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation.

In this article, the authors examine whether delayed substance initiation during adolescence, achieved through universal family-focused interventions conducted in middle school, can reduce problematic substance use during young adulthood. Sixth-grade students enrolled in 33 rural midwestern schools and their families were randomly assigned to 3 experimental conditions. Self-report questionnaires provided data at 7 time points for the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years (PDFY), and control groups through young adulthood. Five young adult substance frequency measures (drunkenness, alcohol-related problems, cigarettes, illicit drugs, and polysubstance use) were modeled as distal outcomes affected by the average level and rate of increase in substance initiation across the adolescent years in latent growth curve analyses. Results show that the models fit the data and that they were robust across outcomes and interventions, with more robust effects found for ISFP. The addition of direct intervention effects on young adult outcomes was not supported, suggesting long-term effects were primarily indirect. Relative reduction rates were calculated to quantify intervention-control differences on the estimated proportion of young adults indicating problematic substance use; they ranged from 19% to 31% for ISFP and from 9% to 16% for PDFY. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of Posttraumatic Stress Symptoms in Adolescent Survivors of Childhood Cancer and Their Families: A Randomized Clinical Trial.

Posttraumatic stress symptoms (PTSS), particularly intrusive thoughts, avoidance, and arousal, are among the most common psychological aftereffects of childhood cancer for survivors and their mothers and fathers. We conducted a randomized wait-list control trial of a newly developed 4-session, 1-day intervention aimed at reducing PTSS that integrates cognitive-behavioral and family therapy approaches-the Surviving Cancer Competently Intervention Program (SCCIP). Participants were 150 adolescent survivors and their mothers, fathers, and adolescent siblings. Significant reductions in intrusive thoughts among fathers and in arousal among survivors were found in the treatment group. A multiple imputations approach was used to address nonrandom missing data and indicated that treatment effects would likely have been stronger had more distressed families been retained. The data are supportive of brief interventions to reduce PTSS in this population and provide additional support for the importance of intervention for multiple members of the family. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increasing school success through partnership-based family competency training: Experimental study of long-term outcomes.

An expanding body of research suggests an important role for parent or family competency training in children's social-emotional learning and related school success. This article summarizes a test of a longitudinal model examining partnership-based family competency training effects on academic success in a general population. Specifically, it examines indirect effects of the Iowa Strengthening Families Program (ISFP) on school engagement in 8th grade and academic success in the 12th grade, through direct ISFP effects on intervention-targeted outcomes--parenting competencies and student substance-related risk--in 6th grade. Twenty-two rural schools were randomly assigned to either ISFP or a minimal-contact control group; data were collected from 445 families. Following examination of the equivalence of the measurement model across group and time, a structural equation modeling approach was used to test the hypothesized model and corresponding hypothesized structural paths. Significant effects of the ISFP were found on proximal intervention outcomes, intermediate school engagement, and the academic success of high school seniors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief treatment for young substance abusers: A pilot study in an addiction treatment setting.

The present study evaluated a motivationally based, 4-session outpatient intervention for young substance abusers presenting for addiction treatment. Follow-up interviews were conducted 6 months after assessment on (a) clients who sought additional help (n = 22) and (b) clients who did not seek additional help (n = 28). Results indicated that (a) participating in an assessment and brief intervention was associated with reduced use and consequences and increased confidence in high-risk situations up to 6 months after entry into the program, and (b) clients who participated in additional treatment showed less of a decrease in substance-related consequences. These findings suggest that brief interventions can serve as either a stand-alone intervention for individuals who need short-term assistance or a first-step intervention for those with more specialized or long-term needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns and correlates of initial and subsequent drug use among adolescents.

Studied survey data collected in 1978–1981 examining prior and current drug use in 8th, 10th, and 12th graders in Maryland public schools. A 6-variable model (legal drugs, cannabis, pills, psychedelics, cocaine, and heroin) was used to examine the sequential and cumulative nature of drug use in a sample of 2,036 students drawn from a total sample of 34,479 males and females. Guttman scaling, using current use data for both the original and a cross-validational sample, found a stable, sequential, and cumulative hierarchy of drug use in all grades. Regression analysis of psychosocial variables found that age at first use; frequency of use of marihuana, alcohol, and cigarettes; and amount of available spending money emerged as significant predictors of use, but with little difference in predictors between the 6 drug categories. For individuals who go on to hard drug use, the data indicate that initiation into the sequence begins with a legal substance such as alcohol or tobacco and proceeds through use of marihuana. The relationship between prevalence, as well as intensity of drug use, and several psychosocial variables (e.g., academic goals, grades, spending money) emphasizes the need for further causal modeling. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of culturally focused and generic skills training approaches to alcohol and drug abuse prevention among minority adolescents: Two-year follow-up results.

Two-year follow-up data (from inner-city, minority adolescents) were collected to test the effectiveness of 2 skills-based substance abuse prevention programs and were compared both with a control condition and with each other. Students were originally recruited from 6 New York City public schools while in 7th grade. Schools were matched and assigned to receive a generic skills training prevention approach, a culturally focused prevention approach, or an information-only control. Students in both prevention approaches had less current alcohol use and had lower intentions to engage in future alcohol use relative to students in the control group. Students in the culturally focused group also engaged less in current alcohol behavior and had lower intentions to drink beer or wine than those in the generic skills group. Both prevention programs influenced several mediating variables in a direction consistent with nondrug use, and these variables also mediated alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in self-control problems and attention problems during middle school predict alcohol, tobacco, and marijuana use during high school.

Although deficits in impulse control have been linked to adolescent use of alcohol and illicit drugs, less attention has been given to variability in change in impulse control across adolescence and whether this variability may be a signal of risk for early substance use. The goals of the current study were to examine growth in two aspects of impulse control, self-control problems and attention problems, across middle adolescence, and to test the prospective effects of level and change in these variables on levels and change over time in substance use. Data are from a community sample of 955 adolescents interviewed (along with their parents and teachers) annually from 6th to 11th grade. Results indicated that greater self-control problems and attentional problems in the 6th grade and increases in these problems over time were associated with higher levels of substance use at 11th grade. Our results suggest that modeling change over time enhances the understanding of how impulse control influences the development of substance use. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Short-term effects of a brief motivational intervention to reduce alcohol and drug risk among homeless adolescents.

The short-term results of a randomized trial testing a brief feedback and motivational intervention for substance use among homeless adolescents are presented. Homeless adolescents ages 14-19 (N = 285) recruited from drop-in centers at agencies and from street intercept were randomly assigned to either a brief motivational enhancement (ME) group or 1 of 2 control groups. The 1-session motivational intervention presented personal feedback about patterns of risks related to alcohol or substance use in a style consistent with motivational interviewing. Follow-up interviews were conducted at 1 and 3 months postintervention. Youths who received the motivational intervention reported reduced illicit drug use other than marijuana at 1-month follow-up compared with youths in the control groups. Treatment effects were not found with respect to alcohol or marijuana. Post hoc analyses within the ME group suggested that those who were rated as more engaged and more likely to benefit showed greater drug use reduction than did those rated as less engaged. Limitations of the study are discussed as are implications for development of future substance use interventions for this high-risk group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social competence promotion with inner-city and suburban young adolescents: Effects on social adjustment and alcohol use.

Assessed the impact of school-based social competence training on skills, social adjustment, and self-reported substance use of 282 6th and 7th graders. Training emphasized broad-based competence promotion in conjunction with domain-specific application to substance abuse prevention. The 20-session program comprised 6 units: stress management, self-esteem, problem solving, substances and health information, assertiveness, and social networks. Findings indicated positive training effects on Ss' skills in handling interpersonal problems and coping with anxiety. Teacher ratings revealed improvements in Ss' constructive conflict resolution with peers, impulse control, and popularity. Self-report ratings indicated gains in problem-solving efficacy. Results suggest some preventive impact on self-reported substance use intentions and excessive alcohol use. In general, the program was found to be beneficial for both inner-city and suburban students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing a public health approach to delay onset and progression of adolescent substance use: Latent transition and log-linear analyses of longitudinal family preventive intervention outcomes.

This study examined the effects of the Iowa Strengthening Families Program (ISFP) and the Preparing for the Drug-Free Years program (PDFY) on young adolescent transitions from nonuse of substances to initiation and progression of substance use. Analyses incorporated 3 waves of data collected over a 2.5-year period from 329 rural young adolescents. Outcomes were analyzed by using log-linear models that incorporated substance use status frequencies derived from latent transition analyses. Effects on delayed substance use initiation were shown for both the ISFP and the PDFY at a 2-year follow-up. Also at this follow-up, the PDFY showed effects on delayed progression of use among those previously reporting initiation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Direct and indirect latent-variable parenting outcomes of two universal family-focused preventive interventions: Extending a public health-oriented research base.

Recent literature underscores the need for studies of family-based preventive interventions oriented toward public health objectives. This article illustrates a program evaluation approach for the study of family intervention outcomes in general populations. Thirty-three rural schools were randomly assigned to 1 of 3 conditions: the Preparing for the Drug-Free Years Program (PDFY), the Iowa Strengthening Families Program (ISFP), and a minimal-contact control group. Self-report and observational data collected from 523 families were used to develop measurement models of 3 latent parenting constructs that included measurement method effects. Analyses were conducted to ensure initial and attrition-related group equivalencies and to assess school effects. Structural equation models of the hypothesized sequence of direct and indirect effects for both PDFY and ISFP were then fit to the data. All hypothesized effects were significant for both interventions. The discussion addresses the potential public health benefits of evaluation research on universal preventive interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Good self-control as a buffering agent for adolescent substance use: An investigation in early adolescence with time-varying covariates.

This study tested the prediction that self-control would have buffering effects for adolescent substance use (tobacco, alcohol, and marijuana) with regard to 3 risk factors: family life events, adolescent life events, and peer substance use. Participants were a sample of public school students (N = 1,767) who were surveyed at 4 yearly intervals between 6th grade and 9th grade. Good self-control was assessed with multiple indicators (e.g., planning and problem solving). Results showed that the impact of all 3 risk factors on substance use was reduced among persons with higher scores on good self-control. Buffering was found in cross-sectional analyses with multiple regression and in longitudinal analyses in a latent growth model with time-varying covariates. Implications for addressing self-control in prevention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A brief, web-based personalized feedback selective intervention for college student marijuana use: A randomized clinical trial.

Despite clear need, brief web-based interventions for marijuana-using college students have not been evaluated in the literature. The current study was designed to evaluate a brief, web-based personalized feedback intervention for at-risk marijuana users transitioning to college. All entering first-year students were invited to complete a brief questionnaire. Participants meeting criteria completed a baseline assessment (N = 341) and were randomly assigned to web-based personalized feedback or assessment-only control conditions. Participants completed 3-month (95.0%) and 6-month (94.4%) follow-up assessments. Results indicated that although there was no overall intervention effect, moderator analyses found promising effects for those with a family history of drug problems and, to a smaller extent, students who were higher in contemplation of changing marijuana use at baseline. Implications of these findings for selective intervention of college marijuana use and web-based interventions in general are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief Treatments for Cannabis Dependence: Findings From a Randomized Multisite Trial.

This study evaluated the efficacy of 2 brief interventions for cannabis-dependent adults. A multisite randomized controlled trial compared cannabis use outcomes across 3 study conditions: (a) 2 sessions of motivational enhancement therapy (MET); (b) 9 sessions of multicomponent therapy that included MET, cognitive-behavioral therapy, and case management; and (c) a delayed treatment control (DTC) condition. Participants were 450 adult marijuana smokers with a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) diagnosis of cannabis dependence. Assessments were conducted at baseline, and at 4, 9, and 15 months postrandomization. The 9-session treatment reduced marijuana smoking and associated consequences significantly more than the 2-session treatment, which also reduced marijuana use relative to the DTC condition. Most differences between treatments were maintained over the follow-up period. Discussion focuses on the relative efficacy of these brief treatments and the clinical significance of the observed changes in marijuana use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing depression among at-risk early adolescents: Three-year effects of a family-centered intervention embedded within schools.

The Adolescent Transitions Program (ATP) is a family-focused multilevel prevention program designed for delivery within public middle schools to target parenting factors related to the development of behavior problems in early adolescence. The current study examines the effects of the ATP on the development of youth depressive symptoms across early adolescence in a sample of 106 high-risk youths. Youths were recruited in 6th grade, and selected as high risk based on teacher and parent reports of behavioral or emotional problems. Depression symptoms were based on youth and mother reports in 7th, 8th, and 9th grades. Receipt of the family-centered intervention inhibited growth in depressive symptoms in high-risk youths over the 3 yearly assessments compared with symptoms in high-risk youths in the control group. Results support the notion that parental engagement in a program designed to improve parent management practices and parent-adolescent relationships can result in collateral benefits to the youths' depressive symptoms at a critical transition period of social and emotional development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-esteem and perceived control in adolescent substance use: Comparative tests in concurrent and prospective analyses.

The relationship of positive and negative dimensions of self-esteem and perceived control to substance (tobacco, alcohol, and marijuana) use was tested with a sample of 1,775 adolescents, surveyed in 8th grade and followed up 1 year later. Esteem and control were highly correlated. Concurrent multiple regression analyses with simultaneous entry indicated internal control inversely related, and self-derogation positively related, to substance use; the unique contribution for control variables was 6.4 times the unique contribution for esteem variables. In prospective analyses, only internal control was significant. Self-attitudes were less relevant in general for substance use among Black adolescents compared with Hispanic and White adolescents; self-derogation was less relevant for adolescents in single-families compared with two-parent families. Previous findings on self-esteem and substance use may be partially reflecting the effect of perceived control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief motivational intervention with homeless adolescents: Evaluating effects on substance use and service utilization.

A brief motivational intervention with 117 homeless adolescents was evaluated using a randomized design and 3-month follow-up. The intervention was designed to raise youths' concerns about their substance use, support harm reduction, and encourage greater service utilization at a collaborating agency. The study was designed to strengthen initial promising results of an earlier study (P. L. Peterson, J. S. Baer, E. A. Wells, J. A. Ginzler, & S. B. Garrett, 2006). Several modifications in the clinical protocol were included to enhance engagement with the intervention. Analyses revealed no significant benefits for intervention participants when homeless youths' substance use rates were compared with those of control participants. Service utilization during the intervention period increased for those receiving the intervention but returned to baseline levels at follow-up. Participants reported overall reductions in substance use over time. Differences between sampling methods for the current and previous study are discussed, as are the limitations of brief interventions with this population. Future research needs to elucidate mechanisms of change and service engagement for highly vulnerable youth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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.     

Comparison of extended versus brief treatments for marijuana use.

Adult marijuana users (N?=?291) seeking treatment were randomly assigned to an extended 14-session Cognitive–behavioral group treatment (relapse prevention support group; RPSG), a brief 2-session individual treatment using motivational interviewing (individualized assessment and intervention; IAI), or a 4-month delayed treatment control (DTC) condition. Results indicated that marijuana use, dependence symptoms, and negative consequences were reduced significantly in relation to pretreatment levels at l-, 4-, 7-, 13-, and 16-month follow-ups. Participants in the RPSG and IAI treatments showed significantly and substantially greater improvement than DTC participants at the 4-month follow-up. There were no significant differences between RPSG and IAI outcomes at any follow-up. The relative efficacy of brief versus extended interventions for chronic marijuana-using adults is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)