Coping, expectancies, and alcohol abuse: A test of social learning formulations.

The model proposed here postulates that alcohol abuse can be predicted from a causal chain that includes alcohol consumption and "drinking to cope" as proximal determinants and general coping skills and positive alcohol expectancies as more distal determinants. To evaluate this model in a way that permits simultaneous consideration of its multiple determinants and control for demographic influences, path analytic techniques were applied to data from problem and nonproblem drinkers drawn from a general population sample. The hypothesized model accounted for significant variance in abuse status. Drinking to cope emerged as the most powerful predictor, exerting influence via direct and indirect pathways. Coping styles indicative of avoidance of emotion emerged as more important predictors of abuse than problem-focused coping. The predictive value of coping was moderated by alcohol expectancies such that avoidant styles of coping with emotion were predictive of abuse status only among drinkers expressing greater belief in alcohol's positive reinforcing properties. Findings both support and refine the social learning perspective on alcohol abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Homeless men and women: Differential associations among substance abuse, psychosocial factors, and severity of homelessness.

Latent variable multiple-group confirmatory factor analyses assessed gender differences in relationships among drug and alcohol use, measures indicating severity of homelessness, criminal history, prior institutionalization, and mental illness (N?=?531 homeless persons; 386 men and 145 women). Severity was indicated by length of time homeless, housing quality, and victimization. Men reported more substance use, a longer time homeless, poorer housing quality, greater criminal involvement, and less likelihood of living with a child. Constrained multiple-group models surfaced 5 significantly different relationships between latent constructs. Men had stronger relationships between mental illness and prior institutionalization, drug use and mental illness, and drug use and victimization, whereas women had stronger relationships between drug use and alcohol use, and criminal involvement and drug use. Service delivery implications and suggestions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A social stress model of substance abuse.

The social stress model provides a framework for detecting protective factors that may contribute to adolescents" resiliency when confronted with compelling influences to engage in substance abuse. Parameters of the model were tested in 2 urban high school samples (N?=?124) of Black (78%), White (16%), and Hispanic (6%) adolescents aged 12–14 years. Pretest and posttest measures, designed to detect the relative influence of stress, social networks, social competencies, and community resources on levels of students" usage, were completed at the beginning and end of the school year. The parameters of the model, estimated using LISREL7, indicated that the pathway from family characteristics to usage and from assertion to usage were significant. The paths from the remaining hypothesized variables were not significant. Implications for the design of prevention programs that facilitate youths" resiliency are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Protection and vulnerability processes relevant for early onset of substance use: A test among African American children.

This research tested predictions from a self-regulation model of factors relevant for early onset of tobacco and alcohol use with a community sample of 889 African American children (mean age?=?10.5 years). Criterion variables were peer substance use, willingness to use substances, and resistance efficacy (intention to refuse substance offers). Structural modeling indicated effects of temperament dimensions were mediated through self-control and risk-taking constructs, which were related to school involvement, life events, and perceived vulnerability to harmful effects of substances. Peer use was predicted by life events, poor self-control, and parent-child conflict; willingness was predicted by life events, risk taking, and (inversely) parental support; and resistance efficacy was predicted by perceived vulnerability and (inversely) poor self-control. Findings are discussed with reference to theoretical models of early protection and vulnerability processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective test of the negative affect model of substance abuse: Moderating effects of social support.

The authors tested whether dimensions of negative affect--specifically, trait levels of negative emotionality and state levels of depressive symptoms--increased risk for substance abuse onset and whether perceived social support moderated this relation using data from a 5-year prospective study of 496 school-recruited adolescent girls. Initial negative emotionality, but not depressive symptoms, and deficits in parental, but not peer, support predicted future substance abuse onset in a multivariate hazard model. Tests of the interaction between negative affect dimensions and social support suggested that support did not moderate the relation of negative affect to risk for substance abuse onset. Results provide prospective support for the etiological role in the onset of substance abuse of trait-linked negative affect and of parental support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal vulnerability, life events, and depressive symptoms: A test of a specific interactional model.

We tested Beck's (1983) hypothesis that depressive symptoms occur when an individual experiences a negative life event that specifically matches the individual's personal motivational vulnerability. Ninety-eight undergraduates completed measures of depression level, recent life events, and sociotropic and autonomous achievement motivations. Consistent with the theory, sociotropy was associated with depression level and also served as a moderator of the relations between depression and frequency of recent negative social events. However, sociotropy also demonstrated nonpredicted interactive effects with negative events categorized a priori as autonomy related. Autonomy was unrelated to depression and showed no evidence of being a vulnerability to any type of life event. The findings generally support the value of examining the role in depression of interactions between personality characteristics and life events, although they do not support the specific matching predictions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Victimization and substance abuse among women: Contributing factors, interventions, and implications.

Although the literature indicates that there is an association of victimization with substance abuse, there has been limited research focused on understanding and synthesizing the factors that have been identified as contributing to victimization and substance abuse and on interventions designed to address these contributing factors. The purposes of this article are to (a) review the literature on factors related to victimization and substance abuse, (b) review interventions and outcomes, and (c) discuss clinical implications for interventions and research. Results suggest that there is a high rate of co-occurrence of victimization and substance abuse among women, that the factors contributing to victimization and substance abuse are complex, and that there is a lack of treatment models addressing victimization and substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An outbreak of hepatitis A among homosexual men in Melbourne

OBJECTIVE: To describe an outbreak of hepatitis A virus (HAV) infection that occurred in Melbourne in 1991. DESIGN: (i) We reviewed Health Department Victoria surveillance data from 1989 to 1991 (primary surveillance) and identified all notified cases of HAV infection with an onset of illness between 1 January and 31 December 1991 (secondary surveillance data). (ii) We studied HAV seroprevalence in Melbourne among homosexual men attending gay venues. RESULTS: (i) In the two years 1989-1990 there were only 55 notifications of HAV infection to Health Department Victoria, with a male:female ratio of 1.2:1. Of the 495 notifications for 1991, 407 (82%) were male, of whom 210 (52%) were known to be homosexual. Many reported sexual and social contact at Melbourne's gay venues and with the Sydney gay community. (ii) Of men attending gay venues, 27% had serological evidence of past infection with HAV, compared with 45.8% in a 1981 Melbourne study. CONCLUSION: The outbreak of HAV infection in Victoria largely affected homosexual males in their sexually active years. Contact with the Sydney gay community was commonly reported.     

Posttraumatic stress disorder and substance abuse relapse among women: A pilot study.

The authors compared substance-dependent women with and without a comorbid diagnosis of posttraumatic stress disorder (PTSD) on their alcohol and drug use after inpatient substance abuse treatment. Participants were 31 women with a diagnosed substance dependence disorder. Forty-two percent of the entire sample (n?=?13) met DSM-III—R criteria for current PTSD. Follow-up interviews revealed that approximately 70% of the women relapsed during the 3 months posttreatment. Although rates of relapse did not significantly differ by PTSD status, PTSD women were found to relapse more quickly than non-PTSD women. Although preliminary, study findings suggest that the presence of PTSD among substance-dependent women may have prognostic significance as well as important treatment implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing substance abuse among American-Indian adolescents: A bicultural competence skills approach.

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance use and perceived AIDS exposure among homosexual men in Alaska.

Examined demographic factors, drug and alcohol use, and number of sex partners to predict perceived risk of AIDS exposure. Data came from a survey of 323 homosexual men (aged 14–60 yrs) in Alaska. Nitrite use was the most important predictor and accounted for 6.91% of the explained variance. Nitrite use, in combination with number of sex partners, explained 8.76% of the variance. Men who socialized at adult book stores used significantly more nitrites and had significantly more male sex partners in the preceding year than those who did not. In addition to nitrite use, alcohol and barbiturate use were also higher in the perceived-risk group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol expectancies regarding sex, aggression, and sexual vulnerability: Reliability and validity assessment.

This study was designed to validate the Alcohol Expectancies Regarding Sex, Aggression, and Sexual Vulnerability Questionnaire. This instrument includes alcohol expectancies in 4 domains (aggression, sexual affect, sexual drive, and vulnerability to sexual coercion) for 3 targets (self, women, and men). Confirmatory factor analyses with 715 undergraduates supported the hypothesized factor structure for the entire sample, as well as for gender and ethnic subgroups. Each of the subscales had high internal consistency reliability, moderate test-retest reliability, and good discriminant validity. Multivariate analyses of variance supported the hypothesis that participants' alcohol expectancies for other people conformed to gender role stereotypes. Participants saw themselves as being less influenced by alcohol than were others. Implications for sexual assault prevention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training for substance abuse treatment among psychologists in a rural state.

Is treating substance abuse generally a part of psychological practice? Do psychologists feel prepared to deliver substance abuse treatment? Licensed psychologists in Idaho were surveyed about their training and provision of substance abuse services. Of 144 respondents (66% return rate), nearly all (89%) had contact with substance abusers, yet most rated their graduate training as inadequate preparation for practice. Rural psychologists reported seeing the highest percentage of substance abusers. Many psychologists limited their treatment to self-help group referral. Continuing education offers the most immediate solution and might be related to certification efforts. Predoctoral training of generalist psychologists, especially in rural areas, is advocated with an emphasis on integrated behavioral health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent substance abuse treatment outcome: The role of substance abuse problem severity, psychosocial, and treatment factors.

A structural equation model incorporating substance abuse problem severity, psychosocial risk and protection, and treatment variables examined adolescent drug abuse treatment outcome pathways across 6- and 12-month follow-up points. Findings on resiliency factors and an empirical method adapted from previous research were used to select and assign 10 psychosocial factors to either a multiple protective factor index or a risk factor index. Gender, substance abuse problem severity, treatment modality, treatment length, and aftercare participation were also examined as outcome predictors. The findings suggest that treatment intensity decisions may be better informed by pretreatment psychosocial risk level rather than by substance abuse problem severity. The present study also suggests that drug-abusing adolescents who receive sufficiently long treatment, participate in aftercare, and possess at least 1 individual or interpersonal protective factor during their recovery process have the best chance to maintain gains made during treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, family environment, and multiple substance use among seventh graders.

Evaluated the Guttman-scaled nicotine, alcohol, cannabis (marihuana), and multiple substance use in relation to measures of major life stressors, daily hassles, family cohesion, conflict and expressiveness, coping, and anxiety among 425 7th graders. Instruments included the State-Trait Anxiety Inventory. Major life stressors, family cohesion, and the subjective distress of daily hassles contributed significantly in stepwise regression analyses for nicotine, cannabis, and multiple substance use. For alcohol use, major life stressors and family conflict were significant. In the case of cannabis and multiple substance use, a moderating interaction of family cohesion and life stress was obtained. Identified as multiple substance users reported high rates of occurrence of a number of life stressors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls.

This prospective study tested whether early menarche partially accounts for the increases in depression, eating pathology, substance abuse, and comorbid psychopathology that occur among adolescent girls, with structured interview data from a community sample (N?=?496). Early menarche (prior to 11.6 years) was associated with elevated depression, substance abuse, and "any" disorder but did not confer increased risk for anorexia nervosa, bulimia nervosa, or binge eating disorder. Although there was significant comorbidity across all three classes of pathology, early menarche was associated only with comorbid depression and substance abuse. Results provide partial support for the assertion that early menarche is a general risk factor for psychopathology among adolescent girls but suggest that this risk may not apply to certain disorders and that the effects are modest in size. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Variability of substance abuse. Global variability of substance abuse: is latitude a unique etiological factor?

Worldwide substance abuse consequences are a major problem challenging health planners and providers. To mediate these problems effectively, further information on the variability of substance abuse prevalence and associated causes is needed. There is some evidence suggesting that latitude may present unique etiology for substance abuse because of northerly conditions such as extreme light and dark cycles and longer periods of cold harsh environment. This hypothesis is investigated by reviewing the known literature and applying methods for evaluating latitude as a geophysical grouping characteristic on archival substance abuse data. Conclusions are based on previous findings and examples of alcohol-attributable mortality for populations from six northern areas and the United States.     

Stress and alcohol use: A daily process examination of the stressor–vulnerability model.

The authors used a daily diary methodology to examine over 60 days how the within-person associations among event stress, alcohol consumption, and desire to drink varied as a function of gender, positive and negative alcohol-outcome expectancies,' and avoidant coping in a sample of 88 regular drinkers. Multilevel regression analyses indicated that men who more strongly anticipated positive outcomes or a sense of carelessness from drinking drank relatively more on stressful days compared with low-stress days. Similar results were found predicting desire to drink. Men who anticipated greater impairment from drinking drank relatively less on stressful days. In general, these effects did not hold for women. Little evidence was found for the predicted effects for avoidant coping style, and some results showed that avoidant coping style buffered the exacerbating effects of careless unconcern expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dual diagnosis: a treatment model for substance abuse and major mental illness

The treatment of "dual diagnosis", co-occurring substance abuse and mental illness, calls for addressing two serious and often confounding problems. The authors introduce an expanded version of the transtheoretical model of change as formulated by J.O. Prochaska and C.C. DiClemente, and suggest that this new version offers a pragmatic approach to the conceptualization and treatment of dual diagnosis. The potential utility of the treatment model is presented through the authors' experiences in working with inner-city, chronic mentally ill individuals with substance abuse problems. Practical guidelines for dual diagnosis group therapy are discussed.     

Physical and biochemical characteristics of homosexual men.

Compared the height, weight, obesity, muscularity linearity, biacromial-bi-iliac ratio, and muscle strength of 44 homosexual and 111 heterosexual men. Homosexuals had less subcutaneous fat and smaller muscle/bone development and were longer in proportion to bulk. Their shoulders were narrower in relation to pelvic width, and their muscle strength was less. Linearity and muscularity were related to childhood build and certain behaviors. Urinary metabolites and blood serum lipids were compared for smaller groups (27-28 homosexuals, 109-111 heterosexuals). The homosexuals had lower creatinine and 17-ketogenic steroid levels, lower androsterone-etiocholanolone ratio, and higher 11-keto-etiocholanolone. They also had lower triglycerides, phospholipids, cholesterol, and beta-lipoproteins. It is concluded that the data support the thesis of an unidentified common factor underlying physical and personality characteristics and homosexuality. (16 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)