The Intergenerational Transmission of Externalizing Behaviors in Adult Participants: The Mediating Role of Childhood Abuse.

Childhood abuse was investigated as a potential mediator of the intergenerational transmission of externalizing behaviors (EXT) in adulthood among a large general population sample drawn from the National Comorbidity Survey. Community participants (N = 5,424) underwent diagnostic and psychosocial interviews and reported on their own adult symptoms of antisocial behavior and substance dependence, parental symptoms, and childhood abuse history. Multiple group structural equation modeling revealed that (a) EXT in parents was associated with childhood abuse in offspring, particularly among mother- daughter dyads, (b) abuse had a unique influence on adult EXT in offspring above parental EXT, and (c) abuse accounted for the relationship between parental EXT and offspring EXT in female but not male participants. This article emphasizes the importance of examining different environmental processes which may explain familial transmission of destructive behaviors in men and women and highlights the importance of family interventions that target parental symptoms to ameliorate risk to offspring. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disinhibitory psychopathology and delay discounting in alcohol dependence: Personality and cognitive correlates.

Increased discounting of delayed rewards may reflect a decision bias that contributes to excessive use of alcohol and more generally, to an impulsive, disinhibitory predisposition that is characterized by a preference for immediate over long-term rewards. The current study examined the association between delay discounting of rewards and the covariation among several types of disinhibitory problems that are often comorbid with alcohol dependence (AD). Lifetime problems with alcohol, marijuana, other drugs, childhood conduct disorder, and adult antisocial behavior were assessed in a sample of 426 young adults, 257 of whom had a lifetime diagnosis of AD. Higher delay discounting rates were associated with the covariation among all domains of disinhibitory problems and were not uniquely associated with any one domain. Higher delay discounting rates also were associated with lower intelligence, lower working memory capacity, and higher trait impulsivity. The results suggest that increased delay discounting of rewards may reflect aspects of a general vulnerability to externalizing, disinhibitory disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences and developmental change in externalizing disorders from late adolescence to early adulthood: A longitudinal twin study.

Using data from over 1,000 male and female twins participating in the Minnesota Twin Family Study, the authors examined developmental change, gender differences, and genetic and environmental contributions to the symptom levels of four externalizing disorders (adult antisocial behavior, alcohol dependence, nicotine dependence, and drug dependence) from ages 17 to 24. Both men and women increased in symptoms for each externalizing disorder, with men increasing at a greater rate than women, such that a modest gender gap at age 17 widened to a large one at age 24. Additionally, a mean-level gender difference on a latent Externalizing factor could account for the mean-level gender differences for the individual disorders. Biometric analyses revealed increasing genetic variation and heritability for men but a trend toward decreasing genetic variation and increasing environmental effects for women. Results illustrate the importance of gender and developmental context for symptom expression and the utility of structural models to integrate general trends and disorder-specific characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding the role of impulsivity and externalizing psychopathology in alcohol abuse: Application of the UPPS Impulsive Behavior Scale.

The present study explores the relation among 4 personality traits associated with impulsive behavior and alcohol abuse. Personality traits were measured using the 4 subscales of the UPPS Impulsive Behavior Scale (UPPS: S. P. Whiteside & D. R. Lynam. 2001). The UPPS and measures of psychopathology were administered to clinical samples of alcohol abusers high in antisocial personality traits (AAPD), alcohol abusers low in antisocial personality traits (AA), and a control group (total N = 60). Separate analyses of variance indicated that AAPDs had significant elevations on all 4 UPPS scales, whereas the AAs and controls differed only on the Urgency subscale. However, when controlling for psychopathology, group differences on the UPPS scales disappeared. The results suggest that personality traits related to impulsive behavior are not directly related to alcohol abuse but rather are associated with the elevated levels of psychopathology found in a subtype of alcohol abusers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The chemically dependent: Phases of treatment and recovery.

Reviews the book, The chemically dependent: Phases of treatment and recovery edited by Barbara C. Wallace (see record 1992-98403-000). While this book is ambitious, interesting, educational, and useful, it is also disappointing, repetitious, and incomplete. Because it tries to accomplish so much, it may appear to have succeeded too little. This book is organized around, and explicative of, several basic ideas which might have been controversial if not heretical had this book been published ten years ago. Section I, purporting to link specific "phases of recovery" to particular forms and functions of treatment, will certainly be useful for novice clinicians but falls short of its overstated goals and is thereby disappointing. Section II is a collection of moderately redundant chapters describing the etiology and treatment of substance abusers from the viewpoints of psychoanalytic, psychodynamic, ego psychology, and object-relations theorists and therapists. Section III focuses on cognitive-behavioral, self-help, and relapse-prevention treatments. Section IV is quite uneven in quality of writing and applicability of content, and could have benefited from closer editorial scrutiny or selectivity. The final section focuses on special needs of particular subpopulations of substance abusers: African-Americans, prison inmates, HIV/AIDS patients, persons who are homeless, those who have been sexually and physically abused, and others. According to the reviewer this is not the best book on substance abuse treatment, but it does present some clinically useful ideas and it is worth reading. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality traits and the development of nicotine, alcohol, and illicit drug disorders: Prospective links from adolescence to young adulthood.

The personality traits constraint (CN) and negative emotionality (NE) have been more (CN) or less (NE) consistently associated with alcoholism. The authors examined the association of personality at age 17 with timing of onset and with prospective prediction of nicotine, alcohol, and illicit drug disorders 3 years later in a twin sample (569 females; 432 males). Earlier onset of alcohol and drug disorders (by age 17) was related to significantly lower CN compared with later onsets (by age 20); high NE was related to either onset. NE, as well as CN, uniquely predicted new onsets of all 3 types of substance use disorders by follow-up, with preexisting substance disorders taken into account. Personality traits confer generalized risk for developing any substance disorder, though some traits are more strongly linked with some substance disorders than with others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic and environmental bases of childhood antisocial behavior: A multi-informant twin study.

Genetic and environmental influences on childhood antisocial and aggressive behavior (ASB) during childhood were examined in 9- to 10-year-old twins, using a multi-informant approach. The sample (605 families of twins or triplets) was socioeconomically and ethnically diverse, representative of the culturally diverse urban population in Southern California. Measures of ASB included symptom counts for conduct disorder, ratings of aggression, delinquency, and psychopathic traits obtained through child self-reports, teacher, and caregiver ratings. Multivariate analysis revealed a common ASB factor across informants that was strongly heritable (heritability was .96), highlighting the importance of a broad, general measure obtained from multiple sources as a plausible construct for future investigations of specific genetic mechanisms in ASB. The best fitting multivariate model required informant-specific genetic, environmental, and rater effects for variation in observed ASB measures. The results suggest that parents, children, and teachers have only a partly "shared view" and that the additional factors that influence the "rater-specific" view of the child's antisocial behavior vary for different informants. This is the first study to demonstrate strong heritable effects on ASB in ethnically and economically diverse samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Alcohol and substance abuse in adolescence.

Reviews the book, Alcohol and substance abuse in adolescence edited by J. S. Brock, D. J. Lettieri, D. W. Brook, and Barry Stimmell (1985). The introductory "editorial" in this volume sets three goals which sound more like a handbook: elucidate the reasons why youth turn to drugs, how to manage those afflicted and how to educate for prevention. The papers focus largely on the first, and leave the latter two for the readers to infer. Most of the usual themes of adolescent drug use are covered: the influence of peer groups, the influence (or lack thereof) of parents, psychological development of identity and individuation. Drug use is discussed in relation to social influences, personality dynamics and adolescent development and maturation. However, the authors seem to equate any adolescent drug use (particularly marijuana) with excessive involvement. Surely it is important to examine the variations in why and how various drugs are used by that age group. It remains for others to explore the boundaries between drug use and abuse, to identify high risk patterns and to develop strategies to promote normal, healthy maturation of adolescents in a drug-drenched society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Therapeutic communities for addictions: Readings in theory, research and practice.

Reviews the book, Therapeutic communities for addictions: Readings in theory, research and practice edited by George De Leon and James T. Ziegenfus Jr. (1986). The editors represent this collection of articles concerning therapeutic communities (TCs) and substance abuse as "a first." Its stated purpose is to educate "audiences within and outside of the field of addictions" about the relevancy of the TC as a rehabilitative model, to enhance the "credibility and efficacy" of the TC within the range of treatment models and services, and to stimulate dialogue and research among professionals. The first section of this three-part volume addresses the expression of the TC in its two main varieties: the self-help hierarchical model, widely used in the rehabilitation of substance abusers, and the democratic type, more commonly seen in the treatment of psychiatric patients. Part Two concerns the effectiveness of treatment outcomes and processes. Part Three elaborates on some issues previewed in Part Two. A balanced and comprehensive overview of the subject appears to have been accomplished through careful selection of the material. The authors have presented salient issues of theory, practice, research, and development of the TC model within a sociological framework. While this volume has broad appeal for practitioners, researchers, and students, it has special utility for the professional in the addictions field with limited exposure to this treatment modality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of the evidence base for treatment of childhood psychopathology: Externalizing disorders.

This article reviews controlled research on treatments for childhood externalizing behavior disorders. The review is organized around 2 subsets of such disorders: disruptive behavior disorders (i.e., conduct disorder, oppositional defiant disorder) and attention-deficit/hyperactivity disorder (ADHD). The review was based on a literature review of nonresidential treatments for youths ages 6-12. The pool of studies for this age group was limited, but results suggest positive outcomes for a variety of interventions (particularly parent training and community-based interventions for disruptive behavior disorders and medication for ADHD). The review also highlights the need for additional research examining effectiveness of treatments for this age range and strategies to enhance the implementation of effective practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Item response theory analysis of diagnostic criteria for alcohol and cannabis use disorders in adolescents: Implications for DSM-V.

Item response theory (IRT) has advantages over classical test theory in evaluating diagnostic criteria. In this study, the authors used IRT to characterize the psychometric properties of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) alcohol and cannabis use disorder symptoms among 472 clinical adolescents. For both substances, DSM-IV symptoms fit a model specifying a unidimensional latent trait of problem severity. Threshold (severity) parameters did not distinguish abuse and dependence symptoms. Abuse symptoms of legal problems and hazardous use, and dependence symptoms of tolerance, unsuccessful attempts to quit, and physical-psychological problems, showed relatively poor discrimination of problem severity. There were gender differences in thresholds for hazardous use, legal problems, and physical-psychological problems. The results illustrate limitations of DSM-IV criteria for alcohol and cannabis use disorders when applied to adolescents. The development process for the fifth edition (DSM-V) should be informed by statistical models such as those used in this study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Treating substance abuse: Theory and technique.

Reviews the book, Treating substance abuse: Theory and technique edited by Frederick Rotgers, Daniel S. Keller, and Jon Morgenstern (see record 1995-99052-000). The authors initially postulate the question of "why we produced this book": They indicated that it is "a response to forces of change." Their answers are a reflection of "the increasing uneasiness among substance abuse treatment providers, the unstable, and often poor outcomes that result from mainstream treatments." Those who suffer from psychoactive substance use disorders, (PSUD's) constitute a staggering population; and many fail to benefit from treatment over a period of time. The authors organized the book into five major approaches to treatment theory and techniques. (1) 12-step, (2) Psychodynamic, (3) Marital-Family therapy, (4) Behavioral, and (5) Motivational enhancement. This book is essential for the beginning practitioner in the field of substance abuse, but it also serves as a valuable adjunct for those of us who have been in the field for a period of time. The authors were thorough, organized, and clear in their presentations. The text is well written and certainly a valued, up-to-date, adjunct to the field of substance abuse theory and treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Etiologic connections among substance dependence, antisocial behavior and personality: Modeling the externalizing spectrum.

A hierarchical biometric model is presented of the origins of comorbidity among substance dependence, antisocial behavior, and a disinhibited personality style. The model posits a spectrum of personality and psychopathology, united by an externalizing factor linked to each phenotype within the spectrum, as well as specific factors that account for distinctions among phenotypes within the spectrum. This model fit self-report and mother-report data from 1,048 male and female 17-year-old twins. The variance of the externalizing factor was mostly genetic, but both genetic and environmental factors accounted for distinctions among phenotypes within the spectrum. These results reconcile evidence for general and specific causal factors within the externalizing spectrum and offer the externalizing factor as a novel target for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contemplating the new DSM-V: Considerations from psychologists who work with school children.

The standard psychiatric classification system, the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSM-IV-TR; American Psychiatric Association, 2000), is about to be updated. This is important because the DSM-IV-TR, a touchstone document for service providers across several disciplines, contains only some of the conditions reported in the vast developmental/learning, psychiatric, and health literature that are known to hamper school success. Practicing psychologists who work with school-age children and those who conduct educational research confront further limitations when using DSM-IV-TR or the commonly used special education scheme (the Individuals With Disabilities Education Act [IDEA], 2004). IDEA has limited heuristic potential because it was devised for educational administrative purposes, whereas the DSM-IV-TR is a medical nosological system with little concern for school issues. Neither system fully informs needed studies of epidemiology, natural history, and disorder-specific causes and treatments. This article provides a rationale for a set of proposed changes to the new DSM-V and explains how adopting these changes will benefit psychologists concerned with understanding and treating school-age children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supportive-expressive psychodynamic therapy for cocaine dependence: A closer look.

Using data from the National Institute on Drug Abuse Collaborative Cocaine Treatment Study, this article focuses on the outcomes of patients who received supportive-expressive (SE) psychodynamically oriented psychotherapy (plus group drug counseling; GDC). Short-term SE for cocaine dependent individuals, while not the most efficacious treatment examined in the study (individual drug counseling [IDC] plus GDC was), produced large improvements in cocaine use. In addition, there was evidence that SE was superior to IDC on change in family/social problems at the 12-month follow-up assessment, particularly for those patients with relatively more severe difficulties in this domain at baseline. For patients who achieved abstinence early in treatment, SE produced comparable drug use outcomes to IDC, with mean drug use scores numerically lower for SE at all of the follow-up assessments (9, 12, 15, and 18 months). SE patients who achieved initial abstinence decreased cocaine use from a mean 10.1 day per month at baseline to a mean of 1.3 days at 12 months. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early social deprivation induces disturbed social communication and violent aggression in adulthood.

Disturbed social relations during childhood (e.g., social neglect) often lead to aggression-related psychopathologies in adulthood. Social isolation also increased aggressiveness in laboratory animals. Here the authors show in rats, that social isolation from weaning not only increases the level of aggressiveness, but results in abnormal attack patterns and deficits in social communication. In socially deprived rats, the share of attacks aimed at vulnerable body parts of opponents (head, throat, and belly) dramatically increased and the attack/threat ratio was shifted toward attacks, suggesting a decrease in intention signaling. Moreover, a Multiple Regression Analysis showed that the nonassociation of attacks with offensive threats predicted the occurrence of vulnerable attacks with 81.1% accuracy. The authors suggest that the social deprivation-induced abnormal aggression models the aggression-related problems resulting from early social neglect in humans, and studies on its brain mechanisms may increase our understanding of the mechanisms underlying psychopathologies resulting from early social problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The substance abuse problems: New issues for the 1980’s (vol. 2).

Reviews the book, The substance abuse problems: New issues for the 1980’s (vol. 2) by Sidney Cohen (1984). In this second volume of writings on substance abuse problems, Sidney Cohen offers the reader a glimpse into the many substance abuse issues facing society, treatment personnel, and the individual. The 54 chapters in this book, divided almost equally among the sections, offer brief and insightful vignettes on a variety of substance abuse issues. Overall, this book provides information and intellectual stimulation on a broad range of topics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.

Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of childhood psychopathology interventions on subsequent substance abuse: Policy implications, comments, and recommendations.

This article makes observations about policy implications and offers a combination of commentary and recommendation regarding the special issue on the impact of childhood psychopathology interventions on subsequent substance abuse. The authors mention forward-looking directives to expand the mandate for early intervention, to expand the research agenda for randomized clinical trials, and to develop a policy-oriented evidence base. They also note topics that require consideration and offer recommendations with regard to how to proceed. The special issue, as well as this discussion, will spark thought and action directed toward the evaluation of interventions for youths to assess the degree to which treating mental disorders has beneficial effects on the sequelae of the initial intervention target. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-V.

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) groups disorders into diagnostic classes on the basis of the subjective criterion of "shared phenomenological features." There are now sufficient data to eliminate this rational system and replace it with an empirically based structure that reflects the actual similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching class of emotional disorders, which can be decomposed into 3 subclasses: the bipolar disorders (bipolar I, bipolar II, cyclothymia), the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder), and the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia). The optimal placement of other syndromes (e.g., obsessive-compulsive disorder) needs to be clarified in future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)