Longitudinal substance initiation outcomes for a universal preventive intervention combining family and school programs.

This study evaluated the substance initiation effects of an intervention combining family and school-based competency-training intervention components. Thirty-six rural schools were randomly assigned to 1 of 3 conditions: (a) the classroom-based Life Skills Training (LST) and the Strengthening Families Program: For Parents and Children 10-14, (b) LST only, or (c) a control condition. Outcomes were examined 1 year after the intervention posttest, using a substance initiation index (SlI) measuring lifetime use of alcohol, cigarettes, and marijuana and by rates of each individual substance. Planned intervention-control contrasts showed significant effects for both the combined and LST-only interventions on the SII and on marijuana initiation. Relative reduction rates for alcohol initiation were 30.0% for the combined intervention and 4.1% for LST only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Randomized trial of brief family interventions for general populations: Adolescent substance use outcomes 4 years following baseline.

This study examined the long-term substance use outcomes of 2 brief interventions designed for general population families of young adolescents. Thirty-three public schools were randomly assigned to 3 conditions: the 5-session Preparing for the Drug Free Years Program, the 7-session Iowa Strengthening Families Program, and a minimal contact control condition. The pretest involved 667 6th graders and their families. Assessments included multiple measures of initiation and current use of alcohol, tobacco, and marijuana. Pretest data were collected in the 6th grade and the reported follow-up data were collected in the 10th grade. Significant intervention-control differences in initiation and current use were found for both interventions. It is concluded that brief family skills-training interventions designed for general populations have the potential to reduce adolescent substance use and thus have important public health implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiating stages of smoking intensity among adolescents: Stage-specific psychological and social influences.

Researchers' understanding of the impact of sociocultural and psychological factors on the various stages of adolescent smoking update is limited. Using national data, the authors examined transitions across smoking stages among adolescents (N=20,747) as a function of interpersonal, familial, and peer domains. Peer smoking was particularly influential on differentiating regular smoking, whereas alcohol use was most influential on earlier smoking. Although significant, depression and delinquency were attenuated in the context of other variables. Higher school grade was more likely to differentiate regular smoking from earlier smoking stages, whereas African American ethnicity and connectedness to school and family were protective of smoking initiation. Results lend support for an interactional approach to adolescent smoking, with implications for stage-matched prevention and intervention applications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couples' groups for parents of preschoolers: Ten-year outcomes of a randomized trial.

This paper reports the results of a 10-year follow-up of two variations of a couples' group preventive intervention offered to couples in the year before their oldest child made the transition to kindergarten. One hundred couples were randomly assigned to (1) a low-dose control condition, (2) a couples' group meeting for 16 weeks that focused more on couple relationship issues among other family topics, or (3) a couples' group meeting for 16 weeks that focused more on parenting issues among other family issues, with an identical curriculum to condition (2). Earlier papers reported that both variations of the intervention produced positive results on parent-child relationships and on the children's adaptation to kindergarten and first grade, and that the groups emphasizing couple relationships also had additional positive effects on couple interaction quality. The present paper uses growth curve analyses to examine intervention effects extending from the children's transition to kindergarten to the transition to high school—10 years after the couples groups ended. There were 6-year positive effects of the pre-kindergarten interventions on observed couple interaction and 10-year positive effects on both parents' marital satisfaction and the children's adaptation (hyperactivity and aggression). Discussion includes a focus on the implications of these results for family policy, clinical practice, and the need to include a couples focus in preventive interventions to strengthen family relationships and enhance children's adaptation to school. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The role of attachment to family, school, and peers in adolescents’ use of alcohol: A longitudinal study of within-person and between-persons effects.

A great deal of time and money has been spent to understand why adolescents abuse alcohol. Some of the most fruitful work considers the social context navigated by adolescents, including family, school, and peer contexts. However, most of this work focuses on differences between adolescents in these contexts. The present study adds to the literature by considering within-person changes in these contexts and examines the extent to which these changes are related to alcohol use. Significant changes in all 3 contexts were observed, and these changes were significantly related to alcohol use. The significant influence of intrapersonal variability highlights the importance of attending not only to chronic, between-individual issues facing at-risk youths but emergent and transient issues that may temporarily heighten alcohol use risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward dissemination of evidence-based family interventions: Maintenance of community-based partnership recruitment results and associated factors.

A major challenge in the dissemination of evidence-based family interventions (EBFIs) designed to reduce youth substance use and other problem behaviors is effective and sustainable community-based recruitment. This understudied topic is addressed by a preliminary study of 14 community-university partnership teams randomly assigned to an intervention condition in which teams attempted sustained implementation of EBFIs with two cohorts of middle school families. This report describes attendance rates of recruited families maintained over time and across both cohorts, along with exploratory analyses of factors associated with those rates. When compared with community-based recruitment rates in the literature, particularly for multisession interventions, relatively high rates were observed; they averaged 17% across cohorts. Community team functioning (e.g., production of quality team promotional materials) and technical assistance (TA) variables (e.g., effective collaboration with TA, frequency of TA requests) were associated with higher recruitment rates, even after controlling for community and school district contextual influences. Results support the community-university partnership model for recruitment that was implemented in the study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence-based parent and family interventions in school psychology: Overview and procedures.

This special issue, entitled "Evidence-Based Parent and Family Interventions in School Psychology," examines the data that support the use of interventions as methods for changing children's school-related behavior and learning problems. Taken together, the articles reflect the work of the Parent and Family Intervention domain of the Evidence-Based Interventions in School Psychology Task Force. Across the articles in this special issue, the categories of coding criteria in the Manual were used to organize the presentation of results. Six review articles on the evidence base for parent and family intervention appear next; these are followed by commentary from distinguished scholars and a brief reflective comment from the special issue editors. Parent intervention is the exclusive focus of the reviews of parent education and parent consultation. Two reviews focus on the home-school relationship including the articles on parent involvement and home-school collaboration. Two reviews include both parent and family treatments: early childhood family-focused interventions and parent training and family systems interventions. Commentary was sought from the current co-chairs of the Task Force, an expert in evidence-based practice in child clinical psychology, a researcher in family-school linkages and parent consultation, and a methodologist. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Examining a classwide application of cover-copy-compare with and without goal setting to enhance mathematics fluency.

The purpose of this study was to compare the effects of cover-copy-compare alone and combined with two forms of goal setting to a control condition on the mathematics fluency of 173 third-grade students. Treatment sessions occurred twice weekly for a total of 6 weeks, and multilevel modeling was used to examine progress across intervention sessions. Results suggested that combining cover-copy-compare with goal setting (problems correct) leads to steeper slopes and higher final scores than most other treatment conditions, the effects of which were retained over 1 month and generalized to similar stimulus conditions. Initial scores on a third-grade general outcome measure significantly affected growth over time but not final score. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An adaptive approach to family intervention: Linking engagement in family-centered intervention to reductions in adolescent problem behavior.

This study used Complier Average Causal Effect analysis (CACE; see G. Imbens & D. Rubin, 1997) to examine the impact of an adaptive approach to family intervention in the public schools on rates of substance use and antisocial behavior among students ages 11-17. Students were randomly assigned to a family-centered intervention (N = 998) in 6th grade and offered a multilevel intervention that included (a) a universal classroom-based intervention, (b) the Family Check-Up (selected; T. J. Dishion & K. Kavanagh, 2003), and (c) family management treatment (indicated). All services were voluntary, and approximately 25% of the families engaged in the selected and indicated levels. Participation in the Family Check-Up was predicted by 6th-grade teacher ratings of risk, youth reports of family conflict, and the absence of biological fathers from the youths' primary home. Relative to randomized matched controls, adolescents whose parents engaged in the Family Check-Up exhibited less growth in alcohol, tobacco, and marijuana use and problem behavior during ages 11 through 17, along with decreased risk for substance use diagnoses and police records of arrests by age 18. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family-Focused Preventive Interventions: Evaluating Parental Risk Moderation of Substance Use Trajectories.

Four years of longitudinal data from 373 families participating in a randomized intervention-control clinical trial were used to examine whether intervention effects on adolescent alcohol and tobacco use trajectories were moderated by family risk, as defined by parental social emotional maladjustment. Consistent with earlier outcome evaluations based on analyses of covariance, analyses confirmed that both the Preparing for the Drug Free Years program and the Iowa Strengthening Families Program favorably influenced alcohol use index trajectories across the time frame of the study; only the latter program, however, evidenced positive effects on a tobacco use index. Concerning the primary research question, analyses provided no support for family risk moderation of any intervention effect. Findings indicate the feasibility of developing universal preventive interventions that offer comparable benefits to all families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence-based parent training and family interventions for school behavior change.

In this article the guidelines of the Evidence-Based Interventions in School Psychology Task Force were used to evaluate the efficacy of parent training and family intervention for changing children's school behavior. Nineteen parent training and five family intervention studies that were conducted in schools, had a school treatment component, or included measurement of school change were identified and coded. Results found one parent training program and one family intervention to be proven efficacious across two randomized clinical trials. Several family interventions were probably efficacious or promising. Despite the established link between the family environment and school behavior, parent training and family interventions are uncommon in schools, and clinic-based treatment studies infrequently measure generalization of parent and family interventions to the school setting. Future researchers are encouraged to address these limitations and to include samples representative of the diversity of the public schools in family-focused intervention studies. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Developmental, family, and ethnic in influences on adolescent alcohol usage: A growth curve approach.

The influence of the developmental process of individuation, family conflict and cohesion, and ethnicity on adolescent alcohol use was examined in a 3-year longitudinal study. Participants included non-Hispanic White, Mexican American, and African American adolescents (n?=?6,522) from 6th, 7th, and 8th grades. They were surveyed annually for 3 years. Depending on which aspect of individuation was measured, hierarchical linear modeling indicated that changes in adolescent individuation were related to either increases or decreases in alcohol use over the 3-year period. Separation and family conflict were related to increases in alcohol use, and intergenerational individuation and family cohesion were related to decreases in alcohol use. White and Mexican American adolescents had a faster rate of increase in alcohol use than did African American youth. Separation and family process similarly influenced adolescent alcohol use from different ethnic groups. Implications for prevention and intervention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk and Protective Factors for Substance Use Among African American High School Dropouts.

Risk and protective factors that predict substance use were investigated with 318 African American high school dropout youths who completed the 1992 follow-up of the National Educational Longitudinal Study of 1988. A conceptual model linking positive family relationships and religious involvement to youths' substance use and conventional peer affiliations through a positive life orientation was examined with structural equation modeling. Positive life orientation, which included optimism and conventional goals for the future, fully mediated the influence of family relationships on conventional peer affiliations. Religious involvement directly predicted conventional peer affiliations and positive life orientation. Conventional peer affiliations mediated the other variables' influence on substance use. (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)     

Evidence-based parent and family interventions in school psychology: State of scientifically based practice.

The purpose of this special issue was to examine the scientific base that supports the use of parent and family interventions that are implemented in schools or coordinated with school settings, and to demonstrate a change in the school-related behaviors and learning problems of children and youth. Reviews have been conducted in the six sub-domains: parent education, parent involvement, parent consultation, family-school collaboration/partnership, family systems therapy and parent training, and early childhood family-focused interventions. To our knowledge this is the first time standard criteria have been applied across these subdomains to examine the empirical base for the broader family and parent intervention domain. From this review, it would be erroneous to conclude that there is no evidence for the use of parent and family interventions as methods for changing the school-related behavior and learning problems of children and youth. From this review, it is evident that parent and family interventions are multidimensional. In this review, we asked the question, "Do we find evidence that parent and family interventions change children's behavior and learning at school?" Our answer is "yes, but." (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Families and alcoholism: Developments in practice, research, and theory.

Reviews the books, Alcoholism treatment: An integrative family and individual approach by D. I. Davis (see record 1988-97811-000); Substance abuse and family therapy by E. Kaufman (1985); and The alcoholic family by P. Steinglass, L. A. Bennett, S. J. Wolin, and D. Reiss (see record 1987-98538-000). The book by Davis and Kaufman primarily address marital and family therapy (MFT) methods. The Steinglass et al. book presents a long-term, systematic program of theory development and research aimed at understanding the family system dynamics of alcoholic families. Davis provides excellent chapters on strategies for use in identifying and confronting alcohol problems and in getting a commitment from the family to work toward elimination of the problem drinking. The Davis book is an excellent resource; however, family and other therapists reading this book will need other resources for dealing with severe alcoholics, for moving rapidly to attain abstinence, and for dealing with long-term recovery. Kaufman's book is an excellent resource for family therapists wanting to learn more about dealing with alcoholism and other forms of substance abuse and for substance abuse therapists to learn about family therapy. The alcoholic family is an excellent book that will become a classic on this topic. We would recommend it for the serious clinician who wants a theoretical framework to guide decisions about therapeutic approaches with alcoholic families. We recommend all three books quite highly to practicing clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment outcomes for adolescent substance abuse at 4- and 7-month assessments.

This randomized clinical trial evaluated individual cognitive-behavioral therapy (CBT), family therapy, combined individual and family therapy, and a group intervention for 114 substance-abusing adolescents. Outcomes were percentage of days marijuana was used and percentage of youths achieving minimal use. Each intervention demonstrated some efficacy, although differences occurred for outcome measured, speed of change, and maintenance of change. From pretreatment to 4 months, significantly fewer days of use were found for the family therapy alone and the combined interventions. Significantly more youths had achieved minimal use levels in the family and combined conditions and in CBT. From pretreatment to 7 months, reductions in percentage of days of use were significant for the combined and group interventions, and changes in minimal use levels were significant for the family, combined, and group interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the nature of the relationship between child sexual abuse and substance use among women

AIMS: This study investigated whether child abuse (CSA) was associated with earlier substance use and greater severity of substance dependence and what aspects of CSA might predict substance abuse. DESIGN: The study compared (a) drug and alcohol treatment clients with and without a history of CSA and (b) CSA survivors outside drug and alcohol treatment who did or did not have current substance abuse. SETTINGS: Semi-structured interviews took place at participants' homes, treatment agencies or the research centre. PARTICIPANTS: Volunteer participants included 100 women recruited from drug and alcohol treatment programmes and 80 CSA survivors recruited through CSA counseling services and medial advertising. MEASUREMENTS: The results focus on data from the Opiate Treatment Index, Severity of Alcohol Dependence Questionnaire, Substance Dependence Scale, Self-Esteem Inventory and self-reported histories of CSA. FINDINGS: There were no differences between CSA survivors and other drug and alcohol treatment clients in their severity of dependence. Women with a history of CSA more frequently identified stimulants as their main problem drug and reported an earlier age of first intoxication and earlier use of inhalants. Among abused CSA survivors outside drug and alcohol treatment, women with current substance abuse had typically been abused during adolescence by someone outside the family, whereas those without current substance abuse were typically abused by family members before adolescence. CONCLUSIONS: The results suggest that adolescence is a crucial time for the influence of CSA experiences on substance abuse.     

Relationships over time between mental health symptoms and transmission risk among persons living with HIV.

Relationships between mental health symptoms (anxiety and depression) or a positive state of mind and behavior associated with HIV transmission (substance use and risky sexual behavior) were explored in a longitudinal study of persons living with HIV (PLH; N = 936) who were participants in a transmission-prevention trial. Bivariate longitudinal regressions were used to estimate the correlations between mental health symptoms and HIV-related transmission acts for 3 time frames: at the baseline interview, over 25 months, and from assessment to assessment. At baseline, mental health symptoms were associated with transmission acts. Elevated levels of mental health symptoms at baseline were associated with decreasing alcohol or marijuana use over 25 months. Over 25 months, an increasingly positive state of mind was associated with decreasing alcohol or marijuana use; an increasingly positive state of mind in the immediate intervention condition and increasing depressive symptoms in the lagged condition were related to increasing risky sexual behavior. Our findings suggest that mental health symptoms precede a decrease in substance use and challenge self-medication theories. Changes in mental health symptoms and sexual behavior occur more in tandem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)