Poor sleep and reactive aggression: Results from a national sample of African American adults

BACKGROUND

We know that poor sleep can have important implications for a variety of health outcomes and some evidence suggests a link between sleep and aggressive behavior. However, few studies have looked at this relationship among African-Americans in the United States.

METHODS

Data from the National Survey of American Life (NSAL) and the NSAL Adult Re-Interview were used to examine associations between sleep duration and self-reported quality of sleep on reactive aggression among African American and Caribbean Black respondents between the ages of 18 and 65 (n = 2499).

RESULTS

Controlling for an array of sociodemographic and psychiatric factors, sleep was found to be significantly associated with reactive aggression. Specifically, individuals who reported sleeping on average less than 5 h per night were nearly three times more likely to report losing their temper and engaging in a physical fight (AOR = 3.13, 95% CI = 1.22-8.02). Moreover, individuals who reported being "very dissatisfied" with their sleep were more than two times more likely to report losing their temper and engaging in physical fights (AOR = 3.32, 95% CI = 1.50-7.33). Persons reporting everyday discrimination and problems managing stress were more likely to sleep poorly.

CONCLUSIONS

The present study is among the first to document an association between poor sleep and reactive violence among African-Americans. Findings suggest that reducing discrimination may lead to improved sleep and subsequently reduce forms of reactive violence.

Substance use and teen pregnancy in the United States: evidence from the NSDUH 2002-2012

INTRODUCTION

Few, if any, studies have systematically examined the relationship between substance use and teen pregnancy using population-based samples. We aim to provide a comprehensive examination of substance use among pregnant adolescents in the United States.

METHOD

Employing data from the National Survey on Drug Use and Health between 2002 and 2012 (n=97,850), we examine the prevalence of the past 12-month and the past 30-day substance use and substance use disorders among pregnant and non-pregnant adolescents (ages 12-17). We also examine psychosocial and pregnancy-related correlates of current substance use among the subsample of pregnant adolescents (n=810).

RESULTS

Pregnant teens were significantly more likely to have experimented with a variety of substances and meet criteria for alcohol (AOR=1.65, 95% CI=1.26-2.17), cannabis (AOR=2.29, 95% CI=1.72-3.04), and other illicit drug use disorders (AOR=2.84, 95% CI=1.92-4.19). Pregnant early adolescents (ages 12-14; AOR=4.34, 95% CI=2.28-8.26) were significantly more likely and pregnant late adolescents (ages 15-17; AOR=0.71, 95% CI=0.56-0.90) significantly less likely than their non-pregnant counterparts to be current substance users.

CONCLUSIONS

Study findings point not only to a relationship between pregnancy and prior substance use, but also suggest that substance use continues for many teens during pregnancy. We found that substance use is particularly problematic among early adolescents and that the prevalence of substance use attenuates dramatically as youth progress from the first to the second and third trimesters of pregnancy.

Rumble: Prevalence and Correlates of Group Fighting among Adolescents in the United States

Objective. Group fighting is portrayed as a piece of Americana among delinquent youth, but the behavior produces significant multifaceted negative consequences. The current study examines the heterogeneity and correlates of group fighting using national-level data. Method. Employing data from the National Survey on Drug Use and Health between 2002 and 2013 (n = 216,852), we examine links between group fighting and temperamental, parental, and academic factors as well as other externalizing behaviors (i.e., violence, crime, substance use). Results. The prevalence of group fighting in the United States is 14.8% with 11.33% reporting 1–2 group fights and 3.46% reporting 3+ group fights. A clear severity gradient in school functioning and academic performance, sensation seeking, parental disengagement, violence and delinquency, and substance use disorders is seen in the normative, episodic, and repeat offender groups. Conclusions. Youths who participate in 3+ group fights display the exceptionality and severity of other serious/chronic/habitual antisocial youth which suggests that group fighting should be considered a significant indicator of developing criminality.

Prevalence and correlates of psychiatric disorders among former juvenile detainees in the United States

OBJECTIVE

Juvenile offenders face increased liability for psychiatric disorders and greater psychopathology, but little is known about the psychiatric status of former juvenile delinquents as adults.

METHOD

Drawing on data from Wave 1 and Wave 2 of the NESARC, logistic regression models examine correlates of psychiatric disorders in a large nationally representative sample of former juvenile detainees in adulthood (n=1177) compared to adults who did not have a history of juvenile offending (n=33,193). Further, we explored the psychosocial correlates associated with the increased likelihood of psychiatric disorders among former juvenile detainees.

RESULTS

Nearly half of former juvenile detainees met criteria for one or more psychiatric disorders in the past twelve months and approximately two-thirds meet criteria for any lifetime personality disorder. Compared to the general population, former juvenile detainees not only denote greater psychiatric comorbidity across a range of affective, personality, and substance use disorders but are also more likely to report childhood adversity.

CONCLUSIONS

Former juvenile detainees experience significantly greater and more varied psychiatric problems across adulthood.

High school dropouts in emerging adulthood: substance use, mental health problems, and crime

This study examined the distribution of substance use, mental health, and criminal behavior among dropouts derived from a nationally representative sample of 18-25 year old (N = 19,312) emerging adults in the United States. Using public-use data from the 2010 National Survey on Drug Use and Health, this study employed multiple logistic regression with adjustments for complex survey sampling and compared high school dropouts with graduates with respect to substance use, mental health, and criminal behavior. After controlling for the effects of age, gender, race/ethnicity, family income, receipt of government assistance, employment status, and metropolitan population density, dropouts were more likely to meet criteria for nicotine dependence and report daily cigarette use, and more likely to report having attempted suicide in the previous year, been arrested for larceny, assault, drug possession or drug sales relative to their high school graduate counterparts. The findings of this study provide important insights and an initial epidemiologic portrait of mental health, substance use, and criminal behaviors of dropouts during emerging adulthood.

Drugged and Dangerous

The evidence is clear that substance use and drug problems often accompany other antisocial behavior generally and violent behavior specifically; however, the specificity of the drug/violence nexus is less clear. Using data from the National Survey on Drug Use and Health (NSDUH) between 2008 and 2012, the current study examined the prevalence and possible heterogeneity of substance use among serious violent offenders in the United States. Three latent classes were discovered: Class 1 (61.18% of sample) who displayed limited substance use morbidity, Class 2 (28.17% of sample) who displayed comorbid alcohol and marijuana use disorders, and Class 3 (10.65% of sample) who displayed polydrug abuse/dependence and severe criminal careers. Additional results indicated that the most serious violent offenders have substance use problems that appear amenable to treatment; however, the most antisocial violent offenders also have the most severe drug problems. Implications of study findings for the epidemiology of antisocial behavior and correctional interventions are discussed.

Toward a Typology of Acculturative Stress

The objective of this study is to identify latent classes of Hispanic immigrants on the basis of acculturative stress and, in turn, examine the links between membership in acculturative stress classes and the prevalence of mental disorders. We use latent class analysis (LCA) and multinomial logistic regression with data from a population-based study of Hispanic immigrants in the United States ( n = 1,630). Classes were identified as “Low Acculturative Stress” (38.40%); “Social and Linguistic Stress” (32.27%); “Acculturative Stress, No Fear of Deportation” (20.06%); and “Acculturative Stress, Fear of Deportation” (9.26%). Members of the “Acculturative Stress, Fear of Deportation” class were significantly more likely than members of the “Low Acculturative Stress” class to meet criteria for generalized anxiety disorder (risk ratios [RR] = 3.55, 95% confidence interval [CI] [1.00, 12.56]). The present study represents an important step in the development of a typology of acculturative stress among Hispanic immigrants in the United States.

Crime and Violence among MDMA Users in the United States

The question of whether MDMA use is associated with increased crime and violence has not been adequately explored especially in nationally representative samples. This study used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to assess the association between MDMA use and violent and non-violent antisocial behavior while controlling for sociodemographic variables, lifetime psychiatric, alcohol and drug use disorders, and family history of antisocial behavior. MDMA users, both male and female, were involved in a number of crimes in acts of violence including drunk driving, shoplifting, theft, intimate partner violence, and fighting. Notably, female MDMA users were more antisocial than male non-MDMA users. Although adjusting the results for numerous confounds attenuated the relationships, MDMA users were still at significantly greater odds of engaging in violent and nonviolent crime than non-MDMA users. Although MDMA has been considered a facilitator of empathy and closeness, the current study suggests a dark side as MDMA is associated with a broad array of crimes and transgressions. Additional tests of the MDMA-crime link are needed to properly inform policy.

Gambling prevalence rates among immigrants: a multigenerational examination

INTRODUCTION

The present study employed data from Waves I and II of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) to compare gambling prevalence rates across gender and world regions (e.g., Africa, Asia, Europe, and Latin America).

METHODS

Responses from first generation (n=5363), second generation (n=4826), third generation (n=4746), and native-born Americans (n=19,715) were subjected to a series of multinomial regression analyses, after controlling for sociodemographic variables such as age, gender, race/ethnicity, household income, education level, region of the United States, and urbanicity.

RESULTS

The prevalence of gambling and problem gambling was markedly lower among first-generation immigrants than that of native-born Americans and second and third-generation immigrants. Results also point to inter- and intra-generational dynamics related to gender, age of arrival and duration in the United States, and world region from which participants emigrated. Additionally, we found that second-generation immigrants and nonimmigrants were significantly more likely to meet criteria for disordered gambling compared to first-generation immigrants in general.

CONCLUSIONS

Compared to first-generation immigrants, male and female immigrants of subsequent generations and nonimmigrants were significantly more likely to report involvement in all problem gambling behaviors examined. Findings suggest that gambling prevalence rates increase across subsequent generations, and are more likely to occur in women than among men.

Deliberate self-harm and the nexus of violence, victimization, and mental health problems in the United States

Deliberate self-harm (DSH) is associated with diverse psychiatric diagnoses and broad psychopathology but less is known about its association with other forms of interpersonal violence and crime. Using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the current study examined linkages between not only DSH and mental health and substance abuse comorbidity, but also childhood abuse, lifetime victimization, and a variety of violent behaviors. We identified a prevalence of 2.91% for DSH and found that DSH is associated with generalized and severe psychopathology, wide-ranging substance abuse, and adverse childhood experiences. Contrary to other studies, we found significant racial and ethnic differences in DSH. African-American, Latinos, and Asians, were substantially less likely than Whites to report DSH. Our hypothesis that DSH would be associated with a variety of violent behaviors including robbery, intimate partner violence, forced sex, cruelty to animals, and use of a weapon was supported even after adjusting for an array of covariates. We extend previous research on DSH by examining its prevalence in one the largest comorbidity surveys ever conducted and show that DSH is associated with multiple forms of violent behavior toward others, including animals.

A typology of drug selling among young adults in the United States

BACKGROUND

Although studies have found that young adults who sell drugs are more likely to be involved in risky behaviors than those who do not sell drugs, there has been relatively little research that has explored heterogeneity among young adults who sell drugs.

METHODS

Using a pooled sample of 18 to 25 year olds from the National Survey on Drug Use and Health (2006-2010) who report past-year drug selling (N = 5,373), this study employs latent profile analysis to specify latent groups and assess the correlates of group membership.

RESULTS

Findings indicate substantial differences among young adults who sell drugs. In particular, the analysis found four groups of drug sellers: normative (49.6%), club drug users (23.6%), polysubstance users (16.0%), and criminal offenders (10.8%). Club drug users were characterized by high levels of ecstasy and hallucinogen use, polysubstance users were more likely to be depressed and anxious, White and female than the other groups. Criminal offenders were overwhelmingly male and more likely to be comprised of African-Americans and Hispanics.

CONCLUSIONS

RESULTS indicate that drug selling in early adulthood varies substantially. Contrary to media and popular notions most drug sellers are not involved in crime and polysubstance using drug sellers are in clear need of mental health services. Further, most drug sellers in this age range are White. Findings suggest that policy efforts that operate under the assumption of homogeneity of drug selling may be misguided.

Mood, anxiety, and personality disorders among first and second-generation immigrants to the United States

A careful examination of the multigenerational relationship between immigrant status and mental disorders can provide important information about the robustness and nature of the immigrant-mental health link. We examine immigrant status as a protective factor against mental illness, assess intergenerational effects, examine differences across race/ethnicity, and report the prevalence of mood, anxiety, and personality disorders of immigrants across major world regions. We employ data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and compare first (n=5363) and second-generation (n=4826) immigrants from Asia, Africa, Europe, and Latin America to native-born Americans (n=24,461) with respect to mental disorders. First-generation immigrants are significantly less likely than native-born Americans to be diagnosed with a mood, anxiety, or personality disorder, though the prevalence of mental health diagnoses increases among second generation immigrants. Similar results were observed for immigrants from major world regions as the prevalence of psychiatric morbidity was lower among immigrants from Africa, Latin America, Europe, and Asia compared to native-born Americans. Findings provide evidence in support of the notion that the immigrant paradox may be extended to include mood, anxiety, and personality disorders in the United States.

Family functioning and parent support trajectories and substance use and misuse among minority urban adolescents: a latent class growth analysis

We sought to examine latent classes of family functioning and parent support trajectories during high school and whether these trajectories are associated with an increased risk of substance use and misuse among urban youth. A total of 850 adolescents (Mage = 15.1 years) were included in this study, assessed at baseline, 12-, 24-, and 36-months postbaseline, and completed self-report measures on past 30-day alcohol and marijuana use, binge drinking, and measures of family functioning and parent support. Latent class growth analysis revealed that trajectories of high family functioning and parent support are associated with a decreased risk of marijuana use. Findings may be helpful to inform family-based preventive interventions.

A "refugee paradox" for substance use disorders?

BACKGROUND

Few, if any, studies have systematically examined the link between nativity and substance use disorders (SUD) among refugees using national samples. As such, it remains uncertain if the "immigrant paradox" for substance use can be extended to include refugees in the United States.

METHODS

Employing data from the National Epidemiologic Survey on Alcohol and Related Conditions, we examine the lifetime prevalence of SUDs among refugees (n=428) in contrast with non-refugee immigrants (n=4955) and native-born Americans (n=29,267). We also examine the impact of gender and refugee duration on the relationship between nativity, refugee status, and SUDs.

RESULTS

Refugees were between 3 and 6 times less likely than native-born Americans meet criteria for all SUDs examined, and significantly less likely than non-refugee immigrants to meet criteria for alcohol (AOR=0.44, 95% CI=0.41-0.47), cocaine (AOR=0.54, 95% CI=0.50-0.59), hallucinogen (AOR=0.66, 95% CI=0.58-0.74), and opioid/heroin (AOR=0.62, 95% CI=0.58-0.66) use disorders. The refugee-SUD link was significantly moderated by gender. Duration as a refugee was associated with increased risk for alcohol use disorder and decreased risk of cannabis and illicit drug use disorders.

CONCLUSIONS

Study findings provide evidence in support of a "refugee paradox" for SUDs among adults in the United States. Refugees are substantially less likely than native-born Americans to meet criteria for all SUDs examined and, albeit with weaker effects, significantly less likely than non-refugee immigrants to meet criteria for a variety of SUDs.

Correlates of traumatic brain injury among juvenile offenders: a multi-site study

BACKGROUND

There is some evidence that antisocial individuals, including young delinquents, are significantly more likely than people in the general population to incur a traumatic brain injury (TBI). Extant studies are hampered by methodological limitations, such as small sample sizes, lack of control for confounding effects, and use of single sites and may lack representativeness.

HYPOTHESIS

The hypothesis for this study is that young offenders with a history of TBI will not only be at higher risk of impulsivity and negative emotionality than their non-injured peers but also that those with TBI will have had more previous victimisation experiences.

METHODS

Data from two sites (Philadelphia, PA and Phoenix, AZ) in a substantial longitudinal, prospective study - the Pathways to Desistance Study - were used to compare young people (average age 16 years) who reported TBI with those who did not. Independent variables were behavioural, criminogenic and psychosocial measures.

RESULTS

Male youths were about twice as likely as young females to report TBI. Such injury was associated with higher impulsivity and negative emotion ratings, even after allowing for potentially confounding factors, including sex. In addition, TBI was independently associated with self-reported experience of victimisation.

CONCLUSIONS/IMPLICATIONS

This extends the generalisability of earlier suggestions of a relationship between TBI and offending, and various factors thought likely to mediate the relationship. The implications are, thus, that it is likely to be of practical value to screen young people who get into the criminal justice system for a history of TBI, and thus to allow for more specific tailoring of interventions to reduce the range of associated problems, including likely reoffending.

Caution or warning? A validity study of the MAYSI-2 with juvenile offenders

Given the high prevalence of mental health and substance use disorders in the juvenile justice system and the emphasis on efficient screening and referrals, the current study sought to further validate the use of the Massachusetts Youth Screening Instrument version 2 (MAYSI-2). Using data from institutionalized delinquents (N=836) committed to the California Youth Authority, finite mixture modeling was employed to identify distinct latent classes based on MAYSI-2 scale scores. Identified classes were then compared across a range of covariates, including prior offenses, official records of misconduct, and multiple measures of mental health and psychological well-being. Findings revealed a three-class, gradient-based structure: low distress (n=380), moderate distress (n=327), and high distress (n=129). Overall, the MAYSI-2 identified juvenile offenders with mental health and substance use issues, but it did not differentiate youths with respect to offending patterns.

The immigrant paradox: immigrants are less antisocial than native-born Americans

PURPOSE

Although recent research on crime and violence among immigrants suggests a paradox--where immigrants are more socially disadvantaged yet less likely to commit crime--previous research is limited by issues of generalizability and assessment of the full depth of antisocial behavior.

METHODS

We surmount these limitations using data from waves I and II of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and compare immigrants (N = 7,320) from Asia, Africa, Europe, and Latin America to native-born Americans (N = 34,622) with respect to violent and nonviolent forms of antisocial behavior.

RESULTS

After controlling for an extensive array of confounds, results indicate that immigrants are significantly less antisocial despite being more likely to have lower levels of income, less education, and reside in urban areas. These findings hold for immigrants from major regions of the world including Africa, Asia, Europe, and Latin America.

CONCLUSIONS

This study confirms and extends prior research on crime and antisocial behavior, but suggests that it is premature however to think of immigrants as a policy intervention for treating high crime areas.

A confirmatory approach to understanding the four-factor structure of the Adolescent Drinking Index: evidence for a brief version

The purpose of this study was to examine the psychometric properties of the original version of the Adolescent Drinking Index (ADI), and to examine the fit of a series of confirmatory factor analysis models to arrive at an abbreviated version that can be easily administered in settings with limited time for assessment. These aims were examined in a sample of 740 adolescents (Mage=15.26; 58.5% males) who completed the ADI during an emergency department visit. Results suggested that the four-domain design did not fit the data adequately. Results, however, demonstrated good fit for an 8-item adapted version with a four-factor structure: interpersonal, social, psychological, and physical indicators. This abbreviated version was also associated with outcomes such as hangover, alcohol withdrawal, and substance use. Findings from this study provide support for the use of an abbreviated version of the ADI for screening adolescents and referring them to appropriate interventions.

Alcohol use among Hispanic early adolescents in the United States: an examination of behavioral risk and protective profiles

Few studies have examined the behavioral and protective correlates of alcohol use among young Hispanics. Using a national sample (N = 7,606), logistic regression and latent profile analysis (LPA) are employed to examine the relationships between alcohol use, psychosocial factors, and externalizing behavior among Hispanics during early adolescence. Early drinkers are more likely to report truancy, fighting, smoking, and drug use. LPA results revealed a three class solution. Classes identified included: psychosocial risk (41.11%), moderate protection (39.44%), and highly religious (19.44%). Alcohol use is clearly associated with externalizing behavior; however, an important degree of psychosocial and behavioral heterogeneity nevertheless exists.

Religiosity and violence among adolescents in the United States: findings from the national survey on drug use and health 2006-2010

There is a pressing need to develop a more nuanced understanding of the relationships between particular expressions of religiosity and the various manifestations of violence among youth. This study examines these relationships among adolescents in the general population as well as across racial/ethnic, gender, and family income differences. Using a nationally representative sample of adolescents (N = 90,202) from the National Survey on Drug Use and Health (2006-2010), logistic regression is used to examine the relationships between religiosity and violence. Results indicate that multiple components of adolescent religiosity are associated with the decreased likelihood of fighting, group fighting, and, to a lesser extent, violent attacks. A number of noteworthy differences were identified across race/ethnicity, gender, and family income. Findings from this investigation shed light on the relationship between particular facets of religiosity and violence that may be useful for violence prevention organizations seeking to integrate religious components into intervention efforts.

Dropping out of school and chronic disease in the United States

AIM

Despite links between education and health, it is unclear to what extent dropping out of school is associated with major chronic health conditions.

SUBJECTS AND METHODS

Data from the 2006-2010 United States National Survey on Drug Use and Health (NSDUH) was employed and examined associations between dropping out of school and major chronic health conditions among individuals 18 years or older (N=189,896).

RESULTS

Analyses show that dropout status is associated with increased odds of reporting a major chronic health condition; however, the effect is stronger for Whites and African-Americans than Hispanics.

CONCLUSIONS

Study findings suggest that one important strategy to prevent and reduce health disparities is increased education in general including high school completion. Policies and practices that reduce dropout may in turn impact the prevalence of chronic disease.

Addressing Spiritual Needs and Overall Satisfaction With Service Provision Among Older Hospitalized Inpatients

Little research has examined the relationship between addressing older adults’ spiritual needs and overall satisfaction with service provision during hospitalization, despite the importance of spirituality and religion to most older adults. This study examined this relationship, in tandem with the effects of eight potential mediators. Toward this end, structural equation modeling was used with a sample of 4,112 adults age 65 and older who were consecutively discharged over a 12-month period from hospitals in California, Texas, and New England. As hypothesized, addressing spiritual needs was positively associated with overall satisfaction. The relationship between spiritual needs and satisfaction was fully mediated by seven variables: nursing staff, the discharge process, visitors, physicians, the admissions process, room quality, and the administration of tests and treatments. The diverse array of mediating pathways identified highlights the importance of health care practitioners working collaboratively to address older adults’ spiritual needs.

Assessing empathy in Salvadoran high-risk and gang-involved adolescents and young adults: a Spanish validation of the basic empathy scale

Empathy is considered a key construct in the empirical study of high-risk adolescent and young adult delinquency, crime, and violence. This study examined the psychometric properties and criterion-related validity of a Spanish adaptation of the Basic Empathy Scale (BES), which is an important measure designed to capture both affective and cognitive empathy that has been validated in multiple languages but not in Spanish. The study's sample consisted of 208 high-risk and gang-involved adolescents and young adults in the Greater San Salvador Metropolitan Area. The original BES was reduced from its 20-item design to a more culturally appropriate 7-item design. The results of the confirmatory factor analysis and criterion-related validity analysis indicate that the adapted BES is a valid and reliable multidimensional measure of empathy for high-risk Salvadoran adolescents and young adults. Consistent with previous findings, females reported lower levels of empathy than males and delinquent/violent respondents reported lower levels of empathy than their nonoffender counterparts.

Religious coping, spirituality, and substance use and abuse among youth in high-risk communities in San Salvador, El Salvador

Little is known about the relationship between religious coping, spirituality, and substance use in developing nations such as El Salvador. Collected in 2011, the sample consists of 290 high-risk and gang-involved adolescents (11-17 years) and young adults (18-25 years) in San Salvador, El Salvador. Structural equation modeling and logistic regression are employed to examine the associations between the Measure of Religious Coping (RCOPE), the Intrinsic Spirituality Scale, and substance use and abuse. Results suggest that spirituality and, to a far lesser degree, religious coping may serve to protect for substance use and abuse among this high-risk population of Salvadoran youth.