Personality, cognitive, and interpersonal factors in adolescent substance use: A longitudinal test of an integrative model

Non-pharmacologic interventions to improve depression and anxiety among pregnant and parenting women who use substances: An integrative literature review

Pregnant and parenting women who use substances report high rates of comorbid depression and anxiety. Due to the significant impact of this comorbidity on treatment adherence and maternal/child outcomes, effective psychosocial and behavioral interventions to address depression and anxiety in this population are necessary. A directed search of PubMed, PsycINFO, and CINAHL databases produced 22 articles from 20 distinct studies examining non-pharmacologic interventions with an effect on depression and anxiety among pregnant or parenting women using substances. Of the 20 studies reviewed, 8 were randomized controlled trials, 7 were quasi-experimental studies, and 5 were cohort studies. Results revealed a wide array of interventions targeting intrapersonal, interpersonal, and/or structural factors within these women's lives. Parenting therapy and psychosocially enhanced treatment programs had the strongest evidence for positive treatment effect in improving symptoms of depression and anxiety. The use of contingency-management, case-managed care, patient or wellness navigators, mindfulness-based therapy, maternal-child relationship-focused therapy, family therapy, peer support, and therapeutic community-based interventions show promise but warrant further experimental exploration. Comprehensive and gender-specific residential treatment was observationally associated with improvements in depression and anxiety; however, the specific modality of efficacy is unclear. Future research should focus on identifying which modalities are most cost-effective, feasible, and acceptable among this uniquely vulnerable population.

Attachment, Social Value Orientation, Sensation Seeking, and Bullying in Early Adolescence

In this study, bullying is examined in light of the "prosocial security hypothesis"- i.e., the hypothesis that insecure attachment, with temperamental dispositions such as sensation seeking, may foster individualistic, competitive value orientations and problem behaviors. A group of 375 Italian students (53% female; Mean age = 12.58, SD = 1.08) completed anonymous questionnaires regarding attachment security, social values, sensation seeking, and bullying behaviors. Path analysis showed that attachment to mother was negatively associated with bullying of others, both directly and through the mediating role of conservative socially oriented values, while attachment to father was directly associated with victimization. Sensation seeking predicted bullying of others and victimization both directly and through the mediating role of conservative socially oriented values. Adolescents' gender affected how attachment moderated the relationship between sensation seeking and problem behavior.

The Perceptions of Adolescents, Parents and Teachers on the Same Adolescent Health Issues

The aim of this study was to explore and compare the views of Hong Kong Chinese adolescents, parents and teachers on the same adolescent health issues. A total of 22 focus groups were conducted with Form 1 students (aged from 11 to 13) who attended the Basic Life Skills Training program organized by the Student Health Service, Department of Health in Hong Kong. The program covered a wide range of topics including emotions, self-image, stress management, drinking, smoking and substance abuse, self-esteem and interpersonal skills. Responses from the three types of participants were somewhat different and inconsistent on the issues of changes during puberty, stress and stress management, smoking, drinking and substance abuse. Compared to the West, Chinese adolescents tended to report more stress from studying and under-report socially undesirable behaviour. The use of focus groups was recommended as an effective method of collecting qualitative data with Chinese populations. Focus groups can help maximize data collection, and sometimes, the groups can also help different individual members to gain more insights or new ideas.

The impact of media-related cognitions on children's substance use outcomes in the context of parental and peer substance use

Media-related cognitions are a unique influence on adolescents' substance use outcomes even after accounting for the powerful influence of parent and peers. This cross-sectional study expands upon prior research by investigating the impact of media-related cognitions on children's alcohol and tobacco outcomes in the context of parental and peer substance use. Six hundred forty-nine elementary school children (M = 9.4 years of age, SD = 1.1 years; 51 % female) completed self-report questionnaires. After accounting for peer and parental substance use, children's media-related cognitions were independently associated with three outcomes: preferences for alcohol-branded merchandise, moral beliefs about underage alcohol and tobacco use, and intentions to use alcohol and tobacco. Children's perceptions of the desirability and realism of alcohol and tobacco ads--and their similarity to and identification with these ads--predicted greater intentions to use. Desirability and identification with alcohol and tobacco ads were associated with stronger preferences for alcohol-branded merchandise, and understanding advertising's persuasive intent predicted weaker preferences. Media deconstruction skills predicted stronger beliefs that underage alcohol and tobacco use is wrong. Peer and parental substance use were associated with stronger substance-use intentions among children and weaker feelings that substance use is wrong. The findings highlight the role of media influence in contributing to youth substance use and the potential role of media literacy education in the early prevention of substance use.

Improving media message interpretation processing skills to promote healthy decision making about substance use: the effects of the middle school media ready curriculum

The Media Ready Program was designed as a middle school, media literacy education, preventive intervention program to improve adolescents' media literacy skills and reduce their intention to use alcohol or tobacco products. In a short-term efficacy trial, schools in North Carolina were randomly assigned to conditions (Media Ready: n = 214; control: n = 198). Boys in the Media Ready group reported significantly less intention to use alcohol in the future than did boys in the control group. Also, students in the Media Ready group who had used tobacco in the past reported significantly less intention to use tobacco in the future than did students in the control group who had previously used tobacco. Multilevel multiple mediation analyses suggest that the set of logical analysis Message Interpretation Processing variables mediated the program's effect on students' intentions to use alcohol or tobacco in the future.

Improving the use of self-generated identification codes

In panel studies on sensitive topics, respondent-generated identification codes are often used to link records across surveys. However, usually a substantial number of cases are lost due to the codes. These losses may cause biased estimates. Using more components and linking the codes by the Levenshtein string distance function will reduce the losses. In a simulation study and two field experiments, the proposed procedure outperforms the methods previously applied.

Sex-specific relationships among attachment security, social values, and sensation seeking in early adolescence: implications for adolescents' externalizing problem behaviour

In early adolescence, attachment security reflects not only the quality of ongoing relationships with parents, but also how adolescents process social relationships with "others" - that is, their "social value orientation" - with possible implications for adolescents' risk-taking. In this study, a sample of Italian early adolescents were administered self-report measures in order to examine the relationships (a) between early adolescents' perceived attachment security to mothers and fathers, social values (related to family and the socio-cultural context), and sensation seeking (as a temperamental predisposition to risk-taking), and (b) between these variables and adolescents' externalizing problem behaviour. Adolescents were more securely attached to the same-sexed parent. Further, attachment security with the opposite-sexed parent predicted more conservative social value orientations, and lower levels of problem behaviour. In contrast, sensation seeking predicted self-enhancement and openness-to-change values to a greater extent, and, in girls, lower levels of attachment security to mothers and fathers.

A model of substance abuse risk: adapting to the Sri Lankan context

This study translated and validated the Substance Use Risk Profile Scale (SURPS) among 13 to 18 year old Sri Lankan adolescents attending school. A standard systematic translation procedure was followed to translate the original SURPS into Sinhala language. A Delphi process was conducted to determine judgmental validity of Sinhala SURPS. Confirmatory factor analysis was performed to test the translated version against the original theoretical model of the SURPS. Test-retest and internal consistency were used to ensure reliability. A few terms in one of the items posed some difficulty in translating into Sinhala. Adequate judgmental validity was determined except for one item, which was modified to suit the Sri Lankan setting. The four subscales introversion/ hopelessness, impulsivity, sensation seeking and anxiety sensitivity showed satisfactory test-retest reliability estimates of .74, .68, .76, and .88, respectively. The Sinhala SURPS is applicable in Sri Lankan context. Several implications based on the results are discussed.

A Gender-Moderated Model of Family Relationships and Adolescent Adjustment

The objective of this study was to explain why adolescent girls with conduct problems (CP) are more at risk than boys to develop emotional distress (ED) in a sample composed of Israeli-born and immigrant youth from Ethiopia and the former Soviet Union (n = 305, ages 14-18). We tested a structural equation model and found a very good fit to the data for both immigrant and nonimmigrant groups. The hypothesized effects of gender, CP, and parent-child relationships on ED were significant, whereas the effect of family discord was mediated by parent-child relationships. Subsequently, we used multiple-group analyses to test the two interaction hypotheses. We found significantly higher associations between CP and family discord and between ED and negative parent-child relationships in girls compared to boys.

A classroom-administered simulation of a television campaign on adolescent smoking: testing an activation model of information exposure

In recent years, research has shown that mass media can be used effectively either alone or in conjunction with interpersonal and institutional channels, such as schools. Much has yet been be learned about the application of newer, more effective strategies for media campaigns for adolescent smoking prevention interventions. This article describes a study applying an activation model of information exposure and a sensation-seeking targeting approach to the design of a smoking prevention campaign for adolescents. The participants were 1,272 middle school students aged 12-14 from across the Colorado Front Range who were stratified by their level of sensation seeking and then exposed to both high and low sensation value anti tobacco public service announcements (PSAs) at three time points. Hypothesized effects of the intervention on the primary dependent measures--attitudes (against smoking) and behavioral intentions not to smoke--were strongly supported for high sensation seekers. Further support is offered from the secondary indicators, self-efficacy, perceived message effectiveness, and perceived risk from smoking. No differences were demonstrated, however, in message effects between those selected by focus groups to be high in sensation value and those selected to be low in sensation value.

Authoritative parenting and drug-prevention practices: implications for antidrug ads for parents

This research employed the theory of reasoned action to investigate the role of authoritative parenting in 3 drug-prevention behaviors: (a) parental monitoring, (b) parent-child discussions, and (c) awareness of the child's environment. A phone survey of 158 parents of adolescents in 7th, 9th, and 11th grades revealed that authoritative parenting was correlated with parenting practices that reduce the likelihood of adolescent drug use, including discussing family rules about drugs, discussing strategies to avoid drugs, discussing those in trouble with drugs, parental monitoring, knowing the child's plans for the coming day, and personally knowing the child's friends well. Additionally, authoritative parenting moderated the attitude-behavioral intention relation for parental monitoring and awareness of the child's environment, with the weakest relation detected for low-authoritative parents. The utility of these findings in helping design and target antidrug messages for parents more effectively is discussed.

Affect and peer context interactively impact adolescent substance use

Risk factors, such as emotional distress and peer substance involvement, are often tested as competing influences on adolescent substance use. However, the current study examined how affect (both positive and negative) and peers (both in terms of relationship quality and substance involvement) are interactive influences on adolescent substance use. A sample of 398 high school juniors and seniors completed surveys assessing each of these domains. Results of hierarchical regression analyses showed strong associations between an adolescent's and his or her best friend's substance use. Complex interactions supported the study hypothesis in that relations between affect and adolescent substance use were context dependent, with some peer contexts enhancing risk for substance use and others dampening this risk. Implications of these findings for interventions and preventions concerning adolescent substance use are discussed.

Perceived message sensation value (PMSV) and the dimensions and validation of a PMSV scale

Sensation seeking has been linked to drug abuse and risky behaviors, and is positively associated with preferences for messages high in sensation value (i.e., perceived to be highly novel, arousing, dramatic, or intense). This suggests the utility of valid and reliable measures of perceived message sensation value (PMSV) in research on information processing, persuasion, and reducing risk-related behaviors. Dimensions and construct validity of a 17-item PMSV scale were examined via 2 studies: 1 of 368 high school students' reactions to televised antimarijuana public service announcements (PSAs) and one of 444 college students' responses to televised anticocaine PSAs. Exploratory and confirmatory factor analyses indicated 3-dimensional solutions for the PMSV scale were nearly identical for high sensation seeking (HSS) and low sensation seeking (LSS) respondents in Study 1 and HSS respondents in Study 2. Total scale alphas were .87 for Study 1 and .93 for Study 2. The PMSV scale and its dimensions (Emotional Arousal, Dramatic Impact, Novelty) were positively correlated with affective response measures in both studies for HSS and LSS. Study 1 also examined cognitive, narrative, and sensory PSA processing, which were found to be positively associated with total PMSV and the Arousal and Dramatic Impact dimensions of PSMV for both HSS and LSS.

Predictors of exposure from an antimarijuana media campaign: outcome research assessing sensation seeking targeting

Using data from a large-scale antimarijuana media campaign, this investigation examined the demographic and psychographic variables associated with exposure to public service announcements designed to target high sensation-seeking adolescents. The literature on sensation seeking indicates that adolescents high in this trait are at greater risk for substance abuse. Analyses assessed the predictive utility of various risk and protective factors, normative influences, demographic variables, and marijuana-related attitudes, intentions, and behaviors on campaign message exposure. Results confirm that level of sensation seeking was positively associated with greater message exposure. In addition, viewers reporting greater exposure were younger adolescents who indicated that they had poor family relations, promarijuana attitudes, and friends and family who used marijuana. Implications for designing future antimarijuana messages based on these findings are discussed.

Television campaigns and adolescent marijuana use: tests of sensation seeking targeting

OBJECTIVES

This study evaluated the effectiveness of targeted televised public service announcement campaigns in reducing marijuana use among high-sensation-seeking adolescents.

METHODS

The study used a controlled interrupted time-series design in 2 matched communities. Two televised antimarijuana campaigns were conducted in 1 county and 1 campaign in the comparison community. Personal interviews were conducted with 100 randomly selected teenagers monthly in each county for 32 months.

RESULTS

All 3 campaigns reversed upward developmental trends in 30-day marijuana use among high-sensation seekers (P < .002). As expected, low-sensation seekers had low use levels, and no campaign effects were evident.

CONCLUSIONS

Televised campaigns with high reach and frequency that use public service announcements designed for and targeted at high-sensation-seeking adolescents can significantly reduce substance use in this high-risk population.

The effects of perceived parental behaviors, attitudes, and substance-use on adolescent attitudes toward and intent to use psychoactive substances

The effects of parental behaviors, attitudes, and drug-use as perceived by adolescents on the latter's attitudes toward and intent to use psychoactive substances were studied. Perceived parental rejection, acceptance, and attitudes significantly differentiated between adolescents who reported favorable attitudes toward and high intent to use substances and those who expressed less favorable attitudes. On most parameters, the father's influence was significant, whereas the effect of the mother did not reach significance. Positive and significant relationships were also found between perceived parental rejection, acceptance, and attitudes and adolescent attitudes and intent to use psychoactive substances. No relationships were found between controlling parental behavior and adolescent attitudes and intent to use psychoactive substances. The role of the parents, as well as implications of the findings for prevention are discussed.

Adolescent substance use: preliminary examinations of school and neighborhood context

In considering the influences of microsystems on adolescent substance use, familial and peer contexts have received the most extensive attention in the research literature. School and neighborhood settings, however, are other developmental contexts that may exert specific influences on adolescent substance use. In many instances, school settings are organized to provide educational services to students who share similar educational abilities and behavioral repertoires. The resulting segregation of students into these settings may result in different school norms for substance use. Similarly, neighborhood resources, including models for substance use and drug sales involvement, may play an important role in adolescent substance use. We briefly review literature examining contextual influences on adolescent substance use, and present results from two preliminary studies examining the contribution of school and neighborhood context to adolescent substance use. In the first investigation, we examine the impact of familial, peer, and school contexts on adolescent substance use. Respondents were 283 students (ages 13 to 18) from regular and special education classrooms in six schools. Although peer and parental contexts were important predictors of substance use, school norms for drug use accounted for variance in adolescent use beyond that explained by peer and parental norms. Data from a second study of 114 adolescents (mean age = 15) examines neighborhood contributions to adolescent substance use. In this sample, neighborhood indices did not contribute to our understanding of adolescent substance use. Implications for prevention are presented.

Comparison of selected health risk behaviors between adolescents in public and private high schools in South Carolina

This study examined differences in selected health risk behaviors among 5,517 students attending public high schools (PUBHS) and 1,089 students attending private high schools (PVTHS) in South Carolina. The 1995 CDC Youth Risk Behavior Survey was used to collect self-report information on adolescent risk behaviors. Chi-square analyses were performed for comparing public and private students on selected risk behaviors. Both PUBHS and PVTHS students reported substantial involvement in most of the risk-taking behaviors examined. PUBHS students, in general, were more likely to report higher prevalence rates than PVTHS students for most of the selected health risk behaviors. However, PVTHS students reported even higher prevalence rates than PUBHS students for alcohol use, driving after drinking, and binge drinking; smoking cigarettes (past 30 days); chewing tobacco (males only); marijuana use during the past 30 days (females only); and use of alcohol or other drugs before last act of sexual intercourse. Results suggest attendance at a private high school is not a panacea for protection against adolescent risk behaviors, and that all high school students could benefit from a coordinated school health program.

Psychosocial correlates of substance use: comparing high school students with incarcerated offenders in Hong Kong

Drug use prevalence data were obtained from 969 adolescents, high school students and imprisoned offenders who reported use of cough medicine, organic solvents, cannabis, heroin, tranquilizers, and narcotics over the past six months. Incarcerated youths, in particular girls, had higher prevalence rates than students. Drug use frequencies were associated with psychosocial variables such as disinhibition, peer drug use, susceptibility to peer pressure, attitudes, encouragement by peers, and perceived availability of drugs. The psychosocial process of the initiation and maintenance of substance use was specified as a path model that considered 1) personality and social environment as distal precursors and 2) a drug-use predisposition and perceived availability as proximal precursors of three kinds of outcome variables: drug use, the intention to try illicit drugs if they were legal, and adverse outcomes of drug use. It was found that the same structural equation model fit the data of both samples of offenders and students, however, with very different weights assigned to the paths.

Relationship between physical activity level and cigarette, smokeless tobacco, and marijuana use among public high school adolescents

This study analyzed the association between physical activity level and cigarette, smokeless tobacco, and marijuana use among a selected group of public high school students from South Carolina (N = 4,800). The 1993 CDC Youth Risk Behavior Survey was used to collect self-report information on physical activity, substance use, and other risk-taking behaviors. Multiple logistic regression analysis for weighted data (SUDAAN) was used for data analysis. Adjusted analysis showed significant associations (p < .05) among White males for use of cigarettes, smokeless tobacco, and marijuana, where higher levels of physical activity were inversely associated to use of these substances. Results from the study substantiate the importance of physical activity for adolescents, and demonstrate the need for future research to clarify the causal relationship between physical activity and substance use behaviors.