Coping style and substance use intention and behavior patterns in a cohort of BC adolescents

Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents

BACKGROUND

Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts.

OBJECTIVE

The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents.

PARTICIPANTS AND SETTING

A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey.

METHODS

Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems.

RESULTS

CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives.

CONCLUSIONS

The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.

Coping strategies as mediating mechanisms between adolescent polysubstance use classes and adult alcohol and substance use disorders

Adolescent polysubstance use is a robust predictor of substance use in adulthood and can be exacerbated by poor coping with stress over time. We examined whether latent classes of adolescents' polysubstance use predicted alcohol use disorder and substance use disorder diagnoses in adulthood via multiple stress coping strategies. Self-reported frequency of past 3-month alcohol, tobacco, and marijuana use in 792 adolescents (aged 16/17) were used to form latent classes of polysubstance use. Self-reported aggressive, reactive, substance use and cognitive coping strategies (ages 18/19, 22/23, 23/24) were examined as multiple mediators of polysubstance use classes and alcohol use disorder and substance use disorder in adulthood (age 26/27) controlling for demographic covariates. Latent class analysis resulted in High, Experimental, and Low polysubstance use classes. Those in high and experimental polysubstance use classes, compared to those in the low polysubstance use class, had greater use of aggressive and reactive coping strategies, which respectively predicted greater substance use disorder and alcohol use disorder in adulthood. Across all comparisons (high vs low, experimental vs low, and high vs experimental), higher polysubstance use was associated with greater substance use coping, which predicted both alcohol and substance use disorder. Greater polysubstance use, even experimental use, in adolescence is a significant risk factor for developing alcohol use disorder and substance use disorder in adulthood and this occurs, in part, via maladaptive stress coping strategies.

Exploring arts-based interventions for youth substance use prevention: a scoping review of literature

INTRODUCTION

There is a rise in problematic substance use among Canadian youth, which is precipitating a public health crisis. Interventions are needed to empower youth to mitigate substance use risks. Active youth involvement in substance use prevention is urgently needed to increase uptake and ownership of the process and outcome of the intervention. Arts-based interventions are ideal participatory action approaches that can empower young people to be active agents in substance use prevention. These approaches can help promote health, reduce harm, and change behaviours. Scoping reviews are a vital tool that can help the research team identify relevant interventions that can be adapted to a community.

METHODS

This scoping review explores various arts-based substance use prevention interventions for youth. The scoping review used the iterative stages of Arksey and O'Malley to search Portal ERIC, Ovid MEDLINE, C.I.N.A.H.L., E.M.B.A.S.E., Web of Science, and A.P.A. PsycInfo and grey literature from Canadian Centre on Substance Use and Addiction and websites suggested by the Canadian Agency for Drugs and Technologies in Health. Inclusion criteria are a) articles utilizing arts-based intervention on substance use prevention; b) studies with a clearly defined intervention; c) intervention targeting the youth (age 12-17) and d) publications written in English. Thematic analysis was used to identify the main themes from the included articles.

RESULTS AND DISCUSSION

Themes identified in a thematic synthesis of these studies included a) the intent of the intervention; b) intervention characteristics; and c) the perceived effectiveness of interventions. Art-based interventions increased knowledge and changed attitudes and practices on substance use among youth. Making the interventions aesthetically appealing and engaging, active youth involvement in the development of the intervention and developing youth-centred interventions which attended to the realities they faced were central to the success of these interventions.

Resilience profiles predict polysubstance use in adolescents with a history of childhood maltreatment

Background

Childhood maltreatment (CM) can be an impediment to normative development and consistently predicts increased risk for substance misuse and polysubstance use (polySU). Yet, a subset of individuals who experience CM exhibit successful adaptations across the lifespan. Although there is an expansive literature on socioemotional and cognitive protective factors that mitigate impacts of CM, less is known about other, intra-individual resilience-promoting factors (e.g., positive future orientation) known to assuage high-risk SU patterns during adolescence.

Method

This study examined heterogeneity in individual-level resilience characteristics in maltreated youth as it related to CM characteristics and SU patterns during adolescence. Participants included maltreated youth from the longitudinal LONGSCAN sample (N=355; 181 females). Latent Profile Analysis was used to identify subgroups of CM-exposed individuals based on 5 resilience indicator variables (i.e., commitment to goals, engaging in demanding activities, self-reliance, positive future orientation, and externalizing behaviors). Tests for differences in SU patterns and CM characteristics between the resultant profiles were performed.

Results

Data models revealed 3 latent profiles based on participants' resilience traits (i.e., Low Resilience, Average Resilience, and High Resilience). There were no profile differences on the basis of CM characteristics. Those in the High Resilience profile were less likely to engage in polySU compared to the Average Resilience profile.

Implications

These findings highlight the promise of individual-level resilience factors that are not necessarily dependent upon caregiver or environmental inputs as protective against polySU following CM. This work represents a promising avenue for future preventative intervention efforts targeting emergent SU behaviors in high-risk youth.

The Impact of the COVID-19 Pandemic on Adolescent Mental Health and Substance Use

PURPOSE

The aim of this study is to determine whether COVID-19-induced financial impact, stress, loneliness, and isolation were related to perceived changes in adolescent mental health and substance use.

METHODS

Data were from Baseline (2018) and Wave 3 (2020; mean age = 14.8; 50% female) of 1,188 adolescents recruited from 12 Texas public middle schools as part of a randomized controlled trial. Participants were primarily Black (23%), Latinx (41%), Asian (11%), and White (9%). We assessed mental health and substance use (Baseline and Wave 3) and pandemic-related physical interaction, loneliness, stress, family conflict, and economic situation (Wave 3).

RESULTS

COVID-19-induced stress and loneliness were linked to depression (beta = 0.074, p ≤ .001; beta = 0.132, p ≤ .001) and anxiety (beta = 0.061, p = .001; beta = 0.088, p ≤ .001) among ethnically diverse adolescents. Adolescents who did not limit their physical interactions due to COVID-19 had fewer symptoms of depression (beta = -0.036, p = .03); additionally, adolescents who did not restrict their socializing were substantially more likely to report using a variety of substances (e.g., for episodic heavy drinking; odds ratio = 1.81, p = .001). Increased use of a food bank was linked to depression (beta = 0.063, p ≤ .001) and a negative change in financial situation was linked to increased alcohol use (odds ratio = 0.70, p = .04) among adolescents.

DISCUSSION

After controlling for prepandemic psychopathology and race/ethnicity, COVID-19 induced isolation, loneliness, stress, and economic challenges were linked to poor mental health and substance misuse. Substantial structural, community, school, and individual level resources are needed to mitigate the impact of the COVID-19 pandemic on adolescent psychosocial health.

Comparative effectiveness of individual versus family-based substance use treatment on adolescent self-injurious thoughts and behaviors

INTRODUCTION

Self-injurious thoughts and behaviors (SITB) are of increasing concern among adolescents, especially those who use substances. Some evidence suggests that existing evidence-based substance use treatments (EBTs) could impact not only their intended substance use targets but also SITB. However, which types of substance use treatments may have the greatest impact on youth SITB is not yet clear. Based on prior literature showing that family support and connection may buffer youth from SITB, we initially hypothesized that family-based EBTs would show greater improvement in SITB compared to those receiving individually focused EBTs and that the size of the effects would be small given the comparison between two active, evidence-based interventions, and base rates of SITB.

METHODS

In a sample of 2893 youth in substance use treatment, we compared the effectiveness of individually and family-based EBTs in reducing SITBs. The study used entropy balancing and regression modeling to balance the groups on pre-treatment characteristics and examine change in outcomes over a one-year follow-up period.

RESULTS

Both groups improved in self-injury and suicide attempts over the one-year study period, but only youth in individual treatment improved in suicidal ideation. However, the study found no significant difference between the changes over time in the two groups for any outcome. As expected, effect sizes were small and power was constrained in this study given the rarity of the outcomes, but effect sizes are similar to those observed with substance use outcomes.

CONCLUSIONS

The results provide important exploratory evidence on the potential relative effectiveness of these two treatments for SITBs. This study supports prior findings that EBTs for youth substance use may help to improve SITB and suggests that different treatment formats (individual or family-based) could result in different benefits for SITB outcomes.

Impact of coping styles on substance use in persons with psychosis, siblings, and controls

BACKGROUND

Substance use is overrepresented in patients with psychosis. Maladaptive coping has been proposed as one of the mechanisms which might underlie this high prevalence. Patients are known to apply more maladaptive coping compared to the healthy population. However, it is unknown whether coping is associated with the use of different substances across those with different vulnerability for psychosis, and whether coping mediates the possible association between life events and substance use.

METHODS

In this multicenter, cohort study, 429 patients, 504 siblings, and 220 controls were included. We determined whether coping was associated with tobacco smoking, cannabis use, or alcohol consumption. Multivariable logistic regression models were applied whilst correcting for potential confounders. We performed post-hoc analyses to explore the association between negative life events, tobacco smoking, and the role of coping as a mediator in patients with psychosis.

RESULTS

A positive association was found in patients between passive coping and tobacco smoking (fully adjusted OR 1.65, 95% CI 1.18-2.31). Tobacco smoking patients experienced more negative life events compared to non-smoking patients and passive coping mediated this association. In siblings and controls, none of the coping strategies were associated with substance use.

CONCLUSIONS

The coping style of patients with psychosis is associated with tobacco smoking and mediates the association between negative events and tobacco smoking. No significant associations were found in siblings, controls or concerning other substance use. Future research is required to examine whether enhancing healthy coping strategies decreases tobacco use in patients with psychosis.

Pre-Intervention Effects of a Community-Based Intervention Targeting Alcohol Use (LEF); The Role of Participatory Research and Publicity

This study explores the impact of the 'pre-intervention effects' of a community-based intervention. This refers to participatory research processes and parallel publicity in the media on changes in alcohol use and relevant mechanisms (rules and norms about alcohol, accessibility of alcohol in a formal setting) among adolescents before any intervention is implemented. The aim was to investigate the contribution of these processes (i.e., pre-intervention effects) to changes in intervention-targeted factors before any actual intervention was implemented. In a quasi-experimental study, data were collected twice by means of self-report among adolescents living in two municipalities (control and experimental condition). A regression analysis showed negative pre-intervention main effects on adolescents' perceived accessibility of alcohol in a formal setting. Moreover, among adolescents aged 15 years and older, the normative decline in strictness of rules and norms was less steep in the experimental condition compared to the control condition. Additionally, adolescents aged 14 years and younger in the experimental condition reported more weekly drinking compared to their peers in the control condition. No differential effects across gender were found. To conclude, applying a co-creational approach in the development of an intervention not only contributes to more effective interventions in the end, but the involvement of and discussions in the community when planning the intervention contribute to changes in targeted factors. This implies that public discussions about the development of intervention strategies should be considered as an essential feature of co-creation in community-based interventions.

Personal Variables of Protection against Cannabis Use in Adolescence: The Roles of Emotional Intelligence, Coping Styles, and Assertiveness as Associated Factors

(1) Background: Many public bodies have warned of the increased consumption of cannabis, particularly among adolescents. From the Positive Youth Development approach, the promotion of personal protective factors takes on special importance against some risks, such as the consumption of addictive substances. (2) Methods: This research is one of the first to study the role of trait and ability emotional intelligence in relation to cannabis use and with respect to other personal variables of protection, such as coping styles and assertiveness. For this purpose, a final sample of 799 schoolchildren was obtained. (3) Results: After controlling for age and gender, the results of the regression analyses revealed that emotional perception, emotional facilitation, emotional clarity, emotional repair, active coping style, and assertiveness were inversely and significantly associated with cannabis use behaviors. On the other hand, the emotional attention and avoidant coping style factors were positively and significantly associated with these behaviors. (4) Conclusions: These findings provide new evidence that could be useful in terms of guiding health-promoting clinical and educational interventions at an early age.

Stress Coping Strategies as Mediators: Toward a Better Understanding of Sexual, Substance, and Delinquent Behavior-Related Risk-Taking among Transition-Aged Youth

Transitional aged youth (18-24) report increasing and peaking risk-taking (sexual, substance, and delinquent behavior). Stressful life events (SLE) are associated with these risk-taking behaviors. Little is known regarding what mediates these relationships. This study tests whether various coping strategies mediate the relationship between SLE and risky behavior in three domains among 18-24 year olds (N=126; M age = 21.3, SD = 1.9; 52% Black; 56% female). After adjusting for covariates and simultaneously modeling two stress variables, only stressful life events, but not perceived stress, was uniquely associated with risk-taking behaviors at moderate to high levels. Significant indirect effects of SLE via avoidance coping were found for illicit drug use both concurrently and prospectively and for risky sex concurrently. For participants reporting greater stressful life experiences, substance use and risky sex behaviors become greater as avoidance coping increases. Avoidance coping was a partial mediator for the concurrent relationship between stressful life events and substance use/risky sex, but a full mediator for the prospective relationship between stressful life event and substance use. None of the coping strategies mediate the relationship between stressful life events and delinquency. Prevention and intervention strategy implications for reducing avoidance coping and promoting alternative coping styles are discussed.

Cognitive risk, coping-oriented substance use, and increased avoidance tendencies among depressed outpatients: A prospective investigation

OBJECTIVE

The present study was designed to assess the interplay between depressive cognition, coping-oriented substance use, and future behavioral disengagement tendencies. Cognitive risk subtypes examined include brooding rumination, attributional bias (internal/stable/global), and dysfunctional attitudes.

METHOD

Individuals were recruited from outpatient treatment settings and met criteria for a unipolar depressive disorder (N = 70; 66% female; 81% White; M_age  = 31; SD_age  = 13.2). Participants completed self-report measures of brooding rumination, attributional style, dysfunctional attitudes, coping-oriented substance use, and behavioral disengagement tendencies following a 3-week period.

RESULTS

Brooding rumination, stable attributional style, and dysfunctional attitudes were positively associated with later behavioral disengagement tendencies. Coping-oriented substance use moderated associations between both internal attributional style, as well as dysfunctional attitudes onto later behavioral disengagement.

CONCLUSIONS

With regard to stress-related avoidance, subsyndromal substance use may play a detrimental role among cognitively vulnerable, depressed outpatients when said drug or alcohol use serves as a means of coping.

Deprivation and threat, emotion dysregulation, and psychopathology: Concurrent and longitudinal associations

Maltreatment increases risk for psychopathology in childhood and adulthood, thus identifying mechanisms that influence these associations is necessary for future prevention and intervention. Emotion dysregulation resulting from maltreatment is one potentially powerful mechanism explaining risk for psychopathology. This study tests a conceptual model that distinguishes deprivation and threat as distinct forms of exposure with different pathways to psychopathology. Here we operationalize threat as exposure to physical and/or sexual abuse and deprivation as exposure to neglect. We test the hypothesis that threat and deprivation differentially predict use of avoidant strategies and total regulation. Data were drawn from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN study; N = 866), which followed high-risk children from age 4 to 18. At age 6, children and their parents reported on adversity exposure. Case records documented exposure to abuse and neglect. At 18, adolescents reported on regulation strategies and psychopathology. Regression analyses indicated that greater exposure to threat, but not deprivation, predicted greater use of avoidant strategies in adolescence. Moreover, avoidance partially mediated the longitudinal association between exposure to threat in early childhood and symptoms of internalizing psychopathology in adolescence. Results suggest that abuse and neglect differentially predict regulation strategy use and that regulation strategy use predicts psychopathology.

Hookah Use among Russian adolescents: Prevalence and correlates

Hookah use among adolescents is increasing globally. No prior studies in the published literature have examined hookah use among youth in the Russian Federation. We assessed demographic, psychological and behavioral factors associated with lifetime and past 30-day hookah use among Russian youth. This cross-sectional study was conducted in three areas of Bashkortostan, Russia. In 2015, we surveyed Russian high school students (n = 716) on socio-demographic characteristics, tobacco (cigarettes, e-cigarettes, hookah) and drug use (alcohol, marijuana, and other illicit drugs), coping strategies, and getting in trouble (self and/or family). We estimated hookah use prevalence and performed bivariate analyses prior to fitting two multilevel models evaluating lifetime and past 30-day hookah use. Within this sample, 34.92% and 9.36% were lifetime and last 30-day hookah users, respectively. Lifetime hookah use was associated with older age (OR = 1.29), higher anger coping (OR = 1.41), school troubles (OR = 2.30), lifetime cigarette (OR = 1.59), e-cigarette (OR = 4.62), alcohol (OR = 5.61), and marijuana use (OR = 8.05). Additionally, past 30-day hookah use was associated with older age (OR = 1.71), lifetime use of alcohol (OR = 5.39), school troubles (OR = 5.82), and anger coping strategies (OR = 1.40). Hookah use is currently high among Russian youth in Bashkortostan and is associated with other risky behaviors. Effective interventions targeting multiple substances and coping strategies are needed. Social media campaigns encouraging cessation and advocating against its use at home may be beneficial in curbing hookah use among youth.

[Psychological factors predictive of healthy lifestyles]

OBJECTIVE

To present a robust statistical model that considers some psychological factors as predictors of healthy lifestyle.

MATERIALS AND METHODS

A battery composed of validated instruments was applied to evaluate beliefs, healthy practices, coping styles, positive mental health and perceived self-efficacy in a sample of 570 university students from Bogotá, Colombia. Based on the information obtained, descriptive, variance and correlation analyzes were developed, as well as a structural equations model.

RESULTS

High scores were obtained in the categories 'optimal psychological factors', 'beliefs and healthy practices', except for the 'physical activity practice' and 'less adaptive coping factors' categories. Likewise, significant differences were found in most of the variables measured, as well as important correlations between adaptive psychological factors and healthy practices and beliefs. Finally, the structural equations model that showed the greatest adjustment predicts by 89% the variance of positive mental health based on the interaction between the variables 'coping directed to the problem', 'general satisfaction', 'pro social attitude', 'social skills' and 'self-efficacy'. In turn, the presence of positive mental health, when interacting with healthy beliefs, predicts the occurrence of healthy lifestyles by 63%.

CONCLUSION

Even when the model is not conclusive, it can provide empirical support to possible health interventions to be implemented in higher education institutions, based on the strengthening of psychological predictive factors.

[Psychological characteristics of stress in nursing student]

BACKGROUND

Student nurses have perceived stress higher than students taking other training courses. The objective of this work was to investigate psychological characteristics of nursing students in an attempt to understand why they are more subject to stress than others.

METHODS

We carried out a self-administered questionnaire survey to compare students taking various training courses (i.e., sport sciences, psychology, medicine, and nursing). Perceived stress and health, high-risk behaviors, different psychological determinants of stress (i.e. coping, emotional skills, resilience, self-esteem, personality, chronotype) were assessed.

RESULTS

Multiple linear regression analysis yielded a model showing that seven independent variables were correlated with perceived stress among students: perceived health, neuroticism, stress tolerance, active coping, understanding of one's own emotions, chronotype amplitude, and use of one's own feelings. Moreover, medicine and nursing students were more stressed and perceived their health in a more negative way than students taking other training courses. Nursing students were also less stress tolerant.

CONCLUSION

The regression model suggests that psychological characteristics influence stress level among students. Moreover, the results show that medicine and nursing students differ from other students on resilience in stress tolerance dimension as well as on a set of behaviors. Practical perspectives are discussed.

Dissociable psychosocial profiles of adolescent substance users

OBJECTIVE

Alcohol, tobacco and cannabis use in adolescence is associated with adverse outcomes. Characterizing adolescent substance misusers, however, is difficult due to the wide range of risk and protective factors linked to substance use. The aim of the present study was to examine the role of the Individual, Family, School, Peer, and Social Environment on alcohol (lifetime and risky), tobacco (risky only), and cannabis use (lifetime and riskiness).

METHOD

Data were analyzed from a national sample of 5,680 adolescents, capturing substance use behavior alongside risk and protective factors across Individual, Family, School, Peer and Social domains. We applied a sophisticated machine learning classifier to develop models of alcohol, tobacco and cannabis initiation and misuse.

RESULTS

We found highly accurate (area under curve of receiver-operator-characteristic for out-of-sample performance was > .88) and replicable (over multiple iterations and in comparison with permuted outcomes) dissociable psychosocial profiles of alcohol, tobacco and cannabis use. Alongside common predictors (peer relations and externalizing behavior), dissociable risk and resilience factors were observed. Adolescent profiles of alcohol use were distinguished by the contribution of multiple domains. In contrast, tobacco use was characterized by a small number of individual variables, including female gender and poor perceived academic position. Cannabis use was differentiated by the distinct contribution of Individual risk factors, in particular male gender and feelings of anger. Differential associations were also evident, with the strength and direction of association differing substantially across substances.

CONCLUSION

This study indicates that the relationship between the environment and substance use is more complex than previously thought.

Perceptions of Neighborhood Mediate the Relationship Between PTSD Symptoms and Coping in a Neighborhood-Matched Substance-Using Sample

OBJECTIVES

People with substance use problems living in neighborhoods with high levels of disorder are disproportionately likely to experience trauma and develop PTSD symptoms. We sought to evaluate the relationships between objective neighborhood disorder, perceptions of neighborhood, and the use of maladaptive coping behaviors among both non-substance-using and substance-using participants with and without PTSD symptoms.

METHODS

Participants (255 non-drug users [NDUs], 168 marijuana and/or alcohol users [MAUs], and 273 opioid and/or stimulant users) completed the Addiction Severity Index, PTSD Checklist-Civilian Version, The COPE Inventory, and the Perceived Neighborhood Scale. The Neighborhood Inventory for Environmental Typology (NIfETy) was used to objectively assess neighborhood disorder at participants' home addresses. Regression modeling was used to assess within-group predictors of PTSD and test for mediation in the relationships between PTSD, perceptions of neighborhood, and coping behaviors.

RESULTS

In NDUs, lower sense of community partially mediated the relationship between PTSD symptoms and using mental disengagement to cope. In MAUs, higher levels of perceived crime partially mediated the individual relationships between PTSD symptoms and using mental disengagement, focusing on and venting emotions, and using substances to cope. Opioid and/or stimulant users with PTSD symptoms reported using higher levels of mental disengagement, focusing on and venting emotions, and substances to cope and perceived a higher degree of crime; no mediation was inferred.

CONCLUSION

Perceptions of community and crime may be more predictive of PTSD symptoms than objectively measured neighborhood disorder. These perceptions partially mediate the relationship between maladaptive coping behaviors and PTSD symptoms.

Associations between coping and marijuana use in a nationally representative sample of adolescents in the United States

Maladaptive coping strategies have been linked with substance use. Little is known, however, about associations between coping and marijuana use in the general U.S. adolescents. We used nationally representative data to examine associations between coping and marijuana use among U.S. adolescents. We hypothesized that marijuana use would be positively associated with both avoidance and distraction coping and negatively associated with problem solving. We calculated adjusted prevalence ratios and odds ratios to assess associations of three coping styles (avoidance, distraction, problem solving) and six coping profiles based on combinations of the styles (adaptive, low on all styles, distracted, high on all styles, avoidant, maladaptive) with lifetime marijuana use and past 12-month frequency of use using data from the National Comorbidity Survey: Adolescent Supplement (n=8476, ages 14-18years). Avoidance and distraction coping were positively and problem solving was negatively associated with lifetime marijuana use. Avoidance coping was positively associated, and problem solving negatively associated, with past 12-month frequency of use. Compared to the adaptive coping profile (low avoidance and distraction, high problem solving), maladaptive profile (high avoidance and distraction, low problem solving) and avoidance profile (high avoidance, low distraction and problem solving) were each positively associated with lifetime marijuana use and past 12-month frequency of use. Avoidance coping, especially in combination with limited problem solving, was positively associated with lifetime marijuana use and past 12-month frequency of use. Our findings have potential to inform interventions for reducing adolescent marijuana use.

A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions

The majority of adult mental health and substance use (MH&SU) conditions emerge in adolescence. Prevention, diagnosis, and treatment programs targeting this age group have a unique opportunity to significantly impact the well-being of the future generation of adults. At the same time, youth are reluctant to seek treatment and have high rates of dropout from interventions. An emphasis on youth engagement in prevention and treatment interventions for MH&SU results in better health outcomes for those youth. This literature review was undertaken to evaluate opportunities to improve youth engagement in MH&SU programs. The intent was to determine best practices in the field that combined community-level improvement in clinical outcomes with proven strategies in engagement enhancement to inform program development at a local level. The results discuss 40 studies, reviews, and program reports demonstrating effective youth engagement. These have been grouped into six themes based on the underlying engagement mechanism: youth participation in program development, parental relationships, technology, the health clinic, school, and social marketing. A broad range of tools are discussed that intervention developers can leverage to improve youth engagement in prevention or treatment programs.

Polydrug use among urban adolescent cigarette smokers

PURPOSE

Adolescent smokers are at increased risk for polydrug use, which is associated with more consequences than use of a single drug. Here we classified subgroups of polydrug use among urban adolescent cigarette-smokers; described the sociodemographic, smoking, and depression correlates; and identified three-year outcomes associated with subgroup membership.

METHODS

Adolescent cigarette smokers (N=176; Mage=16.1; 35% male; 27% white) completed surveys assessing drug use, smoking characteristics, demographics, and depressive symptoms at baseline and 12, 24, and 36months follow-up.

RESULTS

Almost all participants (96%) reported using, on average, two (SD=0.97) substances (including other tobacco products) in addition to cigarettes. Latent class analysis revealed two distinct classes of polydrug users. "Limited Range Use" (84%) class members reported current use of other tobacco, alcohol, and marijuana, as did "Extended Range Use" class members (16%) who also reported current use of "harder drugs" (i.e., cocaine/crack, hallucinogens, ecstasy, and misused prescriptions). The classes did not differ on demographics or baseline likelihood of marijuana (χ2=0.25; p<0.62) or alcohol use (χ2=3.3; p<0.07). At baseline, a larger proportion of Extended Range Use class members reported both smoking the entire cigarette and symptoms of clinical depression. Extended Range Use class membership at baseline predicted higher mean depression scores at 24 and 36months.

CONCLUSION

Adolescent cigarette-smokers who reported extended range use (18%) also reported symptoms of clinical depression at baseline and follow-up. These findings indicate a need for early monitoring of depression symptoms and prevention and cessation interventions targeting this high-risk group.

Electronic Cigarette Use Among Adolescents in the Russian Federation

BACKGROUND

Information on e-cigarettes among youth in the Russian Federation is lacking.

OBJECTIVE

We examined prevalence of and factors associated with youth e-cigarette use in the Russian Federation.

METHODS

A cross-sectional, anonymous survey, conducted among 716 (females 51.5%) high school students in three cities (i.e., Ufa, Sterlitamak, Karagaevo) within the Republic of Bashkortostan, Russian Federation in 2015, assessed e-cigarette use and its correlates (i.e., sex, age, ethnicity, family structure, parents' highest degrees, antisocial behaviors, stress coping strategies, lifetime cigarette, hookah, alcohol, and marijuana use).

RESULTS

Lifetime use of e-cigarettes was 28.6% and past-30-day use was 2.2%. Multilevel modeling showed that belonging to Tatar/Bashkir ethnicity relative to Russian ethnicity (OR = 1.60) and lifetime use of cigarettes (OR = 21.64), hookah (OR = 4.21), and alcohol (OR = 1.90) was associated with greater odds of lifetime use of e-cigarettes. Furthermore, use of social support coping strategies (i.e., utilizing parents for support) were associated with lower odds of lifetime use of e-cigarettes (OR = 0.94).

CONCLUSIONS

Despite high lifetime e-cigarette use, past-30-day use was low. Greater knowledge of the reasons for e-cigarette discontinuation through continued surveillance is needed in the Russian Federation. Social coping strategies involving parents may inform e-cigarette use prevention.

Examining the relationship between personality and affect-related attributes and adolescents' intentions to try smoking using the Substance Use Risk Profile Scale

Assessments of adolescents' smoking intentions indicate that many are susceptible to smoking initiation because they do not have resolute intentions to abstain from trying smoking in the future. Although researchers have developed personality and affect-related risk factor profiles to understand risk for the initiation of substance use and abuse (e.g., alcohol), few have examined the extent to which these risk factors are related to the tobacco use intentions of adolescents who have yet to try tobacco smoking. The objective of this study was to examine the relationships between personality and affect-related risk factors measured by the Substance Use Risk Profile Scale (SURPS) and smoking intentions in a sample of adolescents who have not experimented with tobacco smoking. Data is based on responses from 1352 participants in the British Columbia Adolescent Substance Use Survey (56% female, 76% in Grade 8) who had never tried smoking tobacco. Of these 1352 participants, 29% (n=338) were classified as not having resolute intentions to not try smoking. Generalized estimating equations were used to examine the relationship between each SURPS dimension (Anxiety Sensitivity, Hopelessness, Impulsivity and Sensation Seeking) and the intention to try cigarettes in the future. Hopelessness (AOR 1.06, 95% CI [1.03, 1.10], p<.001), Impulsivity (AOR 1.07 [1.03, 1.11], p<.001) and Sensation Seeking (AOR 1.05 95% CI [1.02, 1.09], p<.01) had independent statistically significant associations with having an intention to try smoking. These findings may be used to inform a prevention-oriented framework to reduce susceptibility to tobacco smoking.

Young people in drug treatment in Ireland: their views on substance use aetiology, trajectory, parents' role in substance use and coping skills

OBJECTIVES

The aim of the current study was to gain insight into the process of initiation and progression to problematic use among young people who reach clinically significant levels of substance use requiring treatment.

METHOD

Twenty young people, aged between 15 and 19 years from two different drug treatment centres in Ireland were interviewed regarding their views on their pathway into substance use, their progress to more problematic use, their perception of their parents' role, if any, in their trajectory and their typical coping style before treatment. Content analysis was conducted on the resulting narratives.

RESULTS

The use of substances to cope with life stressors emerged as a prominent theme at initial and problematic stages of use. Multiple maladaptive coping approaches were reported. Both direct and indirect influences from parents in their substance use problem were cited. However, some participants reported that parents had no causal role in their substance use trajectory, in particular regarding mothers.

CONCLUSIONS

The current findings suggest that substance misuse is a multi-determined problem and a number of intervention strategies are suggested to delay onset and related harms associated with adolescent substance use.

Sexually transmitted infections in pediatric renal transplant recipients: Time to take notice!

We sought to assess the prevalence of STIs, contraception use, and unintentional pregnancy in our pediatric renal transplant recipients. We performed a retrospective chart review. Forty-nine of 65 patients in our program are currently in the high-risk age window of 13 yr or older (34 men, 15 women; mean age 17 yr old, range 13-23 yr old). There was a disproportionate difference in sexual behavior among the men and women, such that while only 15% of the men reported being sexually active, 53% of the women were sexually active. Among high-risk age-group women, 40% were on hormonal contraception. This increased to 75% in sexually active women. There were no cases of unintentional pregnancy. Thirty percent of sexually active recipients had at least one STI. This was higher among sexually active women (37.5%) compared to men (20%). STIs identified included gonococcal and chlamydial urethritis/cervicitis, Trichomonas vaginitis, HSV-2 genital sores, pelvic inflammatory disease, and HIV. In conclusion, STIs are a realistic public health concern in our pediatric renal transplant recipients. Consensus guidelines on STI screening and reproductive health counseling are needed to address this understudied problem.

Post-traumatic growth, stressful life events, and relationships with substance use behaviors among alternative high school students: a prospective study

A highly stressful life event (SLE) can elicit positive psychosocial growth, referred to as post-traumatic growth (PTG) among youth. We examined PTG and the number of SLEs for their influence on substance use behaviours among a sample of older, diverse alternative high school students participating in a drug prevention programme (n=564; mean age=16.8; 49% female; 65% Hispanic). Surveys assessed PTG, SLEs and substance use behaviours at the two-year follow-up. Multilevel regression models were run to examine the effect of PTG and the number of SLEs on frequency of substance use at the two-year follow-up, controlling for baseline substance use, sociodemographic variables, peer substance use, attrition propensity and treatment group. Greater PTG scores were associated with lower frequencies of alcohol use, getting drunk on alcohol, binge drinking, marijuana use and less substance abuse at the two-year follow-up, but not associated with cigarette or hard drug use. Also, PTG did not moderate the relationship between cumulative number of SLEs and substance use behaviours, rather PTG appears to be protective against negative effects of a single, life-altering SLE. Fostering PTG from a particularly poignant SLE may be useful for prevention programmes targeting alcohol, marijuana and substance abuse behaviours among high-risk youth.