Improving accuracy of adolescents' substance use reports via text messaging

Consumption and foraging behaviors for common stimulants (nicotine, caffeine)

Models are needed to understand the emerging capability to track consumers' movements. Therefore, we examined the use of legal and readily available stimulants that vary in their addictive potential (nicotine, caffeine). One hundred sixty-six participants answered the Kessler Psychological Distress Scale (K10), the Severity of Dependence Scale for nicotine and caffeine, and reported the number of times and locations stimulants were purchased and used. On average, nicotine dependent individuals made their purchases from 2 locations, while caffeine dependent individuals consumed caffeine at 2 locations, but some people exhibited a greater range and intensity of use. Stimulant foraging behavior could be described by power laws, and is exacerbated by dependency. The finding has implications for attempts to control substance use.

Effects of alcohol use initiation on brain structure in typically developing adolescents

BACKGROUND

Alcohol use in excessive quantities has deleterious effects on brain structure and behavior in adults and during periods of rapid neurodevelopment, such as prenatally. Whether similar outcomes characterize other developmental periods, such as adolescence, and in the context of less extensive use is unknown. Recent cross-sectional studies suggest that binge drinking as well as alcohol use disorders in adolescence are associated with disruptions in white matter microstructure and gray matter volumes.

OBJECTIVES

The current study followed typically developing adolescents from a baseline assessment, where no experience with alcohol was present, through two years, after which some individuals transitioned into regular use.

METHODS

Participants (n = 55) completed MRI scans and behavioral assessments.

RESULTS

Alcohol initiators (n = 30; mean baseline age 16.7 ± 1.3 years), compared to non-users (n = 25; mean baseline age 17.1 ± 1.2 years), showed altered patterns of neurodevelopment. They showed greater-than-expected decreases in cortical thickness in the right middle frontal gyrus from baseline to follow-up as well as blunted development of white matter in the right hemisphere precentral gyrus, lingual gyrus, middle temporal gyrus and anterior cingulate. Diffusion tensor imaging revealed a relative decrease over time in fractional anisotropy in the left caudate/thalamic region as well as in the right inferior frontal occipital fasciculus. Alcohol initiators did not differ from non-users at the baseline assessment; the groups were largely similar in other premorbid characteristics.

CONCLUSIONS

Subclinical alcohol use during mid-to-late adolescence is associated with deviations in neurodevelopment across several brain tissue classes. Implications for continued development and behavior are discussed.

Text message interventions for children and adolescents with type 1 diabetes: a systematic review

Daily management challenges and declines in glycemic control are evident among youth with type 1 diabetes (T1D) as responsibility for care transitions from parent to youth. Many behavioral interventions developed for youth and their caregivers have demonstrated a small yet significant impact, and one method to potentially augment or increase their potency may be the use of mobile health strategies such as text messages. The primary aim of this systematic review was to evaluate the current literature regarding interventions incorporating text message-based interventions for youth with T1D. Feasibility was demonstrated across all text message programs, but participant satisfaction and glycated hemoglobin results were mixed. Retention rates varied, and technical difficulties were reported in several studies. Current evidence suggests that text message-based interventions that include text messages are feasible and enjoyable, but yet their clinical significance for long-term daily T1D management behaviors and glycemic control is unclear. Researchers are recommended to carefully consider the format, frequency, and timing of text message interventions and to fully test software before implementation. Future research needs include utilization of experimental designs such as randomized controlled trials, SMART design trials, and stepped wedge design trials to clarify specific medical and psychosocial outcomes, the role of caregivers/peers and incentives, and utility in clinical settings.

Article Commentary: Calling for Help? Considering Function and Meaning when Patients Drunk-Dial Psychotherapists

Drunk-dialing is a term documented in both popular culture and academic literatures to describe a behavior in which a person contacts another individual by phone while intoxicated. In our collective clinical experience we have found that clients drunk-dial their clinicians too, particularly while in substance use treatment, and yet there is a noticeable absence of research on the topic to guide clinical decision-making within a process-based understanding of these events. As the parameters within which psychotherapy takes place become increasingly technologized, a literature base to document clients’ idiosyncratic use of technology will become increasingly necessary and useful. We provide a brief review of the existing research on drunk-dialing and conclude with specific questions to guide future research and practice.