Adolescent Substance Abuse and Mental Health: Problem Co-Occurrence and Access to Services

The purpose of this study is to identify factors associated with adolescent alcohol or drug (AOD) abuse/dependence, mental health and co-occurring problems, as well as factors associated with access to treatment. This is a secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2000. The 12-month prevalence rate of adolescents with only mental health problems was 10.8%, 5.1% had AOD abuse/dependence only, and 2.7% had co-occurring problems. Approximately 15% of youths reported receiving behavioral health treatment in the past 12 months. Several factors associated with having behavioral health problems and receiving treatment are presented.     

Mental Health Service and Drug Treatment Utilization: Adolescents with Substance Use/Mental Disorders and Dual Diagnosis

This research is a secondary data analysis of the impact of adolescents' mental/substance-use disorders and dual diagnosis on their utilization of drug treatment and mental health services. By analyzing the same teenagers who participated in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, logistic regression could be conducted for the data analysis. The results show that any of the following increased the likelihood of adolescents' treatment/service utilization: a dual diagnosis, mental disorders alone, a parent's treatment/service utilization, problematic biological children, adolescent's involvement with police/court system, adolescent having coverage for mental health care, the adolescent being male, and the adolescent living with a single, white parent with a relatively high educational level. Implications for policy and practice are discussed.     

The Link Between Substance Use and Reproductive Health Service Utilization Among Young US Women

ABSTRACT. Background: The authors sought to investigate associations between young women's use of alcohol and other substances and their sexual and reproductive health (SRH) service utilization. Methods: The authors used data from 4421 young women aged 15–24 years in the nationally representative study, National Survey of Family Growth, 2002–2008. The authors examined associations between frequency of tobacco, alcohol, marijuana, and illicit drug use and SRH service use in the past year using logistic regression. Results: Over half (59%) of the young women used SRH services, including contraception (48%), gynecological examination (47%), and sexually transmitted infection (STI) testing/treatment (17%) services. Proportions of SRH service use increased with higher frequencies of substance use (all P values <.001); service use was particularly common among daily substance users (range: 72% of daily marijuana users to 83% of daily binge drinkers). In multivariable analyses, associations between substance and SRH service use varied by substance and service type: weekly marijuana (odds ratio [OR] = 2.5, 95% confidence interval [95% CI] = 1.4, 4.3, P = .002) and alcohol (OR = 1.7, 95% CI = 1.1, 2.4, P = .01) use were positively associated with gynecological service use. All substances were positively associated with STI service use. However, daily smoking was negatively associated with contraceptive service use (OR = 0.6, 95% CI = 0.4, 0.8, P = .001). Conclusion: SRH service use was common among women reporting frequent substance use. SRH settings provide an opportunity to deliver substance use screening and preventive care to young women.     

军事应激条件下医护人员心理健康特点及其相关因素研究

目的：研究军事应激条件下医护人员的心理健康特点及其相关因素，为开展心理健康教育和提高野战救治效率提供科学依据。方法：采用症状自评量表（SCL-90）对参加野战卫勤训练的某部94名医护人员进行现场测试，与SCL-90中国常模、军人常模比较，并按个人职称、人际交往、集体氛围等分组，进行组间比较。结果：①军事应激条件下除恐怖因子外，医护人员SCL-90各因子分、总均分和阳性项目数均显著高于全国常模（P〈0．01）；除抑郁因子外，医护人员SCL-90各因子分、总均分和阳性项目数均显著高于军队常模（P〈0．01）；②军事应激条件下医护人员心理卫生水平与个人职称、人际交往及集体氛围等因素有密切关联。结论：军事应激条件下医护人员心理卫生水平总体较差，心理问题产生的军事相关因素可能是个人职称、人际交往及集体氛围等。     

Parenting and Maternal Substance Addiction: Factors Affecting Utilization of Child Protective Services

The purpose of this study is to identify which personal, familial, environmental, and social factors are associated with the utilization of child protection services, including parental support programs, by mothers who misuse illicit substances. Participants are 56 mothers with substance use and addiction-related problems, of whom 32 were receiving, voluntarily or otherwise, child protection services while 24 mothers had psychotropic drug use-related problems but were receiving no psychosocial services. Data were collected in the province of Quebec, Canada, between August 1998 and August . Results indicate that mothers who receive services are younger, have fewer interpersonal resources, live in lower socioeconomic conditions, and have greater family dysfunction (less parental supervision and more inconsistent discipline) than mothers who do not receive services from child protection agencies. However, there are no significant differences between groups with regards to maternal childhood trauma, psychological distress, antisocial behavior and the quality of the parent–child bond. The results of this study suggest that although both groups misuse drugs and have personal difficulties, some mothers will not need support from social services to take care of their children. Implications of these findings for prevention are discussed. The study's limitations are noted.     

The Moderating Role of Peer Problems on the Relationship Between Substance Use and Mental Health

ABSTRACT

Understanding the interaction of peer problems with substance use influence on psychiatric symptoms has important clinical implications. We tested the hypothesis that peer problems moderate the relationship between substance use and psychiatric symptoms on a sample of 280 adolescents receiving psychiatric treatment. Age, race, and gender served as covariates. Our model accounted for a significant proportion of the variance in psychiatric symptoms (R² = .379, p < .001). A significant moderating effect of peer problems x substance use on psychiatric symptoms was found (p < .05). Next, we estimated the conditional effect of substance use on psychiatric symptoms as a function of low, moderate, and high levels of peer problems. Significant effects for low-level peer problems emerged, such that as peer problems increase by one unit, the effect of substance use on psychiatric symptoms increases by one half unit. Implications for peer-based interventions are discussed.     

Substance Use and Other Mental Health Disorders Among Veterans Returning to the Inner City: Prevalence,Correlates, and Rates of Unmet Treatment Need

Estimates of substance use and other mental health disorders of veterans (N = 269) who returned to predominantly low-income minority New York City neighborhoods between 2009 and 2012 are presented. Although prevalences of posttraumatic stress disorder, traumatic brain injury, and depression clustered around 20%, the estimated prevalence rates of alcohol use disorder, drug use disorder, and substance use disorder were 28%, 18%, and 32%, respectively. Only about 40% of veterans with any diagnosed disorder received some form of treatment. For alcohol use disorder, the estimate of unmet treatment need was 84%, which is particularly worrisome given that excessive alcohol use was the greatest substance use problem.     

Ethnic Differences in Substance Use,Sexual Risk Behaviors,and Psychosocial Factors in a Sample of Heterosexual Methamphetamine Users

Ethnic differences in measures of substance use, sexual risk behaviors, and psychosocial factors (depression, stigma, self-esteem) were examined in a sample of 402 heterosexual methamphetamine users (55.0% Caucasian, 29.9% African American, 15.1% Latino) who participated in a sexual risk reduction intervention between June 2001 and March 2005 in San Diego, California. Participants were primarily male (67%) and noncollege graduates (72%) and belonged to the low-income group (66%). African Americans were older when they first used methamphetamine and had used fewer grams in the past 30 days; Caucasians were more likely to inject. A larger percentage of African Americans reported anonymous sex partners in the past 2 months. African Americans reported lower levels of social stigma, and Caucasians reported lower self-esteem. Limitations and potential applications of these findings to prevention and treatment programs for ethnic minority populations are discussed.     

Self-Help Groups and Mental Health/Substance Use Agencies: The Benefits of Organizational Exchange

Self-help groups benefit clients by linking them to people who have “been there” and are successfully coping with their situations. Mental health/substance use agencies can increase access to evidence-based benefits of self-help groups by engaging them in organizational exchanges. Organizational theories are used to frame beneficial exchanges with self-help groups. Adaptational theory is used to frame exchanges with self-help groups and various service agency subunits, e.g., board, practitioner, and client units. Institutional theory is used to frame joint agency/self-help initiatives to promote community acceptance of self-help groups, which in turn may enhance the credibility of the professional agency.     

Association of Mental Health Symptoms and Peer Behaviors with Risk for Substance Use and Condomless Sex Among Youths in Juvenile Drug Court

Juvenile drug courts (JDCs) are a growing response to adolescent substance use, but better understanding of modifiable risk factors is needed to improve JDC outcomes. JDCs also serve dual public health and justice functions, heightening potential impact on co-occurring health factors like risky sex. However, mental health symptoms and peers’ activities may impede JDC effectiveness. In a unique longitudinal sample of 105 adolescents involved in JDCs, we find elevated internalizing symptoms and deviant peer behavior were each associated with increased substance use, with similar effects on risk for condomless sex. Findings inform intervention targets that could maximize JDC programming impact.     

The Roles of Spirituality in the Relationship Between Traumatic Life Events,Mental Health,and Drug Use Among African American Women from One Southern State

This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n = 206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included.