Social Self-Control Is a Statistically Nonredundant Correlate of Adolescent Substance Use

The social self-control scale (SSCS), which taps provocative behavior in social situations, was compared with five potentially overlapping measures (i.e., temperament-related impulsivity, psychomotor agitation-related self-control, perceived social competence, and rash action in response to negative and positive affectively charged states) as correlates of tobacco use and other drug use among a sample of 3,356 ninth-grade youth in Southern California high schools. While there was a lot of shared variance among the measures, the SSCS was incrementally associated with both categories of drug use over and above alternate constructs previously implicated in adolescent drug use. Hence, SSC may relate to adolescent drug use through an etiological pathway unique from other risk constructs. Given that youth who tend to alienate others through provocative social behavior are at risk for multiple drug use, prevention programming to modify low SSC may be warranted.     

Gender Differences in Drug Use,Sexually Transmitted Diseases,and Risky Sexual Behavior Among Arrested Youths

Data was collected on arrested youths processed at a centralized intake facility, including youths released back to the community and those placed in secure detention. This article reports the results of a test of a structural model involving newly arrested male and female youths' sexually transmitted diseases (STD) test results, urine analysis results for recent cocaine and marijuana use, and self-reported engaging in risky sexual behavior. The across-gender, multiple-group model involved (1) a confirmatory factor analysis of these variables, reflecting a latent variable labeled Risk, (2) a regression of Risk on the youths' age, and (3) an examination of the covariance between Risk and the youths' race and seriousness of arrest charge. Results indicate the youths' STD status, drug use, and reported risky sexual behavior are interrelated phenomena, similarly experienced across gender. Age was the only correlate of Risk status that demonstrated a significant gender group difference. The youths' race and seriousness of arrest charges did not significantly affect Risk, regardless of gender. Research and policy implications of the findings are discussed.     

Adolescent Girls in Out-of-Home Care: Associations Between Substance Use and Sexual Risk Behavior

ABSTRACT

Substance use and sexual risk behaviors continue to be major concerns for today's youths, and are particularly problematic for those who have been placed in out-of-home care settings. The purpose of this study was to explore these associations in a sample of 120 girls placed in a residential treatment setting and attending an on-site school in a major metropolitan area in the Midwest. A modified Youth Risk Behavior Survey (YRBS) was administered including questions relating to the youths' foster care or adjudicated status. The substance use variables targeted were alcohol and drug use. The sexual risk behavior variables were age of onset of first sexual intercourse, virginity status, contraceptive use, age of first sexual partner, and experience with ever having been forced to have sex. Results indicate that earlier onset and greater frequency of substance use were both correlated with number of sexual partners. Frequency of substance use was a significant and consistent contributor. Age of sexual partner was an inconsistent contributor, and history of forced sexual activity was not a contributor. Implications for policy and practice are offered to enhance the health and well-being of this unique population.     

Perceived Self-Control is Related to Mental Distress in Patients Entering Substance Use Disorder Treatment

Background: Levels of mental distress are high in patients with substance use disorders (SUD) and investigation of correlates may broaden our understanding of this comorbidity. Objectives: We investigated self-reported symptoms of mental distress among individuals entering either outpatient opioid maintenance treatment (OMT) or other inpatient SUD treatment and related factors, with a particular focus on perceived self-control. Methods: A cross-sectional study including substance users (n = 548; mean age 34 years; 27% women) entering treatment at 21 different treatment-centers across Norway, interviewed between December 2012 and April 2015. Symptoms of mental distress were assessed with Global Symptom Index (GSI) score. Adjusted relative risk ratios (RRR) with 95% confidence intervals (CI) were estimated through multinomial logistic regression. Results: More than half of the participants in both treatment groups reported mental distress (GSI) above clinical cut-off. The use of alcohol and exposure to violence were associated with increased likelihood of high GSI for both patient groups. Also, lower perceived self-control was related to high GSI in both treatment groups. Conclusion: Symptoms of mental distress were equally common among patients entering OMT and those entering other inpatient SUD treatment, even if the patients differed on a number of clinical characteristics. Use of alcohol and exposure to violence were associated with more mental distress in both groups. Perceived self-control also appeared to be important when explaining symptoms of mental distress among these SUD patients.     

Response Inhibition Moderates the Association between Drug Use and Risky Sexual Behavior

Background: HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. Objective: The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners). Methods: One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners. Results: Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners. Conclusions: Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations.     

Adolescent Sexual Behaviors at Varying Levels of Substance Use Frequency

Combining substance use and sex compounds the risk of contracting sexually transmitted diseases, including HIV. However, the association between substance use and sexual behaviors may vary by substance and sexual behavior. The current study sought to examine the relationship between alcohol and marijuana use frequency and specific sexual behaviors. The International Longitudinal Survey of Adolescent Health was administered to 1432 youths in one middle school and one high school in Minnesota. Results from logistic regression analyses indicated a relationship between alcohol and marijuana use and being sexually active. However, only marijuana use was associated with having multiple partners. To aid researchers in designing more effective HIV prevention interventions, future research should focus on understanding the differential effects of alcohol and marijuana on sexual behaviors.     

Alcohol Use Severity and Sexual Risk Behavior Among Female Substance Users

Background: Substance use has been identified as one of the leading factors related to HIV transmission in the United States. The association of problematic drinking with sexual risk behavior puts individuals at greater risk for HIV transmission. This may be of particular concern for women given that approximately 66% of new HIV infections occurring through heterosexual transmission are female. Objectives: To investigate alcohol use severity and sexual risk behavior among females who use heavy, illicit drugs. Methods: Female substances users (N = 251; M_age = 31.90, SD = 7.67; 63.7% Black) self-reported past month alcohol use and lifetime sexual risk behaviors with both casual and steady sex partners. Results: Problematic alcohol users were more likely to use noninjection drugs and less likely to use injection drugs than abstainers and more likely than moderate alcohol users to use alcohol before/during sex with a steady partner. White problematic alcohol users were less likely to use injection drugs before/during sex with a steady partner than abstainers. Black problematic alcohol users were more likely to use non-injection and alcohol than moderate alcohol users before/during sex with steady partners. Conclusions: The current study extends the existing literature by taking a closer look at the role of alcohol use severity in sexual risk taking behavior of Black and White female substance users, a particularly vulnerable group for HIV transmission.     

Gambling Behavior in Adolescent Substance Abuse

This study assessed the prevalence and correlates of gambling behavior (GB) in adolescent substance abusers (N = 97) consecutively admitted to an outpatient treatment program. Thirty-four percent of the cohort had never gambled; 57% were classified as social/nonpathological gamblers; 8% were labeled as in transition gamblers; and only 1% met criteria for pathological gambling. A significant finding was that males are more likely to gamble and to have a higher severity score than do females. A younger age of GB onset is seen for girls than boys and is correlated with a history of suicide attempts, diagnosis of depression, number of symptoms of oppositional behavior, cluster B personality disorders, and a higher need for psychiatric treatment. None of the gambling youths was ever referred for GB counseling. Increased awareness for and additional studies of adolescent gambling are required.     

Child Maltreatment,Relationship With Father,Peer Substance Use,and Adolescent Marijuana Use

Abstract

This longitudinal prospective study examined the relationship between child maltreatment as per reports to child protective services (CPS) and adolescent self-reported marijuana use, and the association between relationships with mothers and fathers and use of marijuana. The association between relationships with parents early in childhood (ages 6 to 8?years) and during adolescence with adolescent marijuana use were also probed. Another aim examined whether relationships with parents moderated the link between child maltreatment and youth marijuana use. The sample included 702 high-risk adolescents from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a consortium of five studies related to maltreatment. Children were recruited at age 4 or 6?years together with their primary caregiver. Some were recruited due to their risk for child maltreatment, others were already involved with CPS, and children in one site had been placed in foster care. Logistic regression analysis was performed using youth self-report of marijuana use as the criterion variable and child maltreatment and the relationships with parents as predictor variables, controlling for youths’ perceptions of peer substance use and parental monitoring, parental substance use, race/ethnicity, sex, and study site. Approximately half the youths had used marijuana. Most of them described quite positive relationships with their mothers and fathers. Participant marijuana use was associated with a poorer quality of relationship with mother during adolescence, and with peer and parental substance use. A better relationship with father, but not mother, during adolescence attenuated the connection between child maltreatment and youth marijuana use.     

Validity of Adolescent Self-Report of Substance Use

The validity of self-report of substance use was examined in 367 adolescents referred for a substance use assessment between 1996 and 2000. Referrals came from a wide variety of sources, including pediatricians, the courts, and social services, as well as their parents. Average age of the sample was 15, 52% were male, and 82% were Caucasian. Adolescents were first asked about the details of their substance use by a clinician using a structured interview with established reliability and validity (Adolescent Drug and Alcohol Diagnosis). They were subsequently asked to provide a urine sample, a requirement they were unaware of when being interviewed about their substance use. If the urine sample was deemed valid by the laboratory technician, it was analyzed by means of fluorescence polarization immunoassay and paper chromatography. If positive screens were obtained for any substance, the sample was subjected to gas chromatography/mass spectrometry for confirmation and quantification. Biochemical test results were compared to self-report. Overall, 28% (96/338) of the self-reports were not corroborated by urinalysis. In adolescents who reported nonuse of a substance, 26% (56/219) had a positive urinalysis. More surprisingly, 34% (40/119) of adolescents reporting substance use in the urinalysis detection window had a negative urinalysis. The present study found self-report of substance use in adolescents to only have fair validity. It is recommended that biochemical corroboration be routinely used for this population.     

High Rates of Club Drug Use and Risky Sexual Practices Among Hispanic Men Who Have Sex with Men in Miami,Florida

This study measured use of club drugs among 262 Hispanic men who have sex with men (MSM) recruited at community venues in Miami-Dade County, Florida in 2001. More than 50% of men used club drugs, and 36% used them in the last 3 months. Lifetime and 3-month rates were: ecstasy (36% and 20%), cocaine (34% and 12%), amyl nitrates (28% and 9%), and crystal methamphetamine (20% and 15%). Thirty-six percent had used two or more drugs (polydrug use) in their lifetime and 20% reported polydrug use in the last 3 months. Club drug users had significantly more sex partners in the last 12 months than nonclub drug users. High rates (35%) of unprotected anal sex in the last 3 months were reported by both groups. Men who reported polydrug use in the last 3 months were significantly more likely than men who used a single club drug to have had sex under the influence of club drugs (83% vs. 57%; X₂ = 7.4, p = 0.006). At the multivariate level, a significant association between preference for use of English and lifetime club drug use emerged. Effective interventions to reduce club drug use and risky sex for Hispanic MSM are needed.     

Social Support,Family Empowerment,Substance Use,and Perceived Parenting Competency during Pregnancy for Women with Substance Use Disorders

Background: Parenting self-efficacy has been linked to positive parent and child outcomes however, little research exists on factors that influence parenting self-efficacy among pregnant women with substance use disorders. Objectives: This study explored substance use severity, social support, and family empowerment as predictors of parenting self-efficacy among pregnant women (N = 71) entering SUD treatment. Methods: The study used a quantitative cross-sectional design. Results: Statistically significant positive correlations emerged between social support and parenting self-efficacy as well as family empowerment and parenting self-efficacy. Family empowerment and social support were also correlated. A backward elimination regression analysis revealed family empowerment to be the strongest predictor of parenting self-efficacy. No relationships were found among substance use severity and the study variables. Conclusions: When promoting parenting self-efficacy, both social support and family empowerment are important domains to consider for treatment planning and resource development among pregnant women with substance use disorders.     

Adolescent Substance Use and Sensation-Seeking on Sexual Behaviors Among Young Adults from Continuation High Schools

Background: Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. Objective: To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity and the effects of substance use and sensation-seeking in adolescence on age at sexual initiation and numbers of sexual partners by young adulthood. Methods: Baseline and 4-year follow-up data on youth from 14 continuation high schools in Southern California who participated in a drug abuse prevention intervention were analyzed. Structural equation modeling assessed whether or not substance use or sensation-seeking in adolescence predicted age at sexual onset and numbers of sexual partners by young adulthood. Results: Latinos had lower sensation-seeking and frequency of substance use and a later age at sexual onset than non-Latinos. Males were more likely than females to have multiple lifetime and recent sexual partners. The effects of adolescent substance use on the number of sexual partners by young adulthood were mediated fully by their age at sexual initiation. Sensation-seeking had no direct or indirect effects on sexual behaviors. Conclusions/Importance: Factors leading to and actual sexual risk behaviors among youth from continuation high schools vary by race/ethnicity and gender. Targeting these antecedent factors by race/ethnicity and gender may improve prevention efforts.     

Alcohol and Cigarette Free: Examining Social Influences on Substance Use Abstinence among Black Non-Latina and Latina Urban Adolescent Girls

Increases in substance use prevalence among girls, as well as a lack of research conducted with urban girls of color, highlight the importance of understanding both predictors and outcomes of substance use abstinence (SUA) within this population. This study addresses gaps in SUA research through a longitudinal investigation conducted with urban black non-Latina and Latina girls (N = 597) as they transitioned through junior high school. Multivariate logistic regressions found social influences (i.e., friend/family use, drug access) to be significantly associated with girls’ SUA, although differential associations were found by race/ethnicity. SUA was also associated with positive adjustment and wellness by ninth grade. Implications for gender-specific prevention programming are discussed.     

Sexual Identity and Substance Use Among Undergraduate Students

This study examined the association between sexual identity and use of alcohol and other drugs (AOD) among college undergraduate students. A survey regarding AOD use was administered to a random sample of 3607 undergraduate students. The sample included 65 self-identified lesbian or bisexual (LB) women and 54 self-identified gay or bisexual (GB) men. Multivariate logistic regression indicated that while alcohol use did not differ for LB and heterosexual women, LB women were significantly more likely to experience certain AOD-related consequences, smoke cigarettes, and use marijuana, ecstasy, and other drugs. GB men were significantly less likely than heterosexual men to drink heavily but were more likely to use some drugs. These findings provide evidence that sexual identity is an important predictor of AOD use among undergraduate students. These findings support the need for continued research and intervention efforts that target LGB collegians.     

Definitions of Risky and Problematic Cannabis Use: A Systematic Review

Although cannabis is widely used, it remains unclear which consumption patterns are more likely to produce future consequences (risky/hazardous use) or current damage (problematic/harmful use). This unresolved issue contributes to cannabis public health implications. In order to facilitate further consensus, this review analyzes previously used definitions in the literature. Methods: This systematic review was performed following the PRISMA guidelines. Articles published before October 2015 in the Medline, Scopus–Elsevier, ISI-Web of Knowledge and Cochrane databases and fulfilling a-priori decided criteria were retrieved. Definitions in preselected websites of national and international organizations addressing drug problems were also included. Results: Definitions identified in articles (n = 46) and official websites (n = 3) widely varied from each other. Weekly cannabis use was mostly considered risky. Problematic cannabis use was mostly described with the Cannabis Abuse and Screening Test. Evidence-based definitions as well as information on quantities consumed, time-frames and special considerations for risky groups were very limited. Conclusions: Working on official definitions is highly necessary as criteria used remain incomplete, leading to increased confusion in the field. Recommendations to improve existing definitions are given.     

Emotion Regulation Outcomes and Preliminary Feasibility Evidence From a Mindfulness Intervention for Adolescent Substance Use

Based on the evidence that emotion regulation difficulties underpin many mental health struggles during adolescence, including substance use disorders (SUDs), we focused on distress tolerance as a particularly salient mechanism of action for bolstering emotion regulation outcomes for adolescents in early SUD recovery. Mindfulness-based interventions are effective in improving distress tolerance through teaching skills to reduce individuals’ perceived stress or feelings of crisis and increasing a sense of agency and self-regulatory efficacy. The aim of the present study was to improve emotion regulation outcomes in the student body of a recovery high school (N = 27) through six weeks of mindfulness intervention content delivered in a small-group format. Thus, we tested feasibility through recruitment and retention rates and examined preliminary efficacy outcomes from two, randomized mindfulness intervention conditions, and used a comparison group of students without an SUD diagnosis (N = 29) sampled from the community. Results indicate significant post-intervention impacts on recovery students’ depression symptomology and on two separate measures of impulsivity (t(22) = 2.358, p?<?.05; t(20)?=?2.358, p?<?.05; t(17)?=?3.979, p?<?.01, respectively), although no significant differences between intervention condition were noted. Findings from the current study echo similar studies with comparable samples. Implications for the dosage and approach of group-format mindfulness interventions for adolescent samples are discussed.     

Substance Use Coping as a Mediator of the Relationship Between Trauma Symptoms and Substance Use Consequences Among Incarcerated Females With Childhood Sexual Abuse Histories

Rates of substance use and maltreatment are alarmingly high among incarcerated women. Although the direct link between trauma and substance use has been established, less is known about potential mediators. Thus, we examined substance use coping as a mediator between trauma symptoms and substance use consequences among a sample of incarcerated females (N = 111) who were survivors of childhood sexual abuse. Trauma symptoms predicted the severity of substance use consequences, with this relationship being mediated fully by avoidance coping (e.g., using substances to cope). Overall, trauma histories are important in predicting outcomes but must be examined in the context of current coping behaviors and substance use. Findings (data collected in 2007/2008) may help promote interventions that target patterns of coping and/or emotional avoidance among trauma survivors with substance use problems in incarcerated populations. The study's limitations are noted.     

Family Structure and Adolescent Substance Use: An International Perspective

Background: Numerous studies indicate that family structure is a key correlate of adolescent substance use. Yet there are some important limitations to this research. Studies have been conducted mainly in the United States, with relatively few studies that have compared family structure and youth substance use across nations. There is also a lack of recognition of the complexity of family types prevalent in contemporary global society. Moreover, there remains a need to consider personal, interpersonal, and macro-level characteristics that may help account for the association between family structure and youth substance use. Objective: This study uses data from 37 countries to examine several models that purport to explain the association between family structure and substance use. Methods: The data are from the 2005–2006 WHO-sponsored Health Behaviour in School-Aged Children (HBSC) (n = 193,202). Multilevel models, including linear, probit, and structural equation models (SEMs), were used to test several hypotheses. Results: The results suggest that time spent with friends largely accounted for the association between specific types of family structures and frequency of alcohol use and getting drunk, but that cannabis use was negatively associated with living with both biological parents irrespective of other factors.