Family-Based Approaches to Substance Abuse Prevention

In this paper, the prevalence of child and adolescent substance use is briefly presented. The nature of the co-occurrence of multiple antisocial behaviors, including substance use, during adolescence, and the causal factors which contribute to the early onset and maintenance of youth substance use and substance abuse are discussed. Emphasis is placed on parent and family factors, and children's social competence, which are associated with substance use, and which are the potentially mutable targets of family-based preventive interventions. Family-based preventive interventions were classified as either primarily addressing parent and family skills training, or addressing family therapy and in-home family support models. Distinctions were also made between programs that were universal or selective preventive interventions, or that were indicated preventive interventions directed at high risk individuals who were already showing early signs of being on the trajectory to substance abuse. Intervention research conducted within the past 30 years within these topical areas are summarized within tables, and findings indicate consistent intervention effects on children's problem behaviors, and on potential mediating processes such as parenting behaviors and aspects of family functioning. Recent studies with strong designs are described in greater depth. The paper concludes with discussions of the gaps in current intervention research, of barriers encountered in the implementation and evaluation of family-based prevention programs, and of the implications for future preventive intervention research and for social policy related to family-based preventive interventions.     

The Predictors of Parental Use of Corporal Punishment

Abstract: Corporal punishment has been the focus of considerable study over the past decade. Some recent research suggesting that the use of corporal punishment may have significant long‐term negative effects on children has prompted increasing exploration and interest in the issue. We used tobit regression analysis and data from the 2000 National Longitudinal Survey of Youth to examine both the prevalence and the chronicity of spanking in a nationally representative sample of parents. Mother’s characteristics (e.g., age, education) and neighborhood context did not show a relationship with parental use of corporal punishment. Among parents who used corporal punishment, being Protestant had a relatively large relationship with its use. Although children’s externalizing behaviors had some association with parent’s propensity to spank, findings suggest that use of corporal punishment may be better understood as part of a constellation of behaviors relating to a parenting style. Further, findings indicate that it is easier to predict the incidence of corporal punishment than to predict its frequency of use.     

The Parent Child Development Centers and School Achievement: A Follow-Up

The long-term effectiveness of the Parent-Child Development Centers (PCDCs) as primary prevention programs was examined with follow-up data collected 6–13 years after program completion. Data were collected for 576 children who had been in the programs with the mothers (Birmingham, 153; New Orleans, 187; Houston, 244). Mothers and teachers were interviewed and school records were examined. Significant results were sparse. Houston program children had better achievement test results. Birmingham program children repeated grades less often. The largely negative results are interpreted as being a consequence of continuing poverty for the families involved.     

The needs, concerns and coping of mothers of children with cystic fibrosis

The questionnaire CICI:PQ for measuring needs, concerns and coping of parents of chronically ill children was mailed to 85 families with children with cystic fibrosis (CF). Some questions about the parents' experiences of the health care system were also included. Fifty-four per cent responded--in all cases but two the mothers. More than half of the mothers wanted help with or opportunities to discuss the state of health and the emotional development of the child and dietary issues. Many of them were concerned about the child's future. Shortage of time was another problem. The coping strategies used when having problems with the child were partly different from those used when problems arose with the partly different from those used when problems arose with the spouse. Most mothers were satisfied with the hospital care and the CF paediatrician. They wanted further support from the physiotherapist and many of them missed a CF nurse. The project illuminated many areas for further investigation.     

白血病患儿家长心理卫生状况调查

目的研究白血病患儿家长的心理状态。方法应用ＳＣＬ－９０量表检测白血病患儿家长的心理状态。结果白血病患儿家长存在着多种心理障碍，强迫、抑郁、焦虑三项因子得分显著高于正常人群常模。短病程组（病程〈６个月）家长焦虑、抑郁因子得分较长病程组（病程＞６个月）家长为高（Ｐ〈０．０１）。结论白血病患儿患病期间，特别是在患儿确诊初期，应注意其家长心理状态。提高家长的心理承受能力有助于稳定患儿情绪、提高医疗效果。     

Parental response to child illness behavior.

Examined the effects of child age and gender, parent gender, and type of child illness on parents' responses to their children's illness behavior. Study 1 describes the development of the Illness Behavior Encouragement Scale, based on Whitehead et al.'s Social Learning Scales for adults, and provides evidence supporting symptom specificity in children's learning of illness behavior. Results of Study 2 indicate that mothers encourage children's illness behavior more than fathers, that parents encourage children to adopt the sick role for gastrointestinal symptoms more than for cold symptoms, and that girls perceive parents as encouraging their illness behavior more than boys, that is, girls report receiving more sympathy and being allowed more relief from responsibility during illness episodes than boys.     

Swaddling, cradleboards and the development of children

The cross-cultural and historical use of techniques of infant restraint, swaddling with or without the use of a board or cradle, are described. Such techniques were used very widely in temperate latitudes but have declined since the 18th century. Laboratory experiments indicate that swaddled babies sleep more, have reduced levels of motor activity in response to stimulation, fewer startles and lower heart-rate variability. No clear long-term effects of swaddling have been demonstrated. Results are reported of an ethological study of cradleboard use among Navajo Indians. Time on cradleboard declined from about 16 h a day in the first 3 mth to less than 9 h by the first birthday. The extent of cradleboard use was determined by both infant and parental actions. As compared with European infants, Navajo babies spend much more time in actual or potential social contact with adults. It is suggested that swaddling and cradleboard might be used in western cultures to reduce the social iolation of infants, to reduce parental child tension with 'sleep problem' babies and in various paediatric situations.     

Caregivers' inability to identify childhood adiposity: a cross-sectional survey of rural children and their caregivers' attitudes

OBJECTIVES: To determine the prevalence of overweight and obese children in north-western New South Wales and to assess caregivers' ability to detect adiposity in their children. DESIGN: A cross-sectional survey using a standardised caregiver questionnaire and anthropometric measurements of school children attending 10 primary schools selected by stratified random sampling. SUBJECTS: A total of 598 eligible school children aged between five and eight years. MEASUREMENTS: Body mass index for children; caregivers' assessment of their children's dietary intake, physical activity and adiposity by questionnaire. RESULTS: A total of 348 caregivers responded to the survey, yielding a response rate of 58.2%. Significantly more caregivers of boys (200) than girls (144) chose to participate (chi2 = 8.3, d.f. = 1, P < 0.01). The vast majority of caregivers (87%) consented to their children being measured. Body mass index measurements revealed the following: more than three quarters of boys (82%) and girls (77%) were of normal weight. Of boys and girls 13% were overweight. Twice as many girls (6%) than boys (3%) were obese. In total, 31% of caregivers underestimated the weight of their children. This proportion of caregivers underestimating the correct weight category of their children almost doubled to 56% of caregivers of overweight children. Proportionately more caregivers of overweight boys underestimated their children's weight than caregivers of girls (67% compared with 44%). CONCLUSION: Health promotional activities need to address, as a matter of priority, caregivers' ability to accurately assess the correct weight category of their children.     

Effect of adjuvant disease in rats on cyclophosphamide and isophosphamide metabolism

After the injection of a variety of arthritogenic adjuvants into male Wistar rats, hepatic activation of cyclophosphamide and isophosphamide is rapidly and profoundly depressed. This selective injury is largely reversible with phenobarbital and principally restricted to the liver microsomal protein fraction, which demethylates aminopyrine and N, N-dimethylaniline and generates “alkylating metabolites” from cyclophosphamide in vitro. Evidence is presented, based upon both metabolite excretion studies and the duration of hexabarbital-induced hypnosis, that this phenomenon is not an artifact in vitro and must be seriously considered in evaluating both the efficacy of potential anti-arthritic drugs against the rat adjuvant arthritis and their toxicity in these arthritic animals. A quantitative separation of two pathological responses to the same adjuvant may be obtained: (1) in Buffalo rats, whose liver metabolism may be profoundly impaired while they suffer minimal (or no) arthritis after being inoculated with adjuvants which are truly arthritogenic in other rat strains; (2) with Mycobacterium tuberculosis dispersed in methyl oleate, which induces minimal arthritis in Wistar rats, but nevertheless impairs their liver metabolism over a prolonged period (14 days or more). Drug metabolism appeared to be normal in rats with two other immunologically mediated “inflammatory diseases” (graft vs host disease and allergic encephalomyelitis) and in other rodents examined after adjuvant inoculations. A novel bioassay for cyclophosphamide and isophosphamide metabolites is described which utilizes their ability to prevent grafted rat lymphocytes from initiating a graft vs host reaction in tolerant recipient rats. At least four alkylating metabolites of cyclophosphamide were found in rat bile and tentatively identified by thin-layer chromatography. The possible error in relying on changes in urinary excretion (rather than biliary excretion) of drug metabolites as a guide to changes in hepatic xenobiotic metabolism is discussed.