Predictors of Attrition From Residential Treatment for Youths With Addictive Behaviors

The present study sought to examine predictors of attrition from residential treatment for adolescents with addictive behaviors. Using data from 137 adolescents and their families, latent variable models were constructed to examine three child/adolescent factors and three parenting factors as predictors of attrition. Findings indicated that emotional/social difficulties and parental involvement in treatment, as well as their interaction, had a direct effect on attrition. In addition, parenting in adolescence interacted with both substance/behavioral problems and early caregiver discipline to predict attrition. This study provided insight into the exacerbating effects of neglectful or absent parenting practices in the successful completion of adolescent substance use treatment.     

Relational Health in Transitions: Female Adolescents in Chemical Dependency Treatment

Background: Adolescent substance use (SU) remains a serious problem. Inpatient, primary care, and self-treatment models for chemical dependency (CD) yield varying degrees of success impacting the sequelae of chronic or episodic SU. Relational engagement among adolescent substance users is a long known influential factor in the development, maintenance and transformation of addictive behaviors. Objectives: Following tenets of Relational-Cultural Theory and using the Relational Health Indices for Youth (RHI-Y), a validated survey tool for adolescents, we sought to measure relational health (RH) during times of transitions during CD treatment. This article addresses use of the tool and its potential for improving addictions research and practice. Methods: During 2015–2017 we explored differences in RH scores in adolescent girls entering inpatient CD treatment at three points: 51 at admission, 39 at discharge, and 13 at 3 months post-discharge. Data were analyzed using a generalized linear mixed model to compare changes in domain scores of RH. Results: Changes in RH scores were significant in the friend domain, but not the mentor and community domains. The RHI-Y shows promise in discerning RH change during transitions in CD treatment.     

3-Year Follow-up of Lower Risk Cannabis Use Patterns: Evidence from a Longitudinal Survey

Objectives:Following recommendations from the Lower Risk Cannabis Use Guidelines, we evaluated how lower risk cannabis use (late initiation and low use frequency) was associated with the risk of developing cannabis abuse/dependence over a 3-year follow-up period compared to 12-month abstinence (controls) or higher risk cannabis use (early initiation and higher use frequency). We also explored the effect of cannabis quantity.Methods:Data were obtained from the U.S. nationally representative survey, National Epidemiologic Survey on Alcohol and Related Conditions wave I (2001 to 2002) and wave II (2004 to 2005), which included 31,464 respondents with no lifetime history of cannabis abuse/dependence at the first interview. We applied multiple logistic regression and propensity score matching analyses to examine the association between different use patterns at wave I and cannabis abuse/dependence at wave II, adjusting for covariates. Lower risk cannabis use and the transition to higher use frequency were also assessed.Results:For propensity score analysis, lower risk cannabis use at wave I was associated with higher risk of cannabis use/dependence at wave II compared to controls (odds ratio [OR]: 4.27; 95% confidence interval [95% CI], 1.57 to 11.61); however, there was no association with use frequency increase (OR: 2.52; 95% CI, 0.88 to 7.17). Higher risk use had a greater risk of cannabis use/dependence than controls (OR: 6.27; 95% CI, 2.56 to 15.38) and lower risk use (OR: 2.69; 95% CI, 1.12 to 6.47). Logistic regression analyses showed similar results, except that lower risk use was significantly associated with use frequency increase (OR: 2.49; 95% CI, 1.22 to 5.08). For the lower risk use group, 1 to 3 joints/day of use was significantly associated with cannabis abuse/dependence.Conclusions:We found that following recommended use patterns can significantly lower one’s risk of cannabis abuse/dependence. However, risk of cannabis abuse/dependence is still 4 times higher than staying abstinent. Updated recommendations on safe cannabis exposure levels are needed to guide cannabis use in the general population after cannabis legalization.     

Innovation in Behavioral Health Workforce Education

This article describes an effort to promote improvement in the quality and relevance of behavioral health workforce education by identifying and disseminating information on innovative training efforts. A national call for nominations was issued, seeking innovations in the education of behavioral health providers, consumers, and family members. A review committee evaluated each nomination on four dimensions: novelty, significance, transferability, and effectiveness. Nineteen innovations were selected for recognition, all of which are briefly described.     

Emotional Intelligence and Addictions: A Systematic Review

Since the millennium, an expanding number of research articles have examined the relationship between emotional intelligence (EI) and physical and mental health. The relationship between EI and addictive disorders has, however, remained relatively well-hidden. We therefore systematically reviewed and critically evaluated the literature on this relationship. We identified 51 articles on the topic of which 36 fulfilled our inclusion criteria. Results indicate that a lower level of EI is associated with more intensive smoking, alcohol use, and illicit drug use and two components of EI play a key role in addictions: “decoding and differentiation of emotions” and “regulation of emotions.”     

EXTREME RISK SEEKING ADDICTION: THEORY AND TREATMENT

Extreme Risk Seeking Addiction (ERSA) is a behavioural addiction manifested as a repeated voluntary search for risk. This article introduces some theoretical reference points to discuss a clinical case study, a once‐weekly psychotherapy which extended over more than ten years. The model followed assumes that ERSA is due to the feelings of excitement and ‘narrow escape’ which, if reiterated, bring about the construction of a pathological organization, a psychic retreat in Steiner's terms. This organization is a part of the self which is tyrannical and falsely protective, and is able to create illusory feelings of invulnerability and all‐powerfulness. Psychotherapy can offer a benevolent interaction which is sufficiently in tune with the ERSA‐affected person to be able to favour self‐reflective experiences promoting the mentalization of affect and, more generally, the skills which make it possible to recognize emotions in the self and in others, and to manage emotional states within relationships effectively and competently.     

Problematic internet and cell-phone use: Psychological,behavioral, and health correlates

This study aimed to assess pathological Internet and cell-phone use in college students, and to identify psychological, health, and behavioral correlates. A cross-sectional design was utilized to gather data from 337 students. We developed two measures, termed the Internet Over-use Scale (IOS), and the Cell-Phone Over-Use Scale (COS). Additional measures utilized were the Beck Anxiety Inventory, the Beck Depression Inventory, and the General Health Questionnaire-28. Results provide support for internal consistency of the IOS and the COS (α?=?0.88 and α?=?0.87, respectively) as well as for construct validity. Logistic regression analyses indicated that heavy Internet use is associated with high anxiety; high cell-phone use is associated to being female, and having high anxiety and insomnia. The developed measures seem to be promising tools for assessing these new behavioral addictions.