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CORK Bibliography: Family

99 citations. January 2009 to present

Prepared: September 2009

Albers AB; Biener L; Siegel M; Cheng DM; Rigotti NA. Impact of parental home smoking policies on policy choices of independently living young adults. Tobacco Control 18(3): 245-248, 2009. (14 refs.)

Objective: To determine whether adolescents living in parental homes where smoking is banned are more likely to move into smoke-free living quarters when they leave home. Methods: We analysed data on 693 youths from a 4-year, three-wave prospective study of a representative sample of Massachusetts adolescents (aged 12-17). All youths resided in independent living quarters at follow-up. The primary outcome was presence of a smoking ban in the living quarters at follow-up. The primary predictor was presence of a household smoking ban in the parental home, assessed 2 years before the outcome. Generalised linear mixed effects models examined the effect of a parental household smoking ban on the odds of moving into smoke-free living quarters at follow-up overall and stratified by smoking status at follow-up. Results: Youths leaving home had much higher odds of moving to smoke-free living quarters if their parental household had had a smoking ban (odds ratio (OR)= 12.70, 95% CI, 6.19 to 26.04). Other independent predictors included moving into a school or college residence (OR=3.88, 95% CI 1.87 to 8.05), and not living with smokers at follow-up (OR=3.91, 95% CI 1.93 to 7.92). Conclusions: A household smoking ban in the parental home appears to lead youths to prefer smoke-free living quarters once they leave home.

Amodeo M; Griffin ML. Sibling agreement on retrospective reports of parental alcoholism and other childhood events. Substance Use & Misuse 44(7): 943-964, 2009. (38 refs.)

Studies have used siblings to verify subject reports of retrospective data and examined variables influencing subject-sibling agreement, but questions remain. From 1998 to 2000, we examined a community sample of women (N = 143) in a metropolitan area, aged 21-60, balanced by race, parental alcoholism, and social class, as well as their siblings, using standardized, self-administered questionnaires and an interview. Research questions: Do subject and sibling reports agree? Do reports vary by subject characteristics, or the type of childhood experience? Descriptive statistics showed that agreement was strong for measures of parental alcoholism and psychiatric problems, weaker for family environment, and varied little by subject characteristics. Study limitations and implications are noted, and future research suggested.

Anda RF; Dong MX; Brown DW; Felitti VJ; Giles WH; Perry GS et al. The relationship of adverse childhood experiences to a history of premature death of family members. BMC Public Health 9(article 106), 2009

Background: To assess the association between adverse childhood experiences (ACEs), including childhood abuse and neglect, and serious household dysfunction, and premature death of a family member. Because ACEs increase the risk for many of the leading causes of death in adults and tend to be familial and intergenerational, we hypothesized that persons who report having more ACEs would be more likely to have family members at risk of premature death. Methods: We used data from 17,337 adult health plan members who completed a survey about 10 types of ACEs and whether a family member died before age 65. The prevalence of family member premature death and its association with ACEs were assessed. Results: Family members of respondents who experienced any type of ACEs were more likely to have elevated prevalence for premature death relative to those of respondents without such experience ( p < 0.01). The highest risk occurred among those who reported having been physically neglected and living with substance abusing or criminal family members during childhood. A powerful graded relationship between the number of ACEs and premature mortality in the family was observed for all age groups, and comparison between groups reporting 0 ACE and >= 4 ACEs yielded an OR of 1.8 (95% Cl, 1.6-2.0). Conclusion: Adverse childhood experiences may be an indicator of a chaotic family environment that results in an increased risk of premature death among family members.

Arnold EM; Rotheram-Borus MJ. Comparisons of prevention programs for homeless youth. Prevention Science 10(1): 76-86, 2009. (52 refs.)

There are six HIV prevention programs for homeless youth whose efficacy has been or is currently being evaluated: STRIVE, the Community Reinforcement Approach, Strengths-Based Case Management, Ecologically-Based Family Therapy, Street Smart, and AESOP (street outreach access to resources). Programs vary in their underlying framework and theoretical models for understanding homelessness. All programs presume that the youths' families lack the ability to support their adolescent child. Some programs deemphasize family involvement while others focus on rebuilding connections among family members. The programs either normalize current family conflicts or, alternatively, provide education about the importance of parental monitoring. All programs aim to reduce HIV-related sexual and drug use acts. A coping skills approach is common across programs: Problem-solving skills are specifically addressed in four of the six programs; alternatively, parents in other programs are encouraged to contingently reward their children. Each program also engineers ongoing social support for the families and the youth, either by providing access to needed resources or by substituting a new, supportive relationship for the existing family caretaker. All of the interventions provide access to health and mental health services as basic program resources. A comparison of HIV prevention programs for homeless youth identifies the robust components of each and suggests which programs providers may choose to replicate.

Ashford KB; Hahn E; Hall L; Rayens MK; Noland M. Postpartum smoking relapse and secondhand smoke. Public Health Reports 124(4): 515-526, 2009. (42 refs.)

Objective. There has been an abundance of research evaluating prenatal and postnatal smoking abstinence programs. However, few researchers have tested postpartum relapse interventions that address secondhand smoke (SHS) exposure. Pregnant women exposed to SHS are more likely to relapse. This article explores the similarities and differences among postpartum interventions that incorporate SHS education. Generating knowledge about the components of postpartum relapse prevention interventions that do and do not achieve prolongation of abstinence is integral to the development of effective SHS interventions that help women achieve lifelong abstinence. Methods. We used a methodological review of 11 randomized, controlled trials testing the efficacy of relapse prevention interventions that address SHS exposure. We compared intervention strength, biomarker validation of home smoking and SHS, as well as abstinence and relapse rates. We examined three predictors of postpartum relapse: (1) partner smoking in the home, (2) adoption of home smoking restrictions, and (3) motivation/confidence to remain abstinent. Results. Findings revealed a need for more comprehensive SHS interventions and a clear delineation of abstinence/relapse terminology. Biomarker validation of home smoking and SHS was primarily measured by self-report, passive nicotine monitors, and hair nicotine levels. Furthermore, studies using nurse- and pediatrician-led interventions resulted in the lowest relapse rates. Conclusion. A comprehensive intervention that specifically prioritizes parental education on the health effects of SHS on the family, empowerment of the mother and family members to remain abstinent and adopt a smoke-free home smoking policy, and partner influence on smoking could result in a significant reduction in postpartum relapse rates.

Babb B; Danziger G; Moran J. Substance abuse and addiction in Family Courts: Special guest editors' introduction to special issue. Family Court Review 47(April): 204-208, 2009. (4 refs.)

Summary: ... In 2005, the Center for Families, Children and the Courts, in partnership with the Maryland Administrative Office of the Courts and the Open Society Institute-Baltimore, held a conference on addiction and substance abuse devoted to topics such as recent developments in addiction research, the effects of addiction and substance abuse on families, and updates on drug courts and family treatment courts, among others. ... Given the inextricable connection between substance abuse and issues such as child abuse and neglect, family court judges and court staff believe it is their responsibility to address the problems of substance abuse and addiction among litigants. ... With these assessments as a base, the family dependency treatment court team constructs workable case plans that give parents a viable chance to achieve sobriety, provide a safe nurturing home, assume responsibility for themselves and their children, and sustain their families. ... As the family dependency treatment court model has gained popularity, family court judges, attorneys, and staff have realized that the family justice system in general can contribute significantly to improve the lives of families struggling with prob-lems of addiction. ... The authors note the relationship between job satisfaction and efficacy, which is exemplified by the documented accomplishments of drug courts in achieving their goals. ... In her article, Caroline Cooper examines the court's response to adolescent substance abuse, focusing on the significant number of youth and young adults who use drugs, but whose drug and/or alcohol abuse is virtually ignored by the courts until it has become a criminal matter. ... Individuals with drug convictions but no current drug use should not be prevented, based on their past drug use, from obtaining student loans, grants, scholarships, or access to government training programs.

Balsa AI; Homer JF; French MT. The health effects of parental problem drinking on adult children. Journal of Mental Health Policy & Economics 12(2): 55-66, 2009. (34 refs.)

Background: Much of the research on adult children of alcoholics has focused on the transmission of drinking patterns from parents to their children and the development of alcohol-related problems. Less is known about how exposure to parental problem drinking affects children as they progress into adulthood in terms of other mental health outcomes. This is crucial information, in part because the average age of onset for depression and other mental health disorders is during late adolescence or young adulthood. Aims: The objective of this study was to rigorously assess the long-term impacts of parental problem drinking on adult children's mental and self-perceived overall health. The study improves on previous literature by analyzing a range of mental health markers and other predictors of morbidity, by focusing on a period of adulthood that only a limited number of studies have examined, and by using data from a highly regarded and nationally representative panel study. Data: The analysis used data from the NLSY79, a nationally representative sample of 12,686 men and women. The NLSY79 collected detailed information about personal and family characteristics, including alcohol and other substance use, for a cohort of individuals who were between the ages of 14 and 22 when first surveyed in 1979. The survey was re-administered each year through 1994 and on a biennial basis since then. The dataset provides information on parental drinking and identifies problematic drinking behaviors both among mothers and fathers. Beginning with the 1998 survey, an extensive health module was administered to respondents over 40 years of age to provide a baseline health profile of the respondents before retirement. It includes a set of measures that assess the mental, physical, and behavioral health of the respondents when they reached the age of 40. Methods: Estimation was conducted using propensity score matching (PSM) methods. Through the use of PSM methods, we control for a rich set of observed demographic, household, geographic, and economic characteristics, as well as unobserved features correlated with these variables, that predispose a parent to drink problematically, thereby reducing the possibility of estimation bias. In addition, PSM is superior to traditional multivariate regression in that it allows for the possibility of non-linear effects and the comparison of treatment and control individuals with similar characteristics. Results: The results indicate that parental problem drinking is associated with significant mental health consequences for children that persist far into adulthood. Adult respondents with a problem-drinking father were more likely to have been diagnosed with mental health problems relative to other respondents, while those with a problem-drinking mother had poorer self-perceived health and mental health (SF-12) scores. Respondents with a problem-drinking mother were also more likely to have ever been diagnosed with a mental health problem. Outcomes were worse for daughters of problem drinkers than for sons. Policy Implications: These long-lasting consequences of parental problem drinking on adult children's mental health should be considered when designing and financing interventions targeting problem drinkers and their families.

Bernburg JG; Thorlindsson T; Sigfusdottir ID. The neighborhood effects of disrupted family processes on adolescent substance use. Social Science & Medicine 69(1): 129-137, 2009. (55 refs.)

In the current paper, we argue that the neighborhood-level of disrupted family processes (weak social ties to parents and coercive family interaction) should have a contextual effect on adolescent substance use (cigarette smoking, heavy drinking, and lifetime cannabis use), because adolescents living in neighborhoods in which disrupted family processes are prevalent should be more likely to associate with deviant (substance using) peers. We use nested data on 5491 Icelandic adolescents aged 15 and 16 years in 83 neighborhoods to examine the neighborhood-contextual effects of disrupted family processes on adolescent substance use (cigarette smoking, heavy drinking, and lifetime cannabis use), that is, whether neighborhoods in which disrupted family processes are common have more adolescent substance use, even after partialling Out the individual-level effects of disrupted family processes on substance use. As predicted, we find that the neighborhood-levels of disrupted family processes have significant, contextual effects on all the indicators of substance use, and that association with substance using peers mediates a part of these contextual effects. The findings illustrate the limitation of an individual-level approach to adolescent substance use.

Bertrand J. Interventions for children with fetal alcohol spectrum disorders (FASDs): Overview of findings for five innovative research projects. Research in Developmental Disabilities 30(5): 986-1006, 2009

It is well established that prenatal exposure to alcohol causes damage to the developing fetus, resulting in a spectrum of disorders known as fetal alcohol spectrum disorders (FASDs). Although our understanding of the deficits and disturbances associated with FASDs is far from complete, there are consistent findings indicating these are serious, lifelong disabilities-especially when these disabilities result from central nervous system damage. Until recently, information and strategies for interventions specific to individuals with FASDs have been gleaned from interventions used with people with other disabilities and from the practical wisdom gained by parents and clinicians through trial and error or shared through informal networks. Although informative to a limited degree, such interventions have been implemented without being evaluated systematically or scientifically. The purpose of this article is to provide a brief overview of a general intervention framework developed for individuals with FASDs and the methods and general findings of five specific intervention research studies conducted within this framework. The studies evaluated five different interventions in five diverse locations in the United States, with different segments of the FASD population. Nonetheless, all participants showed improvement in the target behaviors or skills, with four studies achieving statistical significance in treatment Outcomes. important lessons emerged from these five interventions that may explain Success: including parent education or training, teaching children specific skills they would usually learn by observation or abstraction, and integration into existing systems of treatment. A major implication of these research studies for families dealing with FASDs is that there are now interventions available that can address their children's needs and that can be presented as scientifically validated and efficacious to intervention agents such as schools, social services, and mental health providers. In the field of FASD research and clinical service, a common theme reported by families has been that clinicians and professionals have been reluctant to diagnose their children because there were no known effective treatments. Results of these five studies dispel that concern by demonstrating several interventions that have been shown to improve the lives of individuals with FASDs and their families.

Bezinovic P; Malatestinic D. Perceived exposure to substance use and risk-taking behavior in early adolescence: Cross-sectional study. Croatian Medical Journal 50(2): 157-164, 2009. (25 refs.)

Aim: To examine the relation between perceived exposure to parents, siblings, and peers' substance use and self-reported substance consumption among early adolescents in Primorsko-goranska county, Croatia, and between perceived exposure to substance use and risk-taking behaviors such as going out late at night, gathering at secluded places, skipping school, and gambling. Method: A self-reported cross-sectional survey was conducted in 2007 among 2219 eight-grade (14-year old) pupils in elementary schools in Primorsko-goranska county. Exposure to substance use in their immediate social environment, self-reported consumption of cigarettes, alcohol, inhalants, and marihuana, ways of spending free time, and family and peer relationships were assessed. Results There was a significant association between perceived exposure to substance use and self-reported consumption of cigarettes, alcohol, inhalants, and marihuana in both sexes (P < 0.001). Pupils whose parents, siblings, and peers used substances significantly more often developed the same behavioral patterns. Level of exposure to substance use in the immediate social environment had the strongest effect on experimenting with smoking among girls (from 26.6% in low exposure to 76.2% in high exposure group) and among boys (from 15.8% in low exposure to 69.4% in high exposure); on regular everyday smoking among girls (from 4.4% in low exposure to 45% in high exposure group) and among boys (from 2.7% in low exposure to 36.7% in high exposure group); on hard liquor consumption among girls (from 25.1% in low exposure to 79.5% in high exposure group) and among boys (from 28.1% in low exposure to 78.4% in high exposure group), as well as on binge drinking among girls (from 10.9% in low exposure to 56.6% in high exposure group) and among boys (from 15.5% in low exposure to 62.4% in high exposure group). Girls and boys exposed to substance use engaged more often in risk-taking and potentially delinquent behaviors (F-(2,F- 1180) = 166 502; P < 0.001, two-way ANOVA). Conclusion: High exposure to substance use in immediate social environment and its great impact on substance use among early adolescents indicate that there is a need for the introduction of preventive programs that would reduce inappropriate behavior among adolescents' social models.

Brent D; Melhem N; Donohoe MB; Walker M. The incidence and course of depression in bereaved youth 21 months after the loss of a parent to suicide, accident, or sudden natural death. American Journal of Psychiatry 166(7): 786-794, 2009. (40 refs.)

Objective: This study examined effects of bereavement 21 months after a parent's death, particularly death by suicide. Method: The participants were 176 offspring, ages 7-25, of parents who died by suicide, accident, or sudden natural death. They were assessed 9 and 21 months after the death, along with 168 nonbereaved subjects. Results: Major depression and alcohol or substance abuse 21 months after the parent's death were more common among bereaved youth than among comparison subjects. Offspring with parental suicide or accidental death had higher rates of depression than comparison subjects; those with parental suicide had higher rates of alcohol or substance abuse. Youth with parental suicide had a higher incidence of depression than those bereaved by sudden natural death. Bereavement and a past history of depression increased depression risk in the 9 months following the death, which increased depression risk between 9 and 21 months. Losing a mother, blaming others, low self-esteem, negative coping, and complicated grief were associated with depression in the second year. Conclusions: Youth who lose a parent, especially through suicide, are vulnerable to depression and alcohol or substance abuse during the second year after the loss. Depression risk in the second year is mediated by the increased incidence of depression within the first 9 months. The most propitious time to prevent or attenuate depressive episodes in bereaved youth may be shortly after the parent's death. Interventions that target complicated grief and blaming of others may also improve outcomes in symptomatic youth with parental bereavement.

Brook JS; Brook DW; Zhang CS; Cohen P. Pathways from adolescent parent-child conflict to substance use disorders in the fourth decade of life. American Journal on Addictions 18(3): 235-242, 2009. (63 refs.)

This 24-year community longitudinal study provides important information regarding parent-child conflict in adolescence (mean ages 14-16), vulnerable personality attributes and peer deviance in the twenties (mean age 22), and marital conflict and partner's illicit drug use in the late twenties and early thirties (mean ages 27-32) as related to a later diagnosis of substance use disorders (SUDs) in the thirties (mean ages 32-37). A community-based sample was interviewed between 1975 and 2007. Results based in structural equation modeling indicated that a weak parent-child bond was related to the development of drug-conducive personality traits, which was associated with the selection of drug-using peers and partners, which in turn, predicted SUDs. Both peer deviance and partner's illicit drug use had the greatest effects on SUDs. The findings should aid in formulating prevention and treatment programs targeting specific risk factors in adolescents, young adults, and adults.

Brook J; McDonald T. The impact of parental substance abuse on the stability of family reunifications from foster care. Children and Youth Services Review 31(2): 193-198, 2009. (46 refs.)

Alcohol and other drug (AOD) abuse by caretakers is frequently cited as a precipitating reason for the entry of children into foster care, however, little research has been done to examine the impact of alcohol and other drugs on the stability of family reunification. This study examined the likelihood of reentry into foster care following reunification for children whose primary caretakers were stratified into groups based on the type of substance abuse cited as a primary reason for the initial removal: those with alcohol only involvement, those with drug only involvement, those with both alcohol and other drug involvement. and those with no alcohol or drug involvement. Event history analysis showed that children whose reasons for initial placement in foster included caretakers with both alcohol and drug involvement were much more likely to reenter care following reunification than any of the other three groups. However, drug or alcohol involvement as the initial reason for removal was also associated with higher risk of reentry.

Brook JS; Saar NS; Zhang CS; Brook DW. Familial and non-familial smoking: Effects on smoking and nicotine dependence. Drug and Alcohol Dependence 101(1-2): 62-68, 2009. (44 refs.)

Background: This study examined the relative impact of familial and non-familial smoking on participant smoking and nicotine dependence. Methods: This is a longitudinal study of 838 African American and Puerto Rican participants who were interviewed four times in their homes over a 15-16-year period (1990, 1994-1996, 2000-2001, and 2004-2006). Results: Parental smoking during adolescence had a direct positive path to peer smoking during adolescence, which in turn had a direct positive path to participant smoking during the mid-twenties. In addition to the direct path between participant smoking in the mid-twenties and participant nicotine dependence during the late twenties, there was an indirect effect mediated by the partner's problems resulting from smoking during the late twenties. Conclusions: This research demonstrates the key role the social environment plays in smoking and nicotine dependence. Both familial and non-familial smoking were significantly related to smoking and nicotine dependence. Public health implications suggest the importance of targeting prevention and treatment policies based on the participants' stage of development. During adolescence the focus should be on parental and peer smoking, whereas during the twenties attention might be paid to their own smoking and that of their partners.

Bruzzese JM; Gallagher R; McCann-Doyle S; Reiss PT; Wijetunga NA. Effective methods to improve recruitment and retention in school-based substance use prevention studies. Journal of School Health 79(9): 400-407, 2009. (39 refs.)

BACKGROUND: Poor recruitment and high attrition may invalidate results of research studies. This paper describes successful recruitment and retention strategies in a school-based substance use prevention trial and explores factors associated with intervention attendance and retention. METHODS: A total of 384 parent-child dyads from 15 schools in the New York Metropolitan area participated in a control trial, testing the efficacy of parent-training to prevent youth substance use. Assessments were completed immediately post-intervention and 6-, 12-, and 24-month postintervention. Logistic regression analyses were used to determine which familial and study characteristics predicted attendance in the intervention and retention by parents and youth. RESULTS: 84% of intervention parents attended 4 of the 5 workshops; 83% of control parents attended their single workshop. Intervention attendance was predicted by parent job status, but this was not significant after controlling for other family factors. Retention rates ranged from 87% to 91% over the 2 years. No family characteristics predicted retention, but time since baseline and attendance at treatment workshops and the control workshop did. For children, age at baseline and ethnicity predicted retention, but this did not remain significant in the adjusted model. CONCLUSION: Intervention attendance was high and retention rates far exceeded the minimum standard of 70% retention in behavioral studies. Recruitment and retention strategies were effective for different family constellations. Efforts to maximize participation in both treatment and control interventions are critical to retention in longitudinal trials.

Buchanan RL; Smokowski PR. Pathways from acculturation stress to substance use among Latino adolescents. Substance Use & Misuse 44(5): 740-762, 2009. (81 refs.)

The purpose of this study was to examine the link between acculturation stress and substance use among Latino adolescents. In-home interviews were completed with the participants at four time-points between 2005 and 2007. Path analysis was completed using longitudinal data from 286 Latino adolescents living in North Carolina and Arizona (65% foreign-born). Results indicate that acculturation stress influences family and friend relationships, which in turn affect adolescent mental health problems, and finally, substance use. Key mediators in the pathway from acculturation stress to substance use were parent-adolescent conflict, internalizing, and externalizing problems. Implications for practice and research have been discussed here.

Buckner JD; Turner RJ. Social anxiety disorder as a risk factor for alcohol use disorders: A prospective examination of parental and peer influences. Drug and Alcohol Dependence 100(1-2): 128-137, 2009. (75 refs.)

Elucidation of mechanisms underlying the high rates of alcohol use disorder (AUD) remains a pressing clinical and research concern. Despite data indicating that social anxiety disorder (SAD) maybe a psychological vulnerability that increases AUD risk, no known prospective research has examined underlying mechanisms. Given the nature of SAD, social support and peer alcohol use may be implicated. The present study set out to clarify the SAD-AUD link in several ways using a prospective dataset comprised of 1803 (47% female) young adults at T1, 1431 of whom were assessed again approximately 3 years later. First, stringent criteria were used to directly test whether SAD was a risk for AUD. Second, we examined whether social support and peer alcohol use moderated the prospective SAD-AUD link. Structured diagnostic interviews were conducted to assess DSM-IV Axis I disorders, negative life events, social support, and peer alcohol use. Among men, Time 1 (T1) SAD was not significantly related to Time 2 (T2) AUD. Yet, among women, T1 SAD was related to T2 AUD. Further, T1 SAD was the only internalizing disorder to significantly predict T2 AUD after controlling for relevant variables (e.g., T1 depression, other anxiety, alcohol and marijuana use disorders). The SAD-AUD relation demonstrated directional specificity. Family cohesion and adverse family relations significantly moderated this relation. Findings highlight the important role of SAD and familial support in the onset of AUD among women.

Buschgens CJM; Swinkels SHN; van Aken MAG; Ormel J; Verhulst FC; Buitelaar JK. Externalizing behaviors in preadolescents: Familial risk to externalizing behaviors, prenatal and perinatal risks, and their interactions. European Child and Adolescent Psychiatry 18(2): 65-74, 2009. (53 refs.)

Background: Accumulating evidence indicates that there is a rich and varied interplay between persons and their environments, which strongly suggests that this involves gene-environment correlations and interactions. We investigated whether familial risk (FR) to externalizing behaviors and prenatal and perinatal risk factors, separately or in interaction with each other, predicted externalizing behaviors. Methods: The subjects were 10- to 12-year-old preadolescents who were taking part in TRAILS, a large prospective population-based cohort study (N=2,230). Regression analyses were used to determine the relative contribution of FR and prenatal and perinatal risks to parent and teacher ratings of inattention, hyperactivity/impulsivity aggression, and delinquency. Results: Regression models explained between 6 and 11% of the variance of externalizing behaviors. We found main effects of FR (vs. no FR), macrosomia (birth weight >4,500 g), maternal prenatal smoking ( MPS), pregnancy and delivery complications (PDCs), and gender that were rather consistent across rater and outcome measures. For some outcome measures, the effect of MPS and PDCs depended on the presence of FR. These included both positive and negative interaction effects. Correlations between FR and prenatal and perinatal risks were significant but rather low. Conclusions: Both main effects and interaction effects of FR and prenatal and perinatal risks contributed to externalizing behaviors in preadolescents, but all effects were of small size. Further research including use of candidate gene polymorphisms is necessary to identify the underlying neurobiological mechanisms of these main and interaction effects.

Buu A; DiPiazza C; Wang J; Puttler LI; Fitzgerald HE; Zucker RA. Parent, family, and neighborhood effects on the development of child substance use and other psychopathology from preschool to the start of adulthood. Journal of Studies on Alcohol and Drugs 70(4): 489-498, 2009. (37 refs.)

Objective: We examined the long-term effects of childhood familial and neighborhood risk on adolescent substance use and psychiatric symptomatology. Method: This study used data from an ongoing 2-decade long study that recruited alcoholic and neighborhood control families through fathers' drunk-driving records and door-to-door canvassing in a four county area. The sample included 220 male, initially 3- to 5-year-old children of the participant families, who received in-home assessments at baseline and thereafter at 3-year intervals. Parental lifetime psychopathology and offspring symptomatology at ages 18-20 were assessed by semistructured diagnostic interviews. Census tract variables were used to indicate neighborhood characteristics. Results: The isomorphic parental symptomatology predicted offspring psychopathology. For marijuana-use disorder, major depressive disorder, and nicotine dependence, the other parental comorbidities were also significant predictors. Neighborhood residential instability in childhood contributed to the development of late adolescent alcohol-use disorder, marijuana-use disorder, major depressive disorder, antisocial personality disorder, and nicotine-dependence symptomatology Although lower family socioeconomic status in childhood contributed to more adolescent marijuana-use disorder, major depressive disorder, and nicotine-dependence symptoms, neighborhood socioeconomic status did not predict adolescent psychopathology. Longitudinal changes in neighborhood environments from early childhood to adolescence had significant effects on alcohol-use disorder, marijuana-use disorder, and major depressive disorder symptoms in late adolescence. A higher frequency of family mobility from early childhood to adolescence predicted more nicotine-dependence symptoms in late adolescence. Conclusions: Findings indicate that parental psychopathology, family socioeconomic status, and neighborhood residential instability are all important risk factors for the development of substance-use disorder and other comorbid psychopathology. Intervention programming might effectively use these early parental psychopathology indicators to identify risk and might target community activity to stabilize the social environment and provide youth services to counteract the effects of family transience.

Chase D; Hora PF. Substance abuse and addiction in family courts: The best seat in the house. Family Court Review 47(April): 209-234, 2009. (96 refs.)

A survey of 355 judges examined the differences in judicial satisfac-tion between those assigned to problem-solving courts--such as drug treatment and unified family--and judges in other more traditional assignments such as family law and criminal courts. The unified family court systems, like drug treatment courts, have generally adopted the principles of therapeutic jurisprudence. Significant differences were found on each of the three survey scales: (1) helpfulness, (2) attitude toward litigants, and (3) positive effects of assignment. The judges who were in the problem-solving courts (drug treatment and unified family court) scored higher on all three scales than those who were not (traditional family and criminal court). The group of problem-solving court judges consistently scored higher than the other group of judges, with the drug treatment court judges scoring the highest. The group of traditional criminal court and family court judges scored less positively, with the criminal court judges having the lowest scores. The problem-solving court judges were more likely to report believing that the role of the court should include helping litigants address the problems that brought them there and were more likely to observe positive changes in the litigants. They were also more likely to believe that litigants are motivated to change and are able to do so. They felt more respected by the litigants and were more likely to think that the litigants were grateful for help they received. The problem-solving court judges were also more likely to report being happy in their assignments and to believe that these assignments have a positive emotional effect on them.

Chassin L; Knight G; Vargas-Chanes D; Losoya SH; Naranjo D. Substance use treatment outcomes in a sample of male serious juvenile offenders. Journal of Substance Abuse Treatment 36(2): 183-194, 2009. (46 refs.)

This study examined drug-treatment-related reductions in alcohol and marijuana use, cigarette smoking, and nondrug offending among male adolescents who bad been adjudicated of a serious (almost exclusively felony) offense. Results indicated that the "real-world" drug treatments that these adolescents experienced had significant effects on substance use, which could not be explained solely by incarceration in controlled environments. However, effects on cigarette smoking and criminal offending were found only for treatments that included family involvement. Results suggest that involving families in adolescents' treatment may be useful for promoting desistence from criminal offending in this population.

Conroy E; Degenhardt L; Mattick RP; Nelson EC. Child maltreatment as a risk factor for opioid dependence: Comparison of family characteristics and type and severity of child maltreatment with a matched control group. Child Abuse and Neglect 33(6): 343-352, 2009. (71 refs.)

Objective: To examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage. Method: The study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex and unemployment and were restricted to those with a lifetime opioid use of less than five times. The interview covered child maltreatment, family environment, drug use and psychiatric history. Results: This study found a high prevalence of child maltreatment among both cases and controls. Despite the elevated prevalence among controls, opioid-dependent males had a higher prevalence of physical and emotional abuse; female cases had a higher prevalence and greater severity of sexual abuse. The prevalence of neglect was similar for both groups. Early parental separation was more prevalent among female cases compared to female controls; otherwise the prevalence of the risk factors was comparable for both groups. The risk factors significantly associated with child maltreatment were also similar for both cases and controls. Conclusions: Given the documented association between child maltreatment and adult mental disorder, child maltreatment may be an important antecedent of current psychological distress in persons presenting to treatment for opioid dependence. Apart from a possible association between early parental separation and sexual abuse among female cases, the increased prevalence of child maltreatment associated with opioid dependence did not appear to be related to differences in early childhood risk factors considered in this paper. Other risk factors may be more pertinent for those with opioid dependence. Practice implications: The high prevalence of child maltreatment among the opioid-dependent sample has implications for the assessment and treatment of clients presenting with opioid dependence. Assessment of child maltreatment history could help inform the development of individual treatment plans to better address those factors contributing to the development and maintenance of opioid dependence. Specifically, management of comorbid mental disorder associated with child maltreatment could be the focus of relapse prevention programmes and also have a positive influence on treatment retention.

Copello A; Templeton L; Orford J; Velleman R; Patel A; Moore L et al. The relative efficacy of two levels of a primary care intervention for family members affected by the addiction problem of a close relative: A randomized trial. Addiction 104(1): 49-58, 2009. (31 refs.)

Objectives: A randomized trial to compare two levels of an intervention (full versus brief) for use by primary health-care professionals with family members affected by the problematic drug or alcohol use of a close relative. Design: A prospective cluster randomized comparative trial of the two interventions. Setting: A total of 136 primary care practices in two study areas within the West Midlands and the South West regions of England. Participants: A total of 143 family members affected by the alcohol or drug problem of a relative were recruited into the study by primary health-care professionals. All recruited family members were seen on at least one occasion by the professional delivering the intervention and 129 (90 %) were followed-up at 12 weeks. Main outcome measures: Two validated and standardized self-completion questionnaires measuring physical and psychological symptoms of stress (Symptom Rating Test) and behavioural coping (Coping Questionnaire) experienced by the family members. It was predicted that the full intervention would show increased reduction in both symptoms and coping when compared to the brief intervention. Results: The primary analysis adjusted for clustering, baseline symptoms and stratifying variables (location and professional group) showed that there were no significant differences between the two trial arms. The symptom score at follow-up was 0.23 [95% confidence interval (CI): _3.65, +4.06] higher in the full intervention arm than in the brief intervention arm, and the coping score at follow-up was 0.12 (95% CI: _5.12, +5.36) higher in the full intervention arm than in the brief intervention arm. Conclusions: A well-constructed self-help manual delivered by a primary care professional may be as effective for family members as several face-to-face sessions with the professional.

Danaher BG; Lichtenstein E; Andrews JA; Severson HH; Akers L; Barckley M. Women helping chewers: Effects of partner support on 12-month tobacco abstinence in a smokeless tobacco cessation trial. Nicotine & Tobacco Research 11(3): 332-335, 2009. (20 refs.)

Social support has been relatively unstudied in smokeless tobacco cessation research; partner support could encourage quitting, buffer the stress of quitting and withdrawal, and counteract tobacco cues. Using 12-month follow-up data, we examined the impact of social support provided by female partners (n = 328) of male participants in a smokeless tobacco cessation program. The ratio of positive support to negative support that participants reported receiving from their partners was significantly related to point prevalence 12-month tobacco abstinence (odds ratio [OR] = 1.43, 95% CI = 1.11-1.84, p < .01)-025EFa finding consistent with the 6-month follow-up-025EFand it was related to repeated point prevalence tobacco abstinence at both 6 and 12 months (OR = 1.43, 95% CI = 1.09-1.88, p < .05). These 12-month follow-up results provide additional evidence that partner support can help encourage long-term tobacco abstinence among participants in smokeless tobacco cessation programs.

de Leeuw RNH; Engels RCME; Vermulst AA; Scholte RHJ. Relative risks of exposure to different smoking models on the development of nicotine dependence during adolescence: A five-wave longitudinal study. Journal of Adolescent Health 45(2): 171-178, 2009. (40 refs.)

Purpose: Many studies have focused upon predictors of smoking onset and continuation in adolescents. However, less is known about the development of nicotine dependence (ND) and how smoking in the interpersonal environment relates to this. To examine which smoking models have the largest impact on the development of ND, we examined the relative impact of current smoking from fathers, mothers, siblings, best friends, and friend groups on the development of ND in adolescents. Methods: Data were used from five annual waves of the "Family and Health" survey project. At baseline 428 adolescents (mean age = 15.2 years; SD = .60), both their parents, and their siblings were participating. In this study we included only smoking adolescents (n = 175). To assess the individual development of ND of each adolescent, and whether current smoking exposure affected changes from baseline across time, we used latent growth curve modeling (LGC). Results: Findings revealed that smoking of sibling and best friend were related to baseline levels of ND, but not to the rates of change over time. Of all models, only having smoking friends in the friend group was related to a faster development of ND. Conclusions: The current findings highlight the key role of smoking friends in the development of ND and suggest that interventions targeting at peers are probably effective in reducing the prevalence of ND symptoms among adolescents.

Delfabbro P; Borgas M; Rogers N; Jeffreys H; Wilson R. The social and family backgrounds of infants in South Australian out-of-home care 2000-2005: Predictors of subsequent abuse notifications. Children and Youth Services Review 31(2): 219-226, 2009. (33 refs.)

The study examined the social and familial characteristics of 498 infants entering South Australian out-of-home care between 2000 and 2004 (n = 225 entered only for respite. n = 273 for other formal placements). Analyses focus'ed on the extent to which background characteristics, most notably a history of prior abuse, was able to predict subsequent child abuse notifications once children has exited care. The results showed that most children entered care due to a clustering of significant background problems, including poverty, domestic violence, physical abuse, substance misuse, and neglect. Around 50% of infants were returned to homes where there were subsequent notifications of abuse. Logistic regression modelling conducted separately for respite only and those formally entering care showed that prior abuse was a reliable predictor of ongoing abuse notifications in both samples. In some models, prior abuse yielded a very high probability (>60%) of some ongoing notifications suggesting that these statistical models could be used to enhance risk assessments conducted prior to reunification decision-making in South Australia.

Delva J; Dietz NA; Perron B; Sanchez N; Woolley ME. Adult awareness of a youth-focused anti-tobacco campaign: Does having children matter? Substance Use & Misuse 44(6): 763-774, 2009

Data from a survey of tobacco use conducted in 2001 was used to examine if Florida's youth-focused anti-tobacco media campaign, which focused on cigarette smoking, reached adults. The majority of the sample was white (87%), high school or college educated (85%), and over half with children (56%). Differences in awareness and intentions to quit among adult smokers with and without children were examined. About 50% of adults were aware of the campaign and the awareness of the tobacco industry manipulation theme was associated with intentions to quit, independent of having children. These findings provide evidence that youth-targeted anti-tobacco media campaigns can reach adults; however, to change the behavior of adults who smoke, it may not be appropriate to have a one-size-fits-all program. The study's limitations are noted.

Doubeni CA; Li WJ; Fouayzi H; DiFranza JR. Perceived accessibility of cigarettes among youth: A prospective cohort study. American Journal of Preventive Medicine 36(3): 239-242, 2009. (28 refs.)

Background: The accessibility of tobacco for youth is difficult to measure, partly because of the varied sources of cigarettes. Perceptions about the accessibility of cigarettes assesses availability from all potential sources and has been found to predict future smoking. This study examines the determinants of perceived accessibility from the perspective of a longitudinal study. Methods: Data were derived from the second Development and Assessment of Nicotine Dependence in Youth study, a 4-year longitudinal study of 1246 sixth-grade students who underwent up to 11 in-person interviews from 2002 to 2006. Perceived accessibility was assessed prospectively by asking students whether they agreed or disagreed with the statement It would be easy for me to get a cigarette. Results: At baseline, the average age was 12 years; 85% had never before smoked; more than 21% perceived that cigarettes were easy to obtain. Perceived accessibility increased over the 4 years among the cohort. Youth with friends who smoked or whose parents allowed the watching of R-rated movies were more likely to perceive easy accessibility of cigarettes. Among nonsmokers, there was a dose-response relationship between perceived accessibility and exposure to smoking in the family environment. Nonsmokers who knew commercial sources of cigarettes also had higher perceived accessibility. Conclusions: Several potentially preventable exposures to tobacco in the family and social environment contribute to confidence among some youth that cigarettes are easy to obtain. Further studies are needed to determine if modifying these factors (e.g., through programs to reduce the exposure of youth to tobacco products in the home) might reduce perceived accessibility.

Eisenberg ME; Neumark-Sztainer D; Feldman S. Does TV viewing during family meals make a difference in adolescent substance use? Preventive Medicine 48(6): 585-587, 2009. (12 refs.)

Objective. Family meals are important to adolescent health, but relatively little is known about TV viewing during family meals. The present paper examines the role that TV viewing during family meals may have on substance use behaviors among adolescents. Methods. A diverse sample of 806 Minnesota high school students (mean age 17.2 years) provided survey data in 2003-2004 regarding family meal frequency, substance use behavior and general family connectedness. General linear modeling was used to compare substance use across three family meal/TV categories in a cross-sectional analysis. Results. 28.6% of participants ate regular family meals without TV, and 27.5% had regular family meals while watching TV. Significant differences in cigarette smoking, alcohol and marijuana use were found for females reporting regular family meals versus no regular family meals, but did not differ significantly by TV viewing. No significant differences were found across groups of males. Conclusions. Results from this study indicate that TV viewing during family meals does not appear to attenuate the previously observed protective relationship between family meals and substance use for females. Benefits of family meals may be derived simply from having adolescents at home during mealtimes.

Ford JA. Nonmedical prescription drug use among adolescents: The influence of bonds to family and school. Youth & Society 40(3): 336-352, 2009. (81 refs.)

There has been a tremendous increase in the prevalence of nonmedical prescription drug use among adolescents in recent years. Research now indicates that the prevalence of nonmedical prescription drug use is greater than the prevalence of other illicit drug use, excluding marijuana. Despite these recent trends, there is a dearth of research in the social sciences on this issue. Furthermore, existing research on this topic is largely atheoretical. Using the 2005 National Survey on Drug Use and Health, a nationally representative survey of persons age 12 and older, the current study examines the impact of social bonds to family and school on nonmedical prescription drug use among adolescents. The findings provide support for social control theory. Adolescents with strong bonds to family and school are less likely to report nonmedical prescription drug use. Important implications and future research needs are discussed.

Frojd S; Kaltiala-Heino R; Pelkonen M; Von der Pahlen B; Marttunenf M. Significance of family life events in middle adolescence: A survey on Finnish community adolescents. Nordic Journal of Psychiatry 63(1): 78-86, 2009. (52 refs.)

Finnish middle adolescents (n=3242) were assessed for family characters, family life events, depression and frequent drunkenness. Odds ratios for maladjustment outcomes associated with each event were computed and logistic regression models were used to estimate the effect of confounders. In the presence of serious illness or injury of a family member, increasing conflicts between parents and financial difficulties in the family, the probability of depression was twice as high than without the presence of these events. Parental unemployment, parent getting involved with the law and financial difficulties in the family were associated with frequent drunkenness. The associations between life events and depression were fairly similar among boys and girls. Among girls there were several events associated with frequent drunkenness even when family structure and socio-economic status were accounted for, while among boys there were only few. The significance of associations between family life events and depression may vary between the specific events while the associations between family life events and frequent drunkenness may be better explained with cumulative stress. Both males and females react to family stress, but the symptoms presented may differ. In case of family adversities, both internalizing and externalizing outcomes must be screened for.

Gau SSF; Lai MC; Chiu YN; Liu CT; Lee MB; Hwu HG. Individual and family correlates for cigarette smoking among Taiwanese college students. Comprehensive Psychiatry 50(3): 276-285, 2009. (100 refs.)

Objective: This college-based questionnaire survey aimed to explore the individual, family, and peer correlates for cigarette smoking among first-year college students. Method: The sample included 2918 first-year college students (males, 45.5%) recruited from a national university in Taiwan (participation rate, 79.1%). The participants reported on questions about various substances, attitudes toward substances, personality characteristics, psychopathology, suicidal behaviors, parenting style, family function and use of substances, and peer substance use. Results: There were 263 (9.0%; males, 70.6%) current smokers. Compared to nonsmokers, college smokers were more extraverted and neurotic, and showed less harm avoidance. and more novelty seeking in their personality. They had more hostile, somatic, depressive, paranoid, and psychotic symptoms in terms of psychopathology. Smokers were more likely to use other substances, and to have suicidal ideations, wishes, plans, and attempts. Smokers perceived lower family cohesion, less care from their fathers, and less overprotection from their mothers. They were more likely to have peers and family members who also smoked or used other substances. The most associated correlates were male sex, older age, other Substance use. novelty seeking, Suicidal ideation and attempts, sibling and peer substance use, a prosubstance attitude, and less maternal overprotection. Conclusions: Our findings support the association of cigarette use in Taiwanese young adults with several individual, family, and peer factors identified in Western studies. Interventon in cigarette use should be multifaceted, by taking its correlates and the concurrent psychopathology, use of substances, and suicidality into consideration

Gearhardt AN; Corbin WR. Body mass index and alcohol consumption: Family history of alcoholism as a moderator. Psychology of Addictive Behaviors 23(2): 216-225, 2009. (48 refs.)

Recent research suggests that excess food consumption may be conceptualized as an addictive behavior. Much of the evidence comes from neurobiological similarities between drug and food consumption. In addition, an inverse relation between alcohol consumption and body mass index (BMI) has been observed. Previous research has hypothesized that this inverse relation is attributable to competition between food and alcohol for similar neurotransmitter receptors. The current study explored this neurobiological hypothesis further by examining the influence of an indicator of biological risk associated with alcohol problems (family history of alcoholism) on the relationship between alcohol and food intake. Data from 37,259 participants in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were included in the study. BMI, family history of alcoholism, gender, and race/ethnicity were assessed as predictors of typical drinking frequency and estimated blood alcohol concentration (BAC). An inverse relationship between alcohol consumption and BMI was demonstrated. An attenuation of family history effects on drinking behavior was evident for obese compared to nonobese participants. The results suggest a neurobiological link between alcohol use and food consumption, consistent with theories characterizing excess food consumption as an addictive behavior.

Gleeson D; Jones JS; McFarlane E; Francis R; Gellion C; Bradley MP et al. Severity of alcohol dependence in decompensated alcoholic liver disease: Comparison with heavy drinkers without liver disease and relationship to family drinking history. Alcohol and Alcoholism 44(4): 392-397, 2009. (28 refs.)

Aim: The aim of this study was to compare alcohol dependence severity in patients with severe alcoholic liver disease (ALD) with that in heavy drinkers without liver disease. Methods: Short alcohol dependence data and lifetime alcohol questionnaires applied to unselected heavy alcohol drinkers (> 60 units/week (M) or 40 units/week (F) for > 5 years) with either (a) decompensated ALD (patients n = 136) or (b) no evidence of serious liver disease by clinical, biochemical and ultrasound evaluation ('controls' n = 148). Results: The SADD alcohol dependence severity score (range 0-42) in patients with ALD was > 28 (severe dependence) in 36 cases (26%); slightly higher than that in heavy-drinking controls taken as a whole; similar to that in controls who were seeking healthcare but higher than that in controls who were not; and lower than that in controls who attended specialist alcohol services. In ALD patients and controls, the SADD score was higher in those with three or more heavy-drinking first-degree relatives than in those with none. In multiple regression analysis, the SADD score showed independent associations with young age, clinically manifest alcohol dependence, seeking healthcare and the presence of multiple heavy drinking relatives, but not with ALD. Conclusions: Alcohol dependence severity in patients with ALD varies and tends to be lower than that in heavy drinkers seeking treatment at alcohol treatment centres but is not as low as implied in some previous studies. Alcohol dependence severity is associated with young age and family drinking history but is not specifically associated with the development of liver disease.

Hamilton AB; Grella CE. Gender differences among older heroin users. Journal of Women & Aging 21(2): 111-124, 2009

Objectives: This purpose of this study was to explore the following question: Are there gender differences among older individuals with a history of heroin addiction with regard to social and family relationships and health problems? Methods: Eight gender-specific focus groups were conducted with 38 (19 women, 19 men) older (50+ years) individuals with long-term histories of heroin dependence. Four groups were conducted in a methadone maintenance (MM) clinic and four groups were derived from the Los Angeles community. Results: Modest gender differences were observed, but mainly in the focus-group dynamics. Women typically described the impact of their addiction on their families, while men typically described their surprise at still being alive. Hepatitis C was the primary health concern in all groups; mental health issues were also discussed. Discussion: Remarkable gender differences were not apparent in the qualitative experiences of these participants. Instead, we found overriding similarities related to the interactive effects of drug use and aging. Longitudinal studies of this population as they age and interact with the health-care system and other social systems will help to untangle the complicated relationship between aging, drug addiction, gender, and health.

Hamilton HA; Noh S; Adlaf EM. Perceived financial status, health, and maladjustment in adolescence. Social Science & Medicine 68(8): 1527-1534, 2009. (34 refs.)

This study examines the relationship between adolescent perception of family financial status and diverse aspects of health and maladjustment. Data were derived from the 2005 Ontario Student Drug Use Survey of 7th-12th grade students in Ontario, Canada. This biennial survey monitors mental and physical health, substance use, and delinquent behavior in adolescent students. Results indicate that the significance of perceived financial status varies across adolescent outcomes. Greater emotional distress and lower self-rated health are associated with a perception of below average financial status. The associations of illicit drug use and hazardous and harmful drinking with perceived financial status vary for younger and older adolescents. Adjustments for parental education highlight differences in the influences of perceived financial status and parental education on health and behavior. Results highlight the utility of perceived family financial status in examinations of adolescent health and behavior, and the importance of examining diverse aspects of health and maladjustment.

Harrell ZA; Slane JD; Klurnp KL. Predictors of alcohol problems in college women: The role of depressive symptoms, disordered eating, and family history of alcoholism. Addictive Behaviors 34(3): 252-257, 2009. (51 refs.)

Disordered eating and depressive symptoms are established correlates of alcohol use in college women. Family history of alcoholism (FHA) is also related to problematic alcohol use, but there have been limited studies of how it relates to other established cofactors in women. Predictive associations between disordered eating (i.e., overall levels as well as binge eating), depressive symptoms, and alcohol problems were examined in a sample of 295 female twins. The direct and moderating effects of FHA on the relationships between alcohol problems, disordered eating, and depressive symptoms were investigated. Using hierarchical linear modeling depressive symptoms, but not disordered eating or FHA, significantly predicted alcohol problems. However, there was a significant interaction between disordered eating and FHA; disordered eating was associated with alcohol problems in those with a positive FHA. The implications for high-risk subgroups of college women are discussed.

Hiilamo H. What could explain the dramatic rise in out-of-home placement in Finland in the 1990s and early 2000s? Children and Youth Services Review 31(2): 177-184, 2009. (40 refs.)

Objectives: Despite exceptionally favourable economic conditions and school children's outstanding educational attainment the number of children placed outside their home in Finland has increased rapidly in the 1990s and early 2000s. This study identifies factors that are related to a child's risk of placement outside the home in Finland and tries to explore possible explanations for an increase in the share of children placed outside the home. Methods: A regression analysis was applied to study the share of children placed outside the home and suggested risk factor indicators on sub-regional level. The use of sub-regional data from SOTKAnet indicator bank allowed us to test indicators for seven areas, namely family structure (single parenthood), receipt of social assistance, unemployment, parents' alcohol and substance abuse, parents' mental health, domestic violence and abortion. Educational level, number of social workers and domestic migration were included as background factors. Results: Child placement outside home in Finland is most clearly associated with long-term economic hardships. However, the results indicate that the rate of change in the share of children placed outside the home is associated with alcohol and substance abuse. Conclusions: The results suggest that the Finnish success story as a world leader in children's issues has a darker side. A change in the distribution of welfare in Finland seems to place the children in the margin of the society into a more disadvantaged position.

Hung CC; Yen LL; Wu WC. Association of parents' alcohol use and family interaction with the initiation of alcohol use by sixth graders: A preliminary study in Taiwan. BMC Public Health 9: article 172, 2009. (45 refs.)

Background: The family is the main environment where children are socialized and learn individual behavior. Although previous studies have examined predictors of preadolescent first alcohol use, few studies have analyzed factors associated with alcohol use in children in a country with low alcohol consumption. The aim of this study was to investigate the initiation of alcohol use by sixth graders and determine family factors associated with first alcohol use. Methods: Data used in this study was collected as part of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project in 2002 (when study participants were in grade 5 and aged 10-11 years) and 2003 (when study participants were in grade 6 and aged 11-12 years). Data from a total of 1,183 participants was analyzed. Main study variables included children's alcohol use: (1) never user (never user in 2002 and 2003), or (2) first-time user (never user in 2002 but ever user in 2003); parents' alcohol use: (1) both parents ever users, (2) mother ever user and father never user, (3) father ever user and mother never user, (4) both parents never users; parental support; and family conflict. Correlates of first alcohol use were identified using logistic regression. Results: There were 183 students (15.5%) who became first-time users of alcohol in the sixth grade. Having parents who both used alcohol, less parental support, and more family conflict were significant predictors of sixth graders' first alcohol use. Family interaction and parents' drinking were equally important predictors of preteen's first use of alcohol. Conclusion: Family factors influence children's initiation of alcohol use. It is important to educate parents about the effects of alcohol on children and to emphasize the importance of prevention.

Ilhan IO; Yildirim F; Demirbas H; Dogan YB. Prevalence and sociodemographic correlates of substance use in a university-student sample in Turkey. International Journal of Public Health 54(1): 40-44, 2009. (16 refs.)

Background: Limited data is available on substance use among university students in Turkey. This study aims to determine the prevalence of substance use among this target group. Methods: A total of 1,720 students were surveyed to assess substance use, and relationships between sociodemographic variables and substance use were assessed using both univariate and multivariate analyses. Results: Of the recorded student sample, 6.4% reported having used a substance; 2.8% used one within the past year. Prevalence of cannabis use at least once during life-time was 5.9%. Males living alone, or students with families residing abroad increased the risk of substance use. Conclusion: Preventive interventions for substance use problems should consider factors related with family relations of the youth.

Jay J; Jay D. Practicing wellness: An avoidable death. Michigan Bar Journal 88: 50-51, 2009. (4 refs.)

This article addresses the importance and impact of reaching out to troubled persons including professional colleagues. It focuses upon the technique of the intervention, through which individuals share concerns and urge an individual to seek assistance. There are several keys to an effective intervention, beginning with planning and preparation. While a large gathering may not be necessary, it's important that a core group of influential people come together [*51] to discuss the problem, before approaching the individual who's suffering. Different members of this group will have different pieces of information, and it's important to get everything on the table. Once the problem is fully understood, a strategy can be built. Even a group as small as two or three people can have a tremendous effect. One of our primary goals in doing an intervention is to preserve the person's dignity. We are not preparing for a confrontation in the normal sense. Rather, we want to use the power of love, respect, and concern in the group in a very specific way to break through denial and bring about a specific action. The planning and preparation process typically takes many hours and is properly facilitated by a professional. But the intervention itself is usually completed in less than an hour or two, resulting in a specific action, such as a program of treatment.

Ji M; Ding D; Hovell MF; Xia X; Zheng PP; Fu H. Home smoking bans in an urbanizing community in China. American Journal of Preventive Medicine 37(2): 132-136, 2009. (38 refs.)

Background: Secondhand smoke (SHS) is a major threat to public health worldwide. Previous studies have suggested that home smoking bans effectively reduce SHS exposure to nonsmokers in the home. In China, the world's largest tobacco producer and consumer, more than 540 million nonsmokers are exposed to SHS. However, to Our knowledge, no published studies have examined the prevalence or correlates of home smoking bans in mainland China. This paper presents a quantitative study on home smoking bans in an urbanizing community in Shanghai, China. Methods: In 2006, a cross-sectional survey based on probability sampling (N=243) was conducted in Changqiao, an urbanizing community in Shanghai, China. Interviews were conducted in person in Mandarin Chinese by trained interviewers. The behavioral ecologic model, which emphasizes the multilevel environmental contingencies of behavior, was applied as the theoretical model. Data were analyzed in 2008 using logistic regression to explore correlates of complete home smoking bans. Results: In this community, only 26% of respondents reported having complete home smoking bans. Smoking respondents and families were less likely to have complete smoking bans in the home. Home smoking bans were positively associated with the perceived density of smoke-free homes in the Community, and with the perceived likelihood of community reprimand for smoking in the home. Conclusions: Home smoking bans were not widely adopted in this community in China. Future interventions should focus on the community and social environment in order to promote home smoking bans.

Jinez MLJ; de Souza JRM; Pillon SC. Drug use and risk factors for secondary students. Revista Latino-Americana de Enfermagem 17(2): 246-252, 2009. (14 refs.)

Adolescence is a phase of exposure to several risk behaviors, especially the experimental use of drugs and its associated problems, The study aims to identify risk factors and drug use among secondary students in Comonfort, Guanajuato, Mexico. This is a cross-sectional study, using a version of the Drug User Screening Inventory (DUSI) adapted from Portuguese to Spanish. The sample was composed of 695 (42.9%) students, 52.8% women. Drug use was present in 20.30%, predominantly alcohol and tobacco. Risk factors are related to the male gender, older than 13 years, second and third grades, living with relatives, poor relationships, curiosity, family conflicts, peer pressure and solidarity. Conclusion: alcohol and tobacco are the most used drugs and are associated to curiosity and peer pressure.

Joya X; Papaseit E; Civit E; Pellegrini M; Vall O; Garcia-Algar O et al. Unsuspected exposure to cocaine in preschool children from a Mediterranean city detected by hair analysis. Therapeutic Drug Monitoring 31(3): 391-395, 2009. (29 refs.)

We used hair testing to investigate the prevalence of unsuspected exposure to cocaine in a group of preschool children presenting to an urban pediatric emergency department without signs or symptoms suggestive of exposure. Hair samples were obtained from 90 children between 18 months and 5 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. In 85 cases, hair samples from the accompanying parent were also provided. The samples were analyzed for the presence of cocaine and benzoylecgonine by gas chromatography-mass spectrometry which also determined opiates and amphetamines. Parental sociodemographics, possible drug history, and information on the child's features were recorded. Hair samples from 21 children (23.3%) were positive for cocaine (concentration range 0.3-5.96 ng/mg of hair) with 1 sample also positive for 3,4-methylenedioxymethamphetamine and another for opiates. In 88% of the positive cases, cocaine was also found in the hair of the accompanying parent (15 of 17 matched parent-child hair samples). Parental sociodemographics were associated neither with children's exposure to cocaine nor with somatometry of children at birth. However, the behavioral patterns with potential harmful effects for the child's health (eg, tobacco smoking, cannabis, benzodiazepines and/or antidepressants use, and shorter breast-feeding time) were significantly higher in the parents of exposed children. A statistically higher percentage of exposed children were in the lower weight percentile group compared with the nonexposed children. In the light of these results, we advocate general hair screening to disclose exposure to cocaine and other drugs of abuse in children from risky environments, which could provide the basis for specific social and health interventions.

Kendler KS; Myers J; Potter J; Opalesky J. A web-based study of personality, psychopathology and substance use in twin, other relative and relationship pairs. Twin Research and Human Genetics 12(2): 137-141, 2009. (24 refs.)

Web-based studies have become increasingly common in the social sciences, but have been rare in genetic epidemiology in general and twin studies in particular. We here review the methods, validity checks and preliminary correlational data from an on-line questionnaire collected from 2005-2008. During this time period, 44,112 individuals completed the questionnaire. This sample was 65.3% female, 85.4% 18 years or older, 72.0% Caucasian and had a mean educational level of 12.2 years. The sample included 609 twin, 333 sibling and 201 parent-offspring pairs as well as 342 dating partners, 313 1 significant other' pairs, 327 spouses and 2,316 friend pairs. A range of checks suggested low levels of invalid data. Correlations for personality, substance use and misuse, lifetime major depression, social attitudes, educational status, and height and weight were broadly similar to those obtained previously using conventional assessment methods. Web-based studies are a relatively easy and inexpensive way to ascertain large numbers of individuals, although obtaining twin pairs is more difficult, and female and monozygotic pairs are overrepresented. The sample is diverse and pair resemblance is generally similar to that obtained using interviews or mailed questionnaires.

King K; Martynenko M; Bergman MH; Liu YH; Winickoff JP; Weitzman M. Family composition and children's exposure to adult smokers in their homes. Pediatrics 123(4): E559-E564, 2009. (46 refs.)

OBJECTIVE. Smoking behavior is strongly influenced by the social environment. More information is needed about how the composition of households with children is associated with adult smoking behavior so that more effective interventions to reduce children's secondhand smoke exposure can be devised and implemented. METHODS. Using data from the Medical Expenditure Panel Survey 2000-2004, we conducted cross-sectional analyses to assess how adult smoking behavior is associated with household characteristics, including the number of adults and smokers present, the relationship of the child to the head of household, and relationships between adult members of the household. RESULTS. More than one third (34.4%) of children lived with >= 1 adult smoker. Almost half (49.4%) of poor children lived with a smoker, and they were more likely to live with multiple smokers compared with those who lived at >400% of the federal poverty level (21.2% vs 7.8%). Approximately 5 million children lived in households headed by an adult other than their parent, and they were significantly more likely to live with smokers: 53.4% of children who lived in their grandparents' homes and 46.2% of children in homes of other adults lived with at least 1 adult smoker, compared with 33.3% who lived in their parents' home. A total of 59.4% of all children who lived with a smoker had a smoking mother, and 56.7% of those children lived with >= 2 smokers, whereas only 17.0% of children whose mother did not smoke had smoking adults in the home. CONCLUSIONS. These findings demonstrate the significant influence of household composition on children's likelihood to live in homes with adult smokers.

Kleinjan M; Engels RCME; van Leeuwe J; Brug J; van Zundert RMP; van den Eijnden RJJM. Mechanisms of adolescent smoking cessation: Roles of readiness to quit, nicotine dependence, and smoking of parents and peers. Drug and Alcohol Dependence 99(1-3): 204-214, 2009. (88 refs.)

Multiple levels of influence should be considered in interventions aimed at the adolescent smoker, including psychological, addiction, peer and parental influences. However, the mechanism by which these variables influence the process of smoking cessation in adolescents is not well elucidated. Therefore, this prospective study tested two models among 850 adolescent smokers, specifying the direct and indirect relations between adolescents' readiness to quit smoking, levels of nicotine dependence, and smoking behavior of their parents and friends. One year later smoking cessation was assessed. Results showed that, among adolescent smokers, readiness to quit was positively associated with quit attempts, while nicotine dependence was inversely associated with successful cessation. Instead of a direct relation, parental and peers' smoking were inversely related to smoking cessation through nicotine dependence. The findings emphasize that interventions should be developed and tested within and outside the school setting, as well as within the family situation. In addition, the strong impact of nicotine dependence on successful cessation indicates that a more direct approach is needed to lower nicotine dependence among adolescents.

Knopik VS; Jacob T; Haber JR; Swenson LP; Howell DN. Paternal alcoholism and offspring ADHD problems: A children of twins design. Twin Research and Human Genetics 12(1): 53-62, 2009. (55 refs.)

Objective: A recent Children-of-Female-Twin design suggests that the association between maternal alcohol use disorder and offspring ADHD is due to a combination of genetic and environmental factors, such as prenatal nicotine exposure. We present here a complementary analysis using a Children-of-Male-Twin design examining the association between paternal alcoholism and offspring attention deficit hyperactivity problems (ADHP). Methods: Children-of-twins design: offspring were classified into 4 groups of varying genetic and environmental risk based on father and co-twin's alcohol dependence status. Results: Univariate results are suggestive of a genetic association between paternal alcohol dependence and broadly defined offspring ADHP. Specifically, offspring of male twins with a history of DSM-III-R alcohol dependence, as well as offspring of non-alcohol dependent monozygotic twins whose co-twin was alcohol dependent, were significantly more likely to exhibit ADHP than control offspring. However, multivariate models show maternal variables independently predicting increased risk for offspring ADHP and significantly decreased support for a genetic mechanism of parent-to-child transmission. Conclusions: In support of earlier work, maternal variables (i.e., maternal ADHD and prenatal exposure) were strongly associated with child ADHP; however, the role of paternal alcohol dependence influences was not definitive. While genetic transmission may be important, the association between paternal alcohol dependence and child ADHP is more likely to be indirect and a result of several pathways.

Kondo A; Wada K. The effectiveness of a mutual-help group activity for drug users and family members in Japan. Substance Use & Misuse 44(4): 472-489, 2009. (30 refs.)

Aims: To understand the efficacy of a mutual-help group activity for drug users and family members in terms of: (a) family members' behavioral changes (b) treatment engagement rate of the drug users, and (c) life satisfaction of family members. Methods: A total of 186 family members answered questionnaires. Results: Attending the group changed the family members' behaviors. The treatment engagement rates within 1, 6, and 12 months for untreated drug users were 23.2%, 39.2%, and 52.3%, respectively. The well-being (Subjective Well-Being Inventory [SUBI]) of long-term group members is higher than that of short-term group members.

Korhonen T; Kujala UM; Rose RJ; Kaprio J. Physical activity in adolescence as a predictor of alcohol and illicit drug use in early adulthood: A longitudinal population-based twin study. Twin Research and Human Genetics 12(3): 261-268, 2009. (30 refs.)

We investigated prospectively whether physical activity level in adolescence predicts use of alcohol and illicit drugs in early adulthood. We studied 4,240 individual twins (1,870 twin pairs). We classified those who consistently reported frequent leisure physical activity at ages 16, 17 and 181/2 as persistent exercisers, those exercising less than three times monthly as persistently inactive, and all others as occasional exercisers. To control for familial confounds, within-family analyses compared activity-substance use associations in co-twins discordant for baseline physical activity. Individual-based analyses showed no clear association between baseline physical activity and subsequent weekly alcohol consumption. However, weekly alcohol intoxication (OR = 1.9, p = .002) and problems due to alcohol use (OR = 2.0, p < .001) were more common among persistently inactive participants. After excluding those reporting weekly intoxication at baseline, the risk for alcohol intoxication remained elevated among women occasionally (OR = 2.4, p = .017) or persistently (OR = 5.8, p < .001) inactive at baseline, but this association was not replicated within discordant twin pairs. Individual-based analyses showed that drug use in adulthood was more common among those persistently physically inactive in adolescence (OR = 3.7, p < .001) in comparison to those persistently active. This finding was replicated within discordant twin pairs. Among those with no drug experience during adolescence, persistent inactivity (OR = 1.9, p = .007) increased risk for drug use. We conclude that persistent physical inactivity in adolescence may increase the risk of later problems due to excess alcohol use. Sedentary lifestyle predicts illicit drug use even when controlling for familial factors.

Kramer TL; Han XT; Leukefeld C; Booth BM; Edlund C. Childhood conduct problems and other early risk factors in rural adult stimulant users. Journal of Rural Health 25(1): 50-57, 2009. (35 refs.)

Context: Understanding childhood risk factors associated with adult substance use and legal problems is important for treatment and prevention. Purpose: To examine the relationship of early substance use, conduct problems before age 15, and family history of substance abuse on adult outcomes in rural, stimulant users. Methods: Adult cocaine and methamphetamine users (N = 544) in rural Arkansas and Kentucky were interviewed. Data were analyzed using both bivariate analyses and multiple logistic and log-linear regression models, with dependent variables being any substance abuse/dependence, stimulant abuse/dependence, total number of arrests since age 18 and days incarcerated since age 18. Findings: One third reported 3 or more conduct disorder problems prior to age 15; half reported initiation of substances (excluding alcohol) before age 15; and 60% reported family history of substance problems. All 3 variables were associated with adult substance abuse/dependence but only the latter two were associated with stimulant abuse/dependence. Conclusions: This study highlights early risk factors for adult substance abuse/dependence among rural stimulant users.

Kraus L; Baumeister SE; Pabst A; Orth B. Association of average daily alcohol consumption, binge drinking and alcohol-related social problems: Results from the German Epidemiological Surveys of Substance Abuse. Alcohol and Alcoholism 44(3): 314-320, 2009. (32 refs.)

Aims: The present study investigates the combined effect of average volume and binge drinking in predicting alcohol-related social problems and estimates the proportion of alcohol-related harms related to specific drinking patterns that could be prevented if transferred to a low-risk drinking group. Methods: Data came from the 1997 and 2000 German Epidemiological Survey of Substance Abuse (ESA) (age: 18-59 years; response rate: 65% and 51%, respectively). The pooled sample consisted of 12,668 current drinkers. By using nine categories of average daily intake and three groups of binge drinking, individuals were grouped into 22 mutual exclusive groups. Social problems were defined as the occurrence of 'repeated family quarrels', 'concern of family members or friends', 'loss of partner or friend' or 'physical fight or injury' in relation to alcohol. Results: The effect of average daily intake is modified by binge drinking frequency such that the association was strongest in those with four or more binge drinking occasions during the last 30 days. Within each binge drinking group, adjusted relative risks (aRR) increased with alcohol intake up to a certain threshold and decreased thereafter. Overall, compared to the reference group (<= 7 g ethanol/day-025EFno binge), the population-attributable fraction (PAF) related to the other drinking groups was 71.4% (95% CI: 64.4-77.1%). Conclusions: The frequency of binge drinking occasions seems to be a better predictor of alcohol-related social problems than volume. Alcohol-related social harms especially among drinkers with moderate volume per day may be reduced by targeting prevention strategies towards episodic heavy drinkers.

Krug I; Pinheiro AP; Bulik C; Jimenez-Murcia S; Granero R; Penelo E et al. Lifetime substance abuse, family history of alcohol abuse/dependence and novelty seeking in eating disorders: Comparison study of eating disorder subgroups. Psychiatry and Clinical Neurosciences 63(1): 82-87, 2009. (36 refs.)

To assess lifetime substance abuse, family history of alcohol abuse/dependence, and novelty seeking in three different eating disorder groups (anorexia nervosa-restrictive; anorexia nervosa-binge eating/purging; anorexia nervosa to bulimia nervosa). A total sample of 371 eating disorder patients participated in the current study. Assessment measures included the prevalence of substance abuse and family history of alcohol abuse/dependence as well as the novelty-seeking subscale of the Temperament and Character Inventory-Revised. Significant differences across groups were detected for lifetime substance abuse, with anorexia nervosa-restrictive individuals exhibiting a significant lower prevalence than the anorexia nervosa to bulimia nervosa and anorexia nervosa-binge eating/ purging patients (P < 0.01). For family history of alcohol abuse/dependence the same pattern was observed (P = 0.04). Novelty seeking was associated with substance abuse (P = 0.002), with the anorexia nervosa to bulimia nervosa group exhibiting significantly higher scores on the novelty-seeking scale than the other two groups (P < 0.001). But family history of alcohol abuse/dependence was not related to novelty seeking (P = 0.092). Lifetime substance abuse appears to be more prevalent in anorexia nervosa patients with bulimic features. Higher novelty-seeking scores may be associated with diagnosis cross-over.

Kuntsche E; Gossrau-Breen D; Gmel G. The role of drunken older siblings and drunken peers in the alcohol-violence nexus. European Journal of Public Health 19(4): 394-399, 2009. (39 refs.)

Background: It is common knowledge that alcohol use and violence in adolescence is interrelated. However, less is known about variables which modify the link between alcohol use and violent behaviours in adolescence. The present study investigates how the interaction of intraindividual [adolescent risky single occasion drinking (RSOD)], intrafamilial (risky drinking of older siblings) and extrafamilial (risky drinking among peers) alcohol-related risk factors contributes to adolescents' violence and delinquency. Methods: Multiple linear regression analyses including two- and three-way interactions were conducted based on a national representative sample of 3711 8-10th graders in Switzerland (mean age 15.0, SD = 0.95) who had older siblings. Results: All three alcohol-related risk factors and the three-way interaction contributed significantly to the frequency of violence and delinquency. Adolescents who frequently engage in RSOD and have both drunken peers and drunken older siblings had the highest levels of violence and delinquency. Moreover, their association between own drinking and violence increased the steepest. Conclusion: The present study confirmed the occurrence of cumulative risk processes and demonstrated that excessive alcohol consumption among older siblings and peers represents a crucial contextual factor for the link between adolescents' risky drinking and violence and delinquency. For prevention, the findings suggest that a focus on peers alone may not be effective if the familial background is not taken into consideration.

LaBrie JW; Feres N; Kenney SR; Lac A. Family history of alcohol abuse moderates effectiveness of a group motivational enhancement intervention in college women. Addictive Behaviors 34(5): 415-420, 2009. (49 refs.)

This study examined whether a self-reported family history of alcohol abuse (FH+) moderated the effects of a female-specific group motivational enhancement intervention with first-year college women. First-year college women (N = 287) completed an initial questionnaire and attended an intervention (n = 161) or control (n = 126) group session, of which 118 reported FH+. Repeated measures ANCOVA models were estimated to investigate whether the effectiveness of the intervention varied as a function of one's reported family history of alcohol abuse. Results revealed that family history of alcohol abuse moderated intervention efficacy. Although the intervention was effective in producing less risky drinking relative to controls, among those participants who received the intervention, FH+ women drank less across five weeks of follow-up than FH- women. The current findings provide preliminary support for the differential effectiveness of motivational enhancement interventions with FH+ women.

Lee RM; Jung KR; Su JC; Tran AGTT; Bahrassa NF. The family life and adjustment of Hmong American sons and daughters. Sex Roles 60(7-8): 549-558, 2009. (46 refs.)

We examined gender differences in intergenerational family conflict and its associations with psychological and academic adjustment using a United States sample of 121 Hmong American first-year college students. Hmong women and men reported similar levels of family conflict. Family conflict was related to psychological distress, above and beyond neuroticism. Gender moderated the relationship between family conflict and substance usage and academic performance. For Hmong college men, higher family conflict was associated with lower rates of smoking and higher rates of completing the first year of college. For Hmong college women, higher family conflict was associated with greater likelihood of alcohol consumption in their lifetime.

Leis R; Rosenbloom D. Substance abuse and addiction in Family Courts: From addiction to abstinence. Maximzing the chances of success. Family Court Review 47(April): 274-282, 2009. (45 refs.)

People with alcohol or other drug problems face discriminatory public and private policies that restrict their access to appropriate health care, employment, and public benefits, discouraging them from seeking treatment, robbing them of hope for recovery, and costing society millions of dollars. Join Together, a project of Boston University School of Public Health, formed a national policy panel in the spring of 2002 to address this discrimination. The panelists developed the two principles and ten recommendations contained in this report, relying principally upon the written and oral testimony they received. Join Together was assisted in this effort by the American Bar Association's (ABA) Standing Committee on Substance Abuse, which facilitated the panel's initial hearing at the ABA's Annual Meeting in August 2002. Among the recommendations: Decisions involving the custodial status of children should be made in the best interests of a child based on what is happening in the home. Insurers should not be allowed to deny claims for the care of any injury sustained by an insured person if he or she was under the influence of alcohol or other drugs at the time of injury. ... Mandated treatment should include mandated ancillary services. All health care providers should be able to identify substance use disorders and refer people to appropriate treatment. Professionals, such as lawyers, judges, probation officers, and child welfare workers, who come into contact with people who may have alcohol or other drug disease should be trained to identify signs of abuse and know what to do next. Trained substance abuse counselors should receive special incentives to locate in rural areas. When confronted with potential or current employees' past alcohol or other drug use, employers should make decisions on whether the person is appropriate for employment based on the job requirements and the individual's health. State licensing boards for attorneys, physicians, and other professionals should not single out past alcohol or other drug use as a bar to licensing or a requirement for special restrictions any more than they would for past health-related conditions. People with drug convictions, but no current drug use, should face no obstacles to getting student loans, other grants, scholarships, or access to government training programs. Local housing authorities should develop balanced policies to help people with active drug or alcohol disease get treatment while protecting the safety of the other residents. Housing authorities should work with treatment providers in their community to establish a referral network or to bring services to housing complexes. People who are disabled as a result of their alcohol or other drug disease should be eligible for SSDI and SSI.

Little M; Handley E; Leuthe E; Chassin L. The impact of parenthood on alcohol consumption trajectories: Variations as a function of timing of parenthood, familial alcoholism, and gender. Development and Psychopathology 21(2): 661-682, 2009. (79 refs.)

The current study tested the impact of the transition to parenthood on growth in alcohol consumption from early adolescence through emerging adulthood. We measured age-related discontinuity in trajectories of alcohol consumption associated with timing of the parenthood transition, above and beyond the effects of accrued educational status, gender, and time-varying marital status. We also examined the impact of a familial selection factor for the transmission of alcohol use problems, family history density of alcoholism (FHD), on both risk for adolescent parenthood and risk for adolescent parents' continuity in alcohol consumption after the parent transition within a mediation structural equation model. Premature timing of parenthood had a distinct effect on emerging adult alcohol trajectories. Although participants who became parents as emerging adults showed role-related decline in alcohol consumption, those who became parents during adolescence showed a role-related rise in emerging adult alcohol consumption. Gender moderated adolescent parents' role-related growth in emerging adult alcohol consumption. Adolescent fathers showed an adverse rise in alcohol consumption after becoming parents, whereas adolescent mothers' alcohol consumption did not change significantly. FHD was related to high adolescent alcohol consumption, which mediated risk for the incidence of early parenthood. Finally, the adverse effect of FHD on trajectories of emerging adult alcohol use was mediated by a dual pathway: (a) developmental continuity of conduct problems and (b) early transition to parenthood.

Mantziou V; Vardavas CI; Kletsiou E; Priftis KN. Predictors of childhood exposure to parental secondhand smoke in the house and family car. International Journal of Environmental Research and Public Health 6(2): 433-444, 2009. (30 refs.)

Childhood exposure to secondhand smoke (SHS) is a serious threat to public health and can be influenced by parental lifestyle habits and beliefs. Taking the above into account we aimed at locating predictors of parental induced exposure to SHS in the house and family car among 614 children who visited the emergency department of two large pediatric hospitals in Athens, Greece. The multivariate analysis revealed that the factors found to mediate household exposure to paternal SHS were the number of cigarettes smoked per day (O.R 1.13, p<0.001) while, having a non-smoking spouse had a protective effect (O.R 0.44, p=0.026). Maternally induced household SHS exposure was related to cigarette consumption. For both parents, child exposure to SHS in the family car was related to higher numbers of cigarettes smoked (p<0.001), and for fathers was also more often found in larger families. Additionally, lower educated fathers were more likely to have a spouse that exposes their children to SHS inside the family car (O.R 1.38 95%C.I: 1.04-1.84, p=0.026). Conclusively, efforts must be made to educate parents on the effects of home and household car exposure to SHS, where smoke free legislation may be difficult to apply.

Martino SC; Ellickson PL; McCaffrey DF. Multiple trajectories of peer and parental influence and their association with the development of adolescent heavy drinking. Addictive Behaviors 34(8): 693-700, 2009. (55 refs.)

This study used latent growth mixture modeling to identify discrete developmental patterns of heavy drinking, perceived parental disapproval of substance use, and association with peers who drink from early to late adolescence among a sample of 5591 youth. We also examined associations among these trajectories to determine how the development of heavy drinking relates to the development of perceived parental disapproval of substance use and association with peer drinkers, both separately and jointly, We found that youth who perceived that their parents maintained consistently strong disapproval of substance use throughout adolescence were much more likely to abstain from heavy drinking during this period than were youth who reported that their parents' disapproval for substance use either decreased or was maintained at only a moderate level. Furthermore. we found that across a variety of peer contexts-stable high association with drinking peers, stable low association, and increasing association-youth were at lowest risk for developing problematic patterns of heavy drinking when they perceived that their parents maintained strong disapproval of substance use throughout adolescence.

Martyn KK; Loveland-Cherry CJ; Villarruel AM; Cabriales EG; Zhou Y; Ronis DL et al. Mexican adolescents' alcohol use, family intimacy, and parent-adolescent communication. Journal of Family Nursing 15(2): 152-170, 2009

Despite widespread adolescent alcohol use, research on individual and contextual factors among Mexican adolescents is limited. This study describes the relationship between adolescent risk/protective factors, parent-adolescent communication, and their effects on alcohol use of 14- to 17-year-old adolescents living in Mexico (N = 829; 458 girls, 371 boys). In this study, adolescents reported that 55% ever used alcohol, 24% used alcohol in the past 30 days, and 10% reported binge drinking. Adolescents with high family intimacy were less likely to report ever using alcohol and binge drinking. Regression analysis revealed that parent-adolescent communication mediated the effect of family intimacy on overall and binge drinking. Alcohol use prevention with Mexican adolescents should focus on family intimacy and parent-adolescent communication.

Maxwell JC; Freeman J; Davey J. Too young to drink but old enough to drive under the influence: A study of underage offenders as seen in substance abuse treatment in Texas. Drug and Alcohol Dependence 104(1-2): 107-112, 2009. (32 refs.)

Driving under the influence (DUI) is a major road safety problem. Historically, alcohol has been assumed to play a larger role in crashes and DUI education programs have reflected this assumption, although recent evidence suggests that younger drivers are becoming more likely to drive drugged than to drive drunk. This is a study of 7096 Texas clients under age 21 who were admitted to state-funded treatment programs between 1997 and 2007 with a past-year DUI arrest, DUI probation, or DUI referral. Data were obtained from the State's administrative dataset. Multivariate logistic regressions models were used to understand the differences between those minors entering treatment as a DUI as compared to a non-DUI as well as the risks for completing treatment and for being abstinent in the month prior to follow-up. A major finding was that over time, the primary problem for underage DUI drivers changed from alcohol to marijuana. Being abstinent in the month prior to discharge, having a primary problem with alcohol rather than another drug, and having more family involved were the strongest predictors of treatment completion. Living in a household where the client was exposed to alcohol abuse or drug use, having been in residential treatment, and having more drug and alcohol and family problems were the strongest predictors of not being abstinent at follow-up. As a result, there is a need to direct more attention towards meeting the needs of the young DUI population through programs that address drug as well as alcohol consumption problems.

Milne BJ; Caspi A; Harrington H; Poulton R; Rutter M; Moffitt TE. Depression, anxiety, alcohol dependence, and drug dependence. (review). Archives of General Psychiatry 66(7): 738-747, 2009. (111 refs.)

Context: If family history is associated with clinical features that are thought to index seriousness of disorder, this could inform clinicians predicting patients' prognosis and researchers selecting cases for genetic studies. Although tests of associations between family history and clinical features are numerous for depression, such tests are relatively lacking for other disorders. Objective: To test the hypothesis that family history is associated with 4 clinical indexes of disorder (recurrence, impairment, service use, and age at onset) in relation to 4 psychiatric disorders (major depressive episode, anxiety disorder, alcohol dependence, and drug dependence). Design: Prospective longitudinal cohort study. Setting: New Zealand. Participants: A total of 981 members of the 1972 to 1973 Dunedin Study birth cohort (96% retention). Main Outcome Measures: For each disorder, family history scores were calculated as the proportion of affected family members from data on 3 generations of the participants' families. Data collected prospectively at the study's repeated assessments (ages 11-32 years) were used to assess recurrence, impairment, and age at onset; data collected by means of a life history calendar at age 32 years were used to assess service use. Results: Family history was associated with the presence of all 4 disorder types. In addition, family history was associated with a more recurrent course for all 4 disorders (but not significantly for women with depression), worse impairment, and greater service use. Family history was not associated with younger age at onset for any disorder. Conclusions: Associations between family history of a disorder and clinical features of that disorder in probands showed consistent direction of effects across depression, anxiety disorder, alcohol dependence, and drug dependence. For these disorder types, family history is useful for determining patients' clinical prognosis and for selecting cases for genetic studies.

Milne BJ; Caspi A; Crump R; Poulton R; Rutter M; Sears MR et al. The validity of the family history screen for assessing family history of mental disorders. American Journal of Medical Genetics. Part B. Neuropsychiatric Genetics 150B(1): 41-49, 2009. (54 refs.)

There is a need to collect psychiatric family history information quickly and economically (e.g., for genome-wide studies and primary care practice). We sought to evaluate the validity of family history reports using a brief screening instrument, the Family History Screen (FHS). We assessed the validity of parents' reports of seven psychiatric disorders in their adult children probands from the Dunedin Study (n = 959, 52% male), using the proband's diagnosis as the criterion outcome. We also investigated whether there were informant characteristics that enhanced accuracy of reporting or were associated with reporting biases. Using reports from multiple informants, we obtained sensitivities ranging from 31.7% (alcohol dependence) to 60.0% (conduct disorder) and specificities ranging from 76.0% (major depressive episode) to 97.1% (suicide attempt). There was little evidence that any informant characteristics enhanced accuracy of reporting. However, three reporting biases were found: the probability of reporting disorder in the proband was greater for informants with versus without a disorder, for female versus male informants, and for younger versus older informants. We conclude that the FHS is as valid as other family history instruments (e.g., the FH-RDC, FISC), and its brief administration time makes it a cost-effective method for collecting family history data. To avoid biasing results, researchers who aim to compare groups in terms of their family history should ensure that the informants reporting on these groups do not differ in terms of age, sex or personal history of disorder.

Morean ME; Corbin WR; Sinha R; O'Malley SS. Parental history of anxiety and alcohol-use disorders and alcohol expectancies as predictors of alcohol-related problems. Journal of Studies on Alcohol and Drugs 70(2): 227-236, 2009. (68 refs.)

Objective: Research has consistently identified a family history of alcoholism as a risk factor for alcohol-related problems, and global positive expectancies have been found to moderate this association. High rates of comorbidity between alcohol use and anxiety disorders suggest that a family history of anxiety disorders may also increase risk. Further, expectations of negative reinforcement (e.g., tension reduction) have been found to moderate the influence of anxiety-related traits. The current study sought to extend previous research by examining the influence of parental history of alcoholism, anxiety disorders, and the combination, as predictors of alcohol-related problems, Expectancies of global positive changes and tension reduction were hypothesized to moderate the influence of parental history of alcoholism and anxiety, respectively. Method: Direct interviews with parents assessed their history of alcoholism and anxiety for 144 offspring (ages 18-32; 53.5% male) creating four groups: those with a parental history of alcoholism (27.80%), anxiety (22.20%), both alcoholism and anxiety (33.30%), and no history of psychopathology (16.70%). Established measures assessed the offsprings' alcohol expectancies, alcohol use, and alcohol-related problems. Results: Although expected interactions between parental alcoholism and global positive expectancies and between parental anxiety and tension-reduction expectancies were not found, global positive expectancies were associated with alcohol-related problems among the group with parental history of both alcoholism and anxiety. Conclusions: The results suggest that the relation between parental history of alcoholism and global positive expectancies observed in previous studies may be strongest among individuals with a comorbid parental history of alcohol and anxiety disorders. Incorporating expectancies into interventions targeting individuals with a comorbid parental history of alcohol and anxiety disorders may have utility.

Muilenburg JL; Latham T; Annang L; Johnson WD; Burdell AC; West SJ et al. The home smoking environment: Influence on behaviors and attitudes in a racially diverse adolescent population. Health Education & Behavior 36(4): 777-793, 2009. (32 refs.)

Although studies indicate that public policy can influence the decrease in smoking behaviors, these policies have not necessarily transferred to home environments at the same rate. The authors surveyed 4,296 students in a southern urban area. African American students were 76.3% of the respondents and Caucasians accounted for 23.7%. African American homes are less likely to have full bans on smoking inside the home. Home smoking bans impact smoking behaviors, acceptance of smoking, susceptibility to smoking, smoking beliefs, and motivation to quit smoking. Along with home smoking bans, there are differences among African American and Caucasian youth in smoking exposure, behaviors, beliefs, and motivation to quit smoking. This study suggests that particularly in African American youth, educational efforts should be directed toward more restrictive home smoking policies to thwart the initiation of smoking in adolescents and to encourage positive attitudes toward smoking behaviors.

Naito T; Miyaki K; Naito M; Yoneda M; Suzuki N; Hirofuji T et al. Parental smoking and smoking status of Japanese dental hygiene students: A pilot survey at a dental hygiene school in Japan. International Journal of Environmental Research and Public Health 6(1): 321-328, 2009. (27 refs.)

This study aimed to determine the frequency of smoking and to explore factors associated with the smoking habits of female students at a dental hygiene school in Japan. Questionnaires regarding cigarette smoking were given to 168 female students. The response rate was 97.6%. The prevalence of smoking, including current and occasional smokers, was 20.3%. Among family members, only the smoking status of their mother significantly influenced the smoking status of the students. The odds ratio for smoking among dental hygiene students whose mothers were smokers in comparison to students whose mothers were not smokers was 5.1 (95% confidence interval 2.1-12.2, p=0.000). Decision tree analysis showed that the smoking habit of dental hygiene students was correlated with their mothers' smoking history, as well as the smoking status of junior high school teachers, the smoking habits of close friends and a history of participating in a smoking prevention program when in elementary school. The increased smoking rate of young females, including dental hygienists, is a growing problem in Japan. The smoking statuses of dental hygiene students might be closely influenced by their mothers' smoking status.

Nasim A; Belgrave FZ; Corona R; Townsend TG. Predictors of tobacco and alcohol refusal efficacy for urban and rural African-American adolescents. Journal of Child & Adolescent Substance Abuse 18(3): 221-242, 2009. (69 refs.)

This study sought to determine the relative contributions of individual, family, peer, and community risk and promotive factors in explaining alcohol and tobacco refusal attitudes among 227 African-American adolescents (ages 12 to 17) from urban and rural areas. Hierarchical linear regression (HLR) results revealed differences in the predictive value of risk and promotive factors with respect to tobacco and alcohol refusal attitudes. Specifically, individual and peer risk factors were predictive of tobacco refusal attitudes among youths. Individual, peer, and family risk, and promotive factors were predictive of adolescents' alcohol refusal attitudes. Community factors were not significant predictors of youths' ability to refuse tobacco and alcohol, after controlling for more proximal influences. Future research should consider other psychosocial influences within an ecological framework that may account for additional variance in substance use altitudes among African-American adolescents.

Nilsson KW; Oreland L; Kronstrand R; Leppert J. Smoking as a product of gene-environment interaction. Upsala Journal of Medical Sciences 114(2): 100-107, 2009. (59 refs.)

A strong hereditary influence on smoking has been demonstrated. As one of the candidate genes in relation to smoking, the serotonin transporter gene (5-HTTLPR) has been suggested, however with conflicting results. In recent studies, it has been shown that genotypic and environmental (G*E) factors interact in the shaping of a variety of phenotypic expressions. The objective of the present study was to investigate the interaction between a variation in the 5-HTTLPR and family environment in relation to smoking habits, nicotine dependence, and nicotine and cotinine levels in hair samples. A random Swedish adolescent population sample (n = 785), from which 200 individuals were stratified regarding behaviour, was genotyped for 5-HTTLPR and assessed with semi-structured interviews, a questionnaire, and hair analyses of nicotine and cotinine. The 5-HTTLPR gene interacted with a poor family environment to predict smoking habits, as well as nicotine and cotinine levels. The risk of being a smoker was increased 13 times for an individual with a combination of the 5-HTTLPR LS genotype and a poor family environment in comparison with the Homozygous Long-Long (LL) genotype and a good family environment.

Nilsson M; Weinehall L; Bergstrom E; Stenlund H; Janlert U. Adolescent's perceptions and expectations of parental action on children's smoking and snus use; national cross sectional data from three decades. BMC Public Health 9: e-article 74, 2009. (37 refs.)

Background: Parents play a vital role as children develop tobacco behaviours. Many parents feel unsure about their possibility to influence their teenager's lifestyle. Knowledge about young people's acceptance for parental intervention could increase parental involvement. The overall objective of this study was to explore adolescents' perceptions and expectations of parental action regarding children's smoking and snus use, and whether they have changed over time. To see if there were differences whether the adolescent was a tobacco user or not the adolescents' tobacco use was followed; and described to put the findings on their perceptions and expectations of parental action in a context. Methods: The study used a repeated cross-sectional design, reporting Swedish national data from three decades. Data were collected in 1987, 1994 and 2003 by a questionnaire mailed to homes, in total to 13500 persons. The annual samples, which were random and national representative, consisted of 4500 young people aged 13, 15 and 17 yr, 1500 individuals per age group. The sampling and data collection procedures were done the same way during each survey. Chi2-tests were used to evaluate differences in distributions. Results: Adolescents in all age groups became more positive toward parental action over time. In 2003, more then 86% of the adolescents, including both smokers and non-smokers, strongly supported parental action on their children's smoking by trying to persuade them not to smoke (94%), by not smoking themselves (87%) and by not allowing their children to smoke at home (86%). Both non-smokers and smokers supported the idea of parental action in a similar way. Reduced pocket money had a weak support (42%), especially from girls. Eighty-nine percent of the adolescents expected their parents to act against smoking and 85% against snus use. Smoking was stable at 8% in 1987 and 1994 but decreased to 4% in 2003. In 1987 the snus use prevalence was 4% and in 2003 it was 3%. Snus users were mostly boys while few girls had done more than tried snus. More young people in all age groups had never tried smoking compared to the previous studies. In 2003 57% stated that they had never tried smoking. Conclusion: Adolescent smoking in Sweden has decreased and the proportion who never tried smoking has increased. The results of this study show that a growing majority of adolescents support strong parental intervention to help them refrain from tobacco, but preferably not in a punitive manner. This finding dismisses the notion that adolescents ignore or even disdain parental practices concerning tobacco. Prevention strategies and interventions addressing adolescent tobacco use that involve parents can be improved by using these findings to encourage parents to intervene against their children's tobacco use.

Philibert RA; Todorov A; Andersen A; Hollenbeck N; Gunter T; Heath A et al. Examination of the Nicotine Dependence (NICSNP) Consortium findings in the Iowa adoption studies population. Nicotine & Tobacco Research 11(3): 286-292, 2009. (29 refs.)

Nicotine dependence results from a complex interplay of genetic and environmental factors. Over the past several years, a large number of studies have been performed to identify distinct gene loci containing genetic vulnerability to nicotine dependence. Two of the most prominent studies were conducted by the Collaborative Study of the Genetics of Nicotine Dependence (NICSNP) Consortium using both candidate gene and high-density association approaches. We attempted to confirm and extend the most significant findings from the high-density association study and the candidate gene study using the behavioral and genetic resources of the Iowa Adoption Studies, the largest case-control adoption study of substance use in the United States. We found evidence that genetic variation at CHRNA1, CHRNA2, CHRNA7, and CHRNB1 alters susceptibility to nicotine dependence, but we did not replicate any of the most significant single nucleotide polymorphism associations from the NICSNP high-density association study. Further examination of the NICSNP findings in other population samples is indicated.

Pinto E; Reggers J; Gorwood P; Boni C; Scantamburlo G; Pitchot W et al. The TaqI A DRD2 polymorphism in type II alcohol dependence: A marker of age at onset or of a familial disease? Alcohol 43(4): 271-275, 2009. (34 refs.)

Cloninger's type II is it severe, early-onset, male-limited, and genetically influenced, impulsive form of alcoholism. Significant association has been reported between the A1 allele of the D2 dopamine receptor (DRD2) gene, substance misuse and personality traits of impulsivity and novelty seeking. We assessed the association between the TaqI A DRD2 gene polymorphism with Cloninger's typology and family history of alcohol abuse, which is thought to be more frequent in type II alcoholics. Fifty-one male alcohol-dependent patients were discriminated between type I and type II according to age at onset of alcohol-related problems and interviewed about family history of alcoholism. The associations between DRD2 (A1 or A2 alleles), family history, and typology were assessed by Pearson's chi-square test. Although typology was not associated with the studied polymorphism, a higher rate of general family history of alcohol abuse was still observed in type II patients (chi(2)(1) = 4.53; P = .033). Furthermore, the A1 allele of the DRD2 was significantly associated with paternal history of alcoholism (chi(2)(1) = 4.66; P = .031) and male, first-degree, collateral history of alcoholism (chi(2)(1) = 4.40; P = .036). Age at onset of alcohol related problems as main discriminator between type I and type II alcohol dependence does not seem to be associated by the TaqI A DRD2 polymorphism. However, the A1 allele of the DRD2 may be a marker of male familial alcoholism, which has been associated with type II alcohol dependence.

Poelen EAP; Engels RCME; Scholte RHJ; Boomsma DI; Willemsen G. Predictors of problem drinking in adolescence and young adulthood. European Child and Adolescent Psychiatry 18(6): 345-352, 2009. (40 refs.)

We examined drinking behavior of parents, siblings, and friends of twins as predictors of adolescent and young adult problem drinking over a period of 2 and a period of 7 years. Data of 12 to 30-year-old twins and their family members from the Netherlands Twin Register were analyzed. Problem drinking in twins was assessed in 1995 and 2000 and was defined based on the CAGE and amount of drinking. Data on alcohol use of parents, siblings and friends were collected in 1993. Multinomial logistic regression analyses were used to examine the short-term (1993-1995; n = 2,994) and the long-term longitudinal predictors (1993-2000; n = 1,796) of problem drinking. Age, sex and own alcohol use in 1993 explained 25% of the variance in adolescent and young adult problem drinking. Moreover, adolescents and young adults with fathers who drank frequently and with a large numbers of drinking friends, were at the highest risk for problem drinking 2 years later. Over a period of 7 years the number of drinking friends was no longer a risk factor, but few times a week or daily alcohol use of fathers remained a risk factor for later problem drinking. Drinking behavior of mother and siblings did not substantially predict problem drinking. Sex and age did not moderate these effects.

Rainio SU; Rimpela AH. Home-based sourcing of tobacco among adolescents. Preventive Medicine 48(4): 378-382, 2009. (28 refs.)

Objective. To study home-based sources of tobacco and associated family factors among Finnish adolescents. Methods. Nationwide surveys (1999, 2003, 2007) of 14-16-year-old daily (n = 2355), occasional (n = 708), and experimental (n=2763) smokers. The main outcome measure was home-based sourcing of tobacco (parents, siblings, taking from home) during the past month. Logistic regression was used for statistical analysis. Results. Home-based sources were used by 44% of daily, 11% of occasional, and 9% of experimental smokers; other social sources by 93%, 65%, and 51%; and commercial sources by 70%, 28%, and 10% respectively. Among daily smokers, home sources meant siblings (24%), parents (19%), and taking from home (19%). Parental smoking and absence of a home-smoking ban increased home-based sourcing. The odds ratio (OR) for obtaining tobacco from any home-based source was 6.96 (95% CI: 3.75-12.91) and from parents 7.44 (2.68-20.65) when both parents smoked versus nonsmoking parents. In the absence of a home-smoking ban, corresponding ORs were 2.21 (1.28-3.81) and 21.33 (2.84-60.30) versus those reporting having a ban. Obtaining tobacco from parents was more common in single-parent/reconstituted families than in families with two biological parents. Conclusions. Parents should be provided with guidance about the consequences of home-based sourcing in the persistence of children's smoking habit.

Rende R; Slomkowski C. Incorporating the family as a critical context in genetic studies of children: Implications for understanding pathways to risky behavior and substance use. Journal of Pediatric Psychology 34(6): 606-616, 2009. (61 refs.)

The availability of candidate gene markers for biobehavioral traits will undoubtedly result in increasing attention to genetic influences in studies of childhood risk factors for health behaviors. However, a strict emphasis on genomics without consideration of the social contexts that give rise to risky behaviors will miss opportunities to understand more fully the powerful effect of the family on childhood development. This article discusses the rationale for using the family as a critical context for studying the translation of genetic propensity for risky behavior into developmental pathways that span childhood and adolescence. Attention is given to the importance of family environmental factors; the emerging literature on genetic influences on potential intermediate phenotypes; the need for rich and detailed characterizations of both phenotypes and environmental risk factors embedded within genomic studies of children; and implications for interventions and preventions aimed at risky behaviors. Via discussion of these issues, pragmatic considerations of how studying families as a context may facilitate the thoughtful inclusion of children into genetic paradigms are emphasized.

Roberts RE; Roberts CR; Chan W. One-year incidence of psychiatric disorders and associated risk factors among adolescents in the community. Journal of Child Psychology and Psychiatry 50(4): 405-415, 2009. (64 refs.)

We have few data on incidence of psychiatric disorders among adolescents. This study examined first incidence of disorders among adolescents and baseline factors which increased or decreased risk of new onset cases a year later. Data were analyzed from Teen Health 2000 (TH2K), a probability sample of 4,175 youths 11-17 and their parents assessed at baseline and 3,134 of these youth-parent dyads followed up a year later. Disorders examined were anxiety, mood, attention deficit hyperactivity disorder (ADHD), disruptive, and substance abuse/dependence disorders in the past year. Risk and protective factors were assessed from three domains: status factors, personal and social resources, and stressors. Logistic regression models were used to estimate odds of incident disorders for each risk and protective factor. Incidence rates were 2.8% for anxiety, 1.5% for mood, 1.2% for ADHD, 2.5% for disruptive, 2.9% for substance abuse/dependence, and 7.5% for one or more DSM-IV disorders. Multivariate analyses identified few independent predictors of incidence. The most consistent factors across disorders involved indicators of stress. The role of adverse family context was particularly noteworthy, predicting incidence of every disorder examined. Personal resources such as mastery consistently enhanced resilience to onset of first episodes. The presence of multiple risk factors, cumulative burden, substantially increased risk of first incidence of all disorders examined. The incidence of any disorder of 7.5% was similar to two earlier studies using DSM-III-R criteria (8.9 and 10.6, respectively). This is the first study to estimate incidence of DSM-IV disorders for a range of diagnostic categories, and with the exception of substance use disorders, the rates are quite different from one earlier study using DSM-II-R criteria. A clear pattern emerged from the analyses. That is, psychiatric disorders, like other chronic diseases, are the product of multiple factors and these factors in turn have effects on multiple disorders.

Roozen HG; Blaauw E; Meyers RJ. Advances in management of alcohol use disorders and intimate partner violence: Community reinforcement and family training. Psychiatry, Psychology and Law 16(Supplement S): S74-S80, 2009. (50 refs.)

Substance use disorders are associated with life-threatening behaviours and substance use is found to strongly trigger criminal behaviour, including intimate partner violence (IPV). Although intimate partners are often subject to aggression and injury, most substance-using offenders refuse to enter formal treatments. Community reinforcement and family training (CRAFT) was developed to help intimate partners to (a) recognize and safely respond to potential violence, (b) improve communication with the substance user; (c) decrease stress, (d) improve self efficacy, and (e) assist in encouraging the unwilling substance user to enter therapy. The underlying operant-based belief is that environmental contingencies are key in encouraging or discouraging substance use. This article discusses why CRAFT may be effective in engaging treatment-resistant patients with Substance abuse disorders in formal treatment and to diminish IPV. It is asserted that intimate partners, family members and close friends can make important contributions to assist substance-using offenders.

Ryan C; Huebner D; Diaz RM; Sanchez J. Family rejection as a predictor of negative health outcomes in White and Latino lesbian, gay, and bisexual young adults. Pediatrics 123(1): 346-352, 2009. (37 refs.)

OBJECTIVE. We examined specific family rejecting reactions to sexual orientation and gender expression during adolescence as predictors of current health problems in a sample of lesbian, gay, and bisexual young adults. METHODS. On the basis of previously collected in-depth interviews, we developed quantitative scales to assess retrospectively in young adults the frequency of parental and caregiver reactions to a lesbian, gay, or bisexual sexual orientation during adolescence. Our survey instrument also included measures of 9 negative health indicators, including mental health, substance abuse, and sexual risk. The survey was administered to a sample of 224 white and Latino self-identified lesbian, gay, and bisexual young adults, aged 21 to 25, recruited through diverse venues and organizations. Participants completed self-report questionnaires by using either computer-assisted or pencil-and-paper surveys. RESULTS. Higher rates of family rejection were significantly associated with poorer health outcomes. On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection. Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence. CONCLUSIONS. This study establishes a clear link between specific parental and caregiver rejecting behaviors and negative health problems in young lesbian, gay, and bisexual adults. Providers wve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth.

Sanderson SC; O'Neill SC; White DB; Bepler G; Bastian L; Lipkus IM et al. Responses to online GSTM1 genetic test results among smokers related to patients with lung cancer: A pilot study. Cancer Epidemiology, Biomarkers & Prevention 18(7): 1953-1961, 2009. (34 refs.)

Providing smokers with personal genetic test results indicating increased lung cancer risk may increase uptake of effective smoking cessation services. Using the internet may increase reach and enable real-time assessment of how people process genetic risk information away from the clinic setting. We therefore explored smokers' responses to Web-delivered GSTM1 genetic test results indicating higher or lower lung cancer risk. Participants were smokers (n = 44) biologically related to patients with newly diagnosed lung cancer. Measures were assessed at baseline, before and immediately after receipt of online genetic test results, and at 6-month follow-up. Outcomes included accurate comprehension of results, regret about being tested, cessation-related cognitions (e.g., perceived response efficacy), and uptake of free smoking cessation services (nicotine replacement therapy, printed self-help materials, telephone counseling sessions). Twenty-two "relative smokers" received a GSTM1-missing (higher risk) and 22 a GSTM1-present (lower risk) result. All relative smokers with GSTM1-missing results and 55% of those with GSTM1-present results accurately interpreted their results. No relative smokers regretted having taken the test. Relative smokers receiving GSTM1-missing results reported lower confidence that quitting could reduce lung cancer risk (perceived response efficacy) than those receiving GSTM1-present results. There were no other significant between-group differences. Uptake of smoking cessation services was high (e.g., 91% nicotine replacement therapy uptake). Genetic test results may not influence uptake of free smoking cessation services because of ceiling effects. Further research is needed to determine the risks and benefits of Web-based disclosure of genetic test results.

Saraceno L; Munafo M; Heron J; Craddock N; van den Bree MBM. Genetic and non-genetic influences on the development of co-occurring alcohol problem use and internalizing symptomatology in adolescence: A review. Addiction 104(7): 1100-1121, 2009. (327 refs.)

Alcohol problem use during adolescence has been linked to a variety of adverse consequences, including cigarette and illicit drug use, delinquency, adverse effects on pubertal brain development and increased risk of morbidity and mortality. In addition, heavy alcohol-drinking adolescents are at increased risk of comorbid psychopathology, including internalizing symptomatology (especially depression and anxiety). A range of genetic and non-genetic factors have been implicated in both alcohol problem use as well as internalizing symptomatology. However, to what extent shared risk factors contribute to their comorbidity in adolescence is poorly understood. We conducted a systematic review on Medline, PsycINFO, Embase and Web of Science to identify epidemiological and molecular genetic studies published between November 1997 and November 2007 that examined risk factors that may be shared in common between alcohol problem use and internalizing symptomatology in adolescence. Externalizing disorders, family alcohol problems and stress, as well as the serotonin transporter (5-HTT) S-allele, the monoamine oxidase A (MAOA) low-activity alleles and the dopamine D2 receptor (DDR2) Taq A1 allele have been associated most frequently with both traits. An increasing number of papers are focusing upon the role of gene-gene (epistasis) and gene-environment interactions in the development of comorbid alcohol problem use and internalizing symptomatology. Further research in adolescents is warranted; the increasing availability of large longitudinal genetically informative studies will provide the evidence base from which effective prevention and intervention strategies for comorbid alcohol problems and internalizing symptomatology can be developed.

Sayers SL; Farrow VA; Ross J; Oslin DW. Family problems among recently returned military veterans referred for a mental health evaluation. Journal of Clinical Psychiatry 70(2): 163-170, 2009. (38 refs.)

Context: Existing evidence suggests, that military veterans with mental health disorders have poorer Family functioning, although little research has focused on this topic. Objective: To test whether psychiatric symptoms are associated with family reintegration problems in recently returned military veterans. Design: Cross-sectional survey of a clinical population. Respondents who were referred to behavioral health evaluation from April 2006 through August 2007 were considered for the survey. Setting: Philadelphia Veterans Affairs Medical Center, Pa. Participants: 199 military veterans who served in Iraq or Afghanistan after 2001 and were referred for behavioral health evaluation from primary care (mean age = 32.7 years, SD = 9.1). Main Outcome Measures: Measures included the Mini-International Neuropsychiatric Interview for psychiatric diagnoses, the 9-item Patient Health Questionnaire for depression diagnosis and severity, and screening measures of alcohol abuse and illicit substance use. A measure of military family readjustment problems and a screening measure of domestic abuse were developed for this study. Results: Three fourths of the married/cohabiting veterans reported some type of family problem in the past week, such as feeling like a guest in their household (40.7%), reporting their children acting afraid or not being warm toward them (25.0%), or being unsure about their family role (37.2%). Among veterans with current or recently separated partners, 53.7% reported conflicts involving "shouting, pushing, or shoving," and 27.6% reported that this partner was "afraid " of them." Depression and posttraumatic stress disorder symptoms were both associated with higher rates of family reintegration problems. Conclusions: Mental health problems may complicate veterans' readjustment and reintegration into family life. The findings suggest an opportunity to improve the treatment of psychiatric disorders by addressing family problems.

Schindler A; Thomasius R; Petersen K; Sack PM. Heroin as an attachment substitute? Differences in attachment representations between opioid, ecstasy and cannabis abusers. Attachment & Human Development 11(3): 307-330, 2009. (80 refs.)

Earlier studies indicated a relation between fearful-avoidant attachment and substance abuse. This study compares attachment representations (Family Attachment Interview; Bartholomew Horowitz, 1991) of three groups of substance abusers and non-clinical controls. Heroin abusers (N=22) were mainly fearful-avoidant, ecstasy abusers (N=31) were preoccupied, fearful-avoidant and dismissing-avoidant, cannabis abusers (N=19) were mainly dismissing and secure, and controls (N=22) were mainly secure. Groups did differ in their level of psychosocial functioning (GAF) (cannabisecstasy opioids). Differences in attachment prevailed when GAF was controlled. Based on the self-medication hypothesis we understand the preferences for specific substances to be influenced by specific attachment strategies. Heroin seems to be used as an emotional substitute for lacking coping strategies. Cannabis seems to be used to support existing deactivating and distancing strategies. Ecstasy abuse was related to insecure attachment but not to a specific attachment strategy.

Schwartz SJ; Mason CA; Pantin H; Wang W; Brown CH; Campo AE et al. Relationships of social context and identity to problem behavior among high-risk Hispanic adolescents. Youth & Society 40(4): 541-570, 2009

The present study was designed to examine (a) family and school functioning and (b) personal and ethnic identity are associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion are related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning are related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-a-vis conduct problems and substance use.

Schwartz SJ; Zamboanga BL; Ravert RD; Kim SY; Weisskirch RS; Williams MK et al. Perceived parental relationships and health-risk behaviors in college-attending emerging adults. Journal of Marriage and the Family 71(3): 727-740, 2009. (57 refs.)

The present study investigated the association of perceived parenting with health-risk behaviors in an ethnically diverse sample of 1,728 college-attending emerging adults. Participants completed retrospective measures of perceived maternal and paternal nurturance, connection, psychological control, and disrespect and reported their frequency of binge drinking, illicit drug use, unsafe sexual behavior, and impaired driving. Multivariate Poisson regression analyses indicated that perceived paternal acceptance was associated inversely with 6 of the 12 health-risk behaviors measured, whereas perceived mothering was related only to 2 of these health-risk behaviors. These patterns were consistent across gender, ethnicity, and family structure.

Semple SJ; Strathdee SA; Zians J; Patterson TL. Family conflict and depression in HIV-negative heterosexuals: The role of methamphetamine use. Psychology of Addictive Behaviors 23(2): 341-347, 2009. (39 refs.)

Previous research has reported elevated levels of depressive symptoms among methamphetamine users, but little attention has been paid to possible links between family environment and psychological distress. This study examined relationships between family Conflict, Substance use, and depressive symptoms in it sample of 104 heterosexual methamphetamine users in San Diego, California. Eighty-nine percent of the sample reported conflict with a family member in the past year. Conflict was reported most often with parents and siblings. Sources of conflict included drug use, lifestyle issues, interpersonal and communication issues. and concern for other family members. In regression analyses, being female, being a polydrug user, and facing social and legal stressors were associated with higher levels of family conflict. Multiple regression analyses also revealed it positive association between family conflict and depressive symptoms. Contrary to expectation, methamphetamine dose did not moderate the relationship between family conflict and depressive symptoms. Reducing family conflict may be an important first step toward ameliorating depressive symptoms and creating more supportive environments for methamphetamine users who are in urgent need of effective interventions.

Skeer M; McCormick MC; Normand SLT; Buka SL; Gilman SE. A prospective study of familial conflict, psychological stress, and the development of substance use disorders in adolescence. Drug and Alcohol Dependence 104(1-2): 65-72, 2009. (70 refs.)

Background: Exposure to adverse family environments in childhood can influence the risk trajectory for developing substance use disorders in adolescence. Evidence for this is largely based on cross-sectional studies which have been unable to establish the temporality of this association and investigate underlying pathways. Methods: The sample consisted of 1421 adolescents from the Project on Human Development in Chicago Neighborhoods, a three wave longitudinal study conducted between 1994 and 2001 that followed children from ages 10 to 22. Logistic regression analyses with multiple imputation were conducted to examine the relation between familial conflict in childhood and substance use disorders in late adolescence and emerging adulthood. We conducted mediational analyses to determine if internalizing and externalizing problems explain this relationship, and we investigated whether external social support mitigates the adverse effects of familial conflict on the development of substance use disorders. Results: Familial conflict was significantly associated with the risk of substance use disorders during adolescence (odds ratio: 1.23; 95% CI: 1.02-1.47), and 30% of this effect was due to higher levels of externalizing problems (but not internalizing problems). External social support in childhood did not buffer the effects of familial conflict on substance use disorders during adolescence. Conclusion: Exposure to familial conflict early in life increases the risk of substance use disorders during late adolescence and emerging adulthood, due partly to higher levels of externalizing problems, but not internalizing problems. Future research is needed to identify additional pathways underlying this association, and the extent to which these pathways are modifiable.

Skinner ML; Haggerty KP; Catalano RF. Parental and peer influences on teen smoking: Are White and Black families different? Nicotine & Tobacco Research 11(5): 558-563, 2009. (32 refs.)

Introduction: The health risks associated with smoking disproportionately burden Blacks, and Black adults are more likely to smoke than are White adults. Most adult smokers have their first smoking experience as teenagers; however, rates of smoking initiation during adolescence remain lower among Black compared with White youth. Methods: The level and impact of family and peer risk and protective factors on adolescent smoking across both groups were modeled prospectively from 8th to 10th grade in a sample of 331 (Black n = 162, White n = 168) families using data from self-administered computer-assisted questionnaires. Predictors included parent smoking, guidelines against substance use, monitoring, consistent discipline, attachment to parents, and association with deviant peers. Results: Mean-level differences indicated greater risk for Black teens in some cases and higher protection in others. Multiple-group structural equation modeling indicated no race differences. Several factors affected both groups: (a) parenting factors reduced association with deviant peers, (b) association with deviant peers increased the risk of smoking in the 10th grade, and (c) teens were more likely to smoke if their parents smoked. Discussion: Reduced smoking among Black teens compared with White teens may be due to the protection of clear parental guidelines about substance use and clearly stated consequences for failure to observe those guidelines.

Slesnick N; Bartle-Haring S; Erdern G; Budde H; Letcher A; Bantchevska D et al. Troubled parents, motivated adolescents: Predicting motivation to change substance use among runaways. Addictive Behaviors 34(8): 675-684, 2009. (78 refs.)

Runaway adolescents engage in high rates of substance use and report significant family and individual problems. However, in general, adolescents report low motivation to change their substance use. Because a higher level of motivation for changing substance use is associated with greater substance abuse treatment success, identifying variables associated with motivation for change can be useful for enhancing treatment success. In this study, predictors of motivation for changing substance use were examined among 140 shelter-recruited adolescents and their parents/primary caretakers. Several findings were noteworthy. A perceived negative family environment increased parents' and adolescents' depressive symptoms, which increased adolescent's motivation to change. Also, greater severity of adolescent substance use predicted higher motivation to change. Consideration of the family environment and parent problems when addressing motivation for changing substance use among these adolescents might be important foci for motivational interventions and future research.

Spoth R; Trudeau L; Guyll M; Shin C; Redmond C. Universal intervention effects on substance use among young adults mediated by delayed adolescent substance initiation. Journal of Consulting and Clinical Psychology 77(4): 620-632, 2009. (61 refs.)

In this article, the authors examine whether delayed substance initiation during adolescence, achieved through universal family-focused interventions conducted in middle school, can reduce problematic substance use during young adulthood. Sixth-grade students enrolled in 33 rural midwestern schools and their families were randomly assigned to 3 experimental conditions. Self-report questionnaires provided data at 7 time points for the Iowa Strengthening Families Program (ISFP), Preparing for the Drug Free Years (PDFY), and control groups through young adulthood. Five young adult substance frequency measures (drunkenness, alcohol-related problems, cigarettes, illicit drugs, and polysubstance use) were modeled as distal outcomes affected by the average level and rate of increase in substance initiation across the adolescent years in latent growth curve analyses. Results show that the models fit the data and that they were robust across outcomes and interventions, with more robust effects found for ISFP. The addition of direct intervention effects on young adult outcomes was not supported, suggesting long-term effects were primarily indirect. Relative reduction rates were calculated to quantify intervention-control differences on the estimated proportion of young adults indicating problematic substance use; they ranged from 19% to 31% for ISFP and from 9% to 16% for PDFY.

Steinglass P. Systemic-motivational therapy for substance abuse disorders: An integrative model. Journal of Family Therapy 31(2): 155-174, 2009. (45 refs.)

Although recent reviews of the literature on families and substance misuse offer compelling evidence that inclusion of families significantly improves treatment engagement, retention and outcome, family therapy remains peripheral in most substance abuse treatment programmes. Furthermore, many of the treatment approaches that have been included under the term 'family therapy' continue to focus on the substance abuser as the sole target of treatment. Still conspicuously absent are treatment models based on family systems approaches, with outcomes targeted at non-abusing family members as well. This article presents an overview of one such family-focused substance abuse treatment model - systemic-motivational therapy - that combines a family systems approach with techniques derived from motivational interviewing, but this time is applied to work with the family as a unit. The background for the development of the model will be described, as well as the assessment/consultation, family-level action plan, and aftercare/relapse prevention phases of the treatment approach.

Thrasher JF; Boado M; Sebrie EM; Bianco E. Smoke-free policies and the social acceptability of smoking in Uruguay and Mexico: Findings from the International Tobacco Control Policy Evaluation Project. Nicotine & Tobacco Research 11(6): 591-599, 2009. (27 refs.)

Little research has been conducted to determine the psychosocial and behavioral impacts of smoke-free policies in middle-income countries. Cross-sectional data were analyzed from the 2006 waves of the International Tobacco Control Policy Evaluation. Survey comparing adult smokers in Mexico (n = 1,080), where smoke-free legislation at that time was weak, and Uruguay (n = 1,002), where comprehensive smoke-free legislation was implemented. Analyses aimed to determine whether exposure to smoke-free policies and perceived antismoking social norms were associated with smokers' receiving cues about the bothersome nature of secondhand smoke (SHS), with smokers' reactance against such cues, and with smokers' level of support for smoke-free policies in different venues. In bivariate analyses, Uruguayan smokers were more likely than Mexican smokers to experience verbal anti-SHS cues, lower reactance against anti-SHS cues, stronger antismoking societal norms, and stronger support for 100% smoke-free policies in enclosed workplaces, restaurants, and bars. In multivariate models for both countries, the strength of voluntary smoke-free policies at home was independently associated with support for smoke-free policies across all venues queried, except for in bars among Uruguayans. Perceived strength of familial antismoking norms was consistently associated with all indicators of the social acceptability of smoking in Uruguay but only with the frequency of receiving anti-SHS verbal cues in Mexico. These results are generally consistent with previous research indicating that comprehensive smoke-free policies are likely to increase the social unacceptability of smoking and that resistance against such policies is likely to diminish once such policies are in place.

Van Der Vorst H; Vermulst AA; Meeus WHJ; Dekovic M; Engels RCME. Identification and prediction of drinking trajectories in early and mid-adolescence. Journal of Clinical Child and Adolescent Psychology 38(3): 329-341, 2009

The aim of this study was to identify subgroups of early and mid-adolescents with different drinking trajectories. In addition, we examined whether gender, parental, and peer factors predicted adolescents' membership of these drinking trajectories. We used longitudinal data of 428 families (fathers, mothers, mid-adolescents, and their younger siblings). Latent Class Growth Analyses were performed to identify drinking trajectories. Four drinking trajectories emerged for early adolescents: abstainers, light drinkers, increasers, and heavy drinkers. For mid-adolescents, we identified a fifth group (stable drinkers) in addition to the four trajectories identified for early adolescents. Our results showed that being a boy, having a best friend or father who drinks heavily, and having parents who are permissive toward adolescents' alcohol creates increased risk for both siblings to attend the more heavy drinking trajectories.

Vaske J; Beaver KM; Wright JP; Boisvert D; Schnupp R. An interaction between DAT1 and having an alcoholic father predicts serious alcohol problems in a sample of males. Drug and Alcohol Dependence 104(1-2): 17-22, 2009. (58 refs.)

The current study examines whether the dopamine transporter (DAT1) VNTR polymorphism and paternal alcoholism are related to serious alcohol problems. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we found that the DAT1 polymorphism interacted with paternal alcoholism to predict serious alcohol problems among males. Specifically, the 10-repeat allele conferred an increase of alcohol problems only among males who also had an alcoholic father; the 10-repeat allele was unrelated to alcohol problems for males without an alcoholic father. Coefficient tests revealed that this interaction effect was stronger among African-American males. Females who possessed the 9-repeat allele were more likely to report serious alcohol problems, but this effect was not moderated by paternal alcoholism. These analyses suggest that additive and interactive effects of DAT1 and paternal alcoholism may operate differently across genders and races.

Veselska Z; Geckova AM; Orosova O; Gajdosova B; Van Dijk JR; Reijneveld SA. Self-esteem and resilience: The connection with risky behavior among adolescents. Addictive Behaviors 34(3): 287-291, 2009. (29 refs.)

The aim was to explore the association of self-esteem and resilience with smoking and cannabis use among adolescents, separately for gender. A sample of 3694 adolescents (mean age 14.3 years) from elementary schools in Slovakia filled out the Rosenberg Self-esteem scale, the Resiliency scale and answered questions about cigarette and cannabis use. Logistic regression models showed associations between negative self-esteem and risky behavior, but only among boys. Regarding resilience, structured style and family cohesion were associated with a lower probability of smoking and cannabis use among both boys and girls. In contrast, social competence increased the probability of smoking and cannabis use among both groups. Negative self-esteem seems to play an important role regarding smoking and cannabis use among boys. Resilience seems to have mixed effects, some aspects being protective while other aspects increase the likelihood of smoking and use of cannabis. These results imply that the prevention of substance use should target not only specific individual characteristics, but also the possible risk or protective influences of the social environment, i.e. the family and social network.

Wells K. Substance abuse and child maltreatment. Pediatric Clinics of North America 56(2): 345+, 2009. (70 refs.)

Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

Young-Wolff KC; Kendler KS; Sintov ND; Prescott CA. Mood-related drinking motives mediate the familial association between major depression and alcohol dependence. Alcoholism: Clinical and Experimental Research 33(8): 1476-1486, 2009. (74 refs.)

Background: Major depression and alcohol dependence co-occur within individuals and families to a higher than expected degree. This study investigated whether mood-related drinking motives mediate the association between major depression and alcohol dependence, and what the genetic and environmental bases are for this relationship. Methods: The sample included 5,181 individuals from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders, aged 30 and older. Participants completed a clinical interview which assessed lifetime major depression, alcohol dependence, and mood-related drinking motives. Results: Mood-related drinking motives significantly explained the depression-alcohol dependence relationship at both the phenotypic and familial levels. Results from twin analyses indicated that for both males and females, the familial factors underlying mood-related drinking motives accounted for virtually all of the familial variance that overlaps between depression and alcohol dependence. Conclusions: The results are consistent with an indirect role for mood-related drinking motives in the etiology of depression and alcohol dependence, and suggest that mood-related drinking motives may be a useful index of vulnerability for these conditions.

Zhang HP; Kranzler HR; Weiss RD; Luo XG; Brady KT; Anton RF. Pro-opiomelanocortin gene variation related to alcohol or drug dependence: Evidence and replications across family- and population-based studies. Biological Psychiatry 66(2): 128-136, 2009. (41 refs.)

Background: Opioidergic neurotransmission is critical in many, possibly all, forms of substance dependence. Several opioid-system genes have been shown to be associated with substance dependence disorders. The pro-opiomelanocortin gene (POMC) encodes several peptides important for endogenous opioidergic neurotransmission. We tested whether POMC genetic variation affects risk for substance dependence. Methods: Five single nucleotide polymorphisms spanning POMC were examined in independent family and case-control samples. Family-based studies included 854 subjects from 319 African American (AA) families and 761 subjects from 313 European American (EA) families. Each family had a pair of siblings affected with cocaine and/or opioid dependence. Case-control studies included 791 cases (455 AAs and 336 EAs) affected with alcohol, cocaine, and/or opioid dependence and 682 control subjects (199 AAs and 483 EAs). Results: Family-based analyses revealed an association of rs6719226 with opioid dependence in AA families and rs6713532 with cocaine dependence in EA families (p = .010-044). Case-control analyses demonstrated an association of rs6713532 with alcohol or cocaine dependence in EAs (Pallele-wise = .003-008). Moreover, the minor allele of rs1866146 was found to be a risk factor for cocaine or opioid dependence in AAs (p(allele-wise) = .010-.017) and for alcohol, cocaine, or opioid dependence in EAs (p(allele-wise) = .001-.003). Logistic regression analyses in which sex and age were considered and population stratification analyses confirmed these findings. Additionally, specific haplotypes increased risk for cocaine dependence (p = .023) in AAs and opioid dependence (p = .012) in EAs. Conclusions: Given these replicated results, we conclude that variation in POMC confers vulnerability to multiple forms of substance dependence.