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CORK Bibliography: Parenting

104 citations. January 2008 to present

Prepared: September 2009

Abar C; Abar B; Turrisi R. The impact of parental modeling and permissibility on alcohol use and experienced negative drinking consequences in college. Addictive Behaviors 34(6-7): 542-547, 2009. (42 refs.)

This study examined the impact of parental modeled behavior and permissibility of alcohol use in late high school on the alcohol use and experienced negative drinking consequences of college students. Two-hundred ninety college freshmen at a large university were assessed for perceptions of their parents' permissibility of alcohol use, parents' alcohol-related behavior, and own experienced negative consequences associated with alcohol use. Results indicate that parental permissibility of alcohol use is a consistent predictor of teen drinking behaviors, which was strongly associated with experienced negative consequences. Parental modeled use of alcohol was also found to be a risk factor. with significant differences being seen across the gender of the parents and teens. Discussion focuses on risk factors and avenues for prevention research.

Ackerman JP; Llorente AM; Black MM; Ackerman CS; Mayes LA; Nair P. The effect of prenatal drug exposure and caregiving context on children's performance on a task of sustained visual attention. Journal of Developmental and Behavioral Pediatrics 29(6): 467-474, 2008. (56 refs.)

Objectives: Three groups of children from low-income, urban environments were examined to determine the effects of prenatal drug exposure (PDE) and caregiving environment on sustained visual attention (SVA) at 7 years of age. Methods: Drug-exposed children remaining in maternal care (n = 43), drug-exposed children placed in nonmaternal care (n = 45), and community comparison (CC) children (n = 56) were administered a battery of neurocognitive tests, including the Conners' Continuous Performance Test (CPT). Results: PDE children remaining in maternal care displayed more omission errors than CC children. PDE children in nonmaternal care had intermediate scores that did not differ significantly from PDE children in maternal care or CC children. There were no group differences with respect to commission errors or reaction time. CPT errors of omission and commission were significantly correlated with parent-reported attention problems and academic achievement scores. Conclusions: PDE in the context of care provided by a maternal caregiver with persistent drug use patterns may contribute to problems in children's SVA at school-age. As parental drug abuse can interfere with the provision of early care, children raised in a drug-using context may be highly vulnerable to problems with self-regulation, including sustained attention. SVA problems may contribute to subsequent academic and behavioral problems as demands for concentration and sustained effort increase throughout childhood. Children who have been prenatally exposed to drugs or raised in a drug-using household may benefit from early intervention services to avoid problems in SVA that may interfere with subsequent neurocognitive

Ames SC; Rock E; Hurt RD; Patten CA; Croghan IT; Stoner SM et al. Development and feasibility of a parental support intervention for adolescent smokers. Substance Use & Misuse 43(3/4): 497-511, 2008. (31 refs.)

The aim of this investigation was to develop and evaluate the feasibility and acceptability of a parental support intervention. A new measure of perceived parental support for stopping smoking was also developed. The sample included 59 adolescent-parent pairs recruited from a mid-sized Midwestern town during 2000-2003. The mean SD age of the participants (32 males, 27 females) was 16.3 0.9 (range 14-18) years and 86% were Caucasian, 7% American Indian, 5% African American, and 2% Hispanic. Participants were randomized to parental support or minimum behavioral intervention. Severity of nicotine dependence was evaluated using the Fagerstrm Tolerance Questionnaire, and perceived social support was evaluated using the Family Environment Scale and the new measure of perceived parent support for stopping smoking that was developed as part of this investigation. Treatment attendance, adherence, and acceptability were also evaluated. The parental support intervention was feasible but not superior to the minimum behavioral intervention with respect to attendance, retention, or change in support. This study expands on the knowledge of treating adolescent smokers and presents a new assessment measure. The study's limitations are noted. This investigation was funded by NICHHD.

Arditti J; Few A. Maternal distress and women's reentry into family and community life. Family Process 47(3): 303-321, 2008. (45 refs.)

This paper advances conceptualization of maternal distress following incarceration. We utilized a multiple case study methodology based on interviews with 10 mothers who demonstrated various permutations of "the triple threat" (depression, domestic violence, and substance abuse; Arditti & Few, 2006). Findings suggest that depressive symptomology persisted and worsened for mothers in our study and that maternal distress was indicative not only of women's psychological state, but also a relational and situational construct that embodied women's core experience. Maternal distress was largely characterized by health challenges, dysfunctional intimate relationships, loss related trauma, guilt and worry over children, and economic inadequacy. Further, maternal distress seemed to be intensified by the punitive traumatic context of prison and lessened by rehabilitation opportunities as well as support by kin and probation officers after reentry. Recommendations for clinicians and professionals who work with reentry mothers center around the need to alleviate maternal distress and better address women's emotional and physical health needs during incarceration and reentry.

Arria AM; Kuhn V; Caldeira KM; O'Grady KE; Vincent KB; Wish ED. High school drinking mediates the relationship between parental monitoring and college drinking: A longitudinal analysis. Substance Abuse Treatment, Prevention and Policy 3: e-article 6, 2008. (58 refs.)

Background: College drinking is a significant public health problem. Although parental monitoring and supervision reduces the risk for alcohol consumption among younger adolescents, few studies have investigated the impact of earlier parental monitoring on later college drinking. This study examined whether parental monitoring indirectly exerts a protective effect on college drinking by reducing high school alcohol consumption. Methods: A longitudinal cohort of 1,253 male and female students, ages 17 to 19, attending a large, public, mid-Atlantic university was studied at two time points. First, data on high school parental monitoring and alcohol consumption were gathered via questionnaire during the summer prior to college entry. Second, during the first year of college, past-year alcohol consumption was measured via a personal interview. Multiple regression models tested the relationship between parental monitoring and past year alcohol use (i.e., number of drinks per drinking day). Results: Holding constant demographics, SAT score, and religiosity, parental monitoring had a significant protective effect on both high school and college drinking level. However, the association between parental monitoring and college drinking level became non-significant once high school drinking level was held constant. Conclusion: While parental monitoring did not directly influence college alcohol consumption, evidence for mediation was observed, whereby parental monitoring had an indirect influence on college drinking through reductions in high school drinking. Initiatives that promote effective parenting might be an important strategy to curb high-risk drinking among older adolescents. More research is needed to understand the nature and degree of parent-child communication that is necessary to extend the protective influence of parents into the college years.

Bagner DM; Sheinkopf SJ; Miller-Loncar C; LaGasse LL; Lester BM; Liu J et al. The effect of parenting stress on child behavior problems in high-risk children with prenatal drug exposure. Child Psychiatry & Human Development 40(1): 73-84, 2009. (31 refs.)

Objective: To examine the relationship between early parenting stress and later child behavior in a high-risk sample and measure the effect of drug exposure on the relationship between parenting stress and child behavior. Methods: A subset of child-caregiver dyads (n = 607) were selected from the Maternal Lifestyle Study (MLS), which is a large sample of children (n = 1,388) with prenatal cocaine exposure and a comparison sample unexposed to cocaine. Of the 607 dyads, 221 were prenatally exposed to cocaine and 386 were unexposed to cocaine. Selection was based on the presence of a stable caregiver at 4 and 36 months with no evidence of change in caregiver between those time points. Results: Parenting stress at 4 months significantly predicted child externalizing behavior at 36 months. These relations were unaffected by cocaine exposure suggesting the relationship between parenting stress and behavioral outcome exists for high-risk children regardless of drug exposure history. Conclusions: These results extend the findings of the relationship between parenting stress and child behavior to a sample of high-risk children with prenatal drug exposure. Implications for outcome and treatment are discussed.

Baird C. Treating women with children: What does the evidence say? Journal of Addictions Nursing 19(2): 83-85, 2008. (12 refs.)

This systematic review of the literature examines the barriers women, especially women who are pregnant and parenting, experience when they attempt to access treatment for a substance use problem. These barriers impact their rate of entering and successfully completing treatment thus preventing them from returning to full participation in society. A provider of residential treatment for women with substance use disorders wants to develop a program that can reduce or remove some of these barriers. Does the evidence support a practice change to a gender specific, comprehensive inpatient residential treatment program for women who are pregnant and parenting?.

Bandi P; Cokkinides VE; Westmaas JL; Ward E. Parental communication not to smoke and adolescent cigarette smokers' readiness to quit: Differences by age. Journal of Adolescent Health 43(6): 612-615, 2008. (10 refs.)

There is limited information on the relationship between parental practices that specifically discourage current cigarette smoking and adolescent cessation, and how this relationship varies by age. Among 1629 adolescent smokers, self-reported receipt of parental communication not to smoke was significantly and positively associated with readiness to quit. The strength and significance of this association decreased from early to middle adolescence and was not significant in late adolescence.

Blokland EAWD; Engels RC; Harakeh Z; Hale WW; Meeus W. If parents establish a no-smoking agreement with their offspring, does this prevent adolescents from smoking? Findings from three Dutch studies. Health Education & Behavior 36(4): 759-776, 2009. (29 refs.)

Data from three studies were used to investigate whether the establishment of a no-smoking agreement is related to lower odds of adolescent smoking. The prevalence of a no-smoking agreement was first explored by using a national sample involving 4,501 Dutch adolescents. Second, data from a longitudinal study among 595 early adolescents and their parents were used to test whether establishing a no-smoking agreement prevents adolescents from smoking. Third, the authors tested among 856 early-and mid-adolescents and their parents, whether in addition to the establishment of a no-smoking agreement, the frequency and quality of communication on smoking issues had an effect on adolescent smoking. The findings do not support that establishing a no-smoking agreement is an effective deterrent with regard to adolescent smoking. Parents who want to prevent smoking might consider focusing their efforts on establishing a good quality of communication on smoking issues whereas parents who just talk a lot about smoking issues without considering the quality of their communication might do more harm than good.

Blomeyer D; Laucht M. Hazardous alcohol consumption in adolesccence. Findings from the Manheim longitudinal study. (German). Psychotherapeut 54(3): 179-+, 2009. (29 refs.)

Binge drinking is common in adolescents. Externalizing behavior disorders, novelty seeking, lack of parental monitoring, delinquency and deviant peer affiliations are regarded as major risk factors. In the framework of a prospective longitudinal study, the specific explanatory power of these risk factors for variation in hazardous drinking behavior (here: maximum amount of alcohol drunk on one single occasion) of 15-year-old is determined. A stepwise linear regression analysis revealed statistically significant independent contributions to the maximum amount of alcohol drunk on one single occasion for all risk factors. This implies that each of the risk factors investigated plays a unique role for adolescent binge drinking and provides clues for the conception of preventive strategies. Possible preventive measures derived from these findings are discussed.

Brody GH; Beach SRH; Philibert RA; Chen YF; Lei MK; Murry VM et al. Parenting moderates a genetic vulnerability factor in longitudinal increases in youths' substance use. Journal of Consulting and Clinical Psychology 77(1): 1-11, 2009. (87 refs.)

The authors used a longitudinal, prospective design to investigate a moderation effect in the association between a genetic vulnerability factor, a variable nucleotide repeat polymorphism in the promoter region of 5HTT (5-HTTLPR), and increases in youths' substance use. The primary study hypothesis predicted that involved-supportive parenting would attenuate the link between the 5-HTTLPR polymorphism and longitudinal increases in substance use. African American youths residing in rural Georgia (N = 253, mean age = 11.5 years) provided 4 waves of data on their own substance use; the mothers of the youths provided data on their own parenting practices. Genetic data were obtained from youths via saliva samples. Latent growth curve modeling indicated that 5-HTTLPR status (presence of I or 2 copies of the s allele) was linked with increases in substance use over time; however, this association was greatly reduced when youths received high levels of involved-supportive parenting. This study demonstrates that parenting processes have the potential to ameliorate genetic risk.

Casanueva C; Martin SL; Runyan DK; Barth RP; Bradley RH. Parenting services for mothers involved with child protective services: Do they change maternal parenting and spanking behaviors with young children? Children and Youth Services Review 30(8): 861-878, 2008. (76 refs.)

The most common service provided to parents involved with Child Protective Services (CPS) is parenting training. Nevertheless, most of the programs currently in use with CPS families lack empirical research documenting the effect of parenting training. Moreover, studies of these programs lack observational data with independent reports about changes in parent-child behaviors. Using a nationally representative sample of families investigated by CPS, the authors assessed whether parenting training was related to changes in parenting practices 18 months after training, controlling for maternal, child, and family characteristics. Mothers who received parenting services were compared with mothers who did not receive services even though they had a similar need for services as determined by Propensity Score Matching. This study found some modest benefits in maternal responsiveness and total parenting scores for mothers of 3- to 5-year-old children when these mothers received parenting services, as compared with mothers that did not receive parenting services. However, these findings could not be confirmed with multivariate analysis. These results parallel previous findings that parent training obtained through the Child Welfare System lacks the requisite features to significantly change parenting practices, and they highlight the need for cohesive, national, evidence-based effective parenting training for families involved with CPS.

Chinsembu KC; Siziya S; Mulla AS; Rudtsikira E. Prevalence and social correlates of sexual intercourse among schoolgoing adolescents in Namibia. Journal of Social Aspects of HIV-AIDS 5(3): 129-135, 2008. (41 refs.)

Adolescent sexuality is an important public health issue, as it affects risk to contract HIV and other sexually transmitted infections. The assessment of prevalence of sexual intercourse among adolescents is of public health significance, as it may guide policies and programmes aimed at reducing the transmission of sexually transmitted infections among this age group. This cross-sectional study using standardised methodology was conducted to assess the prevalence and correlates of sexual intercourse among Namibian schoolgoing adolescents in 2004. Overall the prevalence of sexual intercourse was 33.2% (44.0% males and 24.8% females). Variables positively associated with the outcome in multivariate analysis were male gender (OR=2.39; 95% CI (1.81, 3.17)), cigarette smoking (OR= 1.67; 95% CI (1.07, 2.63)), alcohol drinking (OR= 1.63; 95% Cl (1. 18, 2.26)), and drug use (OR=9.82; 95% CI (6.28, 15.36). Parental supervision was negatively associated with sexual intercourse in the last 12 months (OR=0.73; 95% Cl (0.56, 0.94)). Efforts to control unhealthy lifestyles (smoking, alcohol and illicit drug use) may impact on adolescents' sexual activity.

Choi Y; He M; Harachi TW. Intergenerational cultural dissonance, parent-child conflict and bonding, and youth problem behaviors among Vietnamese and Cambodian immigrant families. Journal of Youth and Adolescence 37(1): 85-96, 2008. (62 refs.)

Intergenerational cultural dissonance (ICD)-a clash between parents and children over cultural values-is a frequent issue for Asian American youth. Using longitudinal data from the Cross Cultural Families Project, this study examines the mechanisms by which ICD contributes to problem behaviors, including whether ICD predicts parent-child conflict, whether parent-child conflict then has a direct effect on youth problem behavior, and whether positive bonding with parents mediates the effects of such conflict on youth problem behaviors among Vietnamese (n = 164) and Cambodian (n = 163) families with adolescents [average age = 15.2 years (SD = 1.05)]. The results from the path analyses show that, in both groups, ICD indirectly predicts problem behaviors by increasing parent-child conflict, which in turn weakens positive parent-child bonding. Interventions that target youths' perception of intergenerational cultural gaps, help them manage conflict, and help strengthen bonds with parents may prevent problem behaviors among Cambodian and Vietnamese families. This study contributes to inform how to effectively prevent problems and difficulties among these families.

Chun TH; Sindelar-Manning H; Eaton CA; Lewander WJ; Spirito A. Parental factors influence teen alcohol use after an emergency department visit. Pediatric Emergency Care 24(10): 668-672, 2008. (44 refs.)

Objectives: To determine if parental factors are significant predictors of short-term adolescent drinking after an alcohol-related emergency department (ED) visit. Methods: Adolescents, 13 to 17 years, who either had evidence or reported usage of alcohol in the 6 hours before an ED visit, were eligible for this study. Alcohol use was assessed at baseline and at 3-month follow-up. Data on parental variables and parenting practices were collected at baseline. Linear regression models were created to determine the relationship between parental factors and follow-up drinking. Results: Parental alcohol use, socioeconomic status, and monitoring practices were significant predictors of adolescent alcohol use at 3-month follow-up. Conclusions: Parental factors may significantly influence subsequent adolescent drinking after an ED visit. These factors should be assessed when treating alcohol-positive teens, and parents should be advised to closely monitor their teens.

Crawford LA; Novak KB. Parent-child relations and peer associations as mediators of the family structure-substance use relationship. Journal of Family Issues 29(2): 155-184, 2008. (62 refs.)

Using data from the National Education Longitudinal Survey of 1988, the authors assess the extent to which adolescents' levels of parental attachment and opportunities for participating in delinquent activities mediate the family structure-substance use relationship. A series of hierarchical regressions supported the hypotheses that high levels of substance use among adolescents residing with stepfamilies would be explained by low parental attachment, whereas heightened opportunities for participating in deviant activities would account for the substance use behaviors of individuals living in single-parent households. More generally, the findings suggest that family structure has a moderate effect on youth substance use; that parental and peer relations are better predictors than family structure of levels of alcohol and marijuana consumption; and that variations in parental attachment, parenting style, and peer relations across family types explain some, but not all, of the effects of family structure on adolescents' substance use behaviors.

de Leeuw RNH; Scholte RHJ; Harakeh Z; van Leeuwe JFJ; Engels RCME. Parental smoking-specific communication, adolescents' smoking behavior and friendship selection. Journal of Youth and Adolescence 37(10): 1229-1241, 2008. (51 refs.)

In this study, we investigated whether parental smoking-specific communication is related to adolescents' friendship-selection processes. Furthermore, we investigated whether adolescents and their best friends influence each other over time, and what role parents play in this process. In the present study we used data from the Family and Health project in which at baseline 428 full families participated. In this 2-year, three-wave longitudinal study data were available from fathers, mothers, early adolescents (aged M = 13.4 years, SD = .50), and middle adolescents (aged M = 15.2 years, SD = .60). The majority of the participating adolescents were of Dutch origin (> 95%). There was an almost equal distribution of boys and girls, and adolescents with lower, middle, and higher educational levels were equally represented. Analyses were conducted by means of Structural Equation Modeling. Results demonstrate that a high quality of the smoking-specific communication is related to a lower likelihood of adolescent smoking, whereas the frequency is positively associated with adolescent smoking. Both the quality and frequency of parental smoking-specific communication were related to adolescents' selective affiliation with (non-)smoking friends. The findings suggest that parental smoking-specific communication is associated with adolescent smoking directly but also indirectly by influencing the friends the adolescents will associate with.

Dillon FR; Pantin H; Robbins MS; Szapocznik J. Exploring the role of parental monitoring of peers on the relationship between family functioning and delinquency in the lives of African American and Hispanic adolescents. Crime & Delinquency 54(1): 65-94, 2008. (65 refs.)

This cross-sectional study explores potential mediating effects of parental monitoring of peers on three adolescent problem behaviors (externalizing behavior, drug use, sexual risk behavior) among juvenile delinquents and their families. Participants are 190 African American and Hispanic adolescents and parent guardians enrolled in a family therapy treatment efficacy study targeting delinquency. Parental monitoring of peers mediates the association between family functioning and externalizing behavior in the full sample. Comparable results are not found in post hoc analyses of each racial and ethnic sample or among drug use and sexual risk behaviors. Research and health service implications are discussed.

Ditre JW; Coraggio JT; Herzog TA. Associations between parental smoking restrictions and adolescent smoking. Nicotine & Tobacco Research 10(6): 975-983, 2008. (46 refs.)

The purpose of this study was to examine the cross-sectional relation between reported levels of parental smoking restriction and several behavioral and cognitive variables in a sample of 757 (363 males, 394 females) adolescent smokers. Experimenters administered surveys to students in the homerooms of three Florida high schools. After controlling for student age, gender, and parental smoking status, results revealed that more restrictive parental smoking policies were significantly associated with less smoking on weekdays and weekend days, greater latency to smoking the first cigarette of the day, greater motivation to quit smoking, greater confidence in ability to quit smoking, and higher estimated risk perception regarding the health consequences of smoking. Results also revealed that 44% of adolescent smokers reported that their parents or legal guardians did not know that they smoked tobacco. These findings suggest that parental smoking restrictions may have the potential to impede adolescent progression to adult smoking behavior by reducing smoking rates and nicotine dependence, and increasing motivation to quit, self-confidence to quit, and health risk perception. Parental restrictions on smoking may present obstacles and inconveniences to adolescent smoking behavior that make smoking cessation a more attractive option.

Dixon DR; Kurtz PF; Chin MD. A systematic review of challenging behaviors in children exposed prenatally to substances of abuse. (review). Research in Developmental Disabilities 29(6): 483-502, 2008. (67 refs.)

A review of the existing literature on the occurrence of challenging behavior among children with prenatal drug exposure was conducted. While a large number of studies were identified that evaluated various outcomes of prenatal drug exposure, only 37 were found that directly evaluated challenging behaviors. Of the 37 studies, 23 focused on prenatal cocaine exposure, and 14 focused on prenatal alcohol exposure; most studies relied on broadband measures such as the CBCL for the assessment of challenging behavior. Among the 37 studies, a clear role for the postnatal environment on developing challenging behaviors was evident; however, prenatal alcohol exposure showed a much clearer independent effect upon challenging behaviors than was noted in the prenatal cocaine studies. Additionally, only 3 of the 37 studies addressed interventions for challenging behaviors, each of which showed an improvement in child behavior or parent-child interactions. As researchers have continued to show the importance of the postnatal environment, it is likely that interventions addressing specific environmental risk factors will be helpful to reduce or prevent challenging behaviors among this population.

Ehrlich JB. Breaking the law by giving birth: The war on drugs, the war on reproductive rights, and the war on women. New York University Review of Law & Social Change 32: 381-420, 2008. (310 legal refs.)

Summary... Prosecuting women who become mothers while simultaneously experiencing a drug addiction or engaging in drug use is not necessary to further the government's interest in promoting healthy fetuses and children. ... But, as this article will show, prosecuting as child abusers or even murderers the thousands of American women who carry pregnancies to term despite their drug addictions not only fails to further the states' goal of protecting fetal health, but also violates the constitutional rights of pregnant women. ... This article also argues that either intermediate or strict scrutiny - not the rational basis scrutiny the Supreme Court has often applied to distinctions based on pregnancy outside the employment context - is the proper lens through which to measure the equal protection violations at issue in the prosecutions of pregnant women for drug use. ... Finally, the claim that these prosecutions protect fetal health and encourage healthy births is betrayed by the fact that such prosecutions incentivize abortion by pressuring women to face a sort of Sophie's choice that weighs an unwanted abortion against a severe prison sentence and the relegation of a child to foster care. ... Geduldig, the Court indicated in Satty, should only apply when a state's conferral of benefits is at issue; when alleged pregnancy discrimination is based on a burden borne by only one sex, Geduldig does not apply and pregnancy discrimination may be sex discrimination. ... Applying Intermediate Scrutiny Since it is established that these prosecutions are gender discriminatory, intermediate scrutiny as interpreted under VMI - the standard applied to sex-discrimination claims - should apply. ... Women have been prosecuted due to their use of a range of drugs, but most used crack cocaine, which is often "associated with inner-city Blacks."

Eisenberg ME; Neumark-Sztainer D; Fulkerson JA; Story M. Family meals and substance use: Is there a long-term protective association? Journal of Adolescent Health 43(2): 151-156, 2008. (34 refs.)

Purpose: To examine 5-year longitudinal associations between family meal patterns and subsequent substance use in adolescents. Methods: A total of 806 Minnesota adolescents were surveyed in public schools in 1998-1999 (mean age, 12.8 years) and again by mail in 2003-2004 (mean age, 17.2 years) as part of a longitudinal population-based study. Logistic regression was used to estimate the odds of tobacco, alcohol, and marijuana use at follow-up for adolescents reporting regular farnily meals at baseline compared with those without regular family meals, adjusting for family connectedness and prior substance use. Results: Family meal frequency at baseline was associated with significantly lower odds of cigarette smoking, alcohol use, and rnarijuana use at follow-up among female adolescents, even after adjusting for baseline substance use and additional covariates. Family meals were not associated with use of any substance at follow-up for male adolescents after adjusting for baseline use. Conclusions: Results from this study suggest that regular family meals in adolescence may have a long-term protective association with the development of substance use over 5 years among females. Parents should be encouraged to establish a pattern of regular family meals, as this activity may have long lasting benefits.

Elkington KS; Bauermeister JA; Brackis-Cott E; Dolezal C; Mellins CA. Substance use and sexual risk behaviors in perinatally human immunodeficiency virus-exposed youth: Roles of caregivers, peers and HIV status. Journal of Adolescent Health 45(2): 133-141, 2009. (38 refs.)

Purpose: To examine the association between sexual risk behaviors and substance use, as well as the impact of caregiver characteristics and perceived peer norms among perinatally HIV-exposed but uninfected and perinatally HIV-infected youth. Methods: Using baseline data from a multisite study of psychosocial behaviors in perinatally HIV-exposed urban youth (N = 340; 61% HIV+; 51% female; aged 9-16 years). We conducted interviews with youth-caregiver dyads. Using hierarchical logistic regression, we explored the association between lifetime sexual risk behaviors, cigarettes, alcohol, marijuana, other drug use, caregiver relationship characteristics and peer influence. Results: Cigarettes, alcohol, and marijuana were significantly associated with HIV sexual risk behavior; no youth reported other drug use. After accounting for peer norms, the relationship between substance use and risky sexual behaviors was somewhat diminished. Irrespective of substance use, perception that more peers were involved in risky sex was associated with sexual risk behavior. Caregiver relationship characteristics had no effect on the association between substance use and risky sexual behavior. In all analyses, we found no effect across HIV status. Conclusions: Regardless of HIV status, perinatally exposed youth who use substances are more likely to engage in sexual risk behaviors. Although the current study shows that peer influence on risky sexual behavior is more robust, caregivers are still important. The pediatric and adolescent HIV community must develop multilevel prevention initiatives that target youth, their peers, and their families.

Ellickson PL; Tucker JS; Klein DJ. Reducing early smokers' risk for future smoking and other problem behavior: Insights from a five-year longitudinal study. Journal of Adolescent Health 43(4): 394-400, 2008. (45 refs.)

Purpose: To identify risk and protective factors during early and later adolescence that predict future regular smoking and multiple problem behavior among at-risk youth, defined as those who tried smoking by grade 7. Methods: At grades 7, 10, and 12, data were collected from 2,000 early Smokers drawn from California and Oregon. Multivariate regression analyses tested predictors of the two grade 12 outcomes in separate models using data from grades, 7 and 10. Gender interactions and buffering of risk factors by protective factors were assessed. Results: For at-risk youth, consistent protective factors against future smoking and problem behavior included living in an intact nuclear family (all four models) plus getting good grades and parental disapproval of smoking/drug use (three of four models). Consistent risk factors included exposure to substance-using peers (four models) and problems in school (three of four models). Adult Substance use was a predictor during early, but not later, adolescence pro-smoking/drug use beliefs were significant predictors during later adolescence. There were few differences across gender and no significant buffers against risk. Conclusions: At-risk youth would likely benefit from peer resistance training, parental involvement in prevention efforts, and efforts to improve educational performance during both middle school and high school. Changing pro-drug beliefs may be more effective among older adolescents.

Embry D; Hankins M; Biglan A; Boles S. Behavioral and social correlates of methamphetamine use in a population-based sample of early and later adolescents. (review). Addictive Behaviors 34(4): 343-351, 2009. (113 refs.)

This paper reports relationships between methamphetamine use and behaviors and social influences using data from a population-based survey of 8th- and 11th-grade students in Oregon for the 2001-2003 school years. We analyze methamphetamine use within a general problem behavior framework to identify malleable correlates of behavior for future prevention interventions. We specifically test two models of methamphetamine use employing logistic regression analysis: one comprised of behaviors and traits of the individual students and another focusing on peer and parental influences. This study finds adolescent methamphetamine use related to several problem behaviors. However, the specific problems vary by grade and are moderated by gender. Findings indicate the need for tailored interventions targeting gender/grade-specific behaviors or problems such as antisocial activities, risky sex, and depression, as well as social influences such as peers engaging in antisocial behaviors or using drugs and parents favoring drug use or poorly monitoring or setting limits for their children.

Farhadbiasab A; Allahverdipour H; Bashirian S; Malijoub H. Lifetime pattern of substance abuse, parental support, religiosity, and locus of control in adolescent and young male users. Iranian Journal of Public Health 37(4): 88-95, 2008. (32 refs.)

Background: In the current study, pattern of substance abuse among adolescence and early adulthood that have experienced one or more substances was assessed, and also parental support, religiosity, and locus of control were measured. Methods: This cross-sectional study was conducted in Hamadan City, Iran in 2006. All subjects were selected from Hamadan City (urban area), Iran based on snowball sampling method. Participants were males who used alcohol and illicit drugs in their life (n=398), completed a self-administered questionnaire. Results: Approximately half of the participants were used to smoke, drink, take marijuana and/or use opium regularly, and one in ten had taken ecstasy or heroin in the last weeks. Tobacco and alcohols were most common substance as a gateway and consequently marijuana and opium were the next substances. Initiation age result for using substance was ages 13 to 18 years. More than 90% classified as group who suffering familial support, 60.8% as low level of religiosity, and 51.5% of participants was external focus of control. Conclusion: Our findings were similar to western countries pattern except that for opium. The high rate substances use by adolescents and changes in pattern Of use Suggests that all drug use need to be taken into account when addressing adolescents' substance use. Moreover, research is needed to identify possible mechanisms underlying the association between binge drug uses in the vulnerable groups.

Feske U; Tarter RE; Kirisci L; Gao ZC; Reynolds M; Vanyukov M. Peer environment mediates parental history and individual risk in the etiology of cannabis use disorder in boys: A 10-year prospective study. American Journal of Drug and Alcohol Abuse 34(3): 307-320, 2008. (58 refs.)

Previous research has shown that a trait termed neurobehavior disinhibition (ND) measured in childhood predicts substance use disorder by young adulthood. The present investigation extends these findings by determining the degree to which peer environment mediates the association between ND and development of cannabis use disorder (CUD). ND was measured in a sample of 216 boys 10-12 years of age. The peer environment was assessed at age 16. Current CUD was determined at age 22. Paternal and maternal SUD predicted son's ND which, in turn, predicted son's peer environment and, subsequently, son's cannabis use frequency and CUD. Peer environment mediated the association between ND and cannabis use and ND and CUD. Maternal and paternal SUD predicted the peer environment. Parental SUD, son's ND, and son's peer environment predicted CUD at age 22 with 84% accuracy.

Fidler JA; West R; van Jaarsveld CHM; Jarvis MJ; Wardle J. Smoking status of step-parents as a risk factor for smoking in adolescence. Addiction 103(3): 496-501, 2008. (18 refs.)

Aim: To examine the extent to which smoking by step-parents and biological parents predicts adolescent smoking. Dsign: Five-year cohort study. Setting: Thirty-six schools in South London, England. Participants A subset of 650 students participating in the Health and Behaviour In Teenagers Study (HABITS), who reported living in step-families, were assessed annually from age 11-12 to age 15-16 years. Measurements: Students reported their smoking status, which was cotinine-verified, as well as whether their parents smoked and, if they lived with a step-parent, whether that step-parent smoked. Analyses also controlled for gender, ethnicity and deprivation. Findings Students who reported that just their step-parent smoked at age 11-12 were significantly more likely to report current smoking at any time-point from age 11-16 than those who reported having neither biological parents nor a step-parent who smoked [odds ratio (OR) 2.72, 95% confidence interval (CI) = 1.36-5.47], as were those with both a parent and a step-parent who smoked (OR 2.23, 95% CI = 1.46-3.41). While the association between smoking in students and smoking in biological parents in this subsample did not reach statistical significance (OR 1.39, 95% CI = 0.88-2.19), these students were no more or less likely to smoke than those with just a step-parent who smoked. Conclusion: Smoking by a non-biological parent appears at least as influential as smoking by biological parents. This confirms the importance of social influence on smoking initiation and suggests that attempts to work with parents in smoking prevention should involve, and perhaps pay particular attention to, step-parents who smoke.

Fitzsimons GJ; Moore SG. Should we ask our children about sex, drugs and rock & roll? Potentially harmful effects of asking questions about risky behaviors. Journal of Consumer Psychology 18(2): 82-95, 2008. (93 refs.)

Research shows that asking questions can fundamentally change behavior. We review literature on this question-behavior effect, which demonstrates that asking questions changes both normal and risky behaviors. We discuss potential explanations for the effect and review recent findings that reveal interesting moderators of the influence of questions on behavior. We then highlight the potential impact of the question-behavior effect in an important public health context: screening adolescents for risky behavior. While medical guidelines emphasize the importance of asking adolescents questions about substance (drug, alcohol) use and sexual behaviors, research on the question-behavior effect suggests that asking adolescents about risky behaviors has the potential to increase the frequency with which they engage in these behaviors. We argue that the act of screening or measuring risky behavior is potentially counterproductive. We emphasize the importance of interventions beyond screening, and suggest ways in which screening can be carried out to minimize its impact. in short, asking questions about behaviors can change behavior, and asking questions about risky behaviors may itself be a risky undertaking.

Forrester D; Harwin J. Parental substance misuse and child welfare: Outcomes for children two years after referral. British Journal of Social Work 38(8): 1518-1535, 2008. (34 refs.)

This paper reports on placement and welfare outcomes for children allocated a social worker where there was a concern about parental misuse of drugs or alcohol. All files going for allocation for long term work in four London boroughs over on average one year were examined (290 families). Of the 290, 100 families with 186 children involved concerns about parental substance misuse. File studies were carried out at allocation and two years post-referral for these children. At follow-up only 46% of the children remained with their main carer, with 26% living in the wider family and 27% in the formal care system. Logistic regression found the factors associated with children remaining at home were parental heroin misuse, violence and one or more parents being a first generation immigrant; factors associated with children moving were the child being a baby identified as at risk of harm and particular combinations who misused and family structure. A rating of welfare outcome was made based on educational, emotional/behavioural and health development. At follow-up, 47% of children had no problems, 31% had continuing problems and 22% had problems in more areas than at allocation. Regression analysis found the factors associated with poor welfare outcome were children remaining at home, domestic violence, alcohol misuse and being a boy. The combination of a high proportion of children moving carer and poor outcomes for those at home suggests that attention needs to be paid to improving outcomes in this area.

Freisthler B; Weiss RE. Using Bayesian space-time models to understand the substance use environment and risk for being referred to child protective services. Substance Use & Misuse 43(2): 239-251, 2008. (30 refs.)

Parental substance misuse has often been cited as a cause of children being referred for investigation of child abuse and neglect. Research on how the substance use environment might affect this relationship is still in its infancy with primarily only cross-sectional studies finding a positive relationship of alcohol outlet density at the level of neighborhoods and alcohol prices at level of states and maltreatment. A longitudinal study shows that increasing female drug-related arrests are related to increasing rates of maltreatment in rural and urban counties. The current study incorporates three aspects of the substance use environment in a panel study of 58 California counties over 4 years (n = 232) to study this relationship for referrals to child protective services (CPS) for child abuse and neglect. We use conditionally autoregressive (CAR) Bayesian models to model the spatial and temporal structure in the data. We find that use of welfare benefits, the number of outliers per population, and the number of drug-related arrests per population are positively related to referrals while unemployment and admissions to publicly funded alcohol and drug user treatment programs are negatively correlated to referrals. Significant spatial structure and space-time relationships are also found. The findings indicate that supply of alcohol and drugs (as measured by number of alcohol outlets and arrests for drug use and sales) may increase risk for being referred to CPS, but treatment for substance use does not increase the risk for referral.

Fuchs W; Martens MS; Verthein U. Opioid addicted parents with dependent children - Life situation and risk indicators (German). Suchttherapie 9(3): 130-135, 2008. (21 refs.)

This study aims to empirically explore the connection between parenthood and addiction in terms of the best interest and welfare of the children. Three groups of opioid addicts are compared with regard to fifteen risk indicators (concerning drug use, traumatic live experiences, social circumstances and health): parents who do have care of their children, parents not living with their children and drug users without children. The data set is derived from the documentary system of the Hamburg outpatient drug treatment services (n=4971). 30.3% of the patients have children. Only 35.9% of the parents live together with their children and exercise parenthood. Parents with children at home showed the lowest, parents with children living elsewhere the highest prevalence for almost all of the risk indicators. More appropriate help should be offered to drug using parents in order to empower them to keep their children. However, top priority must be given to the best interest and welfare of the children.

Fulkerson JA; Pasch KE; Perry CL; Komro K. Relationships between alcohol-related informal social control, parental monitoring and adolescent problem behaviors among racially diverse urban youth. Journal of Community Health 33(6): 425-433, 2008. (57 refs.)

The purpose of the present study is to investigate the relationships between alcohol-related informal social control and parental monitoring on alcohol use, behavior and intentions; violent behavior; and delinquent behavior in a racially diverse population of young urban adolescents. Baseline surveys were administered to 6th grade male and female students in 61 urban Chicago schools as part of Project Northland Chicago, a group randomized trial for the prevention/reduction of substance use. A subset of their parents (n = 3,034) was also surveyed regarding alcohol use, violence, and delinquency and related issues. Structural equation modeling was used to assess relationships between alcohol-related informal social control (as measured by parental perceptions of neighborhood action regarding youth drinking) and parental monitoring (as reported by parents), and three adolescent outcomes (alcohol use, behaviors and intentions; violent behavior; and delinquent behavior; as reported by teens). Associations between alcohol-related informal social control and parental monitoring were positive and significant (P < .001). Direct paths from parental monitoring to all three adolescent outcomes were negative and statistically significant (alcohol use, behaviors and intentions, P < .001; violent behavior, P < .001; and delinquent behavior, P < .001). Alcohol-related informal social control was not significantly associated with adolescent outcomes. Efforts to engage parents to be more active in monitoring adolescents' activities may be related to lower levels of underage drinking, violence and delinquency among both female and male urban youth. Neighborhood norms and action against teenage drinking may be too distal to adolescent outcomes to be directly associated.

Gerra G; Leonardi C; Cortese E; Zaimovic A; Dell'Agnello G; Manfredini M et al. Childhood neglect and parental care perception in cocaine addicts: Relation with psychiatric symptoms and biological correlates. (review). Neuroscience and Biobehavioral Reviews 33(4, Special Issue): 601-610, 2009. (68 refs.)

Childhood neglect and poor child-parent relationships have been reported to increase substance use disorders susceptibility. Stressful environmental factors, including emotional neglect, could affect individual personality traits and mental health, possibly inducing stable changes in hypothalamic-pituitary-adrenal (HPA) axis and brain mono-amine function, in turn involved in addictive behavior vulnerability. Therefore, we decided to investigate homovanillic (HVA) and prolactin (PRL) plasma levels, as expression of possible changes in dopamine function, ACTH and cortisol plasma levels, as measures of HPA axis function, and concomitant psychiatric symptoms profile in abstinent cocaine addicts, in relationship to their childhood history of neglect and poor parental care perception. Methods: Fifty abstinent cocaine dependent patients, and 44 normal controls, matched for age and sex, were submitted to a detailed psychiatric assessment (DSM IV criteria). All patients and controls completed the Symptoms Check List-90 (SCL-90) and the Buss Durkee Hostility Inventory (BDHI), to evaluate psychiatric symptoms frequency and aggressiveness levels. The Childhood Experience of Care and Abuse-Questionnaire (CECA-Q) and Parental Bonding Instrument (PBI) have been used to retrospectively investigate parent-child relationships. Blood samples were collected to determine HVA, PRL, ACTH and cortisol basal plasma levels. Results: Cocaine addicted individuals in general showed significantly lower HVA, and higher PRL, ACTH and cortisol basal levels respect to controls. In particular, neuroendocrine changes characterized cocaine addicts with childhood history of neglect and low perception of parental care. Obsessive-compulsive, depression and aggressiveness symptoms have been found related to poor parenting, inversely associated to HVA levels and directly associated to PRL, ACTH and cortisol levels. Conclusions: These findings suggest the possibility that childhood experience of neglect and poor parent-child attachment may partially contribute to a complex neurobiological derangement including HPA axis and dopamine system dysfunctions, playing a crucial role in addictive and affective disorders susceptibility.

Gerra G; Leonardi C; Cortese E; Zaimovic A; Dell'Agnello G; Manfredini M et al. Adrenocorticotropic hormone and cortisol plasma levels directly correlate with childhood neglect and depression measures in addicted patients. Addiction Biology 13(1): 95-104, 2008. (53 refs.)

Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been reported to be involved in vulnerability to alcohol and drug dependence in humans, possibly underlying both addictive behaviour and depression susceptibility. The aim of the present study was to investigate the possible interactions between childhood adverse experiences, depressive symptoms and HPA axis function in addicted patients, in comparison with healthy control. Eighty-two abstinent heroin or cocaine dependent patients and 44 normal controls, matched for age and sex, completed the symptoms Check List-90 (SCL-90), measuring depressive symptoms, and the Childhood Experience of Care and Abuse Questionnaire. Blood samples were collected to determine adrenocorticotropic hormone (ACTH) and cortisol basal plasma levels at 8:00 and 8:30 a.m. Addicted individuals showed significantly higher neglect and depression scores and ACTH-cortisol plasma levels respect to control subjects. Depression scores at SCL-90 in addicted patients positively correlated with plasma ACTH and cortisol values. In turn, plasma ACTH levels were directly associated with childhood neglect measures, reaching statistical significance with 'mother-neglect' scores. Plasma cortisol levels were related to 'father antipathy' among cocaine addicts. These findings suggest the possibility that childhood experience of neglect and poor parent-child attachment may have a persistent effect on HPA axis function as an adult, partially contributing, together with genetic factors and other environmental conditions, to both depressive traits and substance abuse neurobiological vulnerability.

Greene K; Banerjee SC. Examining unsupervised time with peers and the role of association with delinquent peers on adolescent smoking. Nicotine & Tobacco Research 11(4): 371-380, 2009. (52 refs.)

This study explored the association between unsupervised time with peers and adolescent smoking behavior both directly and indirectly through interaction with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers. A cross-sectional survey was used for the study and included 248 male and female middle school students. Results of structural equation modeling revealed that unsupervised time with peers is associated indirectly with adolescent smoking behavior through the mediation of association with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers. Interventions designed to motivate adolescents without adult supervision to associate more with friends who engage in prosocial activities may eventually reduce adolescent smoking. Further implications for structured supervised time for students outside of school time are discussed.

Grella CE; Needell B; Shi YF; Hser YI. Do drug treatment services predict reunification outcomes of mothers and their children in child welfare? Journal of Substance Abuse Treatment 36(3): 278-293, 2009. (67 refs.)

The effect of mothers' participation in substance abuse treatment on reunification with their children who are in out-of-home care is an important policy issue. This article examines the predictors of child reunification among mothers who participated in a statewide treatment outcome study. Data were integrated from multiple sources to determine the contributions of characteristics of mothers (n = 1, 115), their children (n = 2,299), and treatment programs (n = 43) on reunification outcomes. Hierarchical linear modeling was used to determine the fixed and random effects of mother, child, and program characteristics. Mothers with more employment and psychiatric problems were less likely to be reunified with their children; completion of 90 or more days in treatment approximately doubled their likelihood of reunification. Mothers who were treated in programs providing a "high" level of family-related or education/employment services were approximately twice as likely to reunify with their children as those who were treated in programs with "low" levels of these services.

Haggerty KP; Skinner M; Fleming CB; Gainey RR; Catalano RF. Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction 103(12): 2008-2016, 2008. (60 refs.)

This study examines the efficacy of the Focus on Families project (currently called Families Facing the Future), a preventive intervention to reduce substance use disorders among children in families with a parent in methadone treatment. One hundred and thirty families were assigned randomly to a methadone clinic treatment-as-usual control condition or treatment-as-usual plus the Focus on Families intervention between 1991 and 1993. Participants were recruited from two methadone clinics in the Pacific Northwest. This study examines the development of substance use disorders among the 177 children (56.84% male) involved in the program using data from a long-term follow-up in 2005, when these participants ranged in age from 15 to 29 years. The intervention was delivered through group parent-training workshops at the methadone clinics and through individualized home-based services. The intervention taught parenting skills and skills for avoiding relapse to drug abuse. At long-term follow-up, substance use disorders were measured by the Composite International Diagnostic Interview (CIDI). Survival analyses were used to assess intervention versus control differences in the hazard of developing substance use disorders. Overall, intervention and control participants did not differ significantly in risk of developing substance use disorders. However, there was evidence of a significant difference in intervention effect by gender. There was a significant reduction in the risk of developing a substance use disorder for intervention group males compared to control group males (hazard ratio = 0.53, P = 0.03), while intervention versus control differences among females were non-significant and favored the control condition. Results from this study suggest that helping parents in recovery focus on both reducing their drug use and improving their parenting skills may have long-term effects on reducing substance use disorders among their male children. However, the overall long-term benefits of this program are not supported by the results for female children.

Haight WL; Carter-Black JD; Sheridan K. Mothers' experience of methamphetamine addiction: A case-based analysis of rural, midwestern women. Children and Youth Service Review 31(1): 71-77, 2009. (28 refs.)

Engaging mothers who are abusing methamphetamine in services is an important goal for rural child welfare. Four rural, white, mothers in recovery from methamphetamine addiction described their life experiences through in-depth interviews. Three of the women grew up with parents who abused drugs, and all had experienced trauma as children and used other illegal drugs before methamphetamine. Mothers vividly portrayed the rapid loss of control that can occur with methamphetamine use, as well as the power of the addiction. They became "obsessed" with the drug and nothing was more important to them, not even the children whom they loved. They lost the ability to think "rationally," experienced serious lapses in judgment, lost motivation, and lived in a "fog." They described their illness as impacting their children's physical and psychological well-being including through exposure to domestic violence, adult substance abuse and other anti-social behavior, and loss of important relationships. They expressed concern that their children would abuse drugs. Women described recovery as possible only with significant external support, and they reported lasting physical, psychological and social side effects of their illness. Understanding mothers' experience of methamphetamine addiction can increase our awareness of this illness thereby reducing stigma and suggesting strategies for engaging them in intervention.

Hall JC. The impact of kin and fictive kin relationships on the mental health of Black adult children of alcoholics. Health and Social Work 33(4): 259-266, 2008. (19 refs.)

The purpose of this qualitative study was to examine how kin and fictive kinship relationships help to ameliorate or buffer responses to parental alcoholism and the breakdown in parenting. This qualitative study investigated coping responses developed by college students, who self-identified as adult children of alcoholics (ACOAs) who lived with an alcoholic parent or caregiver. In-depth interviews and follow-up participant checks were used. A descriptive model was developed describing conditions that affected the development of positive self-esteem, the phenomena that arose from those conditions, the context that influenced strategy development, the intervening conditions that influenced strategy development, and the consequences of those strategies. Subcategories of each component of the descriptive model are identified and illustrated by narrative data in relation to the ACOAs' psychological well-being. Implications for research, policy, and practice are discussed.

Handley ED; Chassin L. Stress-induced drinking in parents of adolescents with externalizing symptomatology: The moderating role of parent social support. American Journal on Addictions 17(6): 469-477, 2008. (44 refs.)

Parenting adolescents with externalizing symptomatology has been repeatedly shown to be stress-inducing for parents. One possible coping strategy for parents dealing with this chronic stress may be drinking. The current study extended previous research by examining the prospective relations between adolescents' externalizing behaviors and parents' negative affect and alcohol consumption. Additionally, the present study tested whether this mediated effect is a function of parental social support. Adolescents' externalizing symptoms prospectively predicted mothers' negative affect. Interestingly, however, mothers' negative affect prospectively predicted mothers' drinking only for those mothers with low social support. Furthermore, the mediated effect (Wave 1 adolescent externalizing symptoms Wave 2 mother negative affect Wave 3 mother drinking) was significant only for mothers with low social support. There were no effects of adolescents' externalizing symptoms on fathers.

Hanewinkel R; Morgenstern M; Tanski SE; Sargent JD. Longitudinal study of parental movie restriction on teen smoking and drinking in Germany. Addiction 103(10): 1722-1730, 2008. (40 refs.)

Aims To determine if adolescents who report that their parents restrict viewing movies based on rating have a lower risk of trying smoking and drinking alcohol in the future. Design: Prospective observational study. A cohort of 2110 German adolescents younger than 15 years who had never smoked or drunk alcohol at baseline were surveyed 12-13 months later to determine smoking and binge drinking initiation. Risk of substance use was assessed as a function of parental restriction on viewing FSK-16 movies (movies that only those aged 16 years and over would be allowed to see in theaters). Findings The percentage of students who tried smoking was 16.3%, 10.9% initiated binge drinking and 5.0% used both substances during the follow-up period. There was a significant effect of parental movie restriction on each substance use outcome measure after controlling for covariates. Compared with adolescents whose parents never allowed them to view FSK-16 movies, the adjusted relative risk [(RR) (95% confidence interval (CI)] for use of both substances were 1.64 (1.05-2.58) for adolescents allowed to view them once in a while, 2.30 (1.53-3.45) for sometimes and 2.92 (1.83-4.67) for all the time. FSK-16 restrictions were associated with lower viewership of all classes of movies, but especially FSK-16/18 movies; in addition, FSK-16 restrictions were associated with substantially lower exposure to movie depiction of tobacco and alcohol use, suggesting a mediational mechanism for the association. Conclusions: Among young adolescents, parental restriction from viewing movies rated for older adolescents/adults decreases the risk of substance use in the future.

Henderson CE; Rowe CL; Dakof GA; Hawes SW; Liddle HA. Parenting practices as mediators of treatment effects in an early-intervention trial of Multidimensional family Therapy. American Journal of Drug And Alcohol Abuse 35(4): 220-226, 2009. (30 refs.)

Background: Contemporary intervention models use research about the determinants of adolescent problems and their course of symptom development to design targeted interventions. Because developmental detours begin frequently during early-mid adolescence, specialized interventions that target known risk and protective factors in this period are needed. Methods: This study (n = 83) examined parenting practices as mediators of treatment effects in an early-intervention trial comparing Multidimensional Family Therapy (MDFT), and a peer group intervention. Participants were clinically referred, low-income, predominantly ethnic minority adolescents ( average age 14). Assessments were conducted at intake, and six weeks after intake, discharge, and at 6 and 12 months following intake. Results: Previous studies demonstrated that MDFT was more effective than active treatments as well as services as usual in decreasing substance use and improving abstinence rates. The current study demonstrated that MDFT improves parental monitoring -- a fundamental treatment target -- to a greater extent than group therapy, and these improvements occur during the period of active intervention, satisfying state-of-the-science criteria for assessing mediation in randomized clinical trials. Conclusions and Scientific Significance: Findings indicate that change in MDFT occurs through improvements in parenting practices. These results set the foundation for examining family factors as mediators in other samples.

Ichiyama MA; Fairlie AM; Wood MD; Turrisi R; Francis DP; Ray AE et al. A randomized trial of a parent-based intervention on drinking behavior among incoming college freshmen. Journal of Studies on Alcohol and Drugs Supplement 16: 67-76, 2009. (53 refs.)

Objective: Despite research suggesting that parental involvement can affect alcohol involvement among adolescents, few studies have focused on parent-based alcohol prevention strategies among college undergraduates. We report the results of a randomized trial of a parent-based intervention (PBI) in a sample of college freshmen. Method: Across two cohorts, 724 incoming freshman-parent dyads completed baseline assessments and were randomly assigned to PBI or intervention as usual (an alcohol fact sheet for parents). Student follow-up assessments were completed at 4 and 8 months. Results: Two-part latent growth curve modeling was used to test hypothesized intervention effects. Outcome variables were drinks per week (past month), heavy episodic drinking (past 2 weeks), and alcohol-related problems (past 3 months). Over the 8-month follow-up period, PBI had a significant effect on drinks per week but not heavy episodic drinking or alcohol-related problems. Specifically, compared with students in the intervention-as-usual condition, students receiving the PBI were significantly less likely to transition from nondrinker to drinker status and showed less growth in drinking over the freshman year. However. the direct PBI effect on growth was qualified by a PBI x Gender interaction, with probes indicating that the effect applied to women but not men in the PBI condition. Conclusions: This study extends previous research by demonstrating the potential utility for PBIs to decrease the likelihood of transitioning into drinker status and, at least for women, for slowing growth in drinking over the freshman year.

Kelley ML; French A; Schroeder V; Bountress K; Fals-Stewart W; Steer K et al. Mother-daughter and father-daughter attachment of college student ACOAs. Substance Use & Misuse 43(11): 1562-1573, 2008. (14 refs.)

This 2005 study compared parent-child attachment in 89 American female Adult Children of Alcoholics (ACOAs) as compared to 201 non-ACOAs. Women attended a large university in the southeastern United States. Participants categorized as ACOA on the Children of Alcoholics Screen Test (CAST; Jones, 1983) reported significantly more negative affect and less support from their fathers as indicated on the Parental Attachment Questionnaire (Kenney, 1987). When results were examined by the gender of the alcohol-abusing parent, participants who suspected their fathers were problem drinkers did not differ from non-ACOAs in their attachment to either parent. As compared to non-ACOAs, women who self-identified as daughters of problem-drinking mothers reported poorer attachment both to mothers and fathers.

Koutakis N; Stattin H; Kerr M. Reducing youth alcohol drinking through a parent-targeted intervention: The Orebro Prevention Program. Addiction 103(10): 1629-1637, 2008. (32 refs.)

Aims: To evaluate a 2.5-year prevention programme working through parents, targeting drinking among 13-16-year-olds. Design Quasi-experimental using matched controls with a pre-post, intention-to-treat design. Setting Schools located in inner city, public housing and small town areas. Participants: A total of 900 pupils entering junior high school and their parents, followed longitudinally. Intervention: Parents received information by mail and during parent meetings in schools urging them to: (i) maintain strict attitudes against youth alcohol use and (ii) encourage their youth's involvement in adult-led, organized activities. Measurements Evaluation of the implementation used measures of parental attitudes against underage drinking and youths' participation in organized activities. Outcomes were youths' drunkenness and delinquency. Findings: The implementation successfully influenced parents' attitudes against underage drinking, but not youth participation in organized activities. At post-test, youths in the intervention group reported less drunkenness and delinquency. Effect sizes were 0.35 for drunkenness and 0.38 for delinquency. Findings were similar for boys and girls and for early starters. Effects were not moderated by community type. Conclusions: Working via parents proved to be an effective way to reduce underage drinking as well as delinquency.

Kumpfer KL. Why are there no effective child abuse prevention parenting interventions? (editorial). Substance Use & Misuse 43(8/9): 1262-1265, 2008. (9 refs.)

Lac A; Alvaro EM; Crano WD; Siegel JT. Pathways from parental knowledge and warmth to adolescent marijuana use: An extension to the theory of planned behavior. Prevention Science 10(1): 22-32, 2009. (43 refs.)

Despite research indicating that effective parenting plays an important protective role in adolescent risk behaviors, few studies have applied theory to examine this link with marijuana use, especially with national data. In the current study (N = 2,141), we hypothesized that parental knowledge (of adolescent activities and whereabouts) and parental warmth are antecedents of adolescents' marijuana beliefs-attitudes, subjective norms, and perceived behavioral control-as posited by the Theory of Planned Behavior (TPB; Ajzen 1991). These three types of beliefs were hypothesized to predict marijuana intention, which in turn was hypothesized to predict marijuana consumption. Results of confirmatory factor analyses corroborated the psychometric properties of the two-factor parenting structure as well as the five-factor structure of the TPB. Further, the proposed integrative predictive framework, estimated with a latent structural equation model, was largely supported. Parental knowledge inversely predicted pro-marijuana attitudes, subjective norms, and perceived behavioral control; parental warmth inversely predicted pro-marijuana attitudes and subjective norms, ps < .001. Marijuana intention (p < .001), but not perceived behavioral control, predicted marijuana use 1 year later. In households with high parental knowledge, parental warmth also was perceived to be high (r = .54, p < .001). Owing to the analysis of nationally representative data, results are generalizable to the United States population of adolescents 12-18 years of age.

Lam WK; Fals-Stewart W; Kelley ML. Effects of parent skills training with behavioral couples therapy for alcoholism on children: A randomized clinical pilot trial. Addictive Behaviors 33(8): 1076-1080, 2008. (18 refs.)

This pilot study examined preliminary effects of Parent Skills Training with Behavioral Couples Therapy on children's behavioral functioning. Participants were men (N = 30) entering outpatient alcohol treatment, their female partners, and a custodial child between 8 and 12 years of age. Couples were randomly assigned to one of three equally intensive conditions: (a) Parent Skills with Behavioral Couples Therapy (PSBCT), (b) BCT (without parent training), and (c) Individual-Based Treatment (IBT; without couples-based or parent skills interventions). Parents completed measures of child externalizing and internalizing behaviors at pretreatment, posttreatment, 6- and 12-month follow up; children completed self-reports of internalizing symptoms at each assessment. Only PSBCT participants reported significant effects on all child measures throughout the 12-month follow up. PSBCT showed medium to large effects in child functioning relative to IBT, and small to medium effects relative to BCT from baseline through follow up. Effect sizes suggest clinically meaningful differences between PSBCT and both BCT and IBT that warrant further empirical evaluation of BCT with parent training for alcohol-abusing men and their partners.

Lam WKK; Fals-Stewart W; Kelley ML. Parent training with behavioral couples therapy for fathers' alcohol abuse effects on substance use, parental relationship, parenting, and CPS iInvolvement. Child Maltreatment 14(3): 243-254, 2009. (65 refs.)

This pilot study examined effects of Parent Skills with Behavioral Couples Therapy (PSBCT) on substance use, parenting, and relationship conflict among fathers with alcohol use disorders. Male participants (N = 30) entering outpatient alcohol treatment, their female partners, and a custodial child (8 to 12 years) were randomly assigned to (a) PSBCT; (b) Behavioral Couples Therapy (BCT); or (c) Individual-Based Treatment (IBT). Children were not actively involved in treatment. Parents completed measures of substance use, couples' dyadic adjustment, partner violence, parenting, and Child Protection Services (CPS) involvement at pretreatment, posttreatment, 6- and 12-month follow-up. PSBCT was comparable to BCT on substance use, dyadic adjustment, and partner violence; both groups showed clinically meaningful effects over IBT. Compared to BCT, PSBCT resulted in larger effect sizes on parenting and CPS involvement throughout follow-up. PSBCT for fathers may enhance parenting couple- or individual-based treatment, and warrant examination in a larger, randomized efficacy trial.

Larrieu JA; Heller SS; Smyke AT; Zeanah CH. Predictors of permanent loss of custody for mothers of infants and toddlers in foster care. Infant Mental Health Journal 29(1): 48-60, 2008. (21 refs.)

The maltreating mothers of abused and neglected infants and toddlers were evaluated as part of an intensive intervention program. The purpose of this study was to examine cumulative risk versus specific risk factors that led to permanent loss of custody by mothers, predicated upon decisions by the Juvenile Court with regard to permanency planning. The following risk factors were analyzed as potential predictors of placement outcomes: maternal education, maternal history of abuse as a child, history of psychiatric difficulties, substance-abuse history, conviction history (excluding child-abuse charges), depressive symptomatology, degree of partner violence experienced, and cumulative number of risks the mother experienced. Results indicated that mothers who lost custody had significantly more risk factors than those who were reunified with their children. Cumulative risk was a stronger predictor than specific risk factors. Implications for intervention are discussed.

Latendresse SJ; Rose RJ; Viken RJ; Pulkkinen L; Kaprio J; Dick DM. Parental socialization and adolescents' alcohol use behaviors: Predictive disparities in parents' versus adolescents' perceptions of the parenting environment. Journal of Clinical and Adolescent Psychology 38(2): 232-244, 2009. (68 refs.)

Among adolescents, many parenting practices have been associated with the initiation and development of drinking behaviors. However, recent studies suggest discrepancies in parents' and adolescents' perceptions of parenting and their links with adolescent use. In this study, we derive two independent sets of underlying parenting profiles ( based on parent and adolescent reported behaviors at age 11-12 years), which were then examined in relation to adolescents' drinking behaviors at ages 14 and 171/2. Results indicated that the two sets of profiles accounted for little shared variance, with those based on adolescents' reports being stronger predictors of adolescent drinking. Moreover, comparisons of drinking levels across profiles pointed to multiple parenting strategies that may effectively reduce adolescent alcohol experimentation, including simply sustaining a moderate level of awareness of adolescents' whereabouts and activities and avoiding excessive conflict and strictness.

Latendresse SJ; Rose RJ; Viken RJ; Pulkkinen L; Kaprio J; Dick DM. Parenting mechanisms in links between parents' and adolescents' alcohol use behaviors. Alcoholism: Clinical and Experimental Research 32(2): 322-330, 2008. (59 refs.)

Background: Adolescence has been identified as a critical period with regard to the initiation and early escalation of alcohol use. Moreover, research on familial risk and protective processes provides independent support for multiple domains of parental influence on adolescent drinking; including parents' own drinking behaviors, as well as the practices they employ to socialize their children. Despite this prevalence of findings, whether and how these distinct associations are related to one another is still not entirely clear. Methods: The present study used data from 4,731 adolescents and their parents to test the nature of associations between (a) parents' frequencies of alcohol use and intoxication, and lifetime alcohol-related problems, (b) adolescents' perceptions of the parenting that they receive, and (c) adolescents' prevalence of alcohol use and intoxication at 14 and 171/2 years of age. As such, multiple mediation modeling was used to assess whether parental alcohol use behaviors influence adolescent alcohol use directly, or if they operate through indirect associations with various aspects of parenting that subsequently influence adolescent use. Results: Examination of simple associations demonstrated that maternal and paternal alcohol use behaviors were positively linked with adolescent use behaviors at 14 and 17 1/2 years of age. Likewise, several parenting behaviors were independently associated with both parental and adolescent drinking. Examined collectively, multivariate path analyses indicated that associations between parents' and adolescents' alcohol-related behaviors were mediated, in part, by adolescents' perceptions of the parenting that they received, especially at 14 years of age. Furthermore, perceived parental monitoring and discipline had unique mediating capabilities, net the effects of all other parenting behaviors. Conclusions: This study demonstrates that parenting is an important mediator of the association between parental and adolescent drinking practices. An important area for future research will be to study how adolescents can avoid alcohol-related problems despite being reared within a risk laden parenting environment and/or having parents who drink frequently.

Libby AM; Orton HD; Beals J; Buchwald D; Manson SM. Childhood abuse and later parenting outcomes in two American Indian tribes. Child Abuse & Neglect 32(2): 195-211, 2008. (53 refs.)

Objectives: To examine the relationship of childhood physical and sexual abuse with reported parenting satisfaction and parenting role impairment later in life among American Indians (AIs). Methods: AIs from Southwest and Northern Plains tribes who participated in a large-scale community-based study (n = 3,084) were asked about traumatic events and family history; those with children were asked questions about their parenting experiences. Regression models estimated the relationships between childhood abuse and parenting satisfaction or parenting role impairment, and tested for mediation by depression or substance use disorders. Results: Lifetime substance use disorder fully mediated the relationship between childhood physical abuse and both parenting satisfaction and parenting role impairment in the Northern Plains tribe. There was only partial mediation between childhood sexual abuse and parenting role impairment in the Southwest. In both tribes, lifetime depression did not meet the criteria for mediation of the relationship between childhood abuse and the two parenting outcomes. Instrumental and perceived social support significantly enhanced parenting satisfaction; negative social support reduced satisfaction and increased the likelihood of parenting role impairment. Exposure to parental violence while growing up had deleterious effects on parenting outcomes. Mothers and fathers did not differ significantly in the relation of childhood abuse experience and later parenting outcomes. Conclusions: Strong effects of social support and mediation of substance abuse disorders in the Northern Plains offer direct ways in which childhood victims of abuse could be helped to avoid negative attributes of parenting that could put their own children at risk. Practice implications: Mothers were not significantly different from fathers in the relation of abusive childhood experiences and later parenting outcomes, indicating both are candidates for interventions. Strong effects of social support offer avenues for interventions to parents. The prevalence of substance use disorders and their role as a mediator of two parenting outcomes in the Northern Plains should focus special attention on substance use treatment, especially among those who experienced childhood victimization. These factors offer direct ways in which childhood victims of abuse can be helped to avoid negative attributes of parenting that could put their own children at risk of violence.

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.

Lopez V; Katsulis Y; Robillard A. Drug use with parents as a relational strategy for incarcerated female adolescents. Family Relations 58(2): 135-147, 2009. (37 refs.)

Problems associated with poor quality, parent-child relationships are compounded for incarcerated girls. Using attachment theory as a framework, the present qualitative study examined how 18 incarcerated adolescent girls made meaning with regard to their parents' drug use. We found that 8 of the 18 girls used drugs with their parents as a relational strategy to be close with them, particularly with their fathers, or as a means to share time together. The unique finding that girls used drugs together with their parents supports the need for relational parenting interventions that, whenever possible, support, encourage, and provide treatment and family strengthening services to parents who use drugs and their children.

Luther EJ; Parzynski CS; Jaszyna-Gasior M; Bagot KS; Royo MB; Leff MK et al. Does allowing adolescents to smoke at home affect their consumption and dependence? Addictive Behaviors 33(6): 836-840, 2008. (13 refs.)

Negative parental attitudes towards smoking decrease adolescent smoking initiation but limited research explores the relationship between parental attitudes and degree of adolescent smoking among established smokers. The aim of this study was to examine the relationship between parental allowance of smoking in the home and adolescent smoking behavior and level of dependence. Interviews from 408 youths seeking assistance to quit smoking showed that adolescents who were allowed to smoke at home smoked more cigarettes per day and had higher scores on the Fagerstrom Test of Nicotine Dependence than those not allowed to smoke at home. Studies that additionally evaluate parental smoking status and the temporal relationship of parental allowance of smoking with changes in adolescent smoking behavior are warranted to clarify public health implications of parental smoking interdictions.

Marcynyszyn LA; Evans GW; Eckenrode J. Family instability during early and middle adolescence. Journal of Applied Developmental Psychology 29(5): 380-392, 2008. (44 refs.)

Two studies investigated associations between family instability (changes in parents' intimate partners, work hours, residence, children's schools) and adolescent adjustment. In Study 1 (N = 141, M age = 15.23 years), instability was associated with increased caregiver-reported externalizing and internalizing behaviors (including youth-reported cigarette use), reduced teacher-reported frustration tolerance, social skills, task orientation, and lower academic grades. Logistic regression results for instability exposure showed an increased risk for school suspensions, Person in Need of Supervision status, binge drinking, and marijuana use. In Study 2 (N = 225, M age = 13.37 years), instability was linked to adolescent-reported externalizing and internalizing behaviors, teacher-reported disruptions. and lower English and math grades. Key sociodemographic factors and negative life events were statistically controlled in regression analyses. Results indicate that a more theoretically coherent measure of family instability, which is distinct from negative life events, may prove valuable in understanding the potentially adverse influence of instability on youth.

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.

Martins SS; Storr CL; Alexandre PK; Chilcoat HD. Adolescent ecstasy and other drug use in the National Survey of Parents and Youth: The role of sensation-seeking, parental monitoring and peer's drug use. Addictive Behaviors 33(7): 919-933, 2008. (60 refs.)

The association between high sensation-seeking, close friends' drug use and low parental monitoring with ecstasy (MDMA) use in adolescence was examined in a sample of US household-dwelling adolescents aged 12 - 18 years (N=5049). We also tested whether associations were of stronger magnitude than associations between these correlates and marijuana or alcohol/tobacco use in adolescence. Data from Round 2 of the National Survey of Parents and Youth (NSPY) Restricted Use Files (RUF) was analyzed via Jackknife weighted multinomial logistic regression models. High sensation-seekers were more likely to be ecstasy, marijuana, and alcohol/tobacco users, respectively, as compared to low sensation-seekers. High sensation-seeking and close friends' drug use were more strongly associated with ecstasy as compared to marijuana and alcohol/tobacco use. Low parental monitoring was associated with marijuana use and alcohol/tobacco use and there was a trend for it to be associated with ecstasy use. Ecstasy use is strongly associated with peer drug use and more modestly associated with high sensation-seeking. School prevention programs should target high-sensation-seeking adolescents and also encourage them to affiliate with non-drug using peers.

McMahon TJ; Winkel JD; Rounsaville BJ. Drug abuse and responsible fathering: A comparative study of men enrolled in methadone maintenance treatment. Addiction 103(2): 269-283, 2008. (62 refs.)

Aim Because very little is known about the parenting of drug-abusing men, this study was designed to document ways that drug abuse contributes to compromise of responsible fathering. Design, setting, participants Generalized linear models and data representing different dimensions of responsible fathering were used to clarify ways that the fathering of 106 men receiving methadone maintenance treatment differed from that of 118 men living in the same community with no history of alcohol or drug abuse. Measurement Men who enrolled in the study completed two structured interviews and a battery of five self-report measures selected to document current and historical dimensions of responsible fathering. Findings When the opioid-dependent fathers were compared to the other fathers, there were significant differences in: (i) economic resources to support family formation; (ii) patterns of pair-bonding; (iii) patterns of procreation; and (iv) parenting behavior. When fathering of the youngest biological child was examined, the opioid-dependent fathers confirmed few differences in historical dimensions of fathering, but they reported significant differences in current dimensions reflecting: (i) constricted personal definitions of the fathering role; (ii) poorer relationships with biological mothers; (iii) less frequent residence with the child; (iv) less frequent provision of financial support; (v) less involvement in positive parenting; (vi) poorer appraisal of self as a father; and (vii) less satisfaction as a father. Conclusions: The findings highlight ways that drug abuse contributes to compromise of responsible fathering, and they raise questions about ways that the drug abuse treatment system might better address parenting as a treatment issue for men.

Meara E; Greenfield S. The relationship between substance use patterns and economic and health outcomes among low-income caregivers and children. Psychiatric Services 59(9): 974-981, 2008. (44 refs.)

Objective: This study estimated how patterns of substance use are related to work status, public program use, and well-being among a sample of female caregivers and children. Methods: This study assessed work, public program use, and well-being measures as a function of substance use among 1,623 female caregivers of children aged zero to four or ten to 14 who participated in the Welfare of Children and Families study and lived in low- and moderate-income neighborhoods in Boston, Chicago, and San Antonio. Data were analyzed from baseline interviews that were conducted from March through December 1999 and from follow-up interviews that were conducted 11 to 26 months after baseline (average of 16 months). Substance use patterns were placed into three categories: light or no substance use reported in both interviews, moderate or heavy substance use (that is, moderate or heavy use in both interviews or increased substance use during the study period), and reduced substance use during the study period. Results: Among caregivers who reduced their substance use, measures of work status, receipt of income assistance, mental health symptoms, and reports of child behavior problems were not significantly different at follow-up from those of caregivers with light or no substance use. At follow-up, compared with caregivers with light or no substance use, those with moderate or heavy substance use were significantly less likely to experience improvements in mental health symptoms and to see improvements in their children's behavioral problems. Caregivers with moderate or heavy substance use were more likely to be "detached" (p=.051) -- that is, neither working nor collecting income assistance -- although this difference was only marginally significant. Conclusions: Caregivers with increased substance use fared poorly on measures of well-being and work. Policies that promote, rather than impede, reductions in substance use are more likely to promote self-sufficiency and well-being.

Mena MP; Dillon FR; Mason CA; Santisteban DA. Communication about sexually-related topics among hispanic substance-abusing adolescents and their parents. Journal of Drug Issues 38(1): 215-234, 2008. (29 refs.)

Hispanic adolescents have been shown to have high prevalence of sexually transmitted infections and HIV and substance abuse has been linked to risky sexual behaviors. The literature indicates that good parent-adolescent communication about sexual risk and safe sexual behaviors may help protect youth, yet little is known about this type of communication in Hispanic families. This article reports data on adolescent and parent factors associated with communication about moral and birth control talk between 108 Hispanic substance abusing adolescents and their parents. Results indicate that Hispanic parents who had older adolescents, reported more involvement, were less concerned of possible negative reactions from their child, and felt more knowledgeable and confident regarding sex and birth control also reported greater frequency of birth control talk. Hispanic parents with a daughter, who reported more involvement, or whose child reported more communication were more likely to report greater frequency of talking about moral issues.

Mena MP; Mitrani VB; Muir JA; Santisteban DA. Extended parent-child separations: Impact on substance-abusing Hispanic adolescents. Journal for Specialists in Pediatric Nursing 13(1): 50-52, 2008. (8 refs.)

Extended parent_child separations, which can take many different forms and occur for different reasons, have the potential to be disruptive to healthy family processes such as attachment and to healthy adolescent functioning. Two types of separations are most prominent in substance-abusing Hispanic adolescents and their families. The first commonly seen type in immigrant Hispanic families is family separations that occur when family members, specifically mothers and children, immigrate separately to the United States. The second type�namely, non-immigration-related separations�can occur because parents are unable to care for the children due to their own financial, mental health, or substance abuse issues; the child's behavioral problems are beyond the parents� control, requiring a new context such as extended family or a residential setting for drug use; or other family circumstances such as divorce and death. Because Hispanic family systems tend to have close extended networks, it is not unusual for extended family members to be available to serve as parental surrogates. This is a strength, insofar as it allows for support and accommodation in times of family crisis. At times, however, there may be negative repercussions resulting from parent_child separations. This column explores some of the clinical characteristics that appear to be associated with these separations and to discuss some of the important clinical implications for nurses as well as other healthcare disciplines.

Mistry R; McCarthy WJ; Yancey AK; Lu Y; Patel M. Resilience and patterns of health risk behaviors in California adolescents. Preventive Medicine 48(3): 291-297, 2009. (54 refs.)

Objectives. Assess whether adolescent health risk behaviors cluster, and whether resiliency factors are associated with observed clusters. Methods. The cross-sectional population-weighted 2003 California Health Interview Survey was used (N = 4010). Four gender-specific clusters were based on smoking, alcohol use, low fruit/vegetables consumption, and physical inactivity. Resiliency factors included parental supervision, parental support, role model presence and adolescent mental health. Conditional regression was used to measure the association of individual health risk behaviors and clusters with resiliency factors. Results. Health risk behaviors clustered as follows: "Salutary Adherents" (no reported health risk behaviors), "Active Snackers" (physically active, low fruit/vegetable consumers), "Sedentary Snackers" (physically inactive, low fruit/vegetable consumers), and "Risk Takers" (smokers, alcohol users, many also physically inactive and low fruit/vegetable consumers). Greater parental supervision was associated with lower odds of being in unhealthful clusters. Among males, having greater parental support reduced odds of being an "Active Snacker" or "Sedentary Snacker." Among females, role model presence reduced odds of being in unhealthful clusters, while depressiveness increased the odds. Conclusions. Health promoting interventions should address multiple health risk behaviors in an integrated fashion. Gender-specific, ethnically-targeted, family-centered strategies that address parenting, particularly parental supervision would be useful. Addressing depressiveness may be especially important for female adolescents.

Mogro-Wilson C. The influence of parental warmth and control on Latino adolescent alcohol use. Hospanic Journal of Behavioral Sciences 30(1): 89-105, 2008. (36 refs.)

Latino adolescent alcohol use is related to substance use, later life addiction, and other negative outcomes. The lack of knowledge on parenting and the parent-youth relationship in Latino families in the context of acculturation and its affects on alcohol use prompted this study. Secondary data analysis using the Add Health data set indicates that high amounts of parental control function positively for Latino families, contrary to some findings for non-Latinos. In addition, parental warmth significantly reduced alcohol use and also positively affected the parent-youth relationship which decreased alcohol use. When families spoke English at home, parental control decreased which lead to an increase in alcohol use. A critical examination of the implications for the cultural understanding of parental influences on adolescent alcohol use is discussed. Findings indicate that there are unique family mechanisms for Latino families that should be considered when developing intervention options.

Montgomery C; Fisk JE; Craig L. The effects of perceived parenting style on the propensity for illicit drug use: The importance of parental warmth and control. Drug and Alcohol Review 27(6): 640-649, 2008. (55 refs.)

Introduction and Aims. Research in adolescents has shown that parental warmth and control are important factors in drug use. The present study focused upon investigating perceived parental warmth and control in a sample of post-adolescent ecstasy/polydrug users, and investigating their relationship to severity of drug use. Design and Methods. A total of 128 (65 male) ecstasy/polydrug users, 51 (17 male), cannabis-only users and 54 (13 male) non-users were recruited from a university population. All participants completed the parenting styles and drug use questionnaires. Results. Compared to non-users, a greater proportion of ecstasy/polydrug users characterised their parents' style as neglectful. The modal style endorsed by non-users was authoritative. Those who rated their parents' style as authoritative had significantly lower lifetime consumption and average dose of ecstasy relative to those describing their parents as neglectful. Again, relative to those describing their parents as neglectful, participants from authoritarian backgrounds had significantly smaller lifetime consumption of ecstasy and cocaine and significantly smaller average doses of cannabis, ecstasy and cocaine. Contrary to expectation, there was no significant association between perceived parental warmth and the severity of ecstasy use. Discussion and Conclusions. The present study is, to our knowledge, the first to quantify drug use, and relate it to perceived parental practices in a post-adolescent sample of ecstasy/polydrug users. The results provide further support for the relationship between perceived parental control and drug use.

Munson MR; McMillen JC. Natural mentoring and psychosocial outcomes among older youth transitioning from foster care. Children and Youth Services Review 35(4): 454-468, 2008. (44 refs.)

This study explores the non-kin natural mentoring relationships among a group of older youth in foster care (n=339), particularly whether or not their relationships last over time. The study also examines the associations between non-kin natural mentoring relationships and psychosocial outcomes among these older youth. Results of simultaneous and hierarchical regression analyses reveal that the presence of a mentor and the duration of the relationship at age 18 are associated with better psychological outcomes, such as fewer depression symptoms, less stress and more satisfaction with life at 18 1/2. Longitudinal data collected at age 18 and 19 on mentoring revealed that of the 339 youth, 25% (n=85) reported no mentor at either data point, 41% (n=139) reported a short term mentor, and 34% (n=115) reported a long term mentoring relationship. After controlling for potential covariates, multivariate analyses revealed that compared to those youth that did not nominate a mentor, youth in long term natural mentoring relationships reported less stress and were less likely to have been arrested at age 19. Further, being in long term natural mentoring relationships was not related to current employment, or past year alcohol and marijuana use. Implications for transitioning foster care youth are discussed.

Nuno-Gutierrez BL; Alvarez-Nemegyei J; Rodriguez-Cerda O. Social representations used by the parents of Mexican adolescent drug users under treatment to explain their children's drug use: Gender differences in parental narratives. Adolescence 43(170): 351-371, 2008. (41 refs.)

The aim of this study was to explore the social representations used by the parents of adolescent drug users to explain the onset of drug use. Differences in explanations between the parents of male and female adolescents were also explored. Sixty parents who accompanied their children to four rehabilitation centers in 2004 completed two semi-structured questionnaires. In addition, indepth interviews were applied to a subsample. The explanation of the drug use was carried out through two social representations: the neglectful family and the son or daughter as an inexperienced teen. The parents-son model was well structured; however, the parents-daughter was unstructured, which suggests a higher resonance in the familial group.

Patock-Peckham JA; Morgan-Lopez AA. Mediational links among parenting styles, perceptions of parental confidence, self-esteem, and depression on alcohol-related problems in emerging adulthood. Journal of Studies on Alcohol and Drugs 70(2): 215-226, 2009. (79 refs.)

Objective: Depression is often found to be comorbid with alcohol-related problems. Parental overprotection, which may be of particular importance during emerging adulthood, has been linked to internalizing symptoms in offspring. This article evaluates the impact of parenting styles and parental confidence in their offspring on an internalizing pathway to alcohol-related problems through self-esteem and depression. Method: Mediational links were tested among parenting styles (authoritative, authoritarian, permissive), parental confidence (overprotection, autonomy), self-esteem, depression, and alcohol-related problems. A two-group, multiple indicator multiple-cause structural equation model with 441 (216 female, 225 male) college students was examined. Results: Overall, having a father who was confident in his child's ability to make autonomous decisions was protective against depression for both genders. Perceptions of paternal autonomy mediated the impact of the fathers' parenting styles (authoritative, permissive) on depression for both genders. For men, parental overprotection mediated the impact of an authoritarian father on self-esteem, and self-esteem mediated the impact of parental overprotection on depression. Moreover, among men, perceptions of maternal autonomy mediated the impact of the mothers' parenting styles (authoritative, permissive) on self-esteem, and self-esteem mediated the impact of maternal autonomy on depression. Conclusions: The current pattern of findings is distinct from pathways through behavioral undercontrol with influences from the same-sex parent for both genders. These findings indicate that parenting may have differential influences on internalizing pathways to alcohol-related problems.

Patock-Peckham JA; Morgan-Lopez AA. The gender specific mediational pathways between parenting styles, neuroticism, pathological reasons for drinking, and alcohol-related problems in emerging adulthood. Addictive Behaviors 34(3): 312-315, 2009. (16 refs.)

Mediational links between parenting styles, neuroticism, pathological reasons for drinking, alcohol use and alcohol-related problems were tested. A two-group SEM path model with 441 (216 female, 225 male) college students was examined. In general, pathological reasons for drinking mediated the impact of neuroticism on alcohol use and alcohol-related problems. A different pattern of relationships was found for each of the two genders. Perceptions of having an authoritarian father were positively linked to higher levels of neuroticism among males but this pattern was not found among females. For males. neuroticism mediated the impact of having an authoritarian father on pathological reasons for drinking with pathological reasons for drinking mediating the impact of neuroticism on alcohol-related problems. Perceptions of having a permissive father were linked to lower levels of neuroticism in females (but have been found as a consistent risk factor for other pathways to alcohol use elsewhere). Compared with other work in this area, these findings indicate parental influences regarding vulnerabilities for alcohol use may be specific to parent-child gender matches for some pathways and specific to one parent (irrespective of child gender) for other pathways.

Peleg-Oren N; Rahav G; Teichman M. Role of family resouces and paternal history of substance use problems in psychosocial adjustment among school-aged children. Journal of Drug Education 38(3): 253-271, 2008. (57 refs.)

The present study examines the role of family resources (parenting style and family cohesion) and paternal history of substance abuse on the psychosocial adjustment of their school-aged children. Data were collected from 148 children aged 8-11 (72 of fathers with history of substance use disorder, 76 children of fathers with no substance use problems) and their mothers. Results draw attention to the differences between the subjective experiences of the child and those of the mother, and by indicating that the effect of the interaction between the father's and the mother's control parenting style on the child's psychosocial outcome is greater than the sum total of influences of each of them separately.

Pettersson C; Linden-Bostrom M; Eriksson C. Parental attitudes and behaviour concerning adolescent alcohol consumption: Do sociodemographic factors matter? Scandinavian Journal of Public Health 37(5): 509-517, 2009. (35 refs.)

Aims: Parental attitudes and behaviour with regard to young people and alcohol are associated with teenagers' drinking behaviour. This study examined the association between sociodemographic factors among parents and parental attitudes and behaviour with regard to alcohol and adolescents. Methods: Postal questionnaires were sent to parents of children aged 12-16 years in six Swedish municipalities. Seven hundred and ninety-five parents were included in the study. Seven sociodemographic factors and four questions identifying parental attitudes and behaviour were examined. Logistic regression was used to compute odds ratios and confidence intervals. Results: The study showed that fathers were more likely than mothers to report that children had been drinking or tasting alcohol at home. Parents who answered the questionnaire together also stated that their children had been served alcohol at home to a larger extent than mothers. Fathers, single parents and parents with older children were more likely to have non-restrictive attitudes towards adolescents and alcohol than mothers, parents living in a household with more than one adult, and parents with younger children. Factors such as age of the parents, employment status and numbers of children in the household were not associated with either parental attitudes or behaviour. Conclusions: The sex of the responding parent was the only sociodemographic factor that was associated with both parental attitudes and behaviour. Fathers were more likely than mothers to have a non-restrictive attitude. The fathers also reported to a greater extent than mothers that children had been drinking or tasting alcohol at home.

Rangarajan S. Mediators and moderators of parental alcoholism effects on offspring self-esteem. Alcohol and Alcoholism 43(4): 481-491, 2008. (62 refs.)

Aims: The goal of the proposed study was fourfold: (i) to examine the effects of parental alcoholism on adult offspring's self-esteem; (ii) to identify and test possible mediators and moderators of parental alcoholism effects on the self-esteem of adult offspring; (iii) to examine the utility and relevance of attachment theory (Bowlby J. (1969) Attachment and Loss: Vol. 1. Attachment. New York: Basic Books) in explaining parental alcoholism effects on self-esteem and (iv) to address some of the methodological limitations identified in past research on adult children of alcoholics (ACOA). Methods: Participants (N = 515) completed retrospective reports of parental alcoholism, family stressors, family communication patterns, parental attachment and a current measure of self-esteem. Results: The results showed support for the detrimental effects of parental alcoholism on offspring self-esteem and offered partial support for family stressors as a mediator of parental alcoholism effects on parental attachment and parental attachment as a mediator of parental alcoholism effects on offspring self-esteem, respectively. Finally, support was found for family communication patterns as a moderator of the effects of family stressors on attachment. Conclusions: The study findings offer preliminary support for the utility of attachment theory in explicating parental alcoholism effects on the self-esteem of adult offspring. Findings from the present study make salient the need to consider factors beyond the identification of parental alcohol abuse when explicating individual differences in offspring self-esteem in adulthood. The identification of protective and risk factors can contribute to the development of optimal intervention strategies to help ACOAs better than simply the knowledge of family drinking patterns.

Roekhill A; Green BL; Newton-Curtis L. Accessing substance abuse treatment: Issues for parents Involved with child welfare services. Child Welfare 87(3): 63-93, 2008. (50 refs.)

The complex issues associated with barriers to treatment entry for parents who are involved with child welfare has not been well explored. Accessing timely treatment is now critical for these parents since the introduction of the Adoption and Safe Families Act of 1997, limiting the time until a permanency decision is made. Using a longitudinal, qualitative approach, substance-abusing parents from 15 families, their relevant family members, and service providers were interviewed approximately every 3 months over an 18-month period. The experiences of these parents add to our knowledge of the unique barriers this population faces, and expands our understanding of the mechanisms by which certain barriers may delay treatment.

Rojas NL; Sherrit L; Harris S; Knight JR. The role of parental consent in adolescent substance use research. Journal of Adolescent Health 42(2): 192-197, 2008. (33 refs.)

Purpose: The objective of our study was to assess the effects of requiring parental consent upon study participation and self-reported substance-related problems among 14-18-year-olds. Methods: This was a secondary analysis of combined data from two similar studies of adolescent substance use that recruited participants from the same adolescent clinic at Children's Hospital Boston. Study I waived parental consent, whereas Study 2 required parental consent. The combined dataset included demographic characteristics and Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) study screening test responses. The CRAFFT is an orally administered screen that yields a score from 0-6 and that has been shown to be a valid and reliable measure of risk for substance-related problems. Results: The participation refusal rate in Study 1, where consent was waived, was 19.7% (132 of 670 eligible individuals) and in Study 2 (243 of 411 eligible individuals), where consent was required, it was 59.1% (p <.0001). Participants did not differ significantly with respect to gender and age but did differ by self-identified race/ethnicity between the two studies. Because the CRAFFT score distributions were highly skewed, we used the nonparametric Mann-Whitney U test for differences in mean rank. The mean rank in Study I was significantly higher than in Study 2 (mean rank 362 vs. 325, p =.02). After controlling for age, gender, and race/ethnicity, the adjusted proportional odds ratio for a one-point increase in CRAFFT score was 1.47 (CI 1.03, 2.10) for Study 1 compared with Study 2. Conclusions: The research requirement of parental consent may result in substantial self-selection bias towards a lower risk sample.

Schepis TS; Desai RA; Smith AE; Cavallo DA; Liss TB; McFetridge A; Potenza MN; Krishnan-Sarin S. Impulsive sensation seeking, parental history of alcohol problems, and current alcohol and tobacco use in adolescents. Journal of Addiction Medicine 2(4): 185-193, 2008. (41 refs.)

Objectives: This study attempted to evaluate whether impulsive sensation seeking mediated the relationship between parental alcohol problems and offspring alcohol and tobacco use. Methods: Participants were Connecticut high school students (n = 2733) completing a survey of high-risk behaviors. Variables of interest included past month alcohol use, past month binge alcohol use, frequency of past month alcohol use, past month tobacco use, having a biologic parent with an alcohol problem, and score on the Impulsive Sensation Seeking scale (ImpSS) from the Zuckerman-Kuhlman Personality Questionnaire-Form III. Results: ImpSS scores were elevated in past month users of alcohol, binge users of alcohol, users of both tobacco and alcohol, and they increased with increasing frequency of past month alcohol use. Also, parental history of alcohol use increased the likelihood of past month alcohol use, binge use, use of both tobacco and alcohol, and higher levels of past month alcohol use. Mediational analyses did not seem to support the hypothesis that impulsive sensation seeking mediates the relationship between parental history of alcohol problems and alcohol and tobacco use in offspring. Conclusions: Impulsive sensation seeking and parental history of alcohol problems seem to be independent factors that contribute to the co-occurrence of alcohol and tobacco use in adolescents. These findings can inform prevention and treatment efforts.

Scherrer JF; Grant JD; Duncan AE; Pan H; Waterman B; Jacob T et al. Measured environmental contributions to cannabis abuse/dependence in an offspring of twins design. Addictive Behaviors 33(10): 1255-1266, 2008. (50 refs.)

Genetic and environmental factors are known to contribute to cannabis abuse/dependence (CAD). We sought to determine the magnitude of the contribution from measured environmental variables to offspring cannabis dependence in a design that controls for familial vulnerability. Data come from a study of 725 twin members of the Vietnam Era Twin Registry, 720 of their biological offspring (age 18-32 years) and 427 mothers. Data were obtained on offspring perception of family and peer support and substance use behaviors and offspring CAD. After adjusting for familial risk, and environmental covariates, CAD was significantly more likely among male offspring (OR=2.73; 95% Cl: 1.69-4.41). Offspring CAD was associated with reporting: siblings used illicit drugs (OR=3.40; 95% Cl: 1.81-6.38). a few friends used drugs (OR=2.72; 95% Cl: 1.04-7.09), a quarter or more friends used drugs (OR=8.30; 95% Cl: 3.09-22.33) and one-half or more 12th grade peers used drugs (OR=3.17; 95% Cl: 1.42-7.08). Perceived sibling, friend and school peer substance use are strongly associated with CAD in young adults even after accounting for latent familial risk and for multiple measured intra-family and extra-family environmental influences.

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.

Self-Brown S; Whitaker DJ. Parent-focused child maltreatment prevention improving assessment, intervention, and dissemination with technology. (review). Child Maltreatment 13(4): 400-416, 2008. (108 refs.)

The goal of this article is to examine how technology has been and can be utilized to enhance parent-focused child maltreatment (CM) prevention efforts. The authors begin with a brief discussion of the current state of the CM prevention field. In the sections that follow, they review studies that have examined the use of technology across three facets of prevention: identification of CM, administration/augmentation of CM prevention programs, and broad dissemination and implementation of evidenced-based CM prevention programs. They conclude with a discussion of limitations and problems related to the use of technology as a tool to enhance CM prevention and future directions.

Shelton KH; Harold GT; Fowler TA; Rice FJ; Neale MC; Thapar A et al. Parent-child relations, conduct problems and cigarette use in adolescence: Examining the role of genetic and environmental factors on patterns of behavior. Journal of Youth and Adolescence 37(10): 1216-1228, 2008. (45 refs.)

This study investigated genetic and environmental influences on the associations between mother-child relationship quality (warmth and hostility) and adolescent conduct problems and cigarette use. Participants included 601 mothers and adolescent twin pairs (aged 12-17 years). Mothers and adolescents provided separate reports of mother-to-child warmth and hostility. A combined measure of mother and adolescent reported conduct problems was used while adolescents provided reports of their cigarette use. Analyses were conducted using bivariate genetic analyses of correlated factors models and regression analyses of monozygotic twin differences. Genetic influences were found for most ratings of the parent-child relationship, with evidence of gender and/or rater-specificity for some measures. The relationship between mother-child hostility with adolescent conduct problems and cigarette use was influenced by genetic and environmental effects. Evidence was found for shared environment effects on the relationship between mother-child warmth and conduct problems. Examining monozygotic twin differences provided further support for non-shared environmental influence on the relationship between mothers' expressions of hostility and low warmth and adolescent adjustment. Findings are discussed in relation to the interplay between genetic and environmental effects underlying links between parent-child relations and adolescent behavior problems.

Spijkerman R; van den Eijnden RJJM; Huiberts A. Socioeconomic differences in alcohol-specific parenting practices and adolescents' drinking patterns. European Addiction Research 14(1): 26-37, 2008. (46 refs.)

The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents' alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents' education level and family income. The present data were collected within the framework of a representative study on alcohol use among Dutch students. The present findings are based on data from respondents who had been drinking in the past year (81.5%), and of whom one of the parents had filled out a short questionnaire including SES characteristics (52%). The sample consisted of 1,344 adolescents. Adolescents were approached in a school setting; parents received a short questionnaire at the home address. The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents' drinking. A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents' drinking on the other. Some moderating effects of SES were found.

Staudt M; Cherry D. Mental Health and Substance Use Problems of Parents Involved With Child Welfare: Are Services Offered and Provided? Psychiatric Services 60(1): 56-60, 2009. (35 refs.)

Objectives: This study examined service delivery to parental caregivers with mental health problems, substance use problems, or both. The study sought to determine whether, once need is identified, suitable services are offered and then provided. Methods: The study was a secondary analysis of the 1994 National Study of Protective, Preventive, and Reunification Services Delivered to Children and Their Families. The national study interviewed child welfare caseworkers about the problems of and services provided to 2,109 families. Results: Of parents with mental problems, 77.9% were offered services and 84.0% of those were provided services. Of parents with substance use problems, 65.7% were offered treatment and 67.5% of those were provided it. Other problems included lack of parenting skills, lack of education and job skills, parent-child conflict, and lack of income. Significant associations were found between caseworkers' identifying problems and offering relevant services. Caregivers with substance use problems were less likely to be offered substance treatment services than caregivers with both mental health and substance use problems. Conclusions: The child welfare system may facilitate service use for caregivers. More research is needed to understand the process of service delivery to caregivers, including why services are not offered to some caregivers and why some services are not provided after being offered. Future research should examine why caregivers with substance use problems are vulnerable to not receiving treatment and whether and how service use varies for other problems not examined in this study.

Stein MT; Drahota A; Chavira DA. Ian: A 7-year old with prenatal drug exposure and early exposure to family violence. (editorial). Journal of Developmental and Behavioral Pediatrics 29(6): 512-515, 2008. (15 refs.)

Suchman N; DeCoste C; Castiglioni N; Legow N; Mayes L. The mothers and toddlers program. Psychoanalytic Psychology 25(3): 499-517, 2008. (37 refs.)

The authors examined pilot data from an attachment-based parenting intervention for substance-abusing mothers of toddlers (ages 12-36 months). The Mothers and Toddlers Program (MTP) is a 20-week individual therapy intervention that aims to help mothers develop more balanced representations of their children and improve their capacity for reflective functioning (i.e., recognition of the intentional nature of children's behavior). The authors hypothesized that improvement in maternal representational balance and maternal capacity for reflective functioning would correspond with improvements in maternal behavior with toddlers (e.g., sensitivity to cues, responsiveness to distress, and social-emotional growth fostering) and reduction in maternal psychiatric distress and substance abuse. Eight mothers who completed MTP showed moderate improvements in representational balance and reflective functioning, and these changes corresponded with significant improvements in maternal behaviors with toddlers. The authors also compared MTP completers and noncompleters on sociodemographic and psychosocial indexes and examined the validity of the intervention's proposed mechanisms of change. Preliminary findings support the importance of attachment mechanisms and indicate that attachment-based interventions may strengthen substance-abusing mothers' capacities to foster their toddlers' socioemotional development.

Suldo SM; Mihalas S; Powell H; French R. Ecological predictors of substance use in middle school students. School Psychology Quarterly 23(3): 373-388, 2008. (67 refs.)

The current study examined important predictors of substance use during early adolescence. The authors hypothesized that adolescents' relationships with key adults (i.e., teachers and parents) influence their choices to use substances indirectly through links with their decisions regarding peer groups. A total of 461 middle school students from an affluent suburban community completed self-report measures of authoritative parenting, perceived social support from teachers, affiliation with rule-breaking and substance-using peers, and frequency of alcohol, cigarette, and drug use. Results of structural equation modeling supported the hypothesized model. Authoritative parenting and teacher support accounted for 31% of the variance in affiliation with deviant peers which, in turn, accounted for 27% of the variance in adolescent substance use; direct paths from parenting and teacher support to substance use were not indicated. Implications for school psychologists' involvement in substance use prevention and intervention are discussed.

Thompson RG; Lizardi D; Keyes KM; Hasin DS. Childhood or adolescent parental divorce/separation, parental history of alcohol problems, and offspring lifetime alcohol dependence. Drug and Alcohol Dependence 98(3): 264-269, 2008. (41 refs.)

Background: This study examined whether the experiences of childhood or adolescent parental divorce/separation and parental alcohol problems affected the likelihood of offspring DSM-IV lifetime alcohol dependence, controlling for parental history of drug, depression, and antisocial behavior problems. Method: Data were drawn from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a nationally representative United States survey of 43,093 civilian non-institutionalized participants aged 18 and older, interviewed in person. Logistic regression models were used to calculate the main and interaction effects of childhood or adolescent parental divorce/separation and parental history of alcohol problems on offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Results: Childhood or adolescent parental divorce/separation and parental history of alcohol problems were significantly related to offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Experiencing parental divorce/separation during childhood, even in the absence of parental history of alcohol problems, remained a significant predictor of lifetime alcohol dependence. Experiencing both childhood or adolescent parental divorce/separation and parental alcohol problems had a significantly stronger impact on the risk for DSM-IV alcohol dependence than the risk incurred by either parental risk factor alone. Conclusions: Further research is needed to better identify the factors that increase the risk for lifetime alcohol dependence among those who experience childhood or adolescent parental divorce/separation.

Tildesley EA; Andrews JA. The development of children's intentions to use alcohol: Direct and indirect effects of parent alcohol use and parenting behaviors. Psychology of Addictive Behaviors 22(3): 326-339, 2008. (62 refs.)

The purpose of this study was to explore the effect of parent alcohol use and parenting behavior on the development of children's intentions to use alcohol in Grades 1 through 8 . The authors hypothesized that the effect of parent alcohol use on children's intention to use alcohol would be mediated through parenting behavior, specifically monitoring/supervision, positive parenting. and inconsistent discipline. Using cohort-sequential latent growth modeling (I-GM). the authors tested 3 models examining the effect of the development of parent alcohol use on the development of children's intentions to use alcohol, as mediated by the development of each of the 3 parenting behaviors. Multiple group analyses were used to explore gender differences. The effect of growth in parent alcohol use on growth in children's intentions was mediated only by parent monitoring/supervision and was significant only for girls. The effect of inconsistent discipline was directly related to growth in intentions for both boys and girls. Although parent alcohol use was related to less positive parenting, positive parenting was unrelated to children's intentions to use alcohol.

Tin ST; Ameratunga S; Robinson E; Crengle S; Schaaf D; Watson P. Drink driving and the patterns and context of drinking among New Zealand adolescents. Acta Paediatrica 97(10): 1433-1437, 2008. (30 refs.)

Aim: To examine the association between drink driving and the patterns and locations of usual drinking among New Zealand adolescents. Methods: This is a secondary analysis of data from a nationally representative youth health survey, the sampling frame for which was all New Zealand secondary schools with more than 50 students enrolled in years 9 to 13 (ages 12 to 18 years) in 2001. The analysis was restricted to the 3408 survey respondents aged 15 years or older who were current drinkers and drivers. Results: In total, 17.3% of participants reported drink driving in the previous month. Drink driving was significantly associated with frequent (at least weekly) alcohol use, binge drinking and usually drinking away from home, that is in cars, outdoors, at bars or nightclubs, at parties, at school and at work. Students' perception that parents and schools care about them, parental monitoring, and high academic achievement was associated with a reduced risk of drink driving while having friends who drink alcohol increased this risk. These associations were similar among boys and girls. Conclusion: The findings support calls to address how and where young people drink, and indicate the potential gains to be made with family- and school-based interventions.

Turrisi R; Larimer ME; Mallett KA; Kilmer JR; Ray AE; Mastroleo NR et al. A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students. Journal of Studies on Alcohol and Drugs 70(4): 555-567, 2009. (88 refs.)

Objective: The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes). Method: Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend, drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested. Results: The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects. Conclusions: The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.

van Ours JC; Williams J. Why parents worry: Initiation into cannabis use by youth and their educational attainment. Journal of Health Economics 28(1): 132-142, 2009. (26 refs.)

In this paper we use individual level data from the Australian National Drug Strategy Household Survey to study the relationship between initiation into cannabis use and educational attainment. Using bivariate duration analysis we find that those initiating into cannabis use are much more likely to dropout of school, and that the reduction in years of education depends on the age at which initiation into cannabis occurs. We also find that the impact of cannabis uptake is larger for females than males.

Vandewalker I. Taking the baby before it's born: Termination of the parental rights of women who ue illegal drugs while pregnant. New York University Review of Law & Social Change 32: 423+, 2008. (211 refs.)

Summary ... While the termination of parental rights for drug use during pregnancy by itself fails to be narrowly tailored (because the alternative of offering treatment and services would not restrict a fundamental right), offering treatment and taking the child away only if the mother refuses treatment or fails to defeat her addiction theoretically restricts the right to care and custody of children only in cases where the state must separate the family to serve its interests in fetal health or child welfare. ... It provides that mothers who give birth to babies with a controlled substance or metabolite thereof in their blood, urine, or meconium are thereby unfit parents. ... A presumption that a woman who used drugs while pregnant is an unfit parent will effect the unnecessary separation of families - that is, the separation of families in which the mother was not unfit despite a drug addiction - counter to the state's interest in maintaining fit families. ... First, since prenatal drug use does not invariably harm the fetus, laws that provide for the termination of parental rights because of the presence of drugs alone infringe upon the interests of more women than is necessary to effect the state's purpose of protecting fetal health.

Watkins LE; O'Farrell TJ; Suvak MK; Murphy CM; Taft CT. Parenting satisfaction among fathers with alcoholism. Addictive Behaviors 34(6-7): 610-612, 2009. (11 refs.)

This study examined parenting satisfaction among a clinical sample of 88 men with alcoholism at baseline and 6-month and 12-month follow-up. Findings indicated no overall improvements in parenting satisfaction from the outset of treatment across assessments. Alcohol consumption variables were associated with parenting satisfaction at the bivariate level, and changes in alcohol consumption from pre to post treatment emerged as a significant predictor of changes in parenting satisfaction over the course of the study. Greater decreases in alcohol consumption were associated with greater improvement in parenting satisfaction.