Project CORK Website

powerpoint presentations
CORK database search
resource materials
bibliographies
clinical tools
user services
newsletters
about cork
home

...on Substance Use and Adolescents

www.ProjectCork.org

Fall 2002

Adolescent treatment for substance use disorders: Outcomes and outcome predictors.

Harrison PA; Asche SE. Journal of Child & Adolescent Substance Abuse 11(2): 1-17, 2001. (22 refs.)
A statewide treatment outcomes monitoring system included baseline interviews with 387 adolescents and 363 parents representing 37 programs. This study examined adolescent and parent predictors of treatment completion and 6-month outcomes; the adolescent follow-up rate was 83.5%. Only 21.4% of the adolescents reported abstinence for the 6 months following treatment; however, marijuana use frequency, symptom counts, illegal activities, and emotional distress declined significantly. Logistic regression analyses showed that female gender increased the likelihood of both treatment completion and posttreatment abstinence, but parent participation in treatment predicted neither. These and other results are discussed in terms of their implications for examining the current treatment system.

Beyond the U-curve: The relationship between sport and alcohol, cigarette and cannabis use in adolescents.

Peretti-Watel P; Beck F; Legleye S. Addiction 97(6): 707-716, 2002. (52 refs.)
Aims: This study aimed at increasing understanding of the relationship between sporting activities and alcohol, cigarette and cannabis use among adolescents, by examining gender, age and the context of sporting practice. Design, setting, subjects The study was a national school survey (n = 10807: ages 14-19 years) conducted in France in 1999. Measures Respondents were asked confidentially by self-administered questionnaire (pen and paper) about their use of licit and illicit drugs and life-style (including sporting activities outside school: hours per week, registration in a club, type of sport). Findings: The U-shaped curve between the intensity of physical activities and licit and illicit drug use appeared not to be systematic. It depended mainly on the product and the level of use. It only remained significant for boys and heavy smoking once gender and age effect were taken into account. Conclusion: The results stress the need to control for age and gender when the survey participants are teenagers. The relationship between drug use and sporting activity also depends on the type of sport.

Brief prevention for adolescent risk-taking behavior.

D'Amico EJ; Fromme K. Addiction 97(5): 563-574, 2002. (47 refs.)
Aims: Despite widespread prevention efforts to decrease adolescent risk-taking, substance use and driving after drinking (DD) are prevalent in the United States. The current study compared the efficacy of an abbreviated version of Drug Abuse and Resistance Education (DARE-A) to it new Risk Skills Training Program (RSTP). Design: Adolescent participation in drinking, drug use, DD and riding with a drunk driver was examined longitudinally. After baseline assessments, adolescents were randomly assigned to the RSTE. DARE-A or a no intervention control group and then completed 2-month post- test and 6-month follow-up assessments. Setting: Adolescents attended a mid-sized suburban high school. Participants: The sample (n = 300) was comprised of 58% females and the age range was 14-19 years. Intervention: The RSTP was developed to target. several risk behaviors and to examine the feasibility of conducting a brief personalized prevention program in a group setting. DARE-A focused on increasing knowledge and understanding the deleterious effects of substance use. Measurements: Risk-taking behavior, perception of peer risk-taking and positive and negative alcohol expectancies were assessed. Findings: RSTP participants decreased participation in several risk behaviors at post-test, but reductions were not maintained at. 6-month follow-up. The control and DARE-A groups increased their positive and decreased their negative alcohol expectancies. The control group increased their alcohol consumption. Conclusions: Results suggest that a brief. personalized, group prevention program is a feasible approach to reducing adolescent risk-taking. Strategies must be developed to solidify these positive changes so that they are longer-lasting.

Caffeine "addiction" in high school youth: Evidence of an adverse health relationship.

Rockett IRH; Putnam SL. Addiction Research & Theory 10(1): 31-42, 2002. (17 refs.)
This exploratory study examined the association between self-reported caffeine "addiction" among high school students and their sociodemographic, health and welfare characteristics. Study subjects (n = 6,867) were drawn from the approximately 59,000 students in grades 9 through 12, who were surveyed about their drug use in 108 randomly selected Tennessee high schools in 1995. They indicated lifetime abstinence from all psychoactive drugs except caffeine, Multiple logistic regression analysis revealed excess risks for caffeine "addiction" among females who were white (OR = 2.0), in poor health and/or physically disabled (OR = 1.6), chronically depressed (OR = 1.5), had a parent with an alcohol or other drug problem (OR = 1.4), and perceived little or no harm from caffeine use (OR = 2.2). Excess risks for caffeine "addiction" were found among males who were white (OR = 1.8), severely stressed (OR = 1.8), had a friend with an alcohol or other drug problem (OR = 1.5), and perceived little or no harm from caffeine use (OR = 2.5).

Delay of gratification: Impulsive choices and problem behaviors in early and late adolescence.

Wulfert E; Block JA; Ana ES; Rodriguez ML; Colsman M. Journal of Personality 70(4): 533-552, 2002. (41 refs.)
High school students were offered a monetary incentive for participating in research. They were given a choice between a smaller fee immediately or a larger fee one week later. Compared to students who delayed gratifycation, those who chose the immediate fee showed more self-regulatory deficits. They showed greater involvement with cigarettes, alcohol, and marijuana, had a poorer self-concept and under-performed academically. A replication study with middle-school students and different reward parameters yielded equivalent results. Younger adolescents who chose the immediate monetary incentive showed a similar pattern of problem behaviors as the high school students. The findings indicate that this simple choice-de-lay procedure yields an unobtrusive behavioral measure of self-regulation and offers a developmentally appropriate extension of the delay-of-gratification paradigm for use with older children and adolescents.

Differentiating peer contexts and risk for adolescent substance use.

Hussong AM. Journal of Youth and Adolescence 31(3): 207-220, 2002. (42 refs.)
The peer context is perhaps the most salient, robust predictor of an adolescent's substance use. However, in previous studies, the peer context is often poorly defined. The current study examined 3 models to understand how substance use within best friendships, peer cliques, and social crowds predicts adolescents' substance involvement. A sample of 377 high school juniors and seniors completed surveys assessing substance use and peer relationships. Results suggest that each of these 3 dimensions of the peer context uniquely predict adolescent substance use. Moreover, these peer contexts interacted in the prediction of adolescents' substance use such that adolescents who were more highly embedded in substance- using peer contexts showed greater risk for substance use whereas adolescents with substance-using best friends showed a reduced risk for substance use if they had other close friends who were less involved with substances.

Discharge status as a performance indicator: Can it predict adolescent substance abuse treatment outcome?

Godley MD; Godley SH; Funk RR; Dennis ML; Loveland D. Journal of Child & Adolescent Substance Abuse 11(1): 91-109, 2001. (43 refs.)
Several market forces including the federal government (Government Performance and Results Act of 1993), managed behavioral health care, and accreditation organizations such its JCAHO, NCQA, and CARF are placing increasing emphasis on substance abuse treatment programs to use performance indicators to monitor quality of outcomes. Discharge status is a frequently cited performance indicator with high intuitive appeal to serve as a low-cost proxy indicator of therapeutic outcome. Researchers are just beginning to address the relationship of discharge status to therapeutic outcomes for adolescents treated for substance abuse. The purpose of the present study was to assess the relationship between discharge status and therapeutic outcomes after discharge from a residential treatment program for adolescents. Eighty-six clients were categorized based on the discharge status assigned to them by the treatment program and interviewed using the Global Appraisal of Individual Needs (GAIN) questionnaire at intake and 90 days after discharge. Results of this study did not indicate superior outcomes for the planned discharge group. Both groups significantly decreased their days of use, heavy use, and problems related to alcohol and other drug use. Several issues are raised regarding the use of discharge status as a performance indicator and recommendations are made for further research in this area.

Friends: The role of peer influence across adolescent risk behaviors.

Maxwell KA. Journal of Youth and Adolescence 31(4): 267-277, 2002. (61 refs.)
This longitudinal project examined peer influence across five risk behaviors: cigarette smoking, alcohol consumption, marijuana use, tobacco chewing, and sexual debut. A total of 1,969 adolescents aged 12-18 years completed two waves of data collection. Each respondent matched behavior data for at least one friend. Results found that a random same sex peer predicts a teen's risk behavior initiation; there is influence only to initiate cigarette and marijuana use; and that there is influence to initiate and stop alcohol and chewing tobacco use. This finding suggests that friends may protect adolescents from risk activities. The study has implications for understanding how peer influence, expressed as social norms, may be used in public health campaigns that target teen behavior.

Intervening with youthful substance abusers: A preliminary analysis of a juvenile drug court.

Applegate BK; Santana S. Justice System Journal 21(3): 281-300, 2000. (40 refs.)
Special drug courts have been established across the country in an effort to provide more-efficient treatment services to drug offenders and to alleviate case-processing difficulties. Although several evaluations have shown promising results for adult drug courts, the evidence on the effects of drug courts for juvenile defendants is scarce. This study analyzes the experiences of a southern juvenile drug court during its first fourteen months of operation. Our results reveal that client retention was comparable to that for adult drug courts, that the drug court was able to improve the participants' overall level of social and psychological functioning, and that recidivism was significantly reduced and delayed for the program graduates compared to the youths who failed to complete the program.

Adolescents' reactions to the imagery displayed in smoking and antismoking advertisements.

Shadel WG; Niaura R; Abrams DB. Psychology of Addictive Behaviors 16(2): 173-176, 2002. (15 refs.)
This study compared adolescents' unbiased perceptions of the images displayed in smoking and antismoking advertising. Twenty-nine adolescents (ages 11-17) were shown images taken from both advertising types; all images were digitally edited so that no product information appeared in them. Participants described each image in a free-response format and rated each image on self-report dimensions. Content analyses of free-response descriptions and analyses of self-reports revealed that adolescents viewed images taken from cigarette advertisements more positively compared with images taken from antismoking advertisements. These findings suggest that 1 reason for the potency of cigarette advertising, compared with antismoking advertising, is the inherent positive appeal of the images displayed. Antismoking advertising may be more effective at limiting adolescent smoking if the images displayed have a more positive valence.

Predictors of motivation to change after medical treatment for drinking-related events in adolescents.

Barnett NP; Lebeau-Craven R; O'Leary TA; Colby SM; Woolard R; Rohsenow DJ; Spirito A; Monti PM. Psychology of Addictive Behaviors 16(2): 106-112, 2002. (29 refs.)
Characteristics associated with intention to change drinking were examined in 254 adolescents treated in an emergency department for alcohol. Younger age, living at home, lower baseline level of drinking and drinking problems, greater depression, having penalties for breaking family drinking rules, higher injury severity, being frightened, and being admitted to the hospital predicted greater intention to change drinking at the time of the event. Baseline characteristics related to being in the action stage of change 3 months later were younger age; lower drinking; having penalties for breaking family drinking rules; injury severity; and number of anticipated consequences, including being in trouble with parents. This study has implications for brief interventions that capitalize on potential teachable moments with problem-drinking adolescents.

Understanding the authoritative parenting-early adolescent tobacco use link: The mediating role of peer tobacco use.

Adamczyk-Robinette SL; Fletcher AC; Wright K. Journal of Youth and Adolescence 31(4): 311-318, 2002. (31 refs.)
Eighth-grade students (N = 156) completed questionnaires in which they reported on their perceptions of parents' warmth, structure, and psychological autonomy granting (used to create an index of authoritative parenting) and their own levels of tobacco use. Adolescents were also asked to list the names of other students at their school with whom they spent time ("friends"). Independent reports obtained from these friends were used to form an index of the mean level of tobacco use among each adolescent's friends. Higher levels of authoritative parenting were associated with lower levels of tobacco use among target adolescents. The association between parental authoritativeness and adolescent tobacco use was mediated by levels of tobacco use among peers. An amplification effect was observed in which adolescents were particularly unlikely to use tobacco products when they both received authoritative parenting at home and were members of non-tobacco-using peer groups.

Parenting style and adolescent smoking.

O'Byrne KK; Haddock CK; Poston WSC. Journal of Adolescent Health 30(6): 418-425, 2002. (38 refs.)
Purpose: To investigate whether parenting style is an independent risk factor of smoking initiation and experimentation among adolescents, and whether there is a relationship between parenting style and readiness to quit, or nicotine dependence among smokers. Methods: The 84-item Health and Smoking Questionnaire, which assesses demographics, smoking status and smoking history, perceptions of risk and risk reduction, risk factors for tobacco use, and parenting style, was administered to 816 adolescents in grades 7 to 12 (mean age, 15.1 years) of whom 22.6% (n = 182) were smokers. Parenting style was measured by the brief, nonretrospective version of the Family of Origin Scale (FOS). Higher scores on the FOS indicated more positive perceived parenting style with high levels of intimacy and autonomy, characteristics of healthy parent-child relationships. Data were analyzed using a model-building approach to logistic regression with demographic and other psychosocial variables in the first two steps, and with parenting style as the last step. Results: Results from two logistic regression models indicate that although parenting style is not a significant risk factor for smoking experimentation [odds ratio (OR) = .998; confidence interval (CI) = .977-1.019; p = .820], it is a significant independent risk factor for smoking initiation (OR = .950; CI = .930-.970; p = .000). Smokers who were more ready to quit had higher parenting style scores than those who were not ready to quit, and smokers who had made a serious quit attempt (an indicator of nicotine addiction) had higher parenting style scores than those who had not made a quit attempt. Moreover, nonsmokers who reported they would smoke a cigarette if their best friend offered had significantly lower parenting style scores than those who reported they would not smoke a cigarette. Conclusions: Additional research on parenting style and its impact on adolescent smoking with a more economically and ethnically diverse sample is warranted. If future research confirms the strength of the relationship between parenting style and adolescent smoking, teaching positive parenting, including facilitating intimate yet autonomous relationships, may be considered as part of smoking prevention and cessation programs.