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...on Adolescents
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www.ProjectCork.org
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Spring 2005
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Alcohol-related services: Prevention, secondary intervention, and treatment preferences of adolescents.
D'Amico EJ; McCarthy DM; Metrik J; Brown SA. Journal of Child & Adolescent Substance Abuse 14(2): 61-80, 2004. (39 refs.)
Many youth experience alcohol-related problems; however, the majority report that they would not use a prevention program even if they perceived a need. Ninth through 12th grade students (N = 2883) completed surveys on alcohol use, willingness to use alcohol-related resources, and factors that might influence utilization. Adolescents were categorized into five groups: non-drinkers, recent abstainers, moderate drinkers, heavy drinkers, and problem drinkers. Level of alcohol use was inversely related to intention to use services. Heavy and problem drinkers also evaluated facilitators differently than abstaining and moderate drinking youth. Findings highlight the difficulty of engaging heavier drinking youth with strategies that may be more appealing to non-problematic drinkers. Results have important implications for the development of distinct alcohol prevention and intervention programs, and highlight the value of using multiple options to increase the likelihood of service utilization by non-drinking and drinking adolescents. Copyright 2004, Haworth Press, Inc.
A new measure of smoking initiation and progression among adolescents.
Sun P; Unger JB; Sussman S. American Journal of Health Behavior 29(1): 3-11, 2005. (25 refs.)
Objective: To develop a new measure of smoking initiation and progression among adolescents. Method. This study used data from 2504 regular and alternative high school students to evaluate the psychometric properties of a new 3-item, 5-stage measure of smoking initiation and progression. Results: The categorization method showed good 4-week test-retest reliability (.83 among boys and.87 among girls). The demographic distribution of adolescents into stages was consistent with previous research. Conclusion: This 5-stage classification method could be a useful framework for describing variation along the smoking uptake and progression continuum. Copyright 2005, PNG Publications.
Adolescent drug use escalation and de-escalation: A 3-year follow-up study.
Bolognini M; Plancherel B; Laget J; Stephan P; Chinet L; Bernard M et al. Addiction Research & Theory 13(1): 19-33, 2005. (32 refs.)
This study aims to assess adolescents drug use with a longitudinal perspective in order to identify factors interacting with drug use onset and course. Supported by the Swiss Federal Office of Publicic Health, the study was initiated in 1999 with a follow-up in 2001 and 2002. The first objective was to measure risk factors for substance use initiation. The second objective was to analyse the co-variation of substance use with environmental, social, relational, medical and psychological factors. A total of 102 adolescents, aged 14-19 years, were recruited for the study in the French-speaking part of Switzerland. Results clearly show that substance use is not a disorder per se in adolescence, but that it is part of a multidimensional complex of problems that some adolescents may encounter: increase and decrease in substance use is paralleled with an increase or decrease in the other areas. This implies that prevention of substance use should not be focused mainly on substances but should consider the adolescent's environment and significant life areas. Copyright 2005, Taylor & Francis Ltd.
Effects of smoking and smoking abstinence on cognition in adolescent tobacco smokers.
Jacobsen LK; Krystal JH; Mencl WE; Westerveld M; Frost SJ; Pugh KR. Biological Psychiatry 57(1): 56-66, 2005. (85 refs.)
Background: In adult animals and humans, nicotine can produce short-term cognitive enhancement and, in some cases, neuroprotection. Recent work in animals, however, suggests that exposure to nicotine during adolescence might be neurotoxic. We tested for evidence of acute and chronic effects of tobacco smoking on cognition in adolescents who smoked tobacco daily and were tested for evidence of acute and chronic effects compared with adolescent nonsmokers. Methods: Verbal working memory, verbal learning and memory, selective, divided, sustained attention, mood, symptoms of nicotine withdrawal, and tobacco craving were examined in 41 adolescent daily smokers and 32 nonsmokers who were similar in age, gender, and education. Analyses were controlled for general intelligence, reading achievement, parental educational attainment, baseline affective symptoms, and lifetime exposure to alcohol and cannabis. Results: In adolescent smokers, cessation of tobacco use increased tobacco craving, symptoms of nicotine withdrawal, and depressed mood. Adolescent smokers were found to have impairments in accuracy of working memory performance irrespective of recency of smoking. Performance decrements were more severe with earlier age of onset of smoking. Adolescent smokers experienced further disruption of working memory and verbal memory during smoking cessation. As a group, male smokers initiated smoking at an earlier age than female smokers and were
significantly more impaired during tests of selective and divided attention than female smokers and nonsmokers. Conclusions: Adolescent daily tobacco smokers experience acute impairments of verbal memory and working memory after smoking cessation, along with chronic decrements in cognitive performance that are consistent with preclinical evidence that neurotoxic effects of nicotine are more severe when exposure to nicotine occurs at earlier periods in development. Copyright 2005, Elsevier Science, Ltd.
Exploring children's conceptions of smoking addiction.
Wang C; Henley N; Donovan RJ. Health Education Research 19(6): 626-634, 2004. (33 refs.)
Tobacco addiction is a major health problem for both adults and young people-between 20 and 60% of
adolescents are dependent on nicotine and more than two-thirds who attempt to quit experience
withdrawal symptoms. Yet, anti-smoking efforts targeted at children emphasize primary prevention
and ignore addiction education, which is generally considered relevant only to adult smoking and
cessation efforts. This study reports children's concepts of smoking and addiction from interviews
with 32 Western Australian boys and girls, aged 9-10 years, all non-smokers. Results suggest
children's concepts of smoking addiction may influence attitudes toward smoking trials. Children
who thought addiction happened immediately were committed to never smoke at all. Others who thought
addiction happened after several cigarettes expressed intentions to experiment. These children
believed they could avoid addiction by smoking less than the number of cigarettes that caused
addiction. Children who defined addiction as 'liking' or 'enjoying the taste of cigarettes'
believed they could avoid being 'hooked' as long as they managed to avoid enjoying the experience.
Recent findings that children can get 'hooked' within a few days of smoking highlight the importance
of addiction strategies targeted at children, particularly in relation to influencing intentions to
experiment with smoking. Copyright 2004, Oxford University Press.
Mental health status of infrequent adolescent substance users.
Williams RJ; Zolner T; Bertrand LD; Davis RM. Journal of Child & Adolescent Substance Abuse 14(2): 41-60, 2004. (54 refs.)
Frequent substance use has a strong association with poor mental health. The relationship between infrequent substance use and mental health is less clear. The present study investigated this relationship in a large group (n = 2118) of 12-19-year-olds from Alberta, Canada. Results indicated that adolescents who used tobacco or alcohol once a month or less tended to have equivalent mental health status to abstainers. Using cannabis 3-5 times/year or less had no adverse mental health associations. However, poorer mental health was associated with single time use of hallucinogens or other drugs. In general, substance usage tended to have more negative mental health associations for younger compared to older adolescents. Copyright 2004, Haworth Press, Inc.
Methods, locations, and ease of cigarette access for American youth, 1997-2002.
Johnston LD; O'Malley PM; Terry-McElrath YM. American Journal of Preventive Medicine 27(4): 267-276, 2004. (36 refs.)
Background: The purpose of this paper is to examine trends in middle and high school students' perceived ease, methods, and locations of access to cigarettes, and to assess differences related to their sociodemographic characteristics and smoking status. Methods: Annual data from nationally representative samples of 8th-, 10th-, and 12th-grade students were analyzed for the 1997-2002 period. Analyses were conducted in 2003. Results: Perceived ease of access decreased significantly among never and past smokers. Decreased individual purchasing in retail outlets, as well as decreased purchasing from vending machines, were reported by 8th- and 10th-grade students. All grades reported decreased purchasing from self-service placements of cigarettes. Decreases in access were not reported across all retailer types, and no significant increases were seen in the percent of underage purchasers who reported being asked to show identification. Both gender and ethnicity were significantly related to where and how underage youth reported obtaining cigarettes. Conclusions: Cigarette access for minors has been declining, but remains high. Findings show that (1) perceived access to cigarettes clearly increases with level of smoking, and (2) policies to reduce such access may be having an impact as evidenced by decreased retail and vending machine purchases and self-service purchases. However, states should continue to strengthen efforts to
reduce youth cigarette access, especially in the areas of confirming buyer age via identification checks, and should make efforts to decrease access across all retailer types. Federal regulations like those previously implemented by the Food and Drug Administration might strongly assist in reducing youth access to cigarettes. Copyright 2004, Elsevier Science, Inc.
National legislation on school smoking restrictions in eight European countries.
Wold B; Currie C; Roberts C; Aaroe LE. Health Promotion International 19(4): 482-488, 2004. (23 refs.)
Objective: To review and compare national legislation addressing smoking at school in eight European countries during the late 1990s. Design: The data are from the EC-funded Control of Adolescent Smoking (CAS) study in eight European countries. The information on national legislation was gathered during the period 1998-1999, through a review of scientific and official documents and interviews with key informants in each country. Results: Four of the participating countries (Austria, French-speaking Belgium, Finland and Norway) had legislation specifically restricting smoking at school, while the remaining countries (Denmark, North Rhein Westphalia region of Germany, Scotland and Wales in the UK) did not have such legislation in place. In those countries with legislation in place, smoking among students aged 15 years and younger was not permitted. The position with regard to teacher smoking varied considerably among countries, but with the exception of Finland, there was no legislation regulating outdoor smoking by teachers during school hours. Conclusions: The findings suggest that there were inconsistencies within countries in terms of legislation that had been developed and the enforcement, compliance and monitoring practices that were in place. Further work is required to develop and resource such mechanisms, although it may be possible to build on existing practice, such as increasing the involvement of school health services,
school inspectorate services or working through health promoting school networks already established in many countries. Copyright 2004, Oxford University Press.
Premature adolescent autonomy: Parent disengagement and deviant peer process in the amplification of problem behaviour.
Dishion TJ; Nelson SE; Bullock BM. Journal of Adolescence 27(5): 515-530, 2004. (39 refs.)
Premature autonomy describes a developmental dynamic where parents of high-risk adolescents reduce their involvement and guidance when confronted with challenges of problem behaviour and the influence of deviant friendships. This dynamic was tested on the sample of Oregon Youth Study boys (N = 206), whose family management practices and friendships were observed on videotaped interaction tasks. Latent growth curve models were used to examine longitudinal trends between deviant friendship interactions and family management. Direct observations of deviant friendship process at age 14 were associated with degradation in family management during adolescence. A comparison of antisocial and well-adjusted boys clarified that parents of antisocial boys (started early and persisted) decreased family management around puberty, in comparison to parents of well-adjusted boys who maintained high levels of family management through adolescence. In predicting late adolescent problem behaviour, there was a statistically reliable interaction between family management degradation and deviant peer involvement in adolescence in support of the premature autonomy hypothesis. Adolescent males involved in deviant friendships, and whose parents decreased their family management, were most likely to use marijuana and commit antisocial acts at age 18. The implications for interventions that target adolescents are discussed. Copyright 2004,
The Association for Professionals in Services for Adolescents.
Prevalence of mental illness and substance abuse disorders among incarcerated juvenile offenders in Mississippi.
Robertson AA; Dill PL; Husain J; Undesser C. Child Psychiatry & Human Development 235(1): 55-74, 2004. (37 refs.)
The prevalence of psychiatric disorders among incarcerated juveniles in Mississippi was examined. A total of 482 adolescents completed a diagnostic questionnaire and a subset (N=317) was assessed with face-to-face semistructured interview. Most of the study participants met criteria for one mental disorder, 71-85% depending on assessment method, one-third have co-occurring mental health and substance abuse disorders. Gender and placement site differences in rates of some psychiatric disorders were also noted. Routine mental health screening should be performed on all juveniles placed in secure detention facilities to identify those who need treatment services. Copyright 2004, Kluwer Academic Publishers.
Teenage drinking and the onset of alcohol dependence: A cohort study over seven years.
Bonomo YA; Bowes G; Coffey C; Carlin JB; Patton GC. Addiction 99(12): 1520-1528, 2004. (42 refs.)
Aim: To determine whether adolescent alcohol use and/or other adolescent health risk behaviour pre-disposes to alcohol dependence in young adulthood. Design: Seven-wave cohort study over 6 years. Participant: A community sample of almost two thousand individuals followed from ages 1415 to 2021 years. Outcome measure: Diagnostic and Statistical Manual volume IV (DSM-IV) alcohol dependence in participants aged 2021 years and drinking three or more times a week. Findings: Approximately 90% of participants consumed alcohol by age 20 years, 4.7% fulfilling DSM-IV alcohol dependence criteria. Alcohol dependence in young adults was preceded by higher persisting teenage rates of frequent drinking [odds ratio (OR) 8.1, 95% confidence interval (CI) 4.2, 16], binge drinking (OR 6.7, 95% CI 3.6, 12), alcohol-related injuries (OR 4.5 95% CI 1.9, 11), intense drinking (OR 4.8, 95% CI 2.6, 8.7), high dose tobacco use (OR 5.5, 95% CI 2.3, 13) and antisocial behaviour (OR 5.9, 95% CI 3.3, 11). After adjustment for other teenage predictors frequent drinking (OR 3.1, 95% CI 1.2, 7.7) and antisocial behaviour (OR 2.4, 95% CI 1.2, 5.1) held persisting independent associations with later alcohol dependence. There were no prospective associations found with emotional disturbance in adolescence. Conclusion: Teenage drinking patterns and other health risk behaviours in adolescence predicted alcohol dependence in adulthood. Prevention and early intervention
initiatives to reduce longer-term alcohol-related harm therefore need to address the factors, including alcohol supply, that influence teenage consumption and in particular high-risk drinking patterns. Copyright 2004, Society for the Study of Addiction to Alcohol and Other Drugs.
The health of young people in a global context. (review).
Blum RW; Nelson-Mmari K. Journal of Adolescent Health 35(5): 402-418, 2004. (103 refs.)
Purpose: To examine the chief causes and influences of morbidity and mortality among young people throughout the world. Methods: A comprehensive literature search was conducted that included WHO's Global Burden of Disease, UNFPA's State of the Worlds' Population, Medline, Popline, Sociological Abstracts, as well as data collected from UNICEF, UNAIDS, Population Reference Bureau, and the United Nations Headquarters. Experts in the fields of substance use, suicide, and infectious diseases were also contacted for unpublished and published sources. Studies were restricted to those completed after 1985, had a sample size of at least 100, focused primarily on the age group of 10-24 years, and examined trends related to unintentional injuries, HIV/AIDS, suicide, homicide, war, maternal mortality, pregnancy, abortion, sexually transmitted diseases, substance abuse, and infectious diseases. Results: Trends in adolescent morbidity and mortality have shifted over the past decade from predominately infectious to social etiologies. Currently, unintentional injury is the leading killer of young people in nearly every region of the world, with homicide, war, and interpersonal violence following closely behind. Conclusions: The changes in population, migration, age of marriage, and education have had profound impact on the mortality and morbidity among adolescents. As we come to learn about the factors that influence adolescent morbidity and mortality,
we begin to have a better understanding of how to improve the health of youth throughout the world. Copyright 2004, Society for Adolescent Medicine.
The relationship between perceptions of neighborhood characteristics and substance use among urban African American adolescents.
Lambert SF; Brown TL; Phillips CM; Ialongo NS. American Journal of Community Psychology 34(3-4): 205-218, 2004. (66 refs.)
Although the neighborhood microsystem is recognized as an important domain for adolescent development, relative to the family and peer contexts, neighborhood factors have been understudied in relation to adolescent substance abuse. In addition. recent research suggests that risk factors for adolescent substance use may differ for African Americans when compared to Caucasian youth. This study investigated the association between perceived neighborhood disorganization and later substance use, as well as possible mediators of that association, among a community sample of urban African American adolescents. Perceptions of neighborhood disorgan-ization (i.e., violence/safety and drug activity) in grade 7 were associated with increased tobacco, alcohol, and marijuana use in grade 9. For females, this association was mediated by attitudes about drug use and perceptions of drug harmfulness. Findings highlight the importance of neighborhood contextual variables for African American substance use. Implications and directions for future research are presented. Copyright 2004, Kluwerr
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