Library Watch - On Adolescents

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Last Update: 31.03.07

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...on adolescents

www.ProjectCork.org

Spring 2007

A national survey of tobacco cessation programs for youths.

Curry SJ; Emery S; Sporer AK; Mermelstein R; Flay BR; Berbaum M et al. American Journal of Public Health 97(1): 171-177, 2007. (26 refs.)
Objectives. We collected data on a national sample of existing community-based tobacco cessation programs for youths to understand their prevalence and overall characteristics. Methods. We employed a 2-stage sampling design with US counties as the first-stage probability sampling units. We then used snowball sampling in selected counties to identify administrators of tobacco cessation programs for youths. We collected data on cessation programs when programs were identified. Results. We profiled 591 programs in 408 counties. Programs were more numerous in urban counties; fewer programs were found in low-income counties. State-level measures of smoking prevalence and tobacco control expenditures were not associated with program availability. Most programs were multisession, school-based group programs serving 50 or fewer youths per year. Program content included cognitive-behavioral components found in adult programs along with content specific to adolescence. The median annual budget was $2000. Few programs (9%) reported only mandatory enrollment, 35% reported mixed mandatory and voluntary enrollment, and 56% reported only voluntary enrollment. Conclusions. There is consider-able homogeneity among community-based tobacco cessation programs for youths. Programs are least prevalent in the types of communities for which national data show increases in youths' smoking prevalence.

Adolescent passengers of drunk drivers: A multi-level exploration into the inequities of risk and safety.

Poulin C; Boudreau B; Asbridge M. Addiction 102(1): 51-61, 2007. (43 refs.)
This study determined the individual-, neighbourhood- and provincial-level effects of rural residence, socio-economic status (SES), substance use and driving behaviours on adolescents' riding with a drunk driver (RDD). Multi-level study based on cross-sectional self-reported anonymous data from the Student Drug Use Survey in the Atlantic Provinces (SDUSAP) and Census Canada data, merged on the postal code of participating schools. The sample design of the SDUSAP was a single-stage cluster sample of randomly selected classes stratified by grade and region. The Atlantic provinces of Canada. A total of 12 990 students in junior and senior high schools, with an average age of 15 years, participated in the 2002 SDUSAP. The outcome variable was past-year RDD. The main individual-level independent variables were SES, rural residence, substance use and driving behaviours. The school-neighbourhood independent variables were the prevalence of heavy episodic drinking, driving under the influence of alcohol, driver's licence, highest level of educational attainment and low income. The prevalence of RDD was 23.3% in 2002. Among students in grades 9-12, lower family SES, rural residence, substance use and driving under the influence were found to be independent individual-level risk factors for RDD; having a driver's licence was found to be protective. At the provincial and school-neighbourhood levels, a high prevalence of driving under the influence of alcohol and low educational attainment were found to be independent risk factors for RDD after taking into account individual characteristics. This study provides evidence that inequities exist in the options for adolescents to be ensured of passenger safety, and that interventions aimed at decreasing the extent to which adolescents engage in riding with a drunk driver should be based on conceptual approaches that recognize ecological factors as well as individual-level susceptibility.

Adolescents' motivations to abuse prescription medications.

Boyd CJ; McCabe SE; Cranford JA; Young A. Pediatrics 118(6): 2472-2480, 2006. (27 refs.)
OBJECTIVES. Our goals were to (1) determine adolescents' motivations (reasons) for engaging in the nonmedical (illicit) use of 4 classes of prescription medications and (2) examine whether motivations were associated with a higher risk for substance abuse problems. RESPONDENTS. The 2005 sample (N = 1086) was derived from one ethnically diverse school district in southeastern Michigan and included 7th-through 12th-grade students. METHODS. Data were collected by using a self-administered, Web-based survey that included questions about drug use and the motivations to engage in nonmedical use of prescription medication. RESULTS. Twelve percent of the respondents had engaged in nonmedical use of opioid pain medications in the past year: 3% for sleeping, 2% as a sedative and/or for anxiety, and 2% as stimulants. The reasons for engaging in the nonmedical use of prescription medications varied by drug classification. For opioid analgesics, when the number of motives increased, so too did the likelihood of a positive Drug Abuse Screening Test score. For every additional motive endorsed, the Drug Abuse Screening Test increased by a factor of 1.8. Two groups of students were compared (at-risk versus self-treatment); those who endorsed multiple motivations for nonmedical use of opioids (at-risk group) were significantly more likely to have elevated Drug Abuse Screening Test scores when compared with those who were in the self- treatment group. Those in the at-risk group also were significantly more likely to engage in marijuana and alcohol use. CONCLUSION. The findings from this exploratory study warrant additional research because several motivations for the nonmedical use of prescription medications seem associated with a greater likelihood of substance abuse problems.

Children, adolescents, and advertising.

Shifrin DL; Broughton DD; Buttross S; Ginsburg KR; de Rivas RG; Committee on Communications. Pediatrics 118(6): 2563-2569, 2006. (95 refs.)
Advertising is a pervasive influence on children and adolescents. Young people view more than 40 000 ads per year on television alone and increasingly are being exposed to advertising on the Internet, in magazines, and in schools. This exposure may contribute significantly to childhood and adolescent obesity, poor nutrition, and cigarette and alcohol use. Media education has been shown to be effective in mitigating some of the negative effects of advertising on children and adolescents.

Dextromethorphan abuse in adolescence: An increasing trend: 1999-2004.

Bryner JK; Wang UK; Hui JW; Bedodo M; MacDougall C; Anderson IB. Archives of Pediatrics & Adolescent Medicine 160(12): 1217-1222, 2006. (14 refs.)
Objectives: To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design: A 6-year retrospective review. Setting: California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants: All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure: The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results: A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43-1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions: Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population.

Drug abuse risk and protective factors among Black urban adolescent girls: A group-randomized trial of computer-delivered mother-daughter intervention.

Schinke S; Di Noia J; Schwinn T; Cole K. Psychology of Addictive Behaviors 20(4): 496-500, 2006. (29 refs.)
A group-randomized design tested a mother-daughter intervention in which researchers aimed to increase protective factors in a community sample of Black urban adolescent girls. Girls and their mothers at 2 community agencies were pretested and, by agency, were randomized to either an intervention arm or a control arm. Intervention arm girls and their mothers received a program for improving mother-daughter rapport. Posttest data collected 3 weeks after program delivery revealed that intervention arm mothers and daughters improved more than did control arm mothers and daughters on measures of communication and closeness. At 3-month follow-up, intervention arm mothers, relative to control arm mothers, continued to report better communication with and closeness to their daughters. Girls and mothers in the intervention arm rated the computer program favorably on parameters of enjoyment. comfort, relevance, usefulness of information, improvements to their relationship with one another. and whether they would recommend the computer program to friends.

Effects of mass communication on attitudes toward anabolic steroids: An analysis of high school seniors.

Denham BE. Journal of Drug Issues 36(4): 809-829, 2006. (28 refs.)
Drawing on a national probability sample of high school seniors (n = 2,560), this research explores relationships between exposure to four types of mass communication-magazines, movies, newspapers, and television-and attitudes toward anabolic steroids, operationalized along three dependent measures. Logistic regression analyses revealed statistically significant relationships among (a) magazine exposure and estimates of drug use in professional sports, (b) newspaper and television exposure and disapproval of steroid use, (c) newspaper exposure and estimates of self-inflicted harm caused by steroid use, and (d) exposure to anti-drug spots and each of the three dependent variables. Theoretical and methodological Implications and suggestions for future research are discussed.

Employment and adolescent alcohol and drug treatment and recovery: An exploratory study.

Godley SH; Passetti LL; White MK. American Journal on Addictions 15(Supplement 1): 137-143, 2006. (31 refs.)
Studies of adolescents in the general population show that most high school students are employed and that there is a positive linear relationship between hours worked and increases in alcohol and other drug use. Mixed methods are used to examine the relationship of employment for adolescents who are in outpatient substance abuse treatment to their use, treatment experiences, and recovery. Several theories offered to explain the relationship between adolescent employment and substance use were examined. Most adolescents were employed, often during treatment, with increasing numbers reporting employment over the year-long follow-up period. Adolescents reported frequent alcohol and other drug use after work and with coworkers and indicated that income from work often was used to purchase alcohol and other drugs. Most parents did not provide monitoring of work-related income. Balancing employment and treatment was often logistically difficult and stressful for the adolescents. Employment situations are a critical aspect of adolescents' recovery environment, and more research is needed to learn how to create support for recovery in this aspect of an adolescent's life.

Family structure, family tension, and self-reported marijuana use: A research finding of risky behavior among youths.

Hollist DR; McBroom WH. Journal of Drug Issues 36(4): 975-998, 2006. (60 refs.)
This article examines the role of family structure in the self-reported lifetime and past month use of marijuana within a sample of American children. The research makes comparisons between youths living in two parent homes where both the biological father and mother are present and those who live in single parent, stepparent, or nonparent families. The results show that youths living in two parent families are far less likely to report ever having used marijuana, associate with marjuana using friends, or have siblings who use marijuana. Youths from two parent families, even those typified by high levels of tension in the household, are shown to report less use of marijuana than youths from low or high conflict homes where one or both of the biological parents are absent. The findings are similar for both males and females. Implications of the results as well as directions for future research are presented.

Impact of victimization on substance abuse treatment outcomes for adolescents in outpatient and residential substance abuse treatment.

Shane P; Diamond GS; Mensinger JL; Shera D; Wintersteen MB. American Journal on Addictions 15(Supplement 1): 34-42, 2006. (32 refs.)
This paper considers whether victimization moderates adolescents' outcomes in substance abuse treatment. Adolescents (N = 975) in outpatient and residential settings were assessed at intake, three, six, nine, and 12 months. Differential outcomes by gender and degree of victimization were analyzed. Dependent variables were marijuana use and substance-related problems. The residential sample reported higher baseline marijuana use and victimization. Both samples significantly reduced marijuana use and associated-problems during treatment. Victimization was significantly related to more substance-related problems at intake and follow-up. More severe trauma histories in residential females were associated with significantly greater persistence in substance-related problems post-discharge.

Medical and nonmedical use of prescription drugs among secondary school students.

McCabe SE; Boyd CJ; Young A. Journal of Adolescent Health 40(1): 76-83, 2007. (28 refs.)
Purpose: The main objective of this study was to assess the prevalence of medical and nonmedical use of four categories of prescription drugs (opioid, stimulant, sleeping, and sedative/anxiety medication) in a racially diverse sample of secondary public school students in the Detroit metropolitan area. A secondary objective was to examine the association between the use of four categories of prescription medications and illicit drug use and probable drug abuse. Methods: In 2005, a Web-based survey was self-administered by 1086 secondary school students in grades seven through 12. Results: The sample consisted of 54% female, 52% White, 45% African American, and 3% from other racial categories. Forty-eight percent of the sample reported no lifetime use of four categories of prescription drugs (nonusers), 31.5% reported medically prescribed use only (medical users), 17.5% reported both medical and nonmedical use (medical/nonmedical users) and 3.3% reported nonmedical use only (nonmedical users). Multivariate analyses indicated that medical/nonmedical users and nonmedical users were significantly more likely than nonusers to report illicit drug use and probable drug abuse. Medical users generally reported similar or increased odds of illicit drug use and probable drug abuse than non-users. Conclusions: These findings provide evidence that nonmedical use of prescription drugs represents a problem behavior among secondary school students.

Parental rules and monitoring of children's movie viewing associated with children's risk for smoking and drinking.

Dalton MA; Adachi-Mejia AM; Longacre MR; Titus-Ernstoff LT; Gibson JJ; Martin SK et al. Pediatrics 118(5): 1932-1942, 2006. (74 refs.)
OBJECTIVES. Evidence suggests that media portrayals of tobacco and alcohol use are important predictors of adolescent smoking and drinking. We examined the role of parents in monitoring and limiting children's movie exposure and whether or not this was associated with a lower risk of adolescent smoking and drinking. DESIGN. We surveyed 2606 child-parent dyads between 2002 and 2003. We asked children (9-12 years of age) how often their parents engaged in specific behaviors to monitor their movie viewing and if their parents allowed them to watch R-rated movies. We also surveyed children about parental monitoring of nonmedia-related behaviors. The primary outcomes were risk of smoking and drinking alcohol, defined by attitudinal susceptibility or early experimentation with either substance. RESULTS. Less than half (45.0%) the children were prohibited from watching R-rated movies. Of those who were allowed to watch R-rated movies, one third (34.7%) always viewed them with a parent and two thirds (65.3%) sometimes watched them without a parent. Less than 10% of the children reported that their parents consistently engaged in all 4 movie-monitoring behaviors. Even after controlling for parental monitoring of nonmedia-related behaviors and other covariates, children were at lower risk of smoking and drinking if their parents prohibited them from watching R-rated movies. Parental coviewing of R-rated movies was associated with a lower risk of child smoking but not drinking if parents consistently monitored what their children watched. CONCLUSIONS. Parental rules and monitoring of children's movie viewing may have a protective influence on children's risk for smoking and drinking, over and above parental monitoring of nonmedia related behaviors. This highlights a potential role for parents in preventing early initiation of tobacco and alcohol use among adolescents.

Randomized clinical trial of an Internet-based versus brief office intervention for adolescent smoking cessation.

Patten CA; Croghan IT; Meis TM; Decker PA; Pingree S; Colligan RC et al. Patient Education and Counseling 64(1-3): 249-258, 2006. (40 refs.)
Objective: Evaluation of novel treatment delivery methods, such as the Internet are notably absent from the adolescent smoking treatment literature. Methods: Adolescent smokers ages 11-18 years were randomized to a clinic-based, brief office intervention (1301; N = 69) consisting of four individual counseling sessions; or to Stomp Out Smokes (SOS), an Internet, home-based intervention (N = 70). Adolescents in SOS had access to the SOS site for 24 weeks. Results: The 30-day, point-prevalence smoking abstinence rates for BOI and SOS were 12% versus 6% at week 24 and 13% versus 6% at week 36, with no significant treatment differences. Among participants who continued to smoke, SOS was associated with a significantly greater reduction in average number of days smoked than BOI (P = 0.006). The BOI was found to be feasible with high session attendance rates. SOS participants accessed the site a mean +/- S.D. of 6.8 +/- 7.1 days. SOS use dropped to less than one-third of participants by week 3. Conclusion: Additional research is needed to tap the potential capabilities of the Internet for adolescent smoking cessation using proactive, personalized, patient-education components. Conclusion: Additional research is needed to tap the potential capabilities of the Internet for adolescent smoking cessation using proactive, personalized, patient-education components. Practice implications: Augmenting the SOS type of intervention with more structured, personal and proactive patient-education components delivered in-person or by telephone or electronic mail is recommended.

Changing provider practices, program environment, and improving outcomes by transporting multidimensional family therapy to an adolescent drug treatment setting.

Liddle HA; Rowe CL; Gonzalez A; Henderson CE; Dakof GA; Greenbaum PE. American Journal on Addictions 15(Supplement 1): 102-112, 2006. (21 refs.)
Effective interventions for drug abusing adolescents are underutilized. Using an interrupted time series design, this study tested a multicomponent, multi-level technology transfer intervention developed to train clinical staff within an existing day treatment program to implement multidimensional family therapy (MDFT), an evidence-based adolescent substance abuse treatment. The sample included 10 program staff and 104 clients. MDFT was incorporated into the program and changes were noted in the program environment, therapist behavior, and in most (e.g., drug abstinence, and out of home placements) but not all (e.g., drug use frequency) client outcomes. These changes remained after MDFT supervision was withdrawn.

Reducing substance use improves adolescents' school attendance.

Engberg J; Morral AR. Addiction 101(12): 1741-1751, 2006. (49 refs.)
Aims: Substance use initiation and frequency are associated with reduced educational attainments among adolescents. We examined if decreases in substance use substantially improve youths' school attendance. Design: A total of 1084 US adolescents followed quarterly for 1 year after entering substance abuse treatment. Methods Random and fixed effects regression models were used to differentiate the lagged effects of drug use from other time-varying and time-invariant covariates. Self-reports of alcohol, marijuana, stimulants, sedatives, hallucinogens and other drug use were used to predict subsequent school attendance, after controlling for demographic and drug use history characteristics, problem indices and other covariates. Findings: Reductions in the frequency of alcohol, stimulants and other drug use and the elimination of marijuana use were each associated independently with increased likelihoods of school attendance. Conclusions: Because years of completed schooling is highly correlated with long-term social and economic outcomes, the possibility that reductions in substance use may improve school attendance has significant implications for the cost-effectiveness of substance abuse treatment and other interventions designed to reduce adolescents' substance use.

Seeking Safety therapy for adolescent girls with PTSD and substance use disorder: A randomized controlled trial.

Najavits LM; Gallop RJ; Weiss RD. Journal of Behavioral Health Services & Research 33(4): 453-463, 2006. (39 refs.)
This randomized, controlled trial evaluated a manualized psychotherapy, Seeking Safety (SS), for posttraumatic stress disorder (PTSD) and substance use disorder (SUD) in adolescent females. To our knowledge, no prior study has evaluated any psychotherapy designed for this population. SS was compared to treatment as usual (TAU) for 33 outpatients, at intake, end-of-treatment, and 3 months follow-up. SS evidenced significantly better outcomes than TAU in a variety of domains at posttreatment, including substance use and associated problems, some trauma-related symptoms, cognitions related to SUD and PTSD, and several areas of pathology not targeted in the treatment (e.g., anorexia, somatization). Effect sizes were generally in the moderate to high range. Some gains were sustained at follow-up. SS appears a promising treatment for this population, but needs further study and perhaps additional clinical modification.

Suicidal ideation among adolescents with alcohol use disorders during treatment and aftercare.

Kaminer Y; Burleson JA; Goldston DB; Burke RH. American Journal on Addictions 15(Supplement 1): 43-49, 2006. (24 refs.)
The objectives of this study are to assess the magnitude and course of suicidal ideation during outpatient treatment and aftercare for adolescents with alcohol use disorders (AUD). One hundred seventy-seven adolescents meeting eligibility criteria, including no past 30-day suicidal behavior, participated in 9 weeks of outpatient cognitive-behavioral group therapy. Treatment completers were randomized into: (1) No-Active, (2) In-Person, or (3) Telephone aftercare conditions for a period of 12 weeks. No specific intervention for suicidal behavior was provided during the study. The Suicide Ideation Questionnaire (SIQ-JR), Reynolds, 1988) was administered at baseline, end of treatment, and end of aftercare. The results are as follows, a higher baseline suicidal ideation was associated with higher retention at the end of treatment and through aftercare. The In-Person Aftercare condition showed a significant decrease in suicidal ideation, relative to the No-Active Aftercare condition. There was a trend for similarly reduced severity of suicidal ideation in the Telephone Aftercare condition. In conclusion, the type of aftercare and resulting decrease in AUD may play a role in the reduction in suicidal ideation. The mechanism of change by which suicidal ideation is reduced in adolescents in treatment for AUD needs to be further explored.

The impact of alcohol-specific rules, parental norms about early drinking and parental alcohol use on adolescents' drinking behavior.

van der Vorst H; Engels RCME; Meeus W; Dekovic M. Journal of Child Psychology and Psychiatry 47(12): 1299-1306, 2006. (22 refs.)
Background: The present study explores the role of having rules about alcohol, parental norms about early alcohol use, and parental alcohol use in the development of adolescents' drinking behavior. It is assumed that parental norms and alcohol use affect the rules parents have about alcohol, which in turn prevents alcohol use by adolescent children. Methods: Longitudinal data collected from 416 families consisting of both parents and two adolescents ( aged 13 to 16 years) were used for the analyses. Results: Results of structural equation modeling show that having clear rules decreases the likelihood of drinking in adolescence. However, longitudinally alcohol-specific rules have only an indirect effect on adolescents' alcohol use, namely through earlier drinking. Analyses focusing on explaining the onset of drinking revealed that having strict rules was related to the postponement of drinking initiation of older and younger adolescents. Further, parental norms about adolescents' early drinking and parental alcohol use were associated with having alcohol-specific rules. Parental norms were also related to adolescents' alcohol use. Conclusions: The current study is one of the first using a full family design to provide insight into the role of alcohol-specific rules on adolescents' drinking. It was shown that having strict rules is related to postponement of drinking, and that having alcohol-specific rules depends on other factors, thus underlining the complexity of the influence of parenting on the development of adolescents' alcohol use.

Traumatic events and alcohol use disorders among American Indian adolescents and young adults.

Boyd-Ball AJ; Manson SM; Noonan C; Beals J. Journal of Traumatic Stress 19(6): 937-947, 2006. (48 refs.)
This study examined the relationship between severe traumatic events and alcohol use disorders in American Indian adolescents and young adults. Interviews of 432 adolescents and young adults who were enrolled tribal members living on or near two closely related American Indian reservations were used. Results indicated that severe trauma increased the odds of alcohol use disorders (p < .001), with the number of traumas having a dose-dependent effect. The authors conclude that trauma is associated with alcohol use disorders in this population. This study's findings yield important insights into the risks in American Indian adolescents and young adults that may result from early trauma, as well as implications for the timing and possible settings for intervention.