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...on Adolescents
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www.ProjectCork.org
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Fall 2012
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Hospitalization for underage drinkers in the United States.
Kim JY; Asrani SK; Shah ND; Kim WR; Schneekloth TD. Journal of Adolescent Health 50(6): 648-650, 2012. (9 refs.)
Purpose: Underage drinking is common in the United States. This article presents nationally representative data on hospitalizations for alcohol use disorder (AUD) in youth. Methods: Using the Nationwide Inpatient Sample database, discharge records of individuals between 15 and 20 years diagnosed with AUD were identified. Incidence rates of these hospitalizations were calculated based on population estimates from the US Census Bureau. Results: In 2008, there were 699,506 nonobstetric discharges in 15- to 20-year-olds, of which 39,619 (5.6%) had an AUD diagnosis with or without an injury diagnosis. The overall annual incidence of AUD hospitalization was 18.3 per 10,000 boys and 12.3 per 10,000 girls. Native American boys in the Midwest had the highest incidence (101 per 10,000), and Asian/Pacific Islander girls in the South had the lowest ( 2 per 10,000). The estimated total charges for these hospitalizations were $755 million in 2008. Conclusions: Hospitalization care for underage drinking is common, especially in certain race and in certain geographic regions and is associated with a substantial health care expenditure. Copyright 2012, Society for Adolescent Health and Medicine.
Gender differences in cigarette smoking, social correlates and cessation among adolescents.
Branstetter SA; Blosnich J; Dino G; Nolan J; Horn K. Addictive Behaviors 37(6): 739-742, 2012. (28 refs.)
Background: Despite well-established gender differences in adult smoking behaviors, relatively little is known about gender discrepancies in smoking behaviors among adolescents, and even less is known about the role of gender in smoking cessation among teen populations. Method: The present study examined gender differences in a population of 755 adolescents seeking to quit smoking through the American Lung Association's Not-On-Tobacco (N-O-T) program. All participants enrolled in the N-O-T program between 1998 and 2009. All participants completed a series of questionnaires prior to and immediately following the cessation intervention. Analyses examined gender differences in a range of smoking variables, cessation success and direct and indirect effects on changes in smoking behaviors. Results: Females were more likely to have parents, siblings and romantic partners who smokes, perceive that those around them will support a cessation effort, smoke more prior to intervention if they have friends who smoke, and to have lower cessation motivation and confidence if they have a parent who smokes. Conversely, males were more likely to have lower cessation motivation and confidence and be less likely to quit if they have a friend who smokes. Conclusions: Gender plays an important role in adolescent smoking behavior and smoking cessation. Further research is needed to understand how these differences may be incorporated into intervention design to increase cessation success rates among this vulnerable population of smokers. Copyright 2012, Elsevier Science.
Screening, brief intervention, and referral for alcohol use in adolescents: A systematic review. (review).
Yuma-Guerrero PJ; Lawson KA; Velasquez MM; von Sternberg K; Maxson T; Garcia N. Pediatrics 130(1): 115-122, 2012. (53 refs.)
Background And Objective: Alcohol use by adolescents is wide-spread and is connected to a number of negative health and social outcomes. Adolescents receiving emergent care for injuries are often linked with risky use of alcohol. The trauma system has widely adopted the use of screening, brief intervention, and referral to treatment (SBIRT) for preventing alcohol-related injury recidivism and other negative outcomes. The purpose of this article is to review the evidence around SBIRT with adolescent patients in acute care settings. Methods: This article reviews 7 randomized controlled trials evaluating risky drinking interventions among adolescent patients in acute care settings. All studies took place in the emergency departments of level I trauma centers. Results: Four of the 7 studies reviewed demonstrated a significant intervention effect; however, no one intervention reduced both alcohol consumption and alcohol-related consequences. Two of these 4 studies only included patients ages 18 and older. Subgroup analyses with adolescents engaged in risky alcohol-related behaviors, conducted in 2 of the studies, showed significant intervention effects. Five studies showed positive consumption and/or consequences for all study participants regardless of condition, suggesting that an emergent injury and/or the screening process may have a protective effect. Conclusions: Based on existing evidence, it is not clear whether SBIRT is an effective approach to risky alcohol use among adolescent patients in acute care. Additional research is needed around interventions and implementation. Copyright 2012, American Academy of Pediatrics.
What if you caught them using? Prospective teachers' beliefs about responding to student substance use.
Ludden AB. Journal of Drug Education 42(1): 59-85, 2012. (41 refs.)
This survey research examined how prospective teachers' (N = 384) beliefs about the nature of adolescence, their substance use, and their preparedness for dealing with substance use situations are linked to perceptions of how they would respond to students' possession or use of cigarettes, alcohol, and marijuana at school. Results suggested that prospective teachers are not prepared for these situations. Feeling prepared, perceiving that few adolescents engage in problem behavior, and low personal substance use were associated with more responses to substance use situations. Women were more likely than men to think they would respond to adolescent substance use yet they felt less prepared. Males who used alcohol, cigarettes, or marijuana recently were the least likely to perceive that they would respond to adolescents using substances at school. Copyright 2012, Baywood Publishing.
Adolescent romantic couples: Influence on substance use in young adulthood.
Gudonis-Miller LC; Lewis L; Tong Y; Tu WZ; Aalsma MC. Journal of Adolescence 35(3): 638-647, 2012. (36 refs.)
Research has demonstrated that adolescent peer group affiliations are consistent predictors of substance use initiation and maintenance; it is less clear how adolescent romantic relationships influence substance use behavior. Data were drawn from the National Longitudinal Study of Adolescent Health. Participants in the final dataset for the current study included adolescents (321 males and 321 females) who were identified in reciprocated romantic relationships at Wave 1 (1994-1995; mean age 16.7 years) that were followed into young adulthood and reassessed at two different time points (Wave 2 in 1996, mean age 17.7, and Wave 3 in 2001-2002, mean age 23.1). Data were gathered from both partners, and included demographic variables, longitudinal measures of substance use (alcohol, tobacco, and marijuana), and relationship seriousness. Hierarchical linear modeling using SAS PROC MIXED were utilized to test for individual versus partner influences. Results revealed individual and partner effects for the prediction of alcohol and tobacco, although individual effects were generally greater than partner influences. For marijuana use, as self-reported relationship seriousness increased, future marijuana use decreased. These findings suggest the developmental significance of adolescent romantic relationships on the prediction of future substance use behavior during young adulthood. Copyright 2012, Elsevier Science.
Youth recovery contexts: The incremental effects of 12-step attendance and involvement on adolescent outpatient outcomes.
Kelly JF; Urbanoski K. Alcoholism: Clinical and Experimental Research 36(7): 1219-1229, 2012. (56 refs.)
Background: A major barrier to youth recovery is finding suitable sobriety-supportive social contexts. National studies reveal most adolescent addiction treatment programs link youths to community 12-step fellowships to help meet this challenge, but little is known empirically regarding the extent to which adolescents attend and benefit from 12-step meetings or whether they derive additional gains from active involvement in prescribed 12-step activities (e.g., contact with a sponsor and other fellowship members). Greater knowledge in this area would enhance the efficiency of clinical continuing care recommendations. Methods Adolescent outpatients (N = 127; M age 16.7; 75% male; 87% white) enrolled in a naturalistic study of treatment effectiveness were assessed at intake and 3, 6, and 12 months later using standardized assessments. Mixed-effects models, controlling for static and time-varying confounds, examined the concurrent and lagged effects of 12-step attendance and active involvement on abstinence over time. Results: The proportion attending 12-step meetings was relatively low across follow-up (24 to 29%), but more frequent attendance was independently associated with greater abstinence in concurrent and, to a lesser extent, lagged models. An 8-item composite measure of 12-step involvement did not enhance outcomes over and above attendance, but separate components did; specifically, greater contact with a 12-step sponsor outside of meetings and more verbal participation during meetings. Conclusions: The benefits of 12-step participation observed among adult samples extend to adolescent outpatients. Community 12-step fellowships appear to provide a useful sobriety-supportive social context for youths seeking recovery, but evidence-based youth-specific 12-step facilitation strategies are needed to enhance outpatient attendance rates. Copyright 2012, Research Society on Alcoholism.
Medical marijuana use among adolescents in substance abuse treatment.
Salomonsen-Sautel S; Sakai JT; Thurstone C; Corley R; Hopfer C. Journal of the American Academy of Child and Adolescent Psychiatry 51(7): 694-702, 2012. (29 refs.)
Objective: To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. Method: This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age = 16.09, SD = 1.12), in substance abuse treatment in the Denver metropolitan area. Bivariate and multivariate analyses were completed to determine factors related to adolescents' use of medical marijuana. Results: Approximately 74% of the adolescents had used someone else's medical marijuana, and they reported using diverted medical marijuana a median of 50 times. After adjusting for gender and race/ethnicity, adolescents who used medical marijuana had an earlier age of regular marijuana use, more marijuana abuse and dependence symptoms, and more conduct disorder symptoms compared with those who did not use medical marijuana. Conclusions: Medical marijuana use among adolescent patients in substance abuse treatment is very common, implying substantial diversion from registered users. These results support the need for policy changes that protect against diversion of medical marijuana and reduce adolescent access to diverted medical marijuana. Future studies should examine patterns of medical marijuana diversion and use in general population adolescents. Copyright 2012, Elsevier Science.
Motives for smoking in movies affect future smoking risk in middle school students: An experimental investigation.
Shadel WG; Martino SC; Setodji C; Haviland A; Primack BA; Scharf D. Drug and Alcohol Dependence 123(1-3): 66-71, 2012. (38 refs.)
Background: Exposure to smoking in movies has been linked to adolescent smoking uptake. This study experimentally examined how motivation for smoking depicted in movies affects self-reported future smoking risk (a composite measure with items that assess smoking refusal self-efficacy and smoking intentions) among early adolescents. Methods: A randomized laboratory experiment was used. Adolescents were exposed to movie scenes depicting one of three movie smoking motives: social smoking motive (characters smoked to facilitate social interaction); relaxation smoking motive (characters smoked to relax); or no smoking motive (characters smoked with no apparent motive, i.e., in neutral contexts and/or with neutral affect). Responses to these movie scenes were contrasted (within subjects) to participants' responses to control movie scenes in which no smoking was present; these control scenes matched to the smoking scenes with the same characters in similar situations but where no smoking was present. A total of 358 adolescents, aged 11-14 years, participated. Results: Compared with participants exposed to movie scenes depicting characters smoking with no clear motive, adolescents exposed to movie scenes depicting characters smoking for social motives and adolescents exposed to movie scenes depicting characters smoking for relaxation motives had significantly greater chances of having increases in their future smoking risk. Conclusions: Exposure to movies that portray smoking motives places adolescents at particular risk for future smoking. Copyright 2012, Elsevier Science.
Adolescent substance use and aggression: A review. (review).
Doran N; Luczak SE; Bekman N; Koutsenok I; Brown SA. Criminal Justice and Behavior 39(6 special issue): 748-769, 2012. (204 refs.)
Substance use disorders (SUDs) in youth are strongly associated with aggression, delinquency, and involvement with the juvenile justice and mental health systems. This article reviews the relationship between aggression and SUDs and discusses evidence-based approaches to assessment and intervention, with a focus on youth in secure settings. While evidence indicates etiological overlap, SUDs also confer risk for aggression and delinquent behavior. SUDs and aggression are each influenced by executive functions that develop as youth transition toward adult roles. Additionally, the effects of substance use on the adolescent brain impair neurocognitive function and increase the risk for aggression and further substance use. In terms of assessment, it is important to identify function and form of aggression in order to understand motives and associations with substance use and to select appropriate interventions. Evidence-based screening and assessment of aggression, substance involvement, and related domains is also critical. In terms of treatment, youth with SUDs tend to be underserved, particularly when they are also involved with the juvenile justice system. Multiple modes of evidence-based treatment for substance use are available. But those found to be most effective (family therapy) but may be difficult to adapt for use in secure settings. Individual therapy approaches also have empirical support and may generally be more practical in secure settings. Copyright 2012, Sage Publications.
Young people in Alcoholics Anonymous: The role of spiritual orientation and AA member affiliation.
Galanter M; Dermatis H; Santucci C. Journal of Addictive Diseases 31(2): 173-182, 2012. (34 refs.)
Empirical findings characterizing long-term, committed Alcoholics Anonymous (AA) members are limited, particularly among younger members. The authors studied a sample of 266 highly committed attendees (mean age, 27 years) at an annual conference of Young People in Alcoholics Anonymous (YPAA), whose first encounter with AA was 6 years previously. Most (72%) had abused drugs and alcohol, and 36% had never received substance abuse treatment. They now reported a mean duration of abstinence of 44 months and had attended an average of 233 AA meetings in the previous year; 66% had served as AA sponsors, and 92% reported experiencing an AA "spiritual awakening," itself associated with a decreased likelihood of alcohol craving. Scores on AA beliefs, affiliation to other members, and the experience of spiritual awakening were associated with lower depression scores. These findings are discussed to clarify the nature of long-term AA membership. Copyright 2012, Taylor & Francis.
Review of risk and protective factors of substance use and problem use in emerging adulthood. (review).
Stone AL; Becker LG; Huber AM; Catalano RF. Addictive Behaviors 37(7): 747-775, 2012. (196 refs.)
This review examines the evidence for longitudinal predictors of substance use and abuse in emerging adulthood. Nationally representative data from the 2007 National Survey on Drug use and Health suggest that many substance use problems reach their peak prevalence during emerging adulthood (usually defined as the period from age 18 to age 26). This stage of development is characterized by rapid transitions into new social contexts that involve greater freedom and less social control than experienced during adolescence. Concurrent with this newfound independence is an increase in rates of substance use and abuse. Understanding the risk and protective factors associated with emerging adult substance use problems is an important step in developing interventions targeting those problems. While multiple reviews have examined risk and protective factors for substance use during adolescence, and many of these earlier predictors may predict emerging adult substance use, few studies have focused primarily on the emerging adult outcomes examining predictors from both adolescence and emerging adulthood. This review used the databases PubMed and PsycInfo to identify articles pertaining to longitudinal predictors of substance use problems in emerging adulthood, building from the conceptual framework presented in a review on risk and protective factors for adolescent substance abuse by Hawkins and colleagues. Predict-ors identified as predictors of substance use in adolescence, sometimes decreased in strength and in one case reversed direction. Unique predictors in emerging adulthood were also identified. Implications for prevention science during adolescence and emerging adulthood are discussed as well as suggestions for future research. Copyright 2012, Elsevier.
Adolescent performance enhancing substance use: Regional differences across the US.
Thorlton JR; McElmurry B; Park C; Hughes T. Journal of Addictions Nursing 23(2): 97-111, 2012. (83 refs.)
Performance enhancing substances (PES) constitute a multi-billion dollar industry, and concerns regarding use in adolescents hoping to enhance athletic performance and body appearance, or fight obesity. Adverse effects may include violent behavior, suicide attempts, and premature deaths. Healthcare providers are less familiar with PES than other types of substance use. A secondary analysis of 2007 National Youth Risk Behavior Survey (YRBS) data was conducted (n =14,041) to assess predictors of PES use (meth-amphetamines, steroid pills/injections, and diet pill/powder/liquids). Feeling sad/hopeless, considering suicide, perceiving being overweight, offered drugs at school, geographic location, sexual activity, smoking, and alcohol use were associated (p<.05) with PES use. Rates of being offered/ sold/given illegal drugs at school ranged from 17-39%; PES use ranged from 5-17% across the US. Multiple factors predicted PES use.. Though policies are designed to ensure safe school settings, high rates of obtaining drugs at school were reported. The South US region reported t the highest rates of PES use. Copyright 2012, Informa.
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