National Institute on Drug Abuse

Director's Report to the National Advisory Council on Drug Abuse

May, 1997

Research Findings

Epidemiology, Etiology and Prevention Research

The Community Epidemiology Work Group (CEWG) met in Austin, Texas on December 9-12, 1996. The CEWG is composed of researchers from 20 selected metropolitan areas of the United States who meet semiannually to report on patterns and trends of drug abuse in their respective areas; emerging drugs of abuse; vulnerable populations and factors that may place people at risk of drug use and abuse; and, negative health and social consequences. Reports are based on drug abuse indicator data, such as morbidity and mortality information, treatment data and local and State law enforcement data. Additional sources of information include criminal justice, correctional, medical and community health data, local and State survey information and research findings from ethnographic studies. * (The most recent available DAWN data are for 1995. Increases noted are for 1994 versus 1995 data and are included only when they are reliable at p<0.05.)

The following are highlights of the meeting held in December 1996.

Cocaine

Crack cocaine continues to dominate the Nation's illicit drug problem, although trends are generally stable. Supplies remain abundant in nearly every city. Indicator data show leveling off in many urban areas: cocaine-related deaths were stable or up slightly in 9 of the 10 areas where such information was reported; emergency department (ED) mentions increased in only 4 of the 19 CEWG cities in the Drug Abuse Warning Network (DAWN); the percentage of treatment admissions for primary cocaine problems declined slightly or remained stable in 12 of the 14 areas where data were available; and prices of cocaine remained stable in most areas. Although demographic data continue to show most cocaine users as older, inner-city crack addicts, isolated field reports indicate new using populations: teenagers smoking crack with marijuana in blunts in some cities; Hispanic crack users in Texas; and, in the Atlanta area, middle-class suburban users of cocaine hydrochloride and female crack users in their thirties with no prior drug history.

Heroin

Quantitative indicators and field reports continue to suggest an increasing incidence of new users (snorters) in the younger age groups, often among women. In some areas, such as Boston, Newark, and San Francisco, the recent initiates increasingly include middle-class members, often from the suburbs. Concern also was expressed that young heroin snorters may shift to injecting because of increased tolerance, nasal soreness, or declining or unreliable purity. Purity has, indeed, been declining or inconsistent in some cities, such as Atlanta, Boston, and New York City. Nevertheless, purity remains high-as does intranasal use-in the East and in some midwestern cities, notably Chicago and Detroit. Supplies remain abundant. Aggressive marketing and price cutting has intensified in some cities, such as Boston, Detroit, and New York; heroin dealers often sell other drugs too, as in Miami and some Atlanta neighborhoods. Recent mortality figures have increased or are stable at elevated levels in 5 of the 9 cities where trend data are available; rates of ED mentions have increased in 8 of the 19 cities in DAWN; and the percentage of those in treatment reporting heroin use has increased in 8 of 14 areas.

Marijuana

The resurgence in marijuana use continues especially among adolescents with rates of ED mentions increasing* in 10 cities, the percentage of treatment admissions increasing in 13 areas, and Drug Use Forecasting (DUF) percentages increasing among juvenile arrestees at numerous sites. In several cities, such as Minneapolis/St. Paul, increasing treatment figures have been particularly notable among juveniles. Two factors may be contributing to the dramatic leap in adverse consequences: (1) higher potency; and (2) use of marijuana mixed with or in combination with other dangerous drugs. Marijuana cigarettes or blunts often include crack, a combination known by various street names, such as "3750s," "diablitos," "primos," "oolies," and "woolies." Joints and blunts are also frequently dipped in PCP and go by street names such as "happy sticks," "wicky sticks," "illies," "love boat," "wet," or "tical." Both types of combinations are reported in Boston, Chicago, and New York; the marijuana-crack combinations are also sold in St. Louis; and the marijuana-PCP combinations are reported in Philadelphia and parts of Texas. In several cities, such as Atlanta and Chicago, teenagers often drink malt liquor when smoking marijuana. Marijuana cigarettes are also sometimes dipped in embalming fluid, as reported in Boston (where they are known as "shermans") and areas of Texas.

Stimulants

In several western and midwestern cities, methamphetamine indicators, which had been steadily increasing for several years, appear mixed this reporting period. All indicators suggest increases in San Francisco and Seattle, while San Diego and Los Angeles indicators show stable or slightly declining trends-however, it is too soon to predict that the indicators in those areas have peaked. Increased methamphetamine availability and use is sporadically reported in diverse areas of the country, particularly rural areas, prompting some concern about its spread outside of the areas of endemic use-the west coast. Most methamphetamine comes from large scale Mexican operations. Recent seizures in Florida have included powder cocaine, heroin, and flunitrazepam in the same shipment with methamphetamine. Additionally, local labs remain common, with seizures increasing in areas such as Seattle, Arizona, and rural Michigan and Missouri. Rural areas, such as those outside of Atlanta and St. Louis, are experiencing a much worse methamphetamine problem than urban areas. All four routes of administration-injecting, snorting, smoking (including "chasing the dragon" in San Francisco), and oral ingestion-are used but vary extensively from city to city. Reports of methamphetamine-related violence persist in Honolulu and are now also occurring in Seattle.

Methylphenidate (Ritalin) abuse continues among heroin users in Chicago and adolescents in Detroit. Methcathinone ("cat" or "goobs") has been reported in several indicators in Detroit and Michigan's Upper Peninsula, including treatment admissions and one death in Detroit. Ephedrine based products sold at convenience stores, truck stops, and health food stores are common among adolescents in Atlanta, Detroit, Minneapolis/St. Paul, and Texas. New York State recently banned the sale of such products in an attempt to curb escalating abuse among adolescents. Methylene dioxymethamphetamine (MDMA or "ecstasy") use was reported-most often among young adults and adolescents at clubs, raves, and rock concerts in Atlanta, Miami, St. Louis, Seattle, and areas of Texas.

Depressants

Use of gamma hydroxybutrate (GHB) in the club scene is becoming more widespread throughout the country, notably in Atlanta, Detroit, Honolulu, Miami, New York City (where it is also reportedly used by fashion models), Phoenix, and Texas. Ketamine ("Special K") use in nightclubs has also been reported in several cities. A mixture of GHB, ketamine, and alcohol, called "Special K-lude" because of the similar effects produced by methaqualone (Quaalude), is reported in New York City. Flunitrazepam (Rohypnol) use continues in many areas of the country (with the exception of the Northeast), most notably in Texas and Florida. Its widespread availability has declined, however, since the Federal ban on its importation. Other medications from the same manufacturer are now being sold and abused as "roofies" in Miami, Minnesota, and Texas. These drugs include clonazepam (another pharmaceutical benzodiazepine, marketed in Mexico as Rivotril), which has the same distinguishing manufacturer's imprint as flunitrazepam. Clonazepam (marketed in the United States as Klonopin) is also used by addicts in Atlanta and Minneapolis/St. Paul to enhance the effects of methadone and other opiates.

Hallucinogens

According to field reports in numerous areas, such as Boston, Chicago, Philadelphia, St. Louis, Texas, and Washington, DC, phencyclidine (PCP) is often used in combination with other drugs. The most frequently reported combination is joints or blunts containing marijuana mixed with or dipped into PCP. However, in other cities, such as Los Angeles and New Orleans, PCP is most commonly purchased as a predipped cigarette. In New York City, PCP is combined with crack in "spaceballs." PCP ED mentions increased in 10 cities, but rates remain relatively low. Lysergic acid diethylamide (LSD) remains widely available in most CEWG cities, especially in suburban and rural areas. Use of psilocybin mushrooms has also been reported among adolescents and young adults in Boston, Minneapolis/St. Paul, and Philadelphia.

Mexico and Canada

While Mexico remains a primary supplier and transshipment point of drugs into the United States, it is also coping with drug abuse problems of its own. Cocaine is the most common primary substance of abuse among treatment admissions, followed by marijuana, inhalants, and alcohol. Flunitrazepam (Rohypnol) is particularly common among cocaine abusers. Heroin has not appeared at high levels in the indicator data, although use is higher in the border regions. Conversely, indicator data in Toronto, Canada, show heroin use has increased dramatically in the past several years, especially among younger users. Survey data also show dramatically increased marijuana use among teenagers. Similar to the United States, however, cocaine remains Toronto's primary illicit drug, but indicators appear relatively stable.

Five Year Follow-Up Results of The Effectiveness of Drug Abuse Resistance Education (Project DARE)

This article reports the results of a 5-year, prospective longitudinal evaluation of the effectiveness of Drug Abuse Resistance Education (DARE), a school-based primary drug prevention curriculum designed for introduction during the last year of elementary school. Twenty-three elementary schools were randomly assigned to receive DARE and 8 were designated comparison schools. No significant differences were observed between intervention and comparison schools with respect to cigarette, alcohol, or marijuana use during the 7th grade, approximately one year after completion of the program, or over the full 5-year measurement period. Significant intervention effects in the hypothesized direction were observed during the 7th grade for measures of students' general and specific attitudes toward drugs, the capability to resist peer pressure, and estimated level of drug use by peers. Over the full measurement interval, however, average trajectories of change for these outcomes were similar in the intervention and comparison conditions. The findings of this study are largely consonant with the results obtained from prior short-term evaluations of the DARE curriculum, which have reported limited effects of the program upon drug use, greater efficacy with respect to attitudes, social skills, and knowledge, but a general tendency for curriculum effects to decay over time. The results of this study underscore the need for more robust prevention programming targeted specifically at risk factors, the inclusion of booster sessions to sustain positive effects, and greater attention to interrelationships between developmental processes in adolescent substance use, individual level characteristics, and social context. Clayton, R.R., Cattarello, A.M., Johnstone, B.M. The Effectiveness of Drug Abuse Resistance Education (Project DARE): 5-Year Follow-Up Results. Preventive Medicine, 25, pp. 307-318, 1996.

Insolubility of Heroin Linked to Syringe Sharing

Over an 18-month period, researchers conducted interviews with three separate samples of heroin injectors in two inner-city Chicago communities. A large majority from each sample (85% of sample 1, n=39; 72% of sample 2, n=417; and 81% of sample 3, n=400) reported that their heroin clogged their needles/syringes. In each of the respective samples, 55%, 28%, and 19% of the heroin injectors said they had shared needles/syringes with others because heroin has clogged works. The researchers explored the reasons for the widespread "jelling-up" of heroin in the Chicago area, and identified several conditions under which inappropriate diluents and adulterants are used to "cut" heroin: control and dominance of the heroin market by gangs, ignorance of proper diluents and adulterants, and the emergence of a dual market (intranasal, injecting) for heroin. The authors discuss the implications of these factors in terms of preventing the spread of HIV and other infections among heroin injectors and their partners. Furst, R., Nettey, R., Wiebel, W. et al. "The 'Jelling-Up of Dope:' Implications for the Transmission of HIV Among IDUs." Addiction Research, 4(4), pp. 309-320, 1997.

Demographic and Psychosocial Risk for Alcohol Use: Ethnic Differences

NIDA supported researchers examined the influence of demographic variables and social (parents and peers), attitudinal, and intentions variables regarding alcohol use on actual drinking behavior among Asian and white populations. Asian (n=148; 79 female, 69 male) and white (n =132; 72 female, 60 male) college students completed a questionnaire. Confirmatory factor analyses revealed that social and attitudinal factors reflected a common construct of psychosocial vulnerability which, in a structural equation model, was significantly predicted by ethnicity. The white population was exposed to more psychosocial risks to alcohol use compared to the Asian population. Ethnicity, however, did not directly predict either drinking intentions or drinking behavior, after the effects on Psychosocial Vulnerability were considered. These findings suggest that ethnic differences in alcohol use between Asians and whites are mainly due to different levels of exposure to risk factors. Effective prevention programs must consider, not only psychosocial factors, but also certain contextual factors such as sex and ethnicity. Keefe, K., and Newcomb, M.D. Demographic and Psychosocial Risk for Alcohol Use: Ethnic Differences. Journal of Studies on Alcohol, 57, pp. 521-530, 1996

Influences of Parental Drug Use, Personality, and Child Rearing on the Toddler's Anger and Negativity

How parental personality and drug use and the parent-child relationship are related to a toddler's anger and negativity was investigated. The sample consisted of 62 female and 53 male 2-year-old children and their parents. The results supported a mediational model. The father's drug use and parental personality attributes were linked to the child's anger and negativity indirectly, through the parent-child relationship. The findings indicated that maternal personality and child-rearing practices had a greater effect on the child than the paternal characteristics or the father-child relationship did. The results also suggested that the effect of one parent on the child was altered by the relationship the child had with the other parent. Implications for prevention and treatment are discussed. Brook, J.S., and Tseng, L. Genetic, Social and General Psychology Monographs, Heldref Publications, 1996.

Toddler Adjustment: Impact of Parents Drug Use, Personality, and Parent-Child Relations

The intercorrelations among parents' drug use, personality, and parent-child relations and the child's anxious/regressive behaviors were investigated in a sample of 2-year-olds (N=115). The results indicate that maternal child-rearing practices mediate the effect of maternal personality attributes on the child's intrapsychic functioning. The father's drug use had a direct influence on the child's reflective behavior. Generally, the mother's drug use, personality, and child-rearing practices were more important than the father's attributes. However, the father's drug use had a strong impact on the child when it interacted with the mother's drug use. Parental differences and implications for prevention are discussed. Brook, J.S., and Tseng, L. The Journal of Genetic Psychology, 157(6), 1996.

Childhood Antecedents of Adolescent Personality Disorders

The purpose of this study was to investigate the childhood antecedents of personality disorders that are diagnosed in adolescence. A randomly selected community sample of 641 youths was assessed mutually in childhood and followed longitudinally over 10 years. Childhood behavior ratings were based on maternal reports: diagnosis of adolescent personality disorders were based on data obtained from both maternal and youth informants. Four composite measures of childhood behavior problems were used: conduct problems, depressive symptoms, anxiety/fear, and immaturity. Adolescent personality disorders were considered present only if the disorders persisted over a 2-year period. For all analyses, personality disorders were grouped into three clusters (A, B, and C) of DSM-III R. Logistic regression analyses indicated that all four of the putative childhood antecedents were associated with greater odds of an adolescent personality disorder in all three clusters, even when other childhood problems were included in the same regression model. Additionally, depressive symptoms emerged as an independent predictor of cluster B personality disorders in girls. No monitoring effects of age at time of childhood assessment were found. These results support the view that personality disorders can be traced to childhood emotional and behavioral disturbances and suggest that these problems have both general and specific relationships to adolescent personality functioning. Bernstein, D.P., Cohen, P., Skodol, A., Bezirganian, S., and Brook, J.S. Childhood Antecedents of Adolescent Personality Disorders. American Journal of Psychiatry, 153(7), pp. 907-913, 1996.

Depression Spectrum Disease

This study used an adoption study design to separate genetic from environmental factors in the etiology of depression spectrum disease, a type of major depression characterized by families in which male relatives are alcoholic and females are depressed. The genetic etiology hypothesis of depression spectrum disease proposes that an alcoholic genetic diathesis predisposes to depression in females but alcoholism, not depression, in males. The study examined 197 adult offspring (95 male and 102 female) of alcoholic biological parents and used logistic regression models to determine the contribution to major depression in male and female adoptees that could be explained by the genetic alcoholic diathesis combined with an environmental factor that was characterized by psychiatrically or behaviorally disturbed adoptive parents. Major depression in females was predicted by an alcoholic diathesis only when combined with the disturbed adoptive parent variable. The same regression model failed to predict depression in males. Other possible environmental confounding factors contributing to an increased chance of depression were found in females: fetal alcohol exposure, age at the time of adoption, and a family with an adopted sibling who had a psychiatric problem. These variables did not diminish the significance of the prediction of depression with the alcohol genetic diathesis and disturbed parent model. Conclusions were that a genetic factor is present for which alcoholism is at least a marker, and which exerts its effect in women as a gene-environment interaction leading to major depression. This finding suggests that an important etiologic factor in depression spectrum disease is gene-environment interaction. The results are important for the substance abuse field because of the lasting effect upon female children of alcoholics and the additional fact that long term follow-up of females with depression spectrum disease find an increase in later life substance abuse. Cadoret, R.J., Winokur, G., Langbehn, D., Troughton, E., Yates, W.R., and Stewart, M.A. Depression Spectrum Disease, I: The Role of Gene-Environment Interaction. American Journal of Psychiatry, 153(7), pp. 892-899, 1996.

An Adoption Study of DSM-IIIR Alcohol and Drug Dependence Severity

The objective of this study was to evaluate the role of genetic factors in alcohol and drug dependence at various levels of DSM-IIIR psychoactive substance dependence severity. One-hundred ninety seven adoptees (95 case adoptees with biological parental alcoholism, drug dependence or antisocial personality disorder and 102 control adoptees) were interviewed for the presence of alcohol abuse or dependence and drug abuse or dependence using the Diagnostic Interview Schedule-DISIIIR. Adoptees with five or more DSM-IIIR criteria for alcohol dependence demonstrated evidence of a genetic effect using this adoption paradigm. Adoptees with one or more DSM-IIIR criteria for drug dependence demonstrated a genetic effect. This study suggests genetic factors influence the risk for alcohol and drug dependence at different thresholds of severity as determined by DSM-IIIR symptom severity count and that consideration of thresholds of diagnosis are important in determining the outcome of genetic studies. Yates, W.R., Cadoret, R.J., Troughton, E., and Stewart, M.A. An Adoption Study of DSM-IIIR Alcohol and Drug Dependence Severity. Drug and Alcohol Dependence, 41, pp. 9-15, 1996.

The Developmental Interface Between Nature and Nurture

In a collaborative study between a consortium of investigators, an adoption paradigm was used to explore a mechanism through which heritable characteristics of adopted children evoke adoptive parent responses. The study focused upon adoptee hostile/antisocial behavior. Subjects were 25 male and 20 female adoptees (separated at birth from biologic parents and placed with non-relatives) and their adoptive parents. Subjects ranged from 12-18 years of age and were selected on the basis of psychopathology reported in biologic parents as determined from hospital and prison records. Antisocial personality and substance abuse were the principal diagnoses in biologic parents. Behavioral observations were made of adoptive parent interactions with their adopted adolescent on a variety of problem-solving tasks. Structural equation modeling demonstrated that psychiatric disorders in the biologic parents correlated positively with their adopted-away offspring's antisocial/hostile behaviors. In turn, the adoptee antisocial/hostile behaviors were associated with harsh/inconsistent disciplinary behaviors in both adoptive mother and father. These results are consistent with an evocative model in which a child's heritable characteristics influence parental practice as a mediator. Further modeling developed evidence for a mutual influence of behaviors between mother's disciplinary practices and adoptee hostile/antisocial behaviors. The results demonstrate the importance of parenting practices in affecting (and being affected by) child behavior, and are relevant to the prevention of behaviors which are known to be associated with substance abuse. Ge, X., Conger, R.D., Cadoret, R.J., Neiderhiser, J.M., Yates, W., Troughton, E., and Stewart, M.A. The Developmental Interface Between Nature and Nurture: A Mutual Influence Model of Child Antisocial Behavior and Parent Behaviors. Developmental Psychology, 32, pp. 574-589, 1996.

Perceived Control and Environmental Predictability Buffer Adolescents from Effects of Parental Alcoholism

Researchers at Arizona State University examined protective factors that may protect adolescents from risks associated with parental alcoholism. Using data from their longitudinal study of adolescents in alcoholic families and demographically matched controls, they compared a subsample of 179 adolescents who abstained from substance use during a 3-year measurement interval with 88 initial abstainers who began to use substances over this period. Predictor variables were derived from computer-assisted interviews at the time of initial measurement when adolescents were 11-15 years of age. Results showed that COAs, older adolescents, and adolescents from disorganized home environments were more likely to initiate substance use than were non-COAs, younger adolescents, and those from homes high in family organization. Moreover, high levels of perceived control and very high or very low levels of coping buffered the risk for substance use initiation that was associated with parental alcoholism. The findings suggest that preventive interventions might either 1) attempt to increase predictability and organization of the home environment or 2) increase adolescents' abilities to cope with these environments, and thus increase their levels of perceived control. Hussong, A. and Chassin, L. Substance Use Initiation Among Adolescent Children of Alcoholics: Testing Protective Factors. Journal of Studies on Alcohol, 58(3), pp. 272-279, 1996.

Comorbidity and Boundaries of Affective Disorders with Anxiety Disorders and Substance Misuse: Results of an International Task Force

Associations between affective disorders, anxiety disorders and substance use disorders were examined in epidemiological studies conducted in Germany, Switzerland, Puerto Rico, and the mainland U.S. There was a remarkable degree of similarity across studies in the magnitude and type of specific disorders associated with the affective disorders. Comorbidity with affective disorders was greater for the anxiety disorders than for substance misuse. Panic disorder was the subtype of anxiety that was most highly comorbid with depression. Social phobia was the specific phobic type with the strongest association with the affective disorders. The magnitude of associations between substance misuse and affective disorders generally was quite low and less consistent across sites. No major differences were found in the patterns of comorbidity by gender or age group, affective subtype or prevalence period. The onset of anxiety disorders generally preceded that of depression, whereas alcohol misuse was equally likely to pre- or post-date the onset of affective disorders. Finally, comorbidity was associated with an elevation in treatment rates across all sites, confirming Berkson's paradox on an international level. Merikangas, K.R., August, J., Eaton, W., Canino, G., Rubio-Stipec, M., Wacker, H., Wittchen, H.U., Andrade, L., Essau, C., Whitaker, A., Kraemer, H., Robins, L.N., and Kupfer, D.J. British Journal of Psychiatry, 168 (30), pp. 58 67, 1996.

Substance Abuse, Comorbidity, and Sensation Seeking: Gender Differences

Two hundred sixty-two probands and 261 of their relatives with DSM-III-R diagnoses of drug and alcohol abuse and/or anxiety disorders completed the Zuckerman Sensation Seeking Scale. It was hypothesized that subjects with both substance abuse disorders and comorbid anxiety disorders would have lower sensation-seeking profiles than subjects with substance abuse alone. This was confirmed in women, with thrill- and adventure-seeking scores showing significant differences between pure substance abusers and those with a comorbid anxiety disorder, lending support of theories that substance abusers are a heterogeneous group. In men, there were fewer significant differences between diagnostic groups. If substance abusers are indeed a heterogeneous group, with some motivated by high sensation-seeking needs, a better understanding of these motivations can lead to more effective strategies of prevention and treatment, according to etiology. Scourfield, J., Stevens, D.E., and Merikangas, K.R. Comprehensive Psychiatry, 37(6), pp. 384-392, 1996.

Gender Related Differences in Circumstances Surrounding Initiation and Escalation of Alcohol and Other Substance Use/Abuse

A series of multivariate logistic regression models specifying the effects of gender and other variables on the initiation and escalation of alcohol and other substance use/abuse was estimated. The sample consisted of 6,074 young adults from a general population who participated in a longitudinal study that began in 1971. The original target sample consisted of a random sample of all seventh grade students (N=9,335) in the Houston Independent School District. A follow-up study of these students in the 1980's, when the subjects were in their mid-20's, resulted in the successful interview of 6,074 subjects. After controlling for race, ethnicity, father's education, and a tendency to over-or under endorse statements, the effects of gender on circumstances surrounding initiation/escalation of binge drinking, marijuana use, and use of other illicit drugs were found. The statistical analysis indicated that males tended to show a need to enhance sense of self-importance through use of alcohol and other substances and to report that they feel more important or more powerful for having done it. In addition, males seek social bonding through the use of alcohol or drugs. Females, however, resort to alcohol and other substances because of personal problems such as having a serious argument with a significant other, feeling angry at someone or something, or having troubles too great to bear. Females' use of alcohol or drugs for self-medication was also suggested by their greater tendency to report use proximate to experiences of feeling down emotionally or feeling worthless, and by their reports of feeling less depressed following use. This research asserts that, in multivariate context, gender differentiation is found in the perceptions of the circumstances surrounding the initiation and escalation of substance use/abuse. Liu, X., and Kaplan, H. Gender-Related Differences in Circumstances Surrounding Initiation and Escalation of Alcohol and Other Substance Use/Abuse. Deviant Behavior, 17(1), pp. 71-106, 1996.

Moderating Effects of Gender on the Relationship Between Not Graduating from High School and Psychological Dysfunction in Young Adulthood

This study compares the strength of the relationship between dropping out of high school and subsequent changes in the latent construct "adult psychological dysfunction". This relationship is considered separately for males and females so that the moderating effect of gender on the impact of not graduating from high school on psychological dysfunction in adulthood can be examined. Thus, this study estimates two male-female sets of models, and then estimates a third set of models that specifies the differential effects of starting college on the psychological functioning of female and male adolescents. The data for this analysis were collected from a longitudinal study of young adolescents that was designed to determine the precursors of a variety of deviant behaviors. The sample data were taken from the responses obtained during the first (Time 1) and fourth (Time 4) waves of data collection and produced a final sample N=4,681 (2,130 males and 2,551 females). The raw data were used as input for LISREL VII to estimate the structural models. Results from the first and second models suggest a negative effect of not graduating on psychological functioning for both male and female students. Results from the third analysis indicate gender effects such that adult psychological dysfunction is more likely to be negatively related to college attendance for females than it is for males. This research illustrates the importance of gender specific effects of high school graduation and college attendance on adult psychological dysfunction. Kaplan, D.S., Damphouse, K.R., and Kaplan, H.B. Moderating Effects of Gender on the Relationship Between Not Graduating from High School and Psychological Dysfunction in Young Adulthood. Journal of Educational Psychology, 88(4), pp. 760-774, 1996.

Women Convicted of Homicide had Drug Use Histories Similar to Men Convicted of Homicides

In a sample of 589 women convicted of homicide, 70% reported being regular users of drugs and alcohol prior to committing the homicide. The women were also as likely as male convicts to have long criminal histories of violent and non-violent crimes and to have been involved in the crack trade business. Spunt, B., Brownstein, H., Crimmins, S., et al. Drugs and Homicide by Women. Substance Use and Abuse, 31(7), pp. 825-845, 1996.

Young Adult Drug Use and Delinquency: Childhood Antecedents and Adolescent Mediators

The aims of this study were to examine the childhood, early adolescent, and late adolescent predictors of young adult drug use and delinquency; and to explore the effects of drug use on delinquent behavior. Data were gathered during the course of a 20-year longitudinal study of children representative of the Northeast. Data were gathered on childhood aggression, early and late adolescent drug use and delinquency, and young adult drug use and delinquency. Overall, the results were consistent with the proposed model. Drug use and delinquency during early and late adolescence served as the mediator between childhood aggression and young adult drug use. Adolescent drug use was associated with later delinquency. The findings indicated that childhood aggression was related to both young adult drug use and delinquency. Second, there was stability of drug use and delinquency between early adolescence and young adulthood. Third, drug use during early adolescence had an impact on delinquency not only in early adolescence, but also in late adolescence and young adulthood. The findings suggest that a decrease in drug use during adolescence should go a long way to decreasing delinquency in early and late adolescence and in young adulthood. Brook, J.S., Whiteman, M., Finch, S.J., and Cohen, P. Young Adult Drug Use and Delinquency: Childhood Antecedents and Adolescent Mediators. Journal of the American Academy of Child Adolescent Psychiatry, 35(12), pp. 1584-1592, 1996.

A Structural Model of Dropout Behavior: A Longitudinal Analysis

Using four wave panel data, a theoretically informed structural model of junior high school antecedents of high school dropout behavior is estimated. The model specifies a linkage between negative school experiences, both academic and disciplinary, and later dropout behavior that is mediated by self derogation in a school context and a contranormative behavior including both avoidant/ withdrawal and deviant acting out behavior. The data for this analysis were drawn from a four-wave panel study of all of the seventh grade students in a random half of the 36 junior high schools of the Houston Independent School District in 1971. The students were again tested in 1972 (Time 2), 1973 (Time 3), and in the 1980's (Time 4). A total of 2,428 students were present for all four tests, after a listwise deletion of missing values for those present, the final N=1,714. Estimation of the model provided strong support for the theoretically predicted relationship between students' self-rejecting feelings in a school setting, stimulated by their negative academic experiences, and their likelihood of dropping out of high school within three to five years. The relationship is mediated by truancy behavior during junior high school, and the relationship still holds after introducing control variables. In general, this study illustrates the important finding that patterns of academic failure and deviant behavior are established early for some students and that monitoring and intervention, if necessary, of students might reduce dropout behavior. Kaplan, D.S., Peck, B.M., and Kaplan, H.B. A Structural Model of Dropout Behavior: A Longitudinal Analysis. Applied Behavioral Science Review, 3(2), pp. 177-193, 1996.

School-Dropout Distortions in Adolescent Substance Use Rates Greater for Native Americans and Hispanics than for Non-Hispanic Whites

Researchers at the Tri-Ethnic Center for Prevention Research at Colorado State University examined how including data on drug use by school dropouts can alter estimates of adolescent drug use rates, and how the effects of dropouts vary across racial/ethnic groups represented in that Center. Rates of self-reported lifetime and past-30-day substance use were obtained from Mexican American, White non-Hispanic, and Native American students (n = 738) and dropouts (n = 774). Rates for the age cohort (students and dropouts) were estimated with a weighted correction formula. Rates of use reported by dropouts were 1.2 to 6.4 times higher than those reported by students. Rates of dropping out are higher for American Indians and Hispanics than for White non-Hispanics, and correction for dropouts differentially affects estimates for the respective groups. When only in-school data are available, errors in estimating drug use among groups with high rates of school dropout can be substantial. Correction of student-based data to include drug use of dropouts leads to important changes in estimated levels of drug use and alters estimates of the relative rates of use for racial/ethnic minority groups with high dropout rates. Swaim, R.C., Beauvais, F., Chavez, E.L., and Oetting, E.R. The Effect of School Dropout Rates on Estimates of Adolescent Substance Use Among Three Racial/Ethnic Groups. American Journal of Public Health, 87(1), pp. 51-55, 1997.

Racial/Ethnic Variations in Validity of Self-Report of Smoking

In a study using both self-report and a criterion physiological measure, Drs. Wills and Cleary compared the validity of self-reports of smoking across racial/ethnic groups and concluded that the lower smoking rates reported for African-American adolescents are real and are not substantially a consequence of reporting artifacts. Previous research has raised a question about the validity of self-report for African Americans. In this study, self-report of cigarette smoking was obtained together with a measure of carbon monoxide from expired air. Convergence between self-reported smoking and the biochemical measure was analyzed separately for three ethnic groups at 7th grade, 8th grade, 9th grade, and 10th grade. Analyses indicated that the validity of self-reports of smoking was generally comparable across ethnic groups. Sensitivity and specificity were comparable with data reported in recent meta-analyses. Though sensitivity was slightly lower for minority adolescents than for White adolescents, prevalence rates corrected for group differences in sensitivity showed significantly lower smoking rates for African-American and Hispanic adolescents than for White adolescents. Wills, T.A. and Cleary, S.D. The Validity of Self-Reports of Smoking: Analyses by Race/Ethnicity in a School Sample of Urban Adolescents. American Journal of Public Health, 87(1), pp. 56-61, 1997.

Differences in Thinking Versus Behavior in Middle and High School Females Concerning Drug Use and Eating Disorders

To evaluate differences as a function of age in middle-school versus high school females in terms of drug use and eating disorders a survey of more than 2,000 young women showed no significant differences across many risk behaviors; use of tobacco, alcohol, cocaine, diet pills, supplements, vitamins, self-induced vomiting or intent to use any of these in the future. However, these females did differ significantly in that the younger females displayed less knowledge of the adverse consequences of these behaviors, they perceived less prevalence of these behaviors among their peers, and expressed less belief in the media. While prevention programs for high school girls may be too late to deter experimentation, the results of this study underscore the need for intervention at an earlier age; at a time when critical knowledge items and attitudes are not yet firmly established. Clarke, G., Goldberg, L, Moe, E., Poole, L., and Witherrite, T. Young Women's Disordered Eating and Drug Use: Do Middle and High School Students Differ? To be presented at the American College of Sports Medicine, Denver, May 1997 and published in Medicine and Science in Sports and Exercise, Vol. 29-S, 1997.

High Rates of Drug and Alcohol Use Found Among Women Who Kill Children

Researchers in New York City interviewed 42 imprisoned women who were convicted for killing children. The majority of women (67%) reported using drugs and/or alcohol 3 or more days per week for a month. Most commonly used drugs were marijuana (by 26% of the women), alcohol (by 19%), and tranquilizers (by 17%). Sixty percent of the sample also reported coming from homes where drugs/alcohol were used daily. Crimmins, S., Langley, S., Brownstein, H.H., and Spunt, B. Convicted Women Who Have Killed Children. Journal of Interpersonal Violence, 12(1), pp. 49-69, 1997.

Factors Associated with a History of Firearm Injuries in Juvenile Drug Traffickers and Violent Juvenile Offenders

Firearm injuries have reached epidemic proportions with both juvenile and adult correctional populations. Relatively little is known, however, about the individual and community factors associated with an increased risk for violence in offender populations. Understanding these correlates of violent victimization would represent the first step in the identification of putative risk factors; permitting the development of meaningful and effective prevention programs. The primary objective of the present study was to develop a model of individual and community factors associated with firearm injury prevalence in a sample of incarcerated juvenile drug traffickers (N=217), and violent juvenile offenders (N=239). The results indicated that the pattern of offending, drug selling or violence, was important in determining the particular factors associated with firearm injuries in juvenile offenders. The results were consistent with the hypothesis that juvenile drug traffickers may have been injured as a result of a general inability to function effectively within the drug trafficking arena, or adequately judge victimization. The profile that emerged for the injured violent offenders suggested that they may have precipitated a violent attack through an aggressive interfactional style, or the predatory nature of their offending. A preliminary review of community variables indicated that the firearm injury prevalence for the two different offender groups varied across locality, again suggesting that community or environmental factors may interact with offending in defining the overall risk or injury. McLaughlin, C.R., Reiner, S.M., Smith, B.W., Waite, D.E., Reams, P.N., Joost, T.F., and Gervin, A.S. Factors Associated with a History of Firearm Injuries in Juvenile Drug Traffickers and Violent Juvenile Offenders. Free Inquiry - Special Issue: Gangs, Drugs and Violence, 24(2), p. 157, 1996.

Female Drug Injectors are Often Peripheral Members of Drug Injection Networks

Female injection drug users (IDUs) reported their usual link to drug injection networks to be by way of their male IDU sex partner. The peripheral or subordinate network positions of women IDUs may explain why they often engage in high risk behaviors. Su, S.S. and Gerstein, D. Understanding Barriers to Positive Behavioral Changes Among Injection Drug Users: A Social Network Approach. Paper presented at the International Sunbelt Social Network Conference, Charleston, SC, 1996.

Children Learn to Model Aggression and Violent Behavior of Adult Crack Sellers/ Abusers

A large ethnographic study was conducted to identify and describe the intergenerational processes by which behaviors are modeled, learned, and practiced. Researchers studied one large kin network in Harlem where the adults used alcohol, crack, and other illicit drugs and were actively involved in the drug trade. In this family system, the children observed that adults often fought over drugs or money and feuded while under the influence of crack and alcohol. They used aggression and violence against family members as retribution or punishment for previous aggressive and violent acts. Aggressive language and excessive profanity were routine adult behaviors and a major means of communication; jokes and insults led to arguments, often followed by fights. Most adults who had been abused physically or sexually as children did the same to their own. Children in this large family rarely obtained special attention and support, and had almost no opportunity to learn nonaggressive patterns. Instead, the children learned to model adult behaviors, such that the intergenerational transmission of aggression and violence was well established in this kin network. Dunlap, E., Johnson, B.D., and Rath, J. Aggression and Violence in Households of Crack Sellers/Abusers. Applied Behavioral Science Review, 4(2), pp. 191-217, 1996.

Powerlessness, Exploitation, and Degradation of Women in the Inner-City Crack Culture

Ethnographic studies of female crack sellers and commercial sex workers were conducted in New York City. Almost all of the women came from poor, precariously housed families and most had lost support from their families and friends because of their crack use. Single Room Occupancy or "welfare" hotels and shelters were viewed as criminogenic and dangerous. A few of the women "slept rough" or squatted curbside, but usually with a man. The most common alternative living arrangement of these women was with an older man with a dependable income for a period of time. In exchange, women typically provided the men with sex, drugs, domestic services, or companionship. Several women avoided crackhouses and shooting galleries by living in so-called "freakhouses" with other women, where they would provide entertainment and sex to men in exchange for crack and other drugs. Although these women of the inner-city crack culture were typically impoverished -- without a regular place to live, sleep, bathe, eat, and store their possessions -- they were rarely homeless and living on the streets. Rather, they tended to find alternative living arrangements which reinforced their powerlessness and reflected their high levels of sexual exploitation and degradation. Maher, L., Dunlap, E., Johnson, B., and Hamid, A. Gender, Power, and Alternative Living Arrangements in the Inner-City Crack Culture. Journal of Research on Crime and Delinquency, 33(2), pp. 181-205, 1996.

Exposure to Adult Substance Use as a Risk Factor in Adolescent Substance Use Onset: Part I

Little is known about the nature of parental influence on the initiation of drug use and subsequent rates of progression through increasingly more advanced stages of substance use. This study suggests that substance use by important adults is a potent risk factor for adolescent substance use experimentation. The risk appears to hold least for tobacco, an intermediate amount for alcohol, and most for marijuana. There is a risk associated with exposure to any one, any two, or all three substances. This report outlines a study designed to assess the impact of exposure to adult substance use on adolescents' progression through increasingly more advanced stages of substance use. Latent Transition Analysis was used to estimate the probabilities of adolescents' belonging to each of nine progressively more advanced stages of adolescent substance use conditional on exposure to adult substance use at each of three times of measurement. Additionally, the probabilities of adolescents moving from one stage in the onset process to another were estimated, conditional on adult substance use. The results show that adolescents reporting exposure to adult use of alcohol, tobacco, or marijuana are more likely to be further advanced in the onset process at each of the junior high school years, grades 7 through 9. The results for exposure to adult use of marijuana are most pronounced. Tracy, A.J., Collins, L.M., and Graham, J.W. Exposure to Adult Substance Use as a Risk Factor in Adolescent Substance Use Onset: Part I. The Methodology Center Technical Report Number 97-13, College of Health and Human Development, The Pennsylvania State University, 1997.

Volatile Solvent Use: Patterns by Gender and Ethnicity Among School Attenders and Dropouts

Differences in patterns of volatile solvent use were explored using self report, with specific focus on the relationship to school enrollment status -- dropout, enrolled but academically at-risk, and control. The sample included American Indian, Mexican American and White American youth. Findings indicated that a higher proportion of the dropout cohort have used volatile solvents, used them regularly and with more intensity than the other two groups. There was also an interaction between gender and ethnicity. Bates, S.C., Plemons, B.W., Thurman-Jumper, P., and Beauvais, F. Volatile Solvent Use: Patterns by Gender and Ethnicity Among School Attenders and Dropouts. Drugs and Society 10( ), pp. 59-75, 1997.

Timing of Paternal Substance Use Disorder Cessation and Effects on Sons' Problem Behavior

Investigators at the Center for Education and Drug Abuse Research (CEDAR) at the University of Pittsburgh report research suggesting that the sensitive period for the influence of fathers' substance use disorder (SUD) on sons' behavioral problems starts when the sons are around six years old. In an examination of the developmental timing of effects of paternal SUD offset on internalizing and externalizing problem behaviors in prepubertal sons, no differences were found between sons of control (SUD-) fathers (n=92 father-son pairs) and SUD+ fathers (n=149 father-son pairs) whose SUD ended before the son's sixth birthday. However, when paternal SUD extended beyond the boys' sixth year, significant increases in these types of problem behaviors were found. These results suggest the importance of early intervention to reduce paternal SUD in order to prevent intergenerational transmission of behavioral problems, and of substance abuse, given that externalizing behavioral problems in male children and adolescents are among the best predictors of subsequent substance abuse in early and late adolescence. Moss, HB; Clark, DB; and Kirisci, L. Timing of Paternal Substance Use Disorder Cessation and Effects of Problem Behaviors in Sons. American Journal on the Addictions, 6(1), pp. 30-37, 1997.

Modeling the Etiology of Adolescent Substance Use: A Test of the Social Development Model

The social development model is a general theory of human behavior that seeks to explain antisocial behaviors through specification of predictive developmental relationships. It incorporates the effects of empirical predictors ("risk factors" and "protective factors") for antisocial behavior and attempts to synthesize the most strongly supported propositions of control theory, social learning theory, and differential association theory. This article examines the power of social development model constructs measured at ages 9 to 10 and 13 to 14 to predict drug use at ages 17 to 18. The sample of 590 is from the longitudinal panel of the Seattle Social Development Project, which in 1985 sampled fifth grade students from high crime neighborhoods in Seattle, Washington. Structural equation modeling techniques were used to examine the fit of the model to the data. Although all but one path coefficient were significant and in the expected direction, the model did not fit the data as well as expected (CFI = .87). The researchers next specified second-order factors for each path to capture the substantial common variance in the constructs' opportunities, involvement, and rewards. This model fit the data well (CFI = .90). The researchers conclude that the social development model provides an acceptable fit to predict drug use at ages 17 to 18. Implications for the temporal nature of key constructs and for prevention are discussed. Catalano, R.F., Kosterman, R., Hawkins, J.D., Newcomb, M.D., and Abbott, R.D. Modeling the Etiology of Adolescent Substance Use: A Test of the Social Development Model. Journal of Drug Issues, 26, pp. 429-455, 1996.

Ethnic Differences in the Psychosocial Antecedents of Needle/Syringe Disinfection

Although injection drug users have responded to the AIDS crisis by reducing their behavioral risks to some degree, the prevalence of needle sharing is still alarmingly high. Also, few injection drug users report disinfecting their needles and syringes on a consistent basis. To identify possible psychosocial leverage points for behavioral change, a longitudinal study was used to apply the AIDS Risk Reduction Model to assess ethnic differences in needle/syringe disinfection by 209 injection drug users. Psychosocial antecedents included perceived risk, peer norms, AIDS knowledge, response efficacy, self-efficacy, and intentions to disinfect needles. Outcome was disinfection attempts at follow-up. Among Whites, high perceived self-efficacy for risk reduction had a positive effect on subsequent disinfection attempts. Among African Americans and Mexican Americans, peer norms favorable to risk reduction had a positive effect on subsequent disinfection attempts, while self-efficacy had no effect. Results suggest that risk-reduction capabilities may be rooted in "individualistic" perceptions of the self among white drug users, while "collective self" perceptions may have more impact in specific ethnic groups. The results demonstrated the utility and importance of comparing models of behavior change across ethnic groups. Longshore, D., Stein, J.A., Anglin, M.D. Ethnic Differences in the Psychosocial Antecedents of Needle/Syringe Disinfection. Drug and Alcohol Dependence, 42, pp. 183-196, 1996.

Needle-Sharing: A Longitudinal Study of Psychosocial Risk and Protective Factors

The authors examined the psychosocial correlates of needle-sharing behavior at two points in time by use of a prospective longitudinal design. Subjects were 278 male intravenous drug users, 111 of whom were HIV-positive. All subjects were given structured questionnaires by trained, ethnically matched interviewers. Pearson correlation coefficients (rs) and hierarchical regression analysis were done to examine interrelationships among time 1 (T1) psychosocial domains, T1 needle-sharing, and time 2 (T2) needle-sharing. T1 psychosocial/personality factors predicting T2 needle-sharing included unconventionality, poor emotional control, and poor intrapsychic functioning. The relationship of T1 needle-sharing to T2 needle-sharing was buffered by the T1 psychosocial protective factors. The findings supported a mediational model, in which personality and peer factors predicted T1 needle-sharing, which served as the mediator for T2 needle-sharing. These findings have important implications for intervention. Thus, an intervention earlier in the sequence might focus on the personality and friendship networks at T1, whereas an intervention a little later in the developmental sequence would focus on altering T1 needle-sharing behavior. Earlier therapeutic interventions focusing on personality disposition, family alienation, or peer group affiliations should reduce the risk of later needle-sharing behavior. Brook, D.W., Brook, J.S., Whiteman, M., Wynn, P.S., Masci, J.R., Roberto, J., de Catalogne, J., Amundsen, F. Needle-Sharing: A Longitudinal Study of Psychosocial Risk and Protective Factors. The American Journal on Addictions, 5(3), pp. 209 219, 1996.

Eating Pathology among Women with Alcoholism and/or Anxiety Disorders

Two hundred one non-treatment seeking women with alcoholism, anxiety disorders, alcoholism and anxiety disorders, or neither alcoholism nor anxiety disorders were interviewed to assess core psychopathology associated with eating disorders using the Eating Disorders Examination and DSM-IIIR psychiatric diagnosis. Alcoholic women had significantly higher mean scores on each of the Eating Disorders Examination subscales of Restraint, Overeating, Eating Concern, Shape Concern, and Weight Concern compared with nonalcoholic women. Women with anxiety disorders had significantly elevated scores on subscales of Overeating, Eating Concern, and Weight Concern compared with women without anxiety disorder. Women with both alcoholism and anxiety disorders had higher rates of bulimia nervosa and/or eating disorder NOS compared with women with either disorder alone. Implications of these findings are discussed in the context of the co-morbid association between alcoholism, eating disorders, and anxiety disorders. Sinha, R., Robinson, J., Merikangas, K., Wilson, G. T., Rodin, J., O'Malley, S. Alcohol Clin Exp Res., 20(7), pp. 1184-1191, 1996.

Comorbidity of Alcoholism and Anxiety Disorders

People with alcoholism frequently also suffer from an anxiety disorder. The mechanisms underlying this comorbidity remain unclear. Clinical findings indicate that anxiety disorders may lead to the development of alcoholism. Conversely, alcoholism may contribute to the development of anxiety symptoms. Family studies have reported elevated rates of anxiety disorders in the relatives of patients with alcoholism and vice versa, suggesting that both disorders may share some susceptibility factors. The Yale Family Study of the comorbidity of alcoholism and anxiety confirmed these observations. The study also found gender-specific differences in the risk for some comorbid anxiety disorders. Moreover, the relatives of people with alcohol dependence or anxiety were at increased risk for alcohol dependence but not alcohol abuse. Merikangas, K.R., Stevens, D., Fenton, B. Alcoholism and Anxiety Disorders, 20(2), pp. 100-106, 1996.

Discriminating Depression and Anxiety in Youth: A Role for Diagnostic Criteria

To test the hypothesis that anxiety and depression in youth, as in adults, become increasingly discriminable when youth meet criteria for an emotional disorder, the study uses cross-sectional data at two points in time from a large (n=776) community sample of youths, aged eight to twenty. Associations between major depression disorders (overanxious, obsessive compulsive and separation anxiety disorders, and social and simple phobias) are examined by symptom scale and diagnosis. Anxiety and depression are moderately correlated, and substantially comorbid by diagnostic category. Symptoms are more discriminable among youth who meet criteria for a specific emotional disorder but more highly associated among youths without such a diagnosis. This suggests that in youth, as has been shown in adults, depression and anxiety become increasingly discriminable as emotional psychopathology becomes more severe. Gurley, D., Cohen, P., Pine, D.S., and Brook, J.S. Journal of Affective Disorders, 39, pp. 191-200, 1996.

Reexamining Gender Differences in Circumstances Surrounding Initiation and Escalation of Binge Drinking

Hypotheses regarding gender differences in circumstances surrounding the initiation/escalation of binge drinking were tested. It was hypothesized in this study that due to socialization in accordance with gender-specific norms, males will use/abuse alcohol out of a need to enhance their sense of potency or self-importance. In contrast, females were hypothesized to be more likely to resort to alcohol for personal and intrapsychic purposes. The data used for this analysis were derived from a household interview of a sample of young adults who were initially studied in 1971 (Time 1). A follow-up study of these people in the 1980's (Time 2), resulted in a successful interview of 6,074 subjects. Of these, 1,129 subjects reported to have engaged in binge drinking sometime in their life. Listwise deletion of missing values produced a final N=1,101. The circumstances that surround initiation and escalation of binge drinking were measured by six scales. In general the multiple regression analyses suggested a congruence between observed gender differences in circumstances surrounding initiation and escalation. Some additional observed differential effects of gender included, level of drinking (light or heavy) and peer influence at the initial level of drinking, but not escalating it. For escalation of binge drinking, no gender-related effect on peer influence was observed. However, all other gender-related effects continued to be observed at even greater levels. The results also supported the conclusion that the gender related effects are at least partially independent, although certain of the effects were attenuated when other circumstances (scales) were included in the model. Liu, X., and Kaplan, H.B. Reexamining Gender Differences in Circumstances Surrounding Initiation and Escalation of Binge Drinking. International Journal of Sociology and Social Policy, 16(5/6), pp. 26-51, 1996.

Stigma, Deviance, and Social Sanctions

This study tests the hypothesis that deviant acts are more likely to evoke negative social sanctions if the person already is stigmatized. The underlying assumption is that possessing a physical stigma defines the individual as the occupant of a deviant master status. The subjects selected for this analysis were drawn from seventh grade respondents in the Houston Independent School District in the fourth wave of data collection in an on going panel study. The initial size of the data set was 6,074. Deleting cases that did not have any reports of committing one or more of the specified deviant acts produced a final N=4,065. Multivariate logistic regression models were estimated with the following control variables: frequency and intensity of deviant acts, tendency to perceive rejection, gender, minority status, and level of education. Partial support was obtained for the hypothesis that individuals who have committed a deviant act will be more likely to invite negative social sanctions if they have a stigma than if they do not have a stigma. Stigma was found to significantly predict reports of having a close call with the police or getting arrested because of a deviant act. Stigma was not a statistically significant predictor for experiencing rejection by a boy/girlfriend, parents, friends, or others who were important to them as a result of committing a deviant act. Additionally, stigma was not found to be a statistically significant predictor for serving time in jail or prison because of the commission of a deviant act. In general, these results suggest the synergistic influence of prior deviant master statuses and other deviant responses on evoking negative social sanctions. Stiles, B.L., and Kaplan, H.B. Stigma, Deviance, and Negative Social Sanctions. Social Science Quarterly, 77(3), pp. 685-696, 1996.

Drug Abuse and Crime are Nurtured in Children Who Live in Crack-Abusing Households

A case study was conducted of child-rearing practices in one large, highly criminal and drug-abusing household/kin network in New York City. This case study delineated the concrete expectations and actual practices -- called conduct norms -- with which the household adults respond to or "nurture" their children. Adults in crack-abusing households typically model deviant activities and rarely engage in conventional behaviors. They rarely take measures to protect their children from harm but are often the ones who inflict the greatest harm. The conduct norms in these deviant households are well designed to nurture anti-social children who later become juvenile delinquents and adult criminals, drug abusers, and prostitutes. Johnson, B., Dunlap, E., and Maher, L. Nurturing for Careers in Drug Abuse and Crime: Conduct Norms for Children and Juveniles in Crack-Abusing Households. Substance Use and Abuse, In press.

Factors Mediating Effects of Parental Support on Adolescents' Substance Use

Researchers at the Albert Einstein College of Medicine examined factors mediating the effects of parental emotional and instrumental support on adolescents' use of tobacco, alcohol, and marijuana. Data were obtained from a sample of 1,702 adolescents surveyed beginning in the 7th grade and continuing in the 8th and 9th grades. At each assessment, parental support was found to be inversely related to substance use, and stress-buffering interactions were observed throughout. Structural modeling analyses indicated the effect of parental support was mediated through multiple pathways. In general, however, the major mediators were higher levels of behavioral coping and academic competence and less tolerance for deviance and behavioral undercontrol; these mediators were related to negative life events and deviant peer affiliations. Multiple-group analyses suggested buffering effects occurred because high support reduced the effect of risk factors and increased the effect of protective factors. Results of this study support the position that enhanced coping ability is an important mechanism through which social support contributes to adjustment. Wills, T.A., and Cleary, S.D. How Are Social Support Effects Mediated? A Test with Parental Support and Adolescent Substance Use. Journal of Personality and Social Psychology (5), pp. 937-952, 1996.

Juvenile Drug Traffickers: Characterization and Substance Use Patterns

Drug trafficking has become one of the dominant issues facing the criminal justice system. Juveniles involved in drug trafficking have been reported to be far more likely to be seriously immersed in substance abuse and delinquent behavior than nonsellers. The primary aim of the present study was to examine the substance use patterns of juveniles incarcerated for drug trafficking offenses in the Commonwealth of Virginia (N=240). A second goal of the study was to characterize juvenile drug traffickers based upon additional information pertaining to their delinquent, social, psychological, educational and medical histories. For this purpose a demographic comparison group was generated (N=433). The results indicated that the most frequently sold substance was cocaine (93%), either powdered or crack, while alcohol and marijuana were the drugs most often used by the juvenile drug traffickers. The juvenile drug traffickers were associated with lower levels of aggressivity, violence and delinquency when compared to other incarcerated juveniles from their community. In addition, the juvenile drug traffickers were characterized by higher ratings in several areas which included social and psychological functioning. Areas that did not correlate well with drug trafficking were physical health, intellectual functioning and academic achievement. The results of this study indicated that juvenile drug traffickers tend not to use the drugs that they sell, and generally present as higher functioning and better adjusted in almost every area evaluated, when compared to their incarcerated delinquent peers. McLaughlin, C.R., Smith, B.W., Reiner, S.M., Waite, D.E., and Glover, A.W. Juvenile Drug Traffickers: Characterization and Substance Use Patterns. Free Inquiry in Creative Sociology, 24(1), p. 3, 1996.

Risk and Protective Factors for Drug Use: Etiological Considerations

This conceptual chapter reviewed the literature in the field of the psychosocial etiological contributions to adolescent drug use and abuse. It outlined the domains of risk and protective factors which contribute to or lessen the risk of drug use. The cultural/societal domain includes adverse economic conditions, neighborhood disorganization, and noxious physical and social environments, as well as ethnicity and acculturation and the influence of the media. The family domains comprise the parental marital relationship domain, the parental drug use and personality domains, the parent-adolescent relationship domain (including parental control variables) and the sibling domain. The childhood and adolescent personality domains focus on aspects of unconventionality, emotional control, personal functioning, and social relatedness. Unconventionality, emphasizing sensation seeking, rebelliousness, tolerance of deviance, and low school achievement, is an especially potent predictor of later drug use. Genetic and physiological factors act as predisposing elements on which the environmental and psychosocial forces act to produce the phenotype of drug use/abuse. This is know as the "risk-diathesis hypothesis." A mutually affectionate parent-adolescent relationship is strongly protective against the risk factors for drug use. The presence of protective factors can ameliorate the adverse effects of risk factors, reducing vulnerability and enhancing resilience. Alcohol and drug use are stable behaviors over time, although adolescents tend to progress through stages of use, from legal to illicit drugs. Almost all drug use begins before the age of 21, and tends to be related to other deviant behavior. Substance abuse and psychopathology seem linked, as comorbidity is increasingly recognized, and the link between drug use and crime is also fairly well-established. Although drug use may continue well into adulthood, generally drug use lessens with the increasing assumption of adult social roles. Principles of prevention intervention include: (1) an early start, (2) education for parenting; (3) the provision of adequate social and economic resources; (4) adequate health care; (5) enhancing educational goals; (6) using a multi-disciplinary approach to enhance protective factors and decrease risk factors. Brook, J.S., and Brook, D.W. Risk and Protective Factors for Drug Use: Etiological Considerations. In: C.B. McCoy, L.R. Metsch, J.A. Inciardi (Eds.), Intervening with Drug Involved Youth, pp. 23-44, 1996. Thousand Oaks, CA: Sage Publications.

Deviancy Training in Male Adolescent Friendships

The conversations of 186 adolescent boys ages 13-14 and their friends were videotaped and analyzed to understand the processes of influence associated with antisocial behavior. Sequential analyses revealed a statistically reliable reciprocal pattern between Rule-Breaking talk and Laugh in the delinquent (both boys arrested) dyads, whereas in the mixed (one arrested) and nondelinquent (neither arrested) dyads, reciprocation occurred between Normative talk and Laugh. Longitudinal analyses of the boys' behavior over 2 years revealed that the deviancy training sequence was prognostic of increases in self-reported delinquent behavior. The data have implications for intervention strategies and policies involving antisocial youth. One implication is that interventions should avoid aggregating high-risk youths in homogeneous groups. Dishion, T.J., Spracklen, K.M., Andrews, D.W., and Patterson, G.R. Deviancy Training in Male Adolescent Friendships. Behavior Therapy, 27, pp. 373-390, 1996.

Environmental Manipulation Alters Drug Efficacy

To further test the impact of different rearing environments on subsequent behavioral and neurologic response to morphine, rats were raised from weaning to young adulthood in either an enriched-EC (group housed with various novel visual objects) or impoverished-IC (housed individually with no objects). As adults, locomotor activity and reward produced by morphine was assessed using the conditioned place preference paradigm (CPP). On Day 1, rats in both groups showed an inverted U-shaped dose effect curve for locomotor activity though the effect was greater for IC than the EC group. Across days, both groups showed locomotor sensitization; although again, the effect was greatest in the IC group. However, in contrast, morphine-induced CPP (the measure of 'reward') was attenuated in the IC group when compared to the EC group indicating that the locomotor versus rewarding effects were dependent on different neural substrates. Measurement of mu opioid receptor density and rates of dopaminergic synthesis in the mesolimbic and nigrostriatal systems of rats from each group showed no difference between IC or EC groups. Therefore, it was concluded that while these receptors do modulate mesolimbic dopamine neurotransmission this does not account for the differential behavioral effects seen in the IC group relative to the EC group. Bardo, M.T., Robiner, P.M., and Hammerd, R.F. Effect of Differential Rearing Conditions of Morphine-Induced Behaviors, Opioid Receptors and Dopamine Synthesis. Neuropharmacology, In press.

The Impact of a Localized Antidrug Media Campaign Associated with Adolescent Drug Use

The purpose of the study was to determine whether local antidrug campaigns can affect variables associated with adolescent drug use. An experiment was conducted with sets of matched communities with populations between 5,000 and 30,000 distributed throughout the United States. Seven through twelfth grade students in the experimental communities were exposed to a year long media campaign. On a follow-up survey, recall of the media campaign was low. Adolescents with low and moderate levels of drug use who recalled individual campaign flights showed beneficial effects on targeted variables in comparison with students who did not recall the campaigns and control students who were not exposed to the campaign. The authors suggest comparing a media campaign alone with that of a media campaign combined with interpersonal or school-based curriculums. Kelly, K.J., Swaim, R.C. and Wayman, J.C. The Impact of a Localized Antidrug Media Campaign on Targeted Variables Associated with Adolescent Drug Use. Journal of Public Policy and Marketing, 15(2), pp. 238-251, 1996.

Is Current Drug Abuse Prevention Programming Generalizable Across Ethnic Groups?

Considerable progress has been made over the past two decades in identifying effective drug abuse prevention strategies. In particular, much support has been obtained for the effectiveness of a comprehensive social influences approach to drug abuse prevention. Given the inclusion of fundamental social psychological principles in comprehensive programs, it is possible that currently developed drug abuse prevention programming is generalizable to different ethnic groups. However, the empirical and theoretical evidence is equivocal regarding the extent to which this is true. In this article, the authors present arguments for (lack of supply or inadequate access, lack of demand, differences in acquisition variables, and inappropriate timing) and against (successful program show results across groups, interactive programs incorporate group differences, similar initiation patterns across groups, and societal and programmatic costs) the need to develop drug abuse prevention programs specifically for minority ethnic groups. Dent, C.W., Sussman,S., Ellickson, P., Brown, P., and Richardson, J. Is Current Drug Abuse Prevention Programming Generalizable Across Ethnic Groups? American Behavioral Scientist, 39(7), pp. 911-918, June 1996.

The Timing and Severity of Antisocial Behavior: Three Hypotheses Within an Ecological Framework

The goal of this chapter is to render an environmental explanation for the timing and severity of child and adolescent antisocial behavior. Three basic hypotheses are discussed: (1) The social interactional hypothesis; (2) the marginal deviation hypothesis; and (3) the contextual sensitivity hypothesis. Three features of a toxic social context are defined: poverty, stigmatization and isolation, and deviant norms. The authors have found that the impact of context on child adjustment is mediated through parenting practices. The ecological framework is used to explain the developmental patterns of childhood and adolescent-onset antisocial behavior. The authors suggest a view of prevention and intervention that emphasizes harm reduction and moves away from the disease model conceptualizations of antisocial behavior. Dishion, T.J., and Patterson, G.R. The Timing and Severity of Antisocial Behavior: Three Hypotheses Within an Ecological Framework. In Stoff, D., Breiling, J., and Maser, J. (Eds), Handbook of Antisocial Behavior. New York: John Wiley & Sons, 1996.

Implicit Cognition in Adolescent Drug Use

Implicit cognitive responses to drug-use cues and drug outcomes, assessed with measures of memory association, were studied in a sample of high risk, White and Latino adolescents. The utility of these responses as predictors of drug use was examined and compared with potentially confounding predictors, including gender, socioeconomic status, ethnicity, and acculturation. The background variables also served as potential moderators of the effects of implicit cognition. The results revealed that measures of memory association were consistent, direct-effect predictors of marijuana and alcohol use. In addition, these implicit cognitive measures were stronger predictors than were the background variables, and their predictive effects were not moderated by other variables. The results provide further support for the implicit cognition perspective in drug use. Stacy, A.W., Ames, S., Sussman, S.Y., and Dent, C.W. Implicit Cognition in Adolescent Drug Use. Psychology of Addictive Behaviors, 10, pp. 190-203, 1996.

Children's Conceptions of AIDS and Related Risky Behavior

This is a seven year longitudinal study of children's understanding of AIDS and beliefs, attitudes, norms, intentions and behaviors regarding cigarette, alcohol and drug use, and sexual intercourse and condom use. The longitudinal sample of 1,173 students was first surveyed in 1992 when they were in grades 3, 4, 5, and 6. Fifty one percent of the sample are girls, 47% are white, 24% African American, 20% Asian American, and 9% of other ethic backgrounds. The most recent publication examines the applicability of Fishbein and Ajzen's (1975) Theory of Reasoned Action to intentions to use cigarettes and alcohol among 5th- and 6th- grade students. The researchers examined the relationships among beliefs, norms, attitudes and intentions to smoke and drink in these students who were in 5th and 6th grade at the Time 1 (1992) survey, and examined the relationship of Time 1 intentions to self-reported behavior at Time 2 (1993). Beliefs and norms about these behaviors were multidimensional. Analyses revealed the following dimensions: For drinking; positive outcomes (e.g., feeling happy); negative outcomes (e.g., feeling sick), parents norm; and friends norm. For smoking; positive outcomes, (e.g., feel more grown up); immediate negative outcomes (e.g., yellow teeth), long term negative outcomes (e.g., hurt your lungs); parents norms; and friends norm. The Theory of Reasoned Action describes these children's decision-making well. Children with attitudes and norms more favorable to smoking or drinking were more likely to intend to drink, and intentions to smoke and drink were positively related to smoking or drinking in the next year. Morrison, D.D., Simpson, E.E., Gillmore, M.R., Wells, E.A., and Hoppe, M.J. Children's Decisions About Substance Use: An Application and Extension of the Theory of Reasoned Action. Journal of Applied Social Psychology, 26(18), pp. 1658-1679, 1996.

Novelty Seeking in Animals Further Linked to Brain Reward Centers

To further evaluate brain function and the role of specific centers on drug use, voltammetric recordings were obtained from specific regions of the forebrain in rats during operant maneuvering given free choice access to a novel environment. Entry into novelty increased the catechol signal in the medial prefrontal cortex and shell of nucleus acumbens by more than 100% when compared to baseline activity and this increase was only detected during initial entry into the novel compartment and did not reoccur upon reentry to the familiar environment. No consistent effect in either neostriatum or the acumbal core was recorded. These results support increasing evidence for a functional distinction between the acumbal core and shell with the latter having been linked to brain reward mechanisms. The results also indicate that novelty activates some of the neurochemical systems that appear to play a critical role in the reinforcing effects of certain drugs of abuse. Rebec, G.V, Grabner, C.P., Johnson, M, Pierce, R.C., and Bardo, M.T. Transient Increases in Catecholamine Activity in Medial Cortex and Nucleus Acumbens Shell During Novelty. Neuroscience, In press.

Drug Rehabilitation in China

The Yunnan Province in China may be experiencing the highest incidence of heroin use in China, in part because of its proximity to the Golden Triangle. This high incidence, as elsewhere, threatens to increase associated problems in China, including the spread of HIV. Moreover, the high purity of heroin used in this Province leads to rapid addiction and increased difficulties in treating the symptoms of withdrawal. One response to this epidemic is described in this article, namely, the development and implementation of the Kunmung Drug Rehabilitation Center. The Center, with a capacity for 620 addicts, is grounded in a recovery-oriented perspective based on the Therapeutic Community Model and modified for the Yunnan Province of China. It is referred to as the Kunmung Model and is known for its own medicine for detoxification and its individualized psychological, psychiatric, medical, and biosocial program. Similarities and differences between the Kunmung Center and treatment programs in the U.S. are discussed and implications for universal approaches to drug treatment are addressed. McCoy, C., Lai, S., Metsch, L. et al. No Pain No Gain, Establishing the Kunmung, China, Drug Rehabilitation Center. Journal of Drug Issues, 27(1), pp. 73-85, 1997.

Psychometric Evaluation of a Health Risk and Anabolic Steroid Questionnaire

Psychometric properties of a questionnaire designed to assess health risk and anabolic steroid use/intent to use in a population of high school football players were evaluated. The questionnaire was created with the competing goals of producing reliable and valid constructs while keeping the length short enough to enable accurate and complete responding. Internal consistency and test retest reliability as well as content, criterion-related and construct validity were assessed. Overall, the questionnaire produced reliable and valid outcome constructs, including intent to use steroids, nutrition behaviors and strength training self-efficacy, and constructs examining peer and nonpeer influence, as well as individual characteristics. These constructs should prove useful in future studies of anabolic steroid use and health behaviors. McKinnon, D.P., Goldberg, L., Lapin, A., Clarke, G.N., Elliott, D.L., and Moe, E. Psychometric Properties of an Adolescent Health Risk and Anabolic Steroid Questionnaire: The Adolescent Training and Learning to Avoid Steroids (ATLAS) Project. Health Education Research, In press.

Modeling Growth and Change Processes: Design, Measurement, and Analysis for Research in Social Psychology

This chapter discusses design, measurement, and analysis issues relevant to the study of growth and change in social psychological research. Individual growth is taken as a starting point by arguing that the assessment of individual growth is a necessary prerequisite to the assessment of interindividual or group differences in growth. Discussed are the age, cohort, and time perspective and its implications for research design. Other design issues are considered including missing data and subject attrition, and measurement effects. Results demonstrate that the timing of data collection is an important and often neglected design consideration. Some new aspects of measurement validity relevant to measurement of change are discussed. The shortcomings of traditional measurement procedures when applied to the measurement of change were reviewed, and a measurement model that incorporates a model of change is presented. Finally, two frameworks for the statistical analysis of change are discussed. Collins, L.M. and Sayer, A.G. Growth and Change in Social Psychology Research: Design, Measurement, and Analysis. In H. Reis and C. Judd (Eds.), Handbook of Research in Social Psychology. Cambridge: Cambridge University Press. In press.

Intrapersonal Contributors to Drug Use: The Willing Host

Although social environmental factors play a large role in the development of substance use and abuse, other important contributors reside within the individual. These intrapersonal factors help determine certain aspects of the social environment, which may in turn alter the probability of drug use and abuse. In addition, these intrapersonal factors alter chances of initiation, the transition from initiation to regular use of a drug, and the transition from regular drug use to problem use. These factors include (but are not limited to) personality, cognition, affect, problem behaviors, biogenetics, demographics, and bonding. The authors explore the potential role of each of these intrapersonal factors in a larger, biopsychosocial model of drug use and abuse. The authors also discuss the implications of each of these factors for prevention. Newcomb, M.D. and Earleywine, M. Intrapersonal Contributors to Drug Use: The Willing Host. American Behavioral Scientist, 39, pp. 823-837, 1996.

Employee Attitude Crystallization and Substance Use Policy: Test of a Classification Scheme

Previous research suggests that employees are often unaware of or ambivalent toward substance abuse policies. These studies focus on one policy component-drug testing-and fail to distinguish employees with clear (or crystallized) from unclear attitudes. The current study explored a broader view of policy and examined both personal and situational factors that may determine attitudes. Survey data from employees in three municipalities support a distinction among five attitude categories; those who are: (a) dissatisfied with efforts to control employee abuse, (b) satisfied, (c) anti-policy, (d) pro-policy, and (e) uninformed. Discriminant analyses suggest that different profiles characterize these attitude groups. For example, dissatisfied employees report low personal alcohol use, high co-worker alcohol use, and low self-referral whereas anti-policy employees report high personal drug use, high co-worker use, and low job identity. Discussion focuses on policy as a social construction and the implications of attitude distinctions for employee training. Bennett, J.B., and Lehman, W.E.K. Journal of Drug Issues, 26(4), pp. 831-864, 1996.

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