Drug Abuse Treatment

Research Findings from May, 1998 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate the child and adolescent drug abuse treatment. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Efficacy of Lithium Treatment for Adolescents With Bipolar Disorders and Secondary Substance Dependency

Dr. Barbara Geller and colleagues at the Washington University School of Medicine conducted a 6-week double-blind, placebo-controlled, parallel group clinical trial to assess the efficacy of lithium for 16 male and 9 female adolescents (12-18 years) with a primary DSM-III-R bipolar disorder and secondary substance dependency disorder. Results indicate lithium to be an efficacious treatment for both disorders in terms of concurrently reducing symptoms of psychopathology (e.g., improved mood) and the use of illicit substances. No gender differences were noted. Geller, B., Cooper, T.B., Sun, K., et al. Journal of the American Academy of Child and Adolescent Psychiatry, 37(2), pp. 171-178, 1998.

Progression From Conduct Disorder to Antisocial Personality Disorder Following Treatment for Adolescent Substance Abuse

Drs. Mark Brown, Sandra Brown and colleagues at the University of California, San Diego, conducted a prospective longitudinal study of 137 substance-abusing adolescents (mean age at intake 15.9 years) who met DSM-III-R criteria for Conduct Disorder. Subjects (39% female) recruited from two adolescent inpatient drug treatment programs were interviewed at intake and again 4 years later. Results indicate that four years after treatment 61% (N=84) of the study group met DSM-III-R criteria for Antisocial Personality Disorder (APD), of which males were disproportionately represented (N=60) compared to female subjects (N=24; p<.005). Pretreatment clinical characteristics which predicted post-treatment APD include deviant behavior at or before age 10, greater diversity of deviant behaviors independent of substance use during childhood and early adolescence, and more extensive drug, but not alcohol use during the 30 days before admission to the program. These findings suggest a poorer prognosis for adolescents when conduct disorder is diagnosed independent of drug use, whereas more favorable drug treatment outcomes might be achieved with adolescents whose pretreatment diagnosis of conduct disorder occurred primarily in the context of or subsequent to their use of illicit substances. Myers, M.G., Stewart, D.G., and Brown, S.A. American Journal of Psychiatry, 155(4), pp. 479-485, 1998.

Childhood, Adolescent, Familial, and Peer Antecedents of Cigarette Smoking in Young Adults

This study examined the interrelation of personality, family, and peer determinants and their effects on tobacco use by young adults. Mothers were first interviewed about their children when they were between the ages of 1 and 10 years old. Three subsequent interviews were conducted with the children when they reached adolescence and young adulthood. Results show support for the mediational model, which is derived from the family interactional theory framework to examine pathways that may lead to adolescent legal and illegal drug use and other problem behavior. There was a sequence in patterning: from parenting during early adolescence, to personality and peer factors, extending to smoking in late adolescence and culminating in smoking in adulthood. With a developmental approach, a number of psychosocial measures appear related in both younger and older children. Developmental differences also emerged, suggesting four possible targets for therapeutic or preventive intervention: the parent, the child, the adolescent, and the peer group. Brook, J.S., et al. Cigarette Smoking in Young Adults: Childhood and Adolescent Personality, Familial, and Peer Antecedents, J. Genetic Psychology, 158(2), pp. 172-188, 1997.

Delinquency and Antisocial Behavior: A Review of Family Processes and Intervention Research

Recent longitudinal research employing complex measurement and analytic strategies has generated new, more intricate conceptualizations of the relationship between family life and delinquency, all of which have important implications for intervention with delinquents and their families. This critical review of the current research on the role of the family, its implications for family-based interventions with delinquents, and the existing treatment outcome research highlights four areas: the link between different family processes and delinquency, reciprocal relationships between parenting and delinquency, the effects of family context on parenting and delinquency, and the family as one cause of delinquency among many. Smith, C.A., and Stern, S.B. Social Service Review, 71, pp. 382-420, 1997.