Drug Abuse Treatment

Research Findings from September, 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.

Amphetamine, Substance Use and Its Relationship to Depression, Anxiety, and Isolation Among Youth Living With HIV

In a series of three papers, drug use and correlates were examined in youth living with HIV (YLH). Amphetamine use, other HIV-related risk acts, T-cell counts, emotional distress, coping style, and symptoms of HIV were examined in 337 HIV+ youth aged 13 to 24 (20% female; 22% African American, 27% Anglo, 35% Latino) from four cities (LA, NY, San Francisco, and Miami). One third of youth were found to have engaged in amphetamine use in their lifetime, and 21% of youths reported current use (i.e. in the last three months). Compared to non-users, users initiated other drug use at younger ages, used more types of drugs, reported more emotional distress, and employed escape coping significantly more often. Substance use pervaded the lives of these YLH. Among this sample, males had used more drugs, more often, and for longer periods than females. However, there had been major reductions in use. Being male, having high emotional distress, and having fewer negative social supports were significantly associated with greater reductions in substance use. The longer an individual had been diagnosed seropositive tended to be associated with reductions in use (p=.06). Compared to non-users, users also had more sexual partners and more sexual encounters. While users and non-users do not differ on physical symptoms or whether they have been diagnosed with AIDS, users of amphetamines report significantly higher T-cell counts than non-users. Despite poor psychosocial functioning, amphetamine users were found to have higher T-cell counts than other YLH. The continued high-risk profile of transmission acts among users suggests that preventive interventions must target specific drugs used by YLH. As the number of youths infected with HIV rises, secondary prevention programs are needed to help youths living with HIV meet three goals: 1) increase self-care behaviors, medical adherence, and health-related interactions; 2) reduce transmission acts; and 3) enhance their quality of life. Based on modifications of the social action model, a small group intervention was developed and tested in this population. Rotheram-Borus, M.J., Mann, T., and Chabon, B. Amphetamine Use Among Youths Living with HIV. AIDS Education and Prevention, In Press; Rotheram-Borus, M.J., Murphy, D.A., Swendeman, D., Chao, B., Chabon, B., Zhou, S., and Birnbaum, J. Substance Use and its Relationship to Depression, Anxiety, and Isolation Among Youth Living with HIV. International Journal of Behavioral Medicine, In Press; Rotheram-Borus, M.J., and Miller, S. Secondary Prevention for Youths Living with HIV. AIDS Care, 10(1), pp. 17-34. 1998.

Aggression Classification and Treatment Response

This preliminary study investigated whether the aggression subtypes derived from the Aggression Questionnaire (AQ) are related to treatment response. Subjects were 28 aggressive conduct-disordered children (25 males, 3 females), ranging in age from 9.8 to 17.0 years (mean=12.69 years), who participated in a double-blind, placebo-controlled study of lithium as a treatment for reducing aggression. The Predatory-Affective Index of the AQ was used to classify subjects into predatory (planned) or affective (explosive) subtypes of aggression and then related this classification to treatment response. This index did not differentiate placebo baseline responders from non-responders but did significantly differentiate responders and non-responders during the experimental treatment period, regardless of whether they received lithium or placebo. Treatment response was associated with a more affective and less predatory subtype of aggression. Authors report that, to the best of their knowledge, this is the first study in children to show an association between aggression subtype and treatment response. Malone R., Bennett D., Luebbert, J., Rowan, A., Biesecker, K., Blaney, B., Delaney, M. Psychopharm. Bulletin, 34(1), pp. 41-45, 1998.

An Ecological Model for School-Based Mental Health Services for Urban Low-Income Aggressive Children

An ecological model for school-based mental health services that targets urban low-income aggressive children--a highly vulnerable and underserved population--is presented. The goals of the model are to increase children's and teachers' involvement in the delivery of services and to increase the integration of these services into existing school resources and activities. The model proposes that mental health service providers work in collaboration with teachers to deliver services that (1) can be managed by existing school resources and personnel, (2) are related to empirically based factors associated with reduced aggression and increased social functioning, and (3) are group administered to increase the number of children served and to reduce stigmatization associated with mental health services. The model is individualized and flexible by acknowledging that contexts for aggression differ across classrooms and children by providing services specific to those contexts. Two studies are presented illustrating the application of this model to decrease aggression and increase academic engagement in low-income urban public schools. Atkins, M.S., McKay, M.M., Arvantis, P., London, L., Madison, S., Costigan, C., Haney, P., Zevenbergen, A., Hess, H., Bennett, D., and Webster, D. The J. of Behav. Health Serv. & Res., 5(1), pp. 64-75, 1998.