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National Institute on Drug Abuse
Women and Sex/Gender Differences Research
Director's Report to Council
Research Findings Excerpts
May, 1996
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Clinical and Services Research |
Retaining Cocaine-Abusing Women in a Therapeutic Community
Researchers found that cocaine abusing women whose children were living with them during residential treatment remained in the programs significantly longer than women whose children were not living with them at the facility. Some 77% of women in the Demonstration Group (with their children living in the facility) were still in the program at 3 months, compared to 45% of the Standard Group (i.e., without their children); at 6 months, the corresponding figures were 65% vs.18%, and at 12 months 29% vs. 5% (p<.05). The average length of stay for women in the demonstration group was 300.4 days, compared to 101.9 days for women in the standard group (t=2.83, p<.05). The clear implication is that providing facilities to accommodate children is a major factor in improving retention and outcome for drug abusing mothers in treatment. In addition, having the children in the facility provides opportunities to assess and meet their needs which may, in turn, affect the mother's prognosis. Hughes, P.H., Coletti, S.D., Neri, R.L., Urmann, C.F., Stahl, S., Sicilian, D.M., Anthony, J.C. Retaining Cocaine-Abusing Women in a Therapeutic Community: The Effect of a Child Live-In Program, American Journal of Public Health, 85(8), pp.1149-1152, 1995.
Postpartum Women in Outpatient Drug Abuse Treatment
This study compared a sample of post-partum crack-abusing women randomly assigned to an intensive day treatment program (DT) and a traditional outpatient program (OP). DT subjects were significantly more likely to remain in treatment beyond 4 months than women in the OP group (60.2% versus 46.1%; z=2.17, p=.02). The completion rate was significantly higher for DT (45%) as compared to the OP (21%) (z=3.4, p=.000). Barriers to treatment that correlated most significantly (p<.01) with retention focus on what the authors identify as personal feelings or conditions and problem denial. These include: a desire to be in another program correlated significantly (-.33); having a relapse (-.25); believing they could manage recovery on their own (-19); child's medical problems (.19); and attitudes of program staff (-.18). Strantz, I.H. and Welch, S.P. Postpartum Women In Outpatient Drug Abuse Treatment: Correlates of Retention/Completion, Journal of Psychoactive Drugs, 27(4), pp. 357-73, 1995.
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Epidemiology, Etiology and Prevention Research |
Substance Abuse and Gender Differences
In a study exploring the effect of gender on circumstances surrounding initiation and escalation of binge drinking, marijuana use, and the use of other illicit drugs, support was found for literature regarding differential motives and consequences as a result of differential socialization. Surrounding literature asserts that gender affects the relevance of peer influence, need to enhance self-importance and sense of power, conflictive consequences, sensation seeking as a motive, and reduction of distress in initiation and escalation of the use of alcohol and drugs. The study examined young adults' self reported circumstances surrounding initiation and escalation of alcohol and other substances. The sample consisted of 6,074 subjects from a longitudinal study that began in 1971 with a random 50% sample of Houston Independent School District 7th grade students (in 1971, N=9,335), who were re-interviewed in 1980. Respondents were asked if they had ever consumed alcohol and each of a list of drugs, and were further asked about heavy use of drugs and alcohol. Respondents were also asked about general circumstances (motives, expectations, and perceived consequences) before initial use and later abuse of drugs and alcohol, situations one week prior to initial drug and alcohol use and later abuse. Logistic regression controlled for race, socioeconomic status, and tendency to over or under endorse items.
General findings show that males are more likely than females to enhance their sense of self importance through the use of alcohol and illicit drugs, and are more likely than females to feel powerful and important through drug and alcohol use. Males are also more likely than females to engage in alcohol and drug use to gain peer approval and as a means of social bonding with peers. Males are more likely than females to be motivated to use alcohol and drugs for personal problems and in circumstances of low self-worth and depression. Other gender effects were substance specific or contingent upon socioeconomic status. This is attributable to the differential effects and social contexts of alcohol and drug use. Liu and Kaplan, Gender Related Differences in Circumstances Surrounding Initiation and Escalation of Alcohol and Other Substance Use/Abuse. Deviant Behavior: An InterdisciplinaryJournal, 17; pp. 71-106, 1996.
Paternal Alcoholism Predicts Rate of Growth of Adolescent Substance Use
Adolescents with alcoholic fathers not only are more likely to use drugs and alcohol, but their substance use increases at a more rapid rate than that of their non-children-of-alcoholic (COA) peers. These findings are based on a 3-year longitudinal study of 246 male and female COA's with at least one biological alcoholic parent who was also a custodial parent and 208 controls, with no alcoholic biological or custodial parents. Subjects were 10.5 to 15.5 years of age at initial recruitment, and computer-assisted interviews were administered annually to the adolescents and parents to ascertain measures of parental monitoring, association with drug-using peers, adolescent life stress, adolescent negative affect, emotionality and sociability, and adolescent substance use. Structural modeling and latent growth curve modeling showed that adolescents with alcoholic fathers were significantly more likely to use drugs and alcohol and also had a higher rate of growth of substance use. Maternal alcoholism was associated with elevated initial levels of adolescent substance use but did not predict the rate of growth. Hierarchical modeling also confirmed that parental monitoring, elevated environmental stress and negative affect, and elevated emotionality and sociability mediated the effects of parental alcoholism. Diminished paternal monitoring, for example, appeared to mediate the effects of the fathers' alcoholism on growth of substance use. Paternal alcoholism also was associated with higher environmental stress and resultant negative affect, which in turn was associated with affiliation with drug-using peers, providing another pathway. Despite these indications of mediators, paternal alcoholism retained significant direct effects. Chassin, Curran, Hussong, and Colder. The Relation of Parent Alcoholism to Adolescent Substance Use: A Longitudinal Follow-Up Study. Journal of Abnormal Psychology, 105(1), pp.
A Multiple Risk Interaction Model: Effects of Temperament and Divorce on Psychiatric Disorder
Effects of family status on the trajectory of problematic temperament adjustment at one to 10 years of age and associated psychiatric disturbance eight years later were examined in an epidemiological sample of 648 children. After adjusting for predivorce temperament-adjustment and background factors, logistic regression yielded independent effects of single custodial mother (SCM) family status for increased risk of disruptive and anxiety disorders, and of stepfamily status for increased risk of disruptive disorders. Increased risk of psychiatric disorder was more pervasive for SCM family boys versus intact family boys than for SCM family girls versus intact family girls, however only significantly more so for depression. No significant gender interaction was observed for stepfamily status. When girls and boys were treated independently, pattern of family status and outcomes of internalizing disorders varied. In step families, an elevated risk of depression and anxiety disorder was observed in girls but not boys, whereas in SCM families an elevated risk of depression was observed in boys but not girls. Within each family status group there was support for an altered risk of later psychiatric disorder given specific problematic predivorce temperament-adjustment characteristics. Kasen, Cohen, Brook, & Hartmark. A Multiple Risk Interaction Model: Effects of Temperament and Divorce on Psychiatric Disorder in Children. Journal of the American Academy of Child and Adolescent Psychiatry, In Press. 70-80, 1996.
The Relation of Parent Alcoholism in Adolescent Substance Use: A Longitudinal Follow-Up Study
Researchers tested parent alcoholism effects on growth curves of adolescent substance use, and whether parent and peer influences, temperamental characteristics, and stress could explain parent alcoholism effects. Participants were 316 families from a 3-year longitudinal study of children of alcoholics (COAs) and demographically matched controls. Adolescents (mean age = 12.7 at Time 1) and their parents received 3 computer-assisted interviews at annual intervals. Latent growth curve modeling showed that COAs, boys, and adolescents with drug-using peers showed steeper growth over time in substance use than did non-COAs, those without drug-using peers, and girls. Data was consistent with father's monitoring, stress, and peer drug use as mediators of COA risk, but these factors did not completely account for paternal alcoholism effects. The findings underscore the importance of parental alcoholism risk because the environmental socialization factors could not entirely explain why adolescent COAs are at increased risk. Chassin, Curran, Hussong, Colder. The Relation of Parent Alcoholism to Adolescent Substance Use: A Longitudinal Follow-Up Study. Journal of Abnormal Psychology, 105, 1996
The Patterns and Predictors of Smokeless Tobacco Use Onset Among Urban Public School Teenagers
This study describes the patterns and predictors of smokeless tobacco (ST) use in large sample of urban public school students (grades 7 and 8) in Los Angeles and San Diego counties. The use of ST is more common among men than women and among Caucasians than African Americans, Hispanics and others. Approximately 20% of the male respondents and 5% of the female respondents reported use of ST at least once, and 10.1% of male students and 3.1% of female students who had never tried ST by seventh grade started to use it by eighth grade. Among Caucasians, about 30% of boys reported trying ST at least once and 13.7% of those who had never used ST by seventh grade initiated experimentation by eighth grade. These data were used to examine the family, peer, and intrapersonal predictors of ST use onset. The family risk factors for ST onset included living with a single parent, parent-child conflict, and parental alcohol use. The peer risk factors for ST use included peer drug use and activities with friends, such as parties and participation in sports. The intrapersonal risk factors included poor grades in school, risk taking, and stress. The study also shows that those who use cigarettes, alcohol, or marijuana are at highest risk of using ST and vice versa. This study supports a problem-prone behavior perspective of ST use and cigarette smoking suggesting that both products be targeted by prevention programs that counteract risk factors for problem-prone behavior. Hu, F.B., Hedeker, D., Flay, B.R., Susman, S., Day, L.E., Siddiqui, O. The Patterns and Predictors of Smokeless Tobacco Onset Among Urban Public School Teenagers. American Journal of Preventive Medicine, 12(1), pp. 22-28, 1996.
The Relationship Between Sensation Seeking and Delinquency: A Longitudinal Analysis
A sample of 584 male and female adolescents were studied at two points in time to determine the relationship between self-reported delinquency and sensation seeking. Analyses of variance and covariance were used to test the effect of delinquency status and frequency of minor delinquent activity on sensation seeking at Time 1 and on changes in sensation seeking from Time 1 to Time 2. Results indicated that delinquency and sensation seeking are related in adolescence regardless of sex: those adolescents who are delinquent score significantly higher on the Disinhibition scale. This finding was not obtained for experience seeking. One implication of the findings is that rates of minor delinquency could be lowered by providing high sensation seekers with socially approved opportunities for meeting their sensation-seeking needs. White, H.B., Labouvie, E., Bates, M. The Relationship Between Sensation Seeking and Delinquency: A Longitudinal Analysis. Journal of Research in Crime and Delinquency, 22(3), pp. 197-211, 1995.
Young Adult Substance Use - Predictors and Consequences
Longitudinal data on substance use of 345 adolescents, from five overlapping age cohorts (11-15) in the Pacific Northwest, measured at four annual time points, were analyzed using Latent Growth Modeling (LAM.). An associative cohort-sequential model was tested for alcohol, cigarette, and marijuana use. Hypotheses concerning the shape of the growth curve, the extent of individual differences in the common trajectory over time, and the influence of family cohesion, peer encouragement, and gender on initial substance use and shape of the growth curve were tested. Results indicated similar upward trends in the initial use and development of alcohol, cigarettes, and marijuana, the greatest increase occurring between 13-14 years. Peer encouragement influenced the developmental trajectories. Females were higher than males in initial status and developed less rapidly in their use of the substances than did males. The similar developmental trajectories across substances and the contradictory influences of family and peers suggest early intervention efforts aimed at both domains are necessary. Duncan, T.E.G., Tildesley, E., Duncan, S.C., Hops, H. The Consistency of Family and Peer Influences on the Development of Substance Use in Adolescence. Addiction, 90, pp. 1647-1660, 1995.
Drugs and Homicide by Women
Data from 215 female homicide offenders incarcerated or on parole in New York were examined for subjects' drug use prior to and at the time of the homicide, their victims' drug use, and their perceptions as to the drug-relatedness of the homicides. Semistructured, conversational interviews we conducted in order to obtain detailed quantitative and qualitative data focusing on drug use histories and the homicide events for which respondents were incarcerated. Approximately 7 out of 10 respondents had been regular users at some point in their lives prior to their incarceration, while over half had been addicted to a substance. Over one-third of the respondents who were present at the scene were high on a drug at the time, while about half of the victims of these homicides used drugs before the homicide. Almost two-thirds of the homicides committed by respondents who were present at the scene were perceived to be drug-related. Alcohol, crack, and powdered cocaine were the drugs most likely to be related to these homicides. Many respondents acknowledged the need for alcohol and drug programs and comprehensive aftercare programs. Spunt, B.I., Brownstein, H.M., Cammins, S.M. and Langley, S. Drugs and Homicide by Women. Substance Use and Misuse, 31 (7), pp. 825-845, 1996.
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