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National Institute on Drug Abuse
Women and Sex/Gender Differences Research
Director's Report to Council
Research Findings Excerpts
September, 2002
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Behavioral Research |
Mood, Stress, and Physiological Reactivity in Withdrawal from Nicotine
A recent study by NIDA investigator Dr. M. al'Absi and colleagues was designed to evaluate the effects of short-term abstinence from smoking on psychophysiological activity and mood changes during rest and following behavioral challenge. Subjective reports indicate that abstinence from smoking leads to anxiety, depression, restlessness, irritability and distractibility that may produce impairments in cognitive performance. These symptoms are reported to occur within 4-24 hr after smoking cessation and may contribute to relapse risk. Moreover, withdrawal symptoms after abstinence may be exacerbated by stressors and subsequently may then contribute to early relapse. The current study investigated the effects of short-term abstinence (18-21 hours) from smoking on psychophysiological activity and responses to brief behavioral challenges evaluated by withdrawal symptoms in male and female habitual smokers (mean years smoking = 4; mean number cigarettes/day = 19.5). Thirty habitual smokers (15 women and 15 men) participated in two sessions conducted after abstinence and after ad lib smoking (in counterbalanced order). Saliva cotinine concentrations and expired carbon monoxide were measured in both conditions. A subset of the sample (8 men and 8 women) provided saliva samples after 18 hr abstinence and after ad lib smoking while outside the laboratory setting (ambulatory controls). Abstinence produced significant withdrawal symptoms in all participants, with women reporting greater desire to smoke than men. Participants showed greater systolic BP responses to a behavioral challenge (fast-paced mental arithmetic tasks) in the abstinence condition than in the control condition. They also showed worse cognitive performance on the challenges in the abstinence than in the ad-lib condition. Salivary cotinine was greater in the ad lib than the abstinence condition, confirming the effectiveness of the abstinence manipulation. Men had greater salivary cortisol levels than women and both men and women showed the expected decline in cortisol levels across time. However, there were no differences in cortisol levels as a function of abstinence or ad lib smoking conditions in either the laboratory or ambulatory measurements. These results show that abstinence alters mood, performance and BP responses, but not adrenocortical responses, seen upon acute challenge. It is possible that these changes contribute to stress-related vulnerability to smoking relapse. On the other hand, absence of effects of abstinence on salivary cortisol production during the ambulatory measurements and in response to the laboratory challenges does not support the hypothesis that abstinence is associated with enhanced adrenocortical activity. al'Absi , M., Amunrud, T., and Wittmers, L.E. Psychophysiological Effects of Nicotine Abstinence and Behavioral Challenges in Habitual Smokers. Pharmacology, Biochemistry and Behavior, 72, pp. 707-716, 2002.
Gender and Phenotype Interact Differently in the Vulnerability to Acquire Heroin or Cocaine Self-administration
Rats that have high preference for sweet-tasting solutions have been shown to acquire self-administration of amphetamine, ethanol, and morphine more rapidly than rats with low preference. Dr. Marilyn Carroll and colleagues sought to extend this observation to cocaine and heroin i.v. self-administration using male and female rats selectively bred for high (HiS) or low (LoS) preference for saccharin. They report that for cocaine, in females, but not males, the HiS subjects met an acquisition criterion of 100 cocaine infusions during 6-hr sessions over 5 consecutive days more rapidly than LoS subjects. In both phenotype groups, females met the criterion more rapidly than males and a higher percentage of females met the criterion for acquisition within 30 days. For heroin, phenotype had no effect on acquisition of self-administration, for which the criterion was 20 infusions during 6-hr sessions over 5 consecutive days; however, females in both phenotype groups acquired more quickly than males, and in the HiS group, females administered more infusions than males. The cocaine subjects were subsequently tested under a progressive ratio schedule whereby successive cocaine infusions requires more and more bar presses until responding ceases, i.e., a breakpoint occurs. The breakpoint was unaffected by phenotype, but was larger in females than males. This work indicates that both saccharin-preference phenotype and sex are determinants of acquisition of drug self-administration; however, sex appears to be a stronger factor than saccharin-preference phenotype. Carroll, M.E., Morgan, A.D., Lynch, W.J., Campbell, U.C., and Dess, N.K. Intravenous Cocaine and Heroin Self-administration in Rats Selectively Bred for Differential Saccharin Intake: Phenotypes and Sex Differences. Psychopharmacology, 161, pp. 304-313, 2002.
Acute Cocaine Alters Oxytocin Levels in the Medial Preoptic Area and Amygdala in Lactating Rat Dams
Child abuse and neglect are strongly correlated with drug abuse in women. Prior research by Dr. Josephine Johns at the University of North Carolina at Chapel Hill, using an animal model of maternal neglect, has shown that chronic cocaine treatment during pregnancy and acute cocaine treatment in postpartum dams both increase maternal neglect, defined as the disruption of pup-directed maternal behavior. Chronic cocaine during pregnancy also increases postpartum maternal aggression toward intruders, but does so to the extent that pups are injured. On the other hand, acute cocaine treatment after partuition decreases the protection of pups from intruders. In humans, lower levels of the peptide oxytocin (OT) and cocaine use in pregnancy have been associated with general feelings of anger and hostility and difficulty in establishing infant attachment. Dr. Johns rodent work has shown that chronic gestational cocaine treatment reduces OT in the medial preoptic area (MPOA) on postpartum day 1 (PPD1), a time at which maternal behavior disruptions were observed, and in the amydala on PPD6 when increases in maternal aggression were observed. OT is a peptide that is associated with sexual behavior, onset of maternal behavior, and maternal aggression in rats. Dr. Johns has now extended these prior findings by showing that acute cocaine treatment during lactation also alters OT. Thirty mg/kg cocaine delivered on PPD1 resulted in a significant reduction of OT in the MPOA, consistent with the effect of gestational cocaine on OT. On PPD6, cocaine resulted in significant increases in OT levels in the amygdala, in contrast to the reduction in OT in the amydala previously observed on PP6 following gestational cocaine. Future work by Dr. Johns will explore the role of OT in chronic and acute cocaine effects on maternal behavior. Elliot, J.C., Lubin, D.A., Walker, C.H. and Johns, J.M. Acute Cocaine Alters Oxytocin Levels in the Medial Preoptic Area and Amygdala in Lactating Rat Dams: Implications for Cocaine-induced Changes in Maternal Behavior and Maternal Aggression. Neuropeptides, 35(2), pp. 127-134, 2001.
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Treatment Research and Development |
Gender Differences in Psychiatric Comorbidity Among Adolescents with Substance Use Disorders
As part of a Stage I behavioral therapy development project, Dr. William Latimer at Johns Hopkins University examined gender differences in the rates of psychiatric disorders among 135 adolescents with one or more psychoactive substance use disorders. Consistent with expectations, male adolescents exhibited a higher rate of ADHD and Conduct Disorder than did females, and females exhibited a higher rate of Major Depressive Disorder than did males. Unexpectedly, rates of ADHD and Conduct Disorder were fairly high among females, despite being significantly lower than for males, and rates of dysthymia, "double depression" (i.e., major depression and dysthymia), and bipolar disorder were equivalent between genders. This study helps to identify common gender differencesÑand similaritiesÑin comorbidities among adolescent substance abusers, one key to developing effective screening, assessment, and treatment interventions. Latimer, W.W., Stone, A., and Winters, K.C. Experimental and Clinical Psychopharmacology, 10, pp. 310-315, August 2002.
Cognitive Function in Methamphetamine Abusers Uncovers Interactive Gender Differences
Chang and colleagues at the Brookhaven National Laboratory investigated regional cerebral blood flow (relative rCBF) and cognitive function in abstinent methamphetamine (METH) users. Twenty METH-dependent participants and 20 age- and gender-matched controls were evaluated with perfusion MRI and neuropsychological tests. Decreased relative rCBF was seen bilaterally in putamen/ insular cortices (right: -12%; left: -10%) and in the right lateral parietal brain region (-11%)in the METH users but increased relative rCBF bilaterally in the left temporo-parietal white matter (+13%), the left occipital brain region (+10%) and the right posterior parietal region (+24%). Interaction effects were observed between METH and gender in the right occipital cortex and a midline brain region; female METH users showed increased relative rCBF (+15% both regions) whereas the male METH users had decreased relative rCBF (-10% and -18%, respectively). METH users performed within normal ranges on standard neuropsychological testing; however, they were slower on tasks on the California Computerized Assessment Package, especially working memory tasks. Findings indicate that METH abuse is associated with persistent physiologic changes in the brain, and these changes are accompanied by slower reaction times on computerized measures of cognitive function. Chang et al., Perfusion MRI and Computerized Cognitive Test Abnormalities in Abstinent Methamphetamine Users. Psychiatry Research: Neuroimaging. 114(2), pp. 65-79-2002.
Gender, Family/Social Environment, and Years of Education Influence Treatment Dropouts in Addicts
Determining pre-treatment variables that predict attrition in an outpatient cocaine abuse program is critically important in efforts to enhance retention and ultimately improve client outcome. Potential predictors have been identified, such as treatment history, deviant behaviors, and level of drug use; however there is not widespread agreement on their applicability across treatments and populations. This study examines the relationship of demographic, drug use severity, and psychosocial factors with treatment attrition and the time of dropout. One hundred and sixty-five individuals from the Houston area, seeking treatment for cocaine dependence, completed a pre-treatment assessment battery prior to starting 12 weeks of outpatient treatment. A series of regression analyses showed that treatment dropouts were more likely to be separated from their spouses, have poorer family/social functioning, have fewer years of education, and to be female. Those participants with higher education levels and those with poorer psychiatric functioning tended to remain in treatment longer. The implications of these findings are discussed. Sayre, S.L., Schmitz, J.M., Stotts, A.L., Averill, P.M., Rhoades, H.M., and Grabowski, J.J. Determining Predictors of Attrition in an Outpatient Substance Abuse Program. Am J Drug Alcohol Abuse, 28(1), pp. 55-72, 2002.
Prevalence of Cigarette Smoking in Pregnant Women Participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in Minneapolis and Saint Paul, Minnesota, USA
It is important to determine the prevalence of cigarette smoking among pregnant low-income women and to evaluate their smoking cessation patterns in order to target appropriate interventions. Ethnically diverse pregnant women aged 15-45 years were recruited from Minneapolis or Saint Paul Women, Infants, and Children (WIC) clinics before their third trimester. Serum cotinine levels were assayed for 98 women and compared with self-report. The women were unaware that their smoking status would be validated. Twenty-one (21%) women had a positive serum cotinine value (>/=3 ng/mL); 16 (76%) admitted smoking within the previous 24 h before interview and five denied smoking. Of the five, four had cotinine levels that could suggest passive smoke exposure. Thirty-seven women (38%) admitted cigarette smoking during the pregnancy but before knowing that they were pregnant; 18 (49%) of these denied current smoking at the interview and also presented with negative cotinine levels. These data suggest that some participants in WIC make a concerted effort to quit smoking when they find out they are pregnant, and are generally truthful when reporting their smoking habits during pregnancy. Ross, J.A., Swensen, A.R., and Murphy, S.E. Paediatr Perinat Epidemiol., 16(3), pp. 246-248, July 2002.
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Research on AIDS and Other Medical Consequences of Drug Abuse |
Decreases in Self-Reported Risks and Increases in New STDs among HIV+ Adults
Researchers examined high-risk sexual behavior among HIV-positive individuals as a factor contributing to the spread of the HIV epidemic. They conducted a retrospective chart review to compare self-reported STD risk behaviors and clinic diagnoses of 191 known HIV-positive clients attending Miami-Dade STD clinics with those of 191 uninfected controls. The analysis included 130 men (68.1%) and 61 (31.9%) women. HIV-positive clients were significantly more likely than controls to be African American, to report a history of injection drug use, to be no more likely than controls to have had sex with an IDU, to be more likely to report no sexual activity in the last 2 months, or if active, to report condom use at last sexual intercourse. Two themes are discussed as emerging from this study: First, although HIV-positive STD clinic patients were more likely than controls to report fewer sexual risk behaviors, they were more likely to be diagnosed with infectious syphilis and/or gonorrhea and to have sex partners with documented gonorrhea, chlamydia, or syphilis. Second, there appears to be a subset of HIV-positive adults who represent core transmitters: they have known about their HIV positive serostatus for a long time, are more likely to have had 4 or more sex partners in the past year, are more likely to have used crack cocaine, and are more likely to be symptomatic for an STD and in need of treatment for exposure to infectious syphilis, gonorrhea or chlamydia. This subset of HIV-positive clients continues to engage in high-risk sexual behavior after their diagnosis of HIV. This group of individuals seems to be playing a key role as core transmitters of HIV and bacterial STDs in the African American community in Miami and is in need of targeted intervention. Brewer, T.H., Metsch, L.R., and Zenilman, J.M. Use of a Public STD Clinic by Known HIV-Positive Adults: Decreased Self-Reported Risk Behavior and Increased Disease Incidence. J Acquired Immune Deficiency Syndromes, 29, pp. 289-294, 2002.
Prenatal Alcohol, Marijuana, and Tobacco Exposure: Neuropsychological Outcomes at 10 Years of Age
In a longitudinal study at the University of Pittsburgh, neuropsychological outcomes at 10 years of age have recently been reported for a sample of 593 children, who had been assessed at multiple times since birth. The mothers had been recruited into the study during pregnancy. Half of the women were African-American, and half were Caucasian. They were generally from lower socioeconomic status families, and light to moderate level users. At the 10-year follow-up, prenatal alcohol use was found to be significantly and negatively associated with performance on a test of memory and learning skills. Prenatal marijuana exposure also was negatively associated with learning and memory performance, as well as with a measure of impulsivity. These associations persisted when other predictors of learning and memory were controlled (e.g., child's intelligence level, gender, and anxiety; parents' socioeconomic level and intellectual ability). An earlier publication (2001) on this sample focused on prenatal tobacco exposure, and documented, after statistically controlling for such factors as other prenatal substance use, current tobacco use, and multiple socioeconomic covariates, an association of prenatal tobacco exposure with various outcomes at 10 years of age (i.e., deficits in verbal learning and design memory, slowed responding on a test of eye-hand coordination, reduced ability for flexible problem solving, and more impulsivity). The investigators are continuing to follow this sample into the adolescent years. Richardson, G.A., Ryan, C., Willford, J., Day, N.L., and Goldschmidt, L. Prenatal Alcohol and Marijuana Exposure: Effects of Neuropsychological Outcomes at 10 Years. Neurotoxicology and Teratology, 24, pp. 309-320, 2002; Cornelius, M.D., Ryan, C.M., Day, N.L., Goldschmidt, L., and Willford, J.A. Prenatal Tobacco Effects on Neuropsychological Outcomes among Preadolescents. Developmental and Behavioral Pediatrics, 22(4), pp. 217-225, 2001.
Head Growth and Neurodevelopment of Infants Born to HIV-Infected Drug-Using Women
Researchers from the Women and Infants Transmission Study (WITS) continue to examine health and development outcomes of children born to HIV-positive mothers, with attention to drug use as a variable of importance. The WITS is a multi-site study of mother-infant HIV transmission and outcomes in the mothers and their children, and is collaboratively supported by three NIH Institutes (NIAID, NICHD, NIDA). Enrollment began in 1990 and has continued since that time. Macmillan et al. report on neurodevelopment and head growth during the first 30 months of life among HIV-positive and HIV-negative infants with and without in utero exposure to opiates and cocaine. Of the 1,094 infants in the analysis, 147 were HIV-positive and 383 were exposed in utero to opiates or cocaine (maternal self-report or positive urine screen). There were differences in developmental test scores and head circumference among the groups at 4 months of age (HIV+/drug negative, and HIV-/drug positive showing the lowest scores and head circumference); by 24 months of age, only HIV infection was found to be associated with decreased neurodevelopment test performance and smaller head circumference. The authors note that as the children enter their school-age years, a more detailed examination of specific developmental domains will be possible (i.e., language, attention, memory , and behavior). Macmillan, C., Magder, L.S., Brouwers, P., et al. Head Growth and Neurodevelopment of Infants Born to HIV-1-Infected Drug-Using Women. Neurology, 57, pp. 1402-1411, 2001.
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Epidemiology, Etiology and Prevention Research |
Community Epidemiology Work Group
The 52nd biannual meeting of the Community Epidemiology Work Group (CEWG), chaired by Nicholas J. Kozel, was held in Philadelphia, PA on June 11Ð14, 2002. The CEWG is composed of researchers from 21 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 abuse, and negative health and social consequences. Reports are based on a variety of 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 findings from focus groups and qualitative research studies. The following are highlights from the meeting:
Cocaine/Crack
Indicators remained high, with a possible resurgence in Boston, increases in Miami and New York, and decreases or stabilization in other CEWG areas.
Heroin indicators increased in Atlanta, Miami, Minneapolis, New Orleans, New York, and Philadelphia and remained high in areas such as Boston, Baltimore, and San Francisco.
Narcotic Analgesic Indicators, especially narcotic analgesics including hydrocodone and oxycodone, continue to rise. DAWN death mentions involving narcotic analgesics/ combinations peaked in 16 CEWG areas, and in 8, exceeded the death mentions for cocaine and heroin.
Marijuana indicators increased in Chicago, Honolulu, Minneapolis, New York, Philadelphia, Phoenix, St. Louis, and San Francisco, but leveled off in other CEWG areas.
Methamphetamine indicators continue to remain at elevated levels in Hawaiian, West Coast, and Southwest CEWG areas. High proportions of adult female arrestees tested methamphetamine- positive in Honolulu, San Diego, and Phoenix (45, 36, and 29 percent, respectively). Rates of DAWN ED methamphetamine/speed mentions per 100,000 population were highest in San Francisco (14) and San Diego (13).
MDMA (methylenedioxymethamphetamine or "ecstasy") indicators continue to rise in most CEWG areas and to spread beyond the young White populations frequenting "raves." Past-year use by 12th graders rose from 5.6 percent in 1998 to 8.2 percent in 2000 in the most recent Monitoring the Future Study, and large percentage increases in lifetime use are estimated from National Household Survey data. Several CEWG sites continue to report that ecstasy is often adulterated with drugs other than MDMA.
Sensation Seeking, Lower Self Esteem, and Early Substance Use Associated with Early Pubertal Onset
Structured questionnaires were administered to 1,002 subjects (571 females and 431 males) who were followed from the 6th to the 10th grades and again at age 20 to investigate the relationship between early pubertal onset, substance use, sensation seeking, and self-esteem. In females, early pubertal onset was associated with greater cigarette use and lower self-esteem. In males, early pubertal onset was associated with elevated alcohol use and higher sensation seeking, with the opposite trends for late pubertal onset. Martin, C., Logan, T.K., Leukefeld, C., Milich, R., Omar, H., and Clayton, R. Adolescent and Young Adult Substance Use: Association With Sensation Seeking, Self Esteem and Retrospective Report of Early Pubertal Onset. A Preliminary Examination. International Journal of Adolescent Medicine & Health, 13(3), pp. 211-219, 2001.
Maternal Smoking During Pregnancy: Not a Stable Phenomenon
Pickett and her colleagues examined smoking fluctuation during pregnancy in the Family Health and Development Project (FHDP), a prospective study of 92 pregnant women, and the National Health Interview Survey 1991 Pregnancy and Smoking Supplement (NHIS-S), a population-based survey of women who had given birth in the previous five years. The authors examined categories of amount smoked for each month in the FHDP and fluctuations in overall smoking status across pregnancy in the NHIS-S. Fluctuations in smoking status were substantial, only 11.5% of women in the FHDP had consistent smoking status throughout pregnancy. While many women quit or reduced their smoking upon learning of their pregnancy (58%), nearly half changed smoking status multiple times. In the NHIS-S, first quit attempts were most frequent in the first trimester. Nearly 40% of women made a serious quit attempt but 44% relapsed during pregnancy. Among women who quit for >1 week, the duration of time off cigarettes varied from 1 to 2 weeks (34%) to 8+ weeks (32%). Smoking during pregnancy is a complex and variable behavior for many women. Average or one-time measures of smoking may lead to substantial misclassification of fetal exposure. The determinants of smoking fluctuation and the significance of multiple variations in dosage and timing of exposure for predicting the risk of adverse outcomes deserve further study. Pickett, K.E., Wakschlag, L.S., and Leventhal, B.L. Maternal Smoking During Pregnancy: Not a Stable Phenomenon. Society for Pediatric and Perinatal Epidemiologic Research, Paediatric and Perinatal Epidemiology, 15, A1-A38, 2001.
Early Pubertal Maturation and Onset of Substance Use in Female Early Adolescents
Data from the National Longitudinal Study of Adolescent Health found important differences between early maturing females and their on-time and late-maturing counterparts in initiation of substance use. Twenty percent of the 7th grade females were identified as early maturers based on body changes (increased breast size and body curviness). During 7th grade, females in the early-maturing group were three times more likely to be in the most advanced group of substance users (involving alcohol use, drunkenness, cigarette use, and marijuana use) than are those in the on-time/late groups. Prevalence rates indicate that early maturers are more likely to have tried alcohol, tried cigarettes, been drunk, and tried marijuana. Prospective findings show that early developers are significantly more likely to transition out of the "No Substance Use" stage between 7th and 8th grade (47% for early developers versus 22% for on-time and late developers). In addition, early developers are more likely to advance in substance use in general, regardless of their level of use at grade 7. Lanza, S.T. and Collins, L.M. Pubertal Timing and the Onset of Substance Use in Females During Early Adolescence. Prevention Science, 3(1), pp. 69-82, 2002.
Elevated Testosterone Levels and Nicotine Use In Young Women
The relationship of testosterone levels, carbon monoxide (CO) levels, current and adolescent nicotine use, and histories of pubertal onset was examined in 30 young adult female smokers. Subjects completed questionnaires regarding nicotine use in the 7th through 10th grades, and again at age 21 as part of a cohort study of drug use. In addition, history of pubertal onset was obtained at age 21, as were testosterone and CO levels. Testosterone levels were positively correlated with cigarette use in the last 30 days, CO levels, and cigarette use reported in the 7th and 10th grades, and negatively correlated with age of pubertal onset. Martin, C., Logan, T.K., Portis, C., Leukefeld, C.G., Lynam, D., Staton, M., Brogli, B., Flory, K., and Clayton, R.R. The Association of Testosterone with Nicotine Use In Young Adult Females. Addictive Behaviors, 26(2), pp. 279-283, 2001.
The Relationship Between Sexual and Physical Abuse and Substance Abuse Consequences
The authors examined the relationship between a history of physical and sexual abuse and drug and alcohol related consequences. Data came from 359 male and 111 female subjects recruited from an inpatient detoxification unit. The Inventory of Drug Use Consequences measured negative life consequences of substance use. Eighty-one percent of women and 69% of men reported past physical/sexual abuse, starting at a median age of 13 and 11, respectively. Physical and sexual abuse was associated with more substance abuse consequences. For men, age 17 or younger, age at first abuse was significantly associated with more substance abuse consequences than an older age at first abuse, or no abuse. For women, the association of abuse with substance use consequences was similar across all ages. Liebschutz, J., Savetsky, J.B., Saitz, R., Horton, N.J., Lloyd-Travaglini, C., and Samet, J.H. Journal of Substance Abuse Treatment, 22, pp.121-128, 2002.
Gender Differences in Relation Between Social Processes and Adolescent Sexual Behavior
This study examined gender-specific contextual and socioeconomic predictors of the timing of first intercourse among low achieving African-American youth. This three year longitudinal sample was comprised of 558 African-American high school students. For women, the significant predictors of timing of intercourse include age, mother's education, time with mother, and involvement in church activities. For males, the significant factors were school achievement, an interaction between living in an intact family and time with father, participation in family decision-making, and neighborhood poverty level. Males and females are differently affected by social control processes and neighborhood poverty plays a significant role in young African-American males' sexual behavior. Ramirez-Valles, J., Zimmerman, M.A., and Juarez, L. Youth and Society, 33(3), pp. 418-441, 2002.
Alcohol and Drug Use among College Students
Monitoring the Future (MTF) researchers at the University of Michigan reported on the extent of alcohol use and other drug use among American college students. MTF plus four additional data sources were examined to estimate recent levels of alcohol and other drug use among college students: Harvard School of Public Health College Alcohol Study (CAS), the Core Institute (CORE), Monitoring the Future (MTF), National College Health Risk Behavior Survey (NCHRBS) and National Household Survey on Drug Abuse (NHSDA). Alcohol use rates were found to be very high among college students; approximately two of five American college students were heavy drinkers, defined as having had five or more drinks in a row in the past 2 weeks. Alcohol use is higher among male than female students. According to race/ethnicity, white students are highest in heavy drinking, black students are lowest and Hispanic students are intermediate. Use of alcohol--but not cigarettes, marijuana and cocaine--is higher among college students than among noncollege age-mates. Longitudinal data show that, while in high school, students who go on to attend college have lower rates of heavy drinking than do those who will not attend college. Both groups increase their heavy drinking after high school graduation, but the college students increase distinctly more and actually surpass their nonstudent age-mates. Trend data from 1980 to 1999 show some slight improvement in recent years. The authors concluded that, despite improvements in the past 20 years, colleges need to do more to reduce heavy alcohol use among students. O'Malley, P.M. and Johnston, L.D. Epidemiology of Alcohol and Other Drug Use among American College Students. Journal of Studies on Alcohol, Supplement 14, pp. 23-39, 2002.
Influence of Peers on Substance Use Continues Into Young Adulthood
Longitudinal data were collected from 294 young adults, ages 19-25, and a same- and opposite-gender best friend or mate across three assessments. Analysis assessed the similarity in drug use patterns between the young adult and his or her peers and the peers' influence on the young adult's drug use. Patterns of cigarette use, alcohol use, binge drinking and, in most cases, marijuana use were similar between the young adult and peers. In prospective analyses, peer use predicted young adult cigarette use, binge drinking and problem use by the young adults. Results were generally consistent across genders and for both same- and opposite-gender peers. Findings emphasize the contribution of peer influence to young adult substance use. Andrews, J.A., Tildesley, E. Hops, H. and Li, F.Z. Health Psychology, 21(4), pp. 349-357, 2002.
Family Effects Decline While Peer Effects Increase Throughout Adolescence
This study examined the effects of sociodemographic, family and peer predictors on the developmental patterns of illicit drug initiation from ages 12-21. A diverse urban sample of 808 children was surveyed longitudinally beginning at age 10 in 1985 through age 21 in 1996. Analyses revealed that the risk for initiating illicit drug use increased steadily from the ages of 12 to 21. High family conflict, low family bonding, and high peers' antisocial activities predicted higher risk of initiation across this developmental period. The effect of family bonding began to decline after age 18, while the effect of peers' antisocial activities began to increase after age 15. Few gender and ethnic differences were found. Implications for prevention include the need to include family and peer factors in developmentally appropriate ways in interventions. Guo, J., Hill, K.G., Hawkins, J.D., Catalano, R.F., and Abbott, R.D. J. Am. Acad. Child Adolesc Psychiatry, 41(7), pp. 838-845, 2002.
Meta-Analysis of Genetic and Environmental Influences on Antisocial Behavior
A meta-analysis of 51 twin and adoption studies was conducted to estimate the magnitude of genetic and environmental influences on antisocial behavior. The best fitting model included moderate proportions of variance due to additive genetic influences (.32), nonadditive genetic influences (.09), shared environmental influences (.16), and nonshared environmental influences (.43). The magnitude of familial influences (i.e., both genetic and shared environmental influences) was lower in parent-offspring adoption studies than in both twin studies and sibling adoption studies. Age and assessment method, but not gender, were significant moderators of the magnitude of genetic and environmental influences on antisocial behavior. Rhee, S.H., and Waldman, I.D. Psychological Bulletin, 128(3), pp. 490-529, 2002.
Gender Differences in Relation Between Social Processes and Adolescent Sexual Behavior
This study examined gender-specific contextual and socioeconomic predictors of the timing of first intercourse among low achieving African-American youth. This three year longitudinal sample was comprised of 558 African-American high school students. For women, the significant predictors of timing of intercourse include age, mother's education, time with mother, and involvement in church activities. For males, the significant factors were school achievement, an interaction between living in an intact family and time with father, participation in family decision-making, and neighborhood poverty level. Males and females are differently affected by social control processes and neighborhood poverty plays a significant role in young African-American males' sexual behavior. Ramirez-Valles, J., Zimmerman, M.A., and Juarez, L. Youth and Society, 33(3), pp. 418-441, 2002.
A Case Study of Transmission of Conduct Norms for Drug Abuse, Sexual Violence, and Violence Across Four Generations of African-American Women
This case report ethnographic study describes how conduct norms for drug abuse, sexual exploitation, and violence are transmitted across generations in severely distressed households in inner-city New York through abuse, neglect, and negative role models. Young girls growing up in these households learn to accept violent physical and sexual assault, substance abuse and sales, and unstable households as effective conduct norms. The continual assault on young girls often leads to mortification of self, characterized by acceptance of their situation and socialization to these behaviors in adulthood. This socialization to accept and expect abusive relationships results in their treating their children no better than they had been treated as children and maintains the intergenerational transmission process of drug abuse/sales, sexual exploitation, and violence. This study suggests that addressing the problems of the inner city will necessitate, in addition to providing needed services such as improved education, policing, and job training, a cultural change in young girls growing up in distressed households. Dunlap, E., Golub, A., Johnson, B.D., and Wesley, D. Intergenerational Transmission of Conduct Norms for Drugs, Sexual Exploitation and Violence: A Case Study. Brit. J. Criminol., 42, pp. 1-20, 2002.
Adolescent Binge-Drinking Trajectories and Substance Abuse in Adulthood
This study describes binge-drinking trajectories from adolescence to early adulthood in 238 children of alcoholics and 208 controls. Mixture modeling identified three trajectory groups of drinkers: early-heavy (early onset, high frequency), late-moderate (later onset, moderate frequency), and infrequent (early onset, low frequency). The early-heavy group was characterized by parental alcoholism and antisociality, peer drinking, drug use, and (for boys) high levels of externalizing behavior, but low depression. The infrequent group was elevated in parent alcoholism and (for girls) adolescent depression, whereas the nonbinger and late-moderate groups showed the most favorable adolescent psychosocial variables. All three drinking trajectory groups raised risk for later substance abuse or dependence compared with the nonbingers, with the early-heavy group at highest risk. Chassin, L., Pitts, S.C., and Prost, J. Journal of Consulting and Clinical Psychology, 70(1), pp. 67-78, 2002.
Most Rape Victims Express Rape-Related HIV Risk Concerns
A sample of 62 recent rape victims who had received post-rape medical care were interviewed an average of 6 weeks after being raped to assess fear or concern about contracting HIV as a result of rape. Fifty-seven of the 62 women (91.9%) reported some degree of initial fear or post-rape concern about contracting HIV; and 45 of the 62 women (72.6%) reported that they were extremely fearful or concerned about contracting HIV. Women who were extremely fearful or concerned about contracting HIV were more likely to have been raped by a stranger. Reported fear/concern was not simply a function of current intensity of intrusive or avoidance symptoms of post-traumatic stress disorder. Fifty-one women (82.3%) wanted more information about HIV at post-rape medical treatment visits. Resnick, H., Monnier, J., Seals, B., Holmes, M., Nayak, M., Walsh, J., Weaver, T.L., Acierno, R., and Kilpatrick, D.G. Rape-Related HIV Risk Concerns Among Recent Rape Victims. Journal of Interpersonal Violence, 17(7), pp. 746-759, 2002.
Patterns of Assault In a Sample of Recent Rape Victims
Intimate partner assault patterns are not well understood in recent rape victims. In an effort to examine these patterns, 47 rape victims seeking care from a forensic medical examination facility were sampled across three assessment points (6 weeks post-assault, 3 months post-assault, and 6 months post-assault). Index rape, prior rape and physical assault, and new rape and subsequent physical assault were classified by victims' relationships to their perpetrators. At the initial medical exam, 17 women had been past victims of domestic violence. Six women were victims of intimate partner violence during the 6 months after the index rape. Monnier, J., Resnick, H.S., Kilpatrick, D.G., Seals, B., and Holmes, M. Violence against Women, 8(5), pp. 585-596, 2002.
The Relationship Between Distress and Resource Loss Following Rape
Rape is a prevalent traumatic stressor, with an estimated 12 million U.S. adult women reporting the experience of rape in their lifetimes. It has been identified as a risk factor for development of a range of negative mental health and physical health outcomes. Previous studies have demonstrated that women who are victims of interpersonal violence experience subsequent disruption in resources (e.g., unemployment, reduced income, divorce) following victimization. The present study examined the impact of resource loss on violent crime victims. Subjects were 57 women over the age of 18 who were recent victims of rape. Results indicate that psychological distress is followed by increased resource loss for rape victims. These results suggest that distress may be an underlying mechanism for resource loss in victims of sexual assault. Monnier, J., Resnick, H.S., Kilpatrick, D.G., and Seals, B. Violence & Victims, 17(1), pp. 85-92, 2002.
Early Drug Use Predicted by Low Birth Weight
The authors used a prospective design and community-based sample to assess whether low birth weight predicted early drug use. A sample of 473 low birth weight and 350 normal birth weight children were assessed at ages 6 and 11. Early onset of drug use was significantly higher for low birth weight boys than for normal birth weight boys, and this finding held even when controlling for potential mediators or confounders such as IQ, externalizing disorders, ADHD, and maternal smoking. Thus, low birth weight in boys may prove to be a useful vulnerability marker for early drug use. Chilcoat, H.D., and Breslau, N. Low Birth Weight as a Vulnerability Marker for Early Drug Use. Experimental and Clinical Psychopharmacology, 10, pp. 104-112, 2002.
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