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National Institute on Drug Abuse
Women and Sex/Gender Differences Research
Director's Report to Council
Research Findings Excerpts
February, 2000
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Treatment Research and Development |
Nicotine Withdrawal and PMS
Investigators at the University of Minnesota used an inpatient setting to test the hypothesis that withdrawal symptoms in short-term smoking cessation in women were increased in the late luteal phase when pre-menstrual symptomatology is the highest. Twenty-one female smokers with clinical, anatomical, and hormonal verification of their menstrual cycle phase were randomized to either a smoking abstinence group (n = 16) or a continued smoking group (n = 5). Participants were admitted during alternate phases of their cycle for two 7-day admissions with a 1-month interim period when they resumed smoking. Nicotine withdrawal scores, Smoking Urges scores and Pre-menstrual Assessment scores were collected during 2 days of baseline and 5 days of smoking deprivation. Smoking behavior was documented by self-report, breath CO levels and saliva cotinine measurements. Withdrawal symptomatology was not affected by menstrual cycle phase during short-term cessation in spite of increased pre-menstrual changes seen in the late luteal phase. In addition, no phase effect on smoking behavior was detected and cigarette consumption remained stable across the cycle in both groups. These results suggest that for some smoking cessation studies, complex strategies to control for menstrual cycle effects may not be necessary. However, Smoking Urges scores did suggest increased desire to smoke and desire to relieve negative affect in the late luteal phase when women have higher pre-menstrual symptomatology. This suggests women may have greater difficulty quitting smoking in late luteal phase, and it seems prudent to recommend that women quit during the follicular phase of their cycle. Allen, S.S., Hatsukami, D.K., Christianson, D., and Nelson, D. Withdrawal and Pre-Menstrual Symptomatology During the Menstrual Cycle in Short-Term Smoking Abstinence: Effects of Menstrual Cycle on Smoking Abstinence. Nicotine & Tobacco Research, 1, pp. 129-142, 1999.
Dynorphin A1-13 Elevation of Serum Prolactin Levels through Opioid Receptor Mechanism in Humans: Gender Differences and Implications for Modulation of Dopaminergic Tone in Addictions Treatment
Dr. Mary Jeanne Kreek and colleagues at the Rockefeller University conducted a study to determine whether dynorphin peptides act to lower dopaminergic tone in the tuberoinfundibular system, resulting in elevated serum prolactin levels and, if so, whether such an effect is mediated by the opioid receptors. Dose-related increases in serum prolactin levels were observed after administration of dynorphin A1-13 in healthy human volunteers with no history of drug or alcohol abuse. Studies were then conducted to determine if this effect is opioid receptor-mediated and, if so, whether at the kappa or mu types. Pretreatment with the opioid antagonist, nalmefene, which has high affinity at both kappa- and mu-opioid receptors, caused a greater attenuation in dynorphin A1-13-stimulated increases in serum prolactin levels than pretreatment with similarly high doses of naloxone, an antagonist with lower affinity for both kappa- and mu-opioid receptors. These results suggest dynorphin A1-13 lowers tuberoinfundibular dopaminergic tone through action at kappa- and possibly mu-opioid receptors. Female subjects were significantly more responsive to the prolactin effects of dynorphin than were male subjects. Dynorphin gene expression, dynorphin peptides, and kappa-opioid receptor gene expression and binding have been shown to be altered in response to cocaine administration. Additionally, both dynorphin peptides and kappa-opioid agonists have been shown to lower dopamine levels in the nucleus accumbens and to attenuate cocaine-induced surges in dopamine levels. The authors suggest that a dynorphin-like compound that is capable of affecting critical mesolimbic-mesocortical and nigrostriatal dopaminergic systems might be effective in the management of cocaine addiction. Kreek, M.J. et al., Dynorphin A1-13 causes elevation of serum levels of prolactin through an opioid receptor mechanism in humans: Gender Differences and Implications for Modulation of Dopaminergic Tone in the Treatment of Addictions. J. Pharmacol. Exp. Therap., 288, pp. 260-269, 1999.
Desipramine May Be A Useful Adjuctive Medication In Facilitating Opioid and Cocaine Abstinence In Opioid-Maintained Patients
The efficacy of opioid medications to treat opioid and cocaine dependence may differ by sex. A 13-week randomized, double-blind, placebo controlled trial evaluated the efficacy of desipramine hydrochloride (0 or 150 mg/d) plus buprenorphine (12 mg/d) or methadone (65 mg/day) in 180 opioid-dependent cocaine abusers (124 men and 56 women). Urine samples were obtained thrice weekly, and self-reported cocaine and heroin use was reported weekly. In men, opioid dependence was increased more rapidly over time when treated with methadone than with buprenorphine, whereas cocaine abstinence was increased more with buprenorphine than with methadone. In women, opioid abstinence was increased the least rapidly when treated with buprenorphine plus placebo, while cocaine abstinence was increased more rapidly over time when treated with methadone than with buprenorphine. Regardless of sex or opioid medication, desipramine increased opioid and cocaine abstinence over time more rapidly than placebo. Desipramine plasma levels were higher in women than men. Higher desipramine plasma levels were associated with greater opioid but not cocaine abstinence. Desipramine in Opioid-dependent Cocaine Abusers maintained on Buprenorphine vs. Methadone, Oliveto, A., Feingold, A., Schottenfeld, R., Jatlow, P., and Kosten, T. Arch Gen Psychiatry, 56, pp. 812-820, 1999.
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Research on AIDS and Other Medical Consequences of Drug Abuse |
Coping Ability among HIV + and - Female Injection Drug Users
This study examined the psychosocial determinants of coping ability in a cohort of 249 HIV positive and HIV negative female injection drug users (IDUs), using a cross-sectional retrospective design. Information collected using a structured questionnaire included data on psychosocial risk and protective factors in the personality, family, and peer domains, HIV status, and coping ability. Coping ability was associated with conventionality, greater control of emotions, less psychopathology, and family cohesion in both HIV positive and HIV negative subjects. The psychosocial factors affected coping in HIV positive and HIV negative IDUs via two different mediational models. The interactional findings supported the influence of risk/protective interactions in both groups. The findings demonstrate the impact of the interplay between personality factors and external support on coping ability in female IDUs. Brook, D.W., Brook, J.S., Whiteman, M., Roberto, J., Masci, J.R., Amundsen, F., and de Catalogne, J. Coping Among HIV Negative and HIV Positive Female Injection Drug Users. AIDS Educ Prev, 11(3), pp. 262-273, 1999.
Coping Strategies of HIV + and HIV - Female Injection Drug Users
This study examined longitudinally the psychosocial correlates of coping strategies among 165 HIV positive and 179 HIV negative female injection drug users (IDUs). Participants were interviewed twice using a structured questionnaire, with a 6-month interval between interviews. The questionnaire included psychosocial measures as well as measures of general coping and specific HIV-related coping. Data were analyzed using logistic regression analyses. The findings indicated that favorable factors in the psychosocial domains at Time 1 were significantly associated with an increased likelihood at Time 2 of the use of general coping and specific adaptive coping strategies, such as problem solving and seeking social support, and with a decreased likelihood at Time 2 of the use of maladaptive coping strategies, such as aggression and the use of illicit drugs. These findings highlight particular areas of psychosocial functioning that can be targeted by intervention programs to promote adaptive coping and minimize maladaptive coping among HIV positive and HIV negative female IDUs. Brook, D.W., Brook, J.S., Richter, L., Whiteman, M., Win, P.T., Masci, J.R., and Roberto, J. Coping Strategies of HIV-Positive and HIV-Negative Female Injection Drug Users: A Longitudinal Study. AIDS Educ Prev, 11(5), pp. 373-388, 1999.
The Impact of Parental AIDS on Adolescent Children
This study examines the problem of adolescent children taking on adult parenting and spousal roles in families where a parent has AIDS (PWA). In Phase 1, relationships among parental AIDS-related illness, parent drug use, parent and adolescent demographics, and parentification indicators (parental, spousal, or adult role-taking) were assessed among 183 adolescent-parent pairs (adolescents aged 11-18 yrs). Adult role-taking was associated with maternal PWAs, female adolescents, and greater parent drug use. Greater parental AIDS-related illness predicted more spousal and parental role-taking. Parent drug use predicted more parental role-taking by adolescents. In Phase 2, the impact of parentification on later adolescent psychological adjustment was examined in 152 adolescents. Adult role-taking predicted more internalized emotional distress; parental role taking predicted externalized problem behaviors such as sexual behavior, alcohol and marijuana use, and conduct problems. Given these dysfunctional outcomes, interventions to mitigate parentification among children of PWAs was discussed. Stein, J.A., Riedel, M., and Rotheram-Borus, M.J. Parentification and its Impact on Adolescent Children of Parents with AIDS. Family Process, 38, pp. 193-208, 1999.
Youth Living With HIV as Peer Leaders
Community-based service providers often hire youth living with HIV (YLH) as peer leaders or facilitators for delivering HIV education to uninfected adolescents. Life narratives were collected from 44 YLH during a hypotheses-generating 2-yr ethnographic study. About 30% of the youth were employed as peer educators. While 60% of the 44 youth had lower-class backgrounds, only 23% of the peer leaders were lower class. One-fifth of the sample was female, but more than one-half of the peer leaders were female. After identifying and categorizing difficulties experienced by the peer leaders, a frequency count of each theme was conducted. Issues about professional boundaries were evident in 38.5% of the youth's narratives, indicating conflicts in their roles as peer leaders; 23% of the youth engaged in substance use and sexual behaviors that placed themselves and uninfected youth in their peer educator programs at risk; and 8% of the youth reported relapse while peer leaders. These data suggest reconsideration or restructuring of existing peer education models that employ YLH. Luna, G.C., and Rotheram-Borus, M.J. Youth Living with HIV as Peer Leaders. American Journal of Community Psychology, 27,pp. 1-23, 1999.
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Epidemiology, Etiology and Prevention Research |
Childhood Victimization and Drug Abuse: Comparison of Prospective and Retrospective Findings
This study examined whether childhood victimization increases risk for drug abuse using prospective and retrospective victimization information. Substantiated cases of child abuse/neglect from 1967 to 1971 were matched on gender, age, race, and approximate social class with nonabused/nonneglected children and followed prospectively into young adulthood. Between 1989 and 1995, 1,196 participants (676 abused/neglected and 520 control) were administered a 2-hr interview, including measures of self-reported childhood victimization and drug use/abuse (NIMH Diagnostic Interview Schedule--Version III--Revised). Prospectively, abused/neglected individuals were not at increased risk for drug abuse. In contrast, retrospective self-reports of childhood victimization were associated with robust and significant increases in risk for drug abuse. The relationship between childhood victimization and subsequent drug problems is discussed and is more complex than originally anticipated. Widom, C.S., Weiler, B.L., and Cottler, L.B. Childhood Victimization and Drug Abuse: Comparison of Prospective and Retrospective Findings. Journal of Consulting and Clinical Psychology, 67(6), pp. 867-880, 1999.
Smoking Initiation and Escalation in Early Adolescent Minority Girls
The objective of this study was to examine the effectiveness of a drug abuse prevention program in reducing the initiation and escalation of smoking in a sample of predominantly minority 7th grade girls. The 15-session prevention intervention teaches social resistance skills within an intervention designed to promote personal and social competence skills. Smoking rates among girls from 29 New York City public schools who received the program (n=1,278) were compared with those of a control group of girls (n=931). Participants were less likely to initiate smoking compared to controls. There were also significant program effects on smoking intentions, smoking knowledge, perceived peer and adult smoking norms, drug refusal skills, and risk taking. Experimental smokers in the intervention group were less likely to escalate to monthly smoking relative to controls. Botvin, G.J., Griffin, K.W., Diaz, T., Miller, N. and Ifill-Williams, M. Smoking Initiation and Escalation in Early Adolescent Girls: One-Year Follow-Up of a School-Based Prevention Intervention for Minority Youth. Journal of the American Medical Women's Association, 54, pp. 1-6, 1999.
Early Deviance in the Children of Narcotic Addicts
This descriptive study examined the self-reported behaviors of 285 male and female adolescent children (aged 12-17 yr) of narcotic addicts participating in methadone maintenance programs. These children responded to an 2.5-hour interview questionnaire focusing on current and past activities, including criminal activities prior to age 12. Findings revealed that early deviance, assessed by measures of both severity and variety, was related to current adolescent drug and alcohol use, association with deviant peers, a negative view of home atmosphere, and psychological symptomatology. These results are contrasted with the retrospective reports of adolescent behavior obtained from adult male narcotic addicts in a prior study of vulnerability to addiction. The comparability of study results is discussed in the context of developmental risk factors, prevention and treatment strategies, and other considerations specifically related to the development of children of narcotic addicts. Nurco, D.N., Blatchley, R.J., Hanlon, T.E., and O'Grady, K.E. Early Deviance and Related Risk Factors in the Children of Narcotic Addicts. American Journal of Drug & Alcohol Abuse, 25, 25-45, 1999.
Factors in Drug Use Initiation vs. Misuse in Women
This study applied a novel modeling technique to data from a sample of female twins, to estimate the role of genetic and environmental risk factors influencing initiation and subsequent misuse of illicit substances. A key feature of this approach is the capacity to distinguish between factors influencing initiation and misuse. The results suggest that shared environmental factors have a significant impact on the probability of drug use initiation, but no new influence on the risk for misuse once drug use is initiated. Furthermore, it appears that one set of genetic risk factors influences risk for initiation while another set appears important to the liability for misuse, once drug initiation has occurred. Kendler, K.S., Karkowski, L.M., Corey, L.A., Prescott, C.A., and Neale, M.C. Genetic and Environmental Risk Factors in the Aetiology of Illicit Drug Initiation and Subsequent Misuse in Women. British Journal of Psychiatry, 175, pp. 351-356, 1999.
Factors in Drug Use Initiation vs. Misuse in Women
This study applied a novel modeling technique to data from a sample of female twins, to estimate the role of genetic and environmental risk factors influencing initiation and subsequent misuse of illicit substances. A key feature of this approach is the capacity to distinguish between factors influencing initiation and misuse. The results suggest that shared environmental factors have a significant impact on the probability of drug use initiation, but no new influence on the risk for misuse once drug use is initiated. Furthermore, it appears that one set of genetic risk factors influences risk for initiation while another set appears important to the liability for misuse, once drug initiation has occurred. Kendler, K.S., Karkowski, L.M., Corey, L.A., Prescott, C.A., and Neale, M.C. Genetic and Environmental Risk Factors in the Aetiology of Illicit Drug Initiation and Subsequent Misuse in Women. British Journal of Psychiatry, 175, pp. 351-356, 1999.
Substance Use and Abuse in Female Twins
This study reports findings on the relative roles of environmental and genetic factors in the risk for use, abuse, and dependence on hallucinogens, opiates, sedatives, and stimulants; previous reports have already examined factors related to use and abuse of marijuana and cocaine. Results suggest that both genetic and familial factors contribute to twin resemblance for the more common patterns of hallucinogen and stimulant use, while twin resemblance on the less common use of opiates and sedatives as well as stimulant abuse and dependence were solely the result of genetic factors. These findings confirm the strong influence of family factors, including genetic factors, in the vulnerability to illicit substance use and abuse in women. Kendler, K.S., Karkowski, L., and Prescott, C.A. Hallucinogen, Opiate, Sedative and Stimulant Use and Abuse in a Population-based Sample of Female Twins. Acta Psychiatrica Scandinavica, 99, pp. 368-376, 1999.
Gender Differences in Drug Use Traced to Differences in Opportunity to Use
Researchers at Johns Hopkins University used data from the 1979-1994 National Household Surveys on Drug Abuse to examine whether male-female differences in rates of drug use could be traced back to differences in rates of exposure to initial opportunities to try drugs, rather than to sex differences in the probability of making a transition to use, once opportunity has occurred. Survey respondents were 131,226 US residents aged 12 years and older. The investigators estimated proportion of males and females with an opportunity to use marijuana, cocaine, hallucinogens and heroin; proportions reporting use among those having an opportunity to use each drug; proportion making a "rapid transition" from initial opportunity to initial use. They found that males were more likely than females to have an initial opportunity to use drugs. Once an opportunity had occurred, however, few male-female differences were observed in the probability of making a transition into drug use,. These results suggest that the previously documented male excess in rates of drug use may be due to greater male exposure to opportunities to try drugs, rather than to greater chance of progressing from initial opportunity to actual use. This suggests that sex differences in drug involvement emerge early in the process. Van Etten, M.L., Neumark, Y.D., and Anthony, J.C. Male-Female Differences in the Earliest Stages of Drug Involvement. Addiction, 94(9), pp. 1413-1419, 1999.
The Epidemiology of Alcohol, Tobacco, and Other Drug Use Among Black Youth
This study examined the patterns, trends, and sociodemographic correlates of alcohol, tobacco, and other drug use within the black youth population. The data indicate that the drug most prevalent among black secondary students is alcohol, followed by tobacco and marijuana. By twelfth grade, 7 in 10 black secondary students have used alcohol, less than 50 percent have smoked cigarettes, 25 percent have used marijuana, and less than 2 percent have used cocaine. Trend data indicate that there were significant declines in drug use among black (and other) youth throughout the 1980s, but tobacco, alcohol, and marijuana have been on the increase throughout the 1990s. Data on the sociodemographic correlates of black students' drug use reveal that levels of substance use are, on average, higher among males than females and among students who do not live with either of their parents than among those who live with one or both parents. Although there is a trend toward lower levels of drug use among youth as parents' level of education increases, the relationship varies across drugs and grade level. The relationship between urbanicity and drug use varies considerably by drug. Finally, cigarette use is highest in the Northeast followed by the North Central region, the South, and the West; alcohol use is highest in the North Central region; and marijuana and cocaine prevalence rates vary by region, with use generally being lowest in the South. Wallace, J.M., Jr., Forman, T.A., Guthrie, B.J., Bachman, J.G., O'Malley, P.M., and Johnston, L.D. The Epidemiology of Alcohol, Tobacco and Other Drug Use among Black Youth. Journal of Studies on Alcohol, 60(6), pp. 800-809, 1999.
Girls' Smoking Influenced More By Parents but Boys' Smoking Influenced More By Peers
In a study of the effects of parental and peer approval of smoking on adolescent smokers' current levels of cigarette use, researchers analyzed data for 913 California 7th-grade students who had previously initiated cigarette use. They applied a Poisson random-effects regression model to examine the number of cigarettes smoked in the past month as a function of race/ethnicity, gender, number of friends approving smoking, and parental approval. Results show a clear correlation between level of smoking and extent of peer and parental approval. However, a stronger relationship between parental approval of smoking and current level of smoking was found for female adolescents than for male adolescents. Conversely, a stronger relationship between peer approval of smoking and current level of smoking was found for male adolescents than for female adolescents. With respect to race, the influence of parental approval of smoking on adolescents' current level of smoking was generally more pronounced for minority adolescents, relative to white adolescents. However, the influence of peer approval of smoking on current level of smoking was strongest for white adolescents and was less strong for black, Hispanic, and Asian adolescents. The findings suggest that smoking cessation programs among adolescents may need to target both parent and peer influences, but these influences may vary by gender and race/ethnicity. Siddiqui, O., Mott, J., Anderson, T., and Flay, B. The Application of Poisson Random-Effects Regression Models to the Analyses of Adolescents' Current Level of Smoking. Preventive Medicine, 29(2), pp. 92-101, 1999.
Predictors of Adolescent Use of Illicit Drugs Other Than Marijuana
Researchers at RAND used multivariate techniques to identify Grade 10 predictors of illicit drug use other than marijuana in Grade 12. A broad range of environmental and personal predictor variables were examined to determine whether social bonds play a protective role and whether certain social bonds have a greater importance for some racial/ethnic groups. The 4,070 subjects in the study sample were drawn from the RAND Adolescent Panel Study that followed adolescents originally drawn from 30 middle schools in eight California and Oregon communities that included urban, suburban, and rural environments. The study population was 75% non-Hispanic Whites, 8% African-Americans, 8% Mexican-Americans, and 9% Asian-Americans. Bonds with family were inversely related to any use of illicit drugs other than marijuana. Prior drug use, especially problem use of "gateway" substances and prior "hard" drug use, were positively related to both any and frequent use. However, variables other than social bonds and prior use were equal to or stronger predictors of both outcomes. African-Americans were less likely to use illicit drugs other than marijuana. Mexican-Americans were more affected by family factors than other groups. Asian-Americans were more affected by school failure. Most predictors of frequent use also presage any use, suggesting that successful efforts to prevent the onset of "hard" drug use should also curb its escalation. Ellickson, P.L., Collins, R.L., and Bell, R.M. Adolescent Use of Illicit Drugs Other Than Marijuana: How Important Is Social Bonding and for Which Ethnic Groups? Substance Use and Misuse, 34(3), pp. 317-346, 1999.
Influence of Child and Adolescent Psychiatric Disorders on Young Adult Personality Disorder
This study examines associations between childhood psychopathology and young adult personality disorder in a random sample of 551 youths, who were 9 to 16 years old at first assessment. Subjects were evaluated for DSM-III-R psychiatric disorders. Information was obtained prospectively from youths and their mothers at three points over 10 years. The predictive effects of prior axis I disorders and adolescent axis II personality disorder clusters A, B, and C on young adult personality disorder were examined in logistic regression analyses. The odds of young adult personality disorder increased given an adolescent personality disorder in the same cluster. Prior disruptive disorders, anxiety disorders, and major depression all significantly increased the odds of young adult personality disorder independent of an adolescent personality disorder. In addition, comorbidity of axis I and axis II disorders heightened the odds of young adult personality disorder relative to the odds of a disorder on a single axis. In conclusion, assessment of personality pathology before late adolescence may be warranted. Childhood or adolescent axis I disorders may set in motion a chain of maladaptive behaviors and environmental responses that foster more persistent psychopathology over time. Identification and treatment of childhood disorders may help to reduce that risk. Kasen, S., Cohen, P., Skodol, A.E., Johnson, J.G., and Brook, J.S. Influence of Child and Adolescent Psychiatric Disorders on Young Adult Personality Disorder. Am J Psychiatry, 156(10), pp.1529-1535, 1999.
Developmental Trends for Adolescent Substance Use Linked with those for Risky Sexual Behavior
Researchers at the Oregon Research Institute examined associations between the development of adolescent alcohol, cigarette, and marijuana use and risky sexual behavior over time, using latent growth modeling methodology. Gender differences in the development and relationships between use of substances and risky sexual behavior were also examined. Participants were 257 adolescents (mean age = 15.96 years) assessed at three time points over an 18-month period. The intercepts of marijuana with cigarettes and alcohol, and all three substances with risky sexual behavior were significantly related. Development of the three substances showed similar patterns and development of cigarette use covaried with development of risky sexual behavior. There were no significant differences for boys and girls in these relationships. Results are discussed in relation to the need for greater understanding of nonsexual and sex-related problem behaviors and for analyses examining development and change in these behaviors during adolescence. Duncan, S.C., Strycker, L.A., and Duncan, T.E. Exploring Associations in Developmental Trends of Adolescent Substance Use and Risky Sexual Behavior in a High-Risk Population. Journal of Behavioral Medicine, 22(1), pp. 21-34, 1999.
Cigarette and Smokeless Tobacco Use Among Minority Youth
Increases in smoking/tobacco-related diseases among the Hispanic population call for an examination of its use among this population. This study examined the relationship between gender, cultural identification, migrant status, and grade level and the use of tobacco and perception of harmfulness among Mexican American youth. Results showed that when grade, cultural identification, and migrant status of parents was held constant, males more likely to use cigarettes (occasional and daily) and smokeless tobacco than females. No gender effect was found for lifetime cigarette use. The odds of using cigarettes and smokeless tobacco increase substantially across grades. Effects were found for Mexican American/Spanish and Anglo/White American cultural identification and daily cigarette use. Youths who belonged to nonmigrant families or who identified with a traditional Mexican American/Spanish culture were more likely to consider regular tobacco use harmful. Casas, J.M., Bimbela, A., Corral, C.V., Yanez, I., Swaim, R.C., Wayman, J.C., and Bates, S. Cigarette and Smokeless Tobacco Use among Migrant and Nonmigrant Mexican American Youth. Hispanic Journal of Behavioral Sciences, 20, pp. 102-121, 1998.
Assessing the Benefits of Attending a Parenting Skills Program
Using a theoretical model to ground this investigation, hypotheses about factors that moderate the benefits of attending the Preparing for the Drug Free Years (PDFY) program were tested. PDFY is a skills-training program designed to teach parents and children skills that reduce a child's risk for drug and alcohol use. It was hypothesized that high levels of family stress (i.e., marital difficulties or financial concerns) reduce the benefits of program attendance, and that strong pre-program skills (i.e., parental communication, parental negativity, or parent-child relationship quality) increase the benefits of program attendance. These hypotheses were tested on a sample of families that each included a sixth or seventh grade child. The results for fathers (N = 144) supported the study hypotheses, while mothers (N = 150) who benefited most from the program showed the weakest pre-program communication skills and reported the greatest marital difficulties. Rueter, M.A., Conger, R.D., and Mikler, S. Assessing the Benefits of Attending a Parenting Skills Program: A Theoretical Approach to Predicting Direct and Moderating Effects. Family Relations, 48, pp. 67-77, 1999.
Variations in Risk and Protective Factors for American Indian Adolescents
High levels of social stress are related to behavior problems in both Caucasian and American Indian adolescent boys, while high levels of self/family-concept are related to less problem behavior in both groups when using self-report. In contrast, teacher report models indicated that negative life events were the only significant predictor of perceived problem behavior in American Indian boys. For Caucasian males a low self/family-concept predicted teachers' perceptions of problematic behavior. For females, negative events predicted self-reported problem behaviors in American Indians while both negative events and positive self/family-concept contributed significantly for Caucasians. This pattern remained the same when using teacher reports of female problem behaviors. Interventions must address the discrepancy between self and teacher report and the increased likelihood of teachers' observing problematic behaviors in male adolescents. Fisher, P.A., Storck, M., and Bacon, J.G. In the Eye of the Beholder: Risk and Protective Factors in Rural American Indian and Caucasian Adolescents. American Journal of Orthopsychiatry, 69, pp. 294-304, 1999.
School-based Support Groups for Adolescents with Addicted Parents
A qualitative pilot study that evaluated a school-based support group for adolescents with addicted parents identified mediator variables that are hypothesized to be important for child outcomes. These include knowledge of the impact of addiction on the family, improved relationships with family and friends, enhanced coping strategies, improved resiliency to chaotic environments and improved scholastic performance. In the next phase of this study a profile of adolescents interested in the support group will be developed and the effectiveness of the support groups will also be assessed. Preliminary analyses with a limited sample have indicated that students not interested in participating in the group are more likely to be male, Hispanic, and have a lower grade point average. Murphy-Parker, D. and Gance-Cleveland, B. Examining the Benefits of a School-Based Support Group for Adolescents who have an Addicted Parent. Substance Misuse Bulletin, 12, pp. 7-8, 1999.
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Services Research |
Gender Differences in Drug Treatment Careers Among Clients in the National Drug Abuse Treatment Outcome Study
Gender differences were examined among 7,652 individuals admitted in the Drug Abuse Treatment Outcome Study, a national multi-site prospective study. Relationships between prior drug treatment, demographic and background characteristics, addiction career, treatment career parameters, family and social relationships, criminal justice involvement, and mental health status were examined. Stepwise discriminant function analyses were conducted separately for men and women to determine both the common and unique characteristics associated with a history of prior drug treatment. More severe drug use history and criminal behavior were related to prior treatment history for both men and women. Prior drug treatment among men was associated with factors related to family opposition to drug use and support for treatment, whereas for women prior drug treatment was associated with antisocial personality disorder and self-initiation into treatment. Treatment initiation among men appears to be facilitated by social institutions, such as employment, the criminal justice system, and one's family. Treatment re-entry among women was associated with referral by a social worker. These findings suggest that different strategies for increasing treatment utilization may be needed for men and women. Grella, C.E., and Joshi, V. American Journal of Drug and Alcohol Abuse, 25(3), pp. 385-406, August 1999.
Assessing the Needs of Substance Abusing Women. Psychometric Data on the Psychosocial History
The Psychosocial History (PSH) is a comprehensive multidisciplinary interview designed to assess the status, history, and needs of women in substance abuse treatment. The PSH retains the fundamental scoring structure of the Addiction Severity Index (ASI), while adding supplemental questions considered clinically useful and relevant for predicting outcomes. The present study examined the psychometric properties and general utility of both instruments with a sample of women enrolled in substance abuse treatment. Initially, the instruments were tested independently and found to have excellent test-retest reliability and acceptable internal consistency. A reliability trial between the instruments found that the composite scores (CS) of the ASI and PSH yielded satisfactory correlations among four of the six CS domains. The PSH had higher CS scores than the ASI across domains, which may reflect the comprehensive nature of the PSH items that prompt greater disclosure of problems and needs. Validity analyses showed significant correlations of PSH and ASI psychiatric CSs with Symptom Checklist-90-Revised totals. These results suggest that the PSH yields reliable and valid assessment data similar to the ASI. Moreover, the PSH provides a more comprehensive assessment than the ASI in the area of pregnancy, family issues, and victimization. Comfort, M., Zanis, D.A., Whiteley, M.J., Kelly-Tyler, A., and Kaltenbach K.A. Journal of Substance Abuse Treatment, 17(1-2), pp. 79-83, 1999.
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