Master of Science / School of Family Studies and Human Services / Joyce Baptist / There is a need for culturally sensitive clinical interventions for substance use disorders. Parental modeling, peer alcohol use, and depression are related to alcohol use, but have not been specifically examined among Latin American adolescents and young adults in the U.S. The purpose of this study is to examine contributing factors to alcohol use in Latin American adolescents and young adults in the U.S. Participants included 400 Hispanic and Latino adolescents from the National Longitudinal Study of Adolescent Health (Add Health). Results from a path analysis suggested that parent and peer alcohol use are associated with adolescent alcohol use and that adolescent alcohol use mediates the relationship between peer alcohol use and young adult alcohol use. Clinical and research implications are described.

O uso problemático de álcool tem sido apontado como problema de saúde pública. A prevalência de dependência de álcool é maior em pessoas com transtornos psiquiátricos. Esta comorbidade pode trazer sérias implicações para a identificação, tratamento e reabilitação do indivíduo doente. O presente estudo teve como objetivo identificar o uso problemático de álcool em pacientes com transtornos psiquiátricos, a partir da realidade clínica assistencial terciária de um serviço universitário. Foi realizado um estudo transversal, com uma amostra clínica ambulatorial composta por 127 indivíduos em tratamento por um dos seguintes diagnósticos: esquizofrenia, transtorno afetivo bipolar, depressão e transtornos de ansiedade. Os dados foram colhidos através de entrevista com o paciente e também através do prontuário. As informações coletadas foram: dados sócio-demográficos, história psiquiátrica, problemas de saúde, características familiares e registros do prontuário relacionados ao diagnóstico do paciente e ao consumo de álcool. Foi aplicado o instrumento de rastreamento CAGE e realizada a entrevista estruturada em conformidade com os diagnósticos da CID-10 para uso nocivo e dependência de álcool. A fim de aumentar a sensibilidade do CAGE,trabalhou-se com o ponto de corte ¡Ý1. Da amostra total, 6,3% fazem uso nocivo de álcool e 3,9% são dependentes, de acordo com os critérios da CID-10. Quarenta e três pessoas (33,9%) pontuaram positivo no CAGE, o que indica a possibilidade de uso problemático de álcool em algum momento de suas vidas. Os fatores sócio-demográficos que mostraram relação com o uso problemático de álcool foram: ser homem, ter menos de 40 anos de idade, não ter companheiro(a) e não ser praticante de religião. Ao se comparar médias de escore no CAGE, entre os quatro grupos diagnósticos estudados, encontrou-se que a maior média foi a do grupo de esquizofrenia, seguida pelo de transtornos ansiosos, transtorno afetivo bipolar e, por último, depressão. Foi encontrada uma relação entre pontuação no CAGE e idade de início da enfermidade. Entre os pacientes que pontuaram positivo no CAGE, 60,5% não tinham registros, em seus prontuários, de uso de álcool. Sugere-se a disseminação de informações a respeito da comorbidade entre transtornos psiquiátricos e uso problemático de álcool na formação de profissionais de saúde, assim como treinamento para uso de instrumentos de rastreamento do uso problemático de álcool. / The problematic use of alcohol is becoming recognised as a serious public health problem. The prevalence of alcohol dependence is higher in persons with a psychiatric disorder. This comorbidity has serious implications for the identification, treatment and rehabilitation of the person. The aim of this research is to identify the problematic use of alcohol among individuals with psychiatric disorders by evaluating patients attending a psychiatric outpatient clinic at a university hospital. A transversal study was carried out, with a clinical sample composed of 127 individuals in treatment for one of the following disorders: schizophrenia, bipolar disorder, depression and anxiety disorders. The data was gathered from the patient’s records and through interview. The information collected was: sociodemographic data, psychiatric history, health problems, family characteristics and information from the records concerning the patient’s diagnosis and their previous alcohol use. The screening instrument CAGE was applied along with a structured interview based on the ICD-10 criteria for harmful use and alcohol dependence. In order to increase the sensitivity of CAGE the cut off point ¡Ý1 was used. It was found that 6.3% of patients met the criteria for harmful alcohol use and 3.9% for dependence (ICD-10). Forty-three persons (33,9%) scored positive with CAGE, indicating the possibility of problematic use of alcohol at a point in their lives. The sociodemographic factors that showed an association with problematic use of alcohol were: to be male, to be less than 40 years of age, to be without a partner and not to be practicing a religion. When the mean averages of CAGE scores for the four studied diagnostic groups were compared, the schizophrenia group scored higher, followed by the anxiety disorder group, bipolar disorder group and the depression group. A relationship was found between CAGE scores and patient age at the onset of the disorder. Among patients that scored positive with CAGE, 60,5% did not have any history, in their records, of alcohol use. It is suggested that information regarding comorbidity between psychiatric disorders and problematic use of alcohol be disseminated among health professionals, in conjunction with training in the use of screening instruments for problematic use of alcohol.

In order to create more efficient, useful alcohol treatment and intervention methods tailored specifically for the older population, it is important to understand the reasons that older adults perceive that they consume alcohol. For this reason, this study explored older adults’ perceptions regarding why they use alcohol. Older adults, age 60 and older, were surveyed through questionnaires completed at senior community centers within San Bernardino County. This was a mixed method design that used qualitative and quantitative analysis for the purpose of exploring the most frequently reported reasons for why older adults use alcohol. The main finding of the study is that older adults in the sample most frequently reported using alcohol for “having fun and celebration” and for “social reasons.” However, it is important to note that older adults reported a variety of motivations for using alcohol. Further research is suggested to determine correlations between demographics, alcohol use patterns, and older adults’ perceptions of why they use alcohol.

This research project is intended to assist with the identification of relapse factors for alcoholics who have relapsed after their twelve‑step program. It is beneficial to understand relapse factors for alcoholics in order to provide effective treatment plans, services, and goals that will assist in attaining sobriety from alcohol. The research study used a qualitative approach; the data was collected through interviews from participants at the Cedar House agency in Bloomington, CA. The data was collected and then analyzed for possible themes of relapse factors. Themes that developed from interviews conducted with alcoholics that had relapsed after their twelve‑step programs were: commitment to therapy, unemployment, availability of healthy support, shame and guilt in seeking support, loneliness, and lack of support from family/peers and community. There are limitations to this study which, include a small sample size and interviews were held at only one agency that incorporated the twelve‑step process. Future studies should be implemented to confirm the results of this study.

Teen problem-d1inking is a pervasive problem in our society. Teens with drinking problems utilize treatment centers and then return to school attempting to stay sober. However, many return to affiliate with problem drinkers instead of with non-drinkers, and risk for relapse is high. One explanation may be that teens without drinking problems do not accept teen problem drinkers into their peer group due to negative reactions toward problem drinkers. One way to examine their attitudes is to examine differences between teen problem drinkers and non-drinkers regarding causal attributions. Attribution theory proposes that various attributions will elicit different emotional reactions and will motivate teens to behave in certain ways. The purpose of this study was to determine if teens with prior experience in treatment (problem drinkers) and teens without that experience (non-problem drinkers) make different causal attributions for teen problem drinking. Furthermore, group differences in emotional reactions, beliefs about how to offset the problem, and help-giving behaviors were also examined. This study also sought to determine whether there was a predictable link between attributions and emotional reactions, and between emotional reactions and helpgiving behaviors. One hundred twenty-one teenagers aged 13 to 20 were recruited as subjects, 79 from Portland area schools and 42 from treatment centers. Subjects completed a written survey measuring causal attributions for teen problem drinking, emotional reactions toward teen problem drinkers, beliefs regarding how to offset the problem, and help-giving behaviors. Four MANOYAs were used to determine group differences. Results revealed group differences on causal attributions, emotional reactions, and offset controllability, but not on help-giving behaviors. Two multiple regressions were used to determine whether attributions predicted emotional reactions and whether emotional reactions predicted help-giving behaviors; results revealed no link. Although results revealed group differences, these were found not to be consistent with the hypothesis based on attribution theory. Results did reveal positive outcomes regarding attitudes toward teen problem drinkers by nonproblem drinkers, which is important as it suggests that teens without prior experience in treatment may be more accepting of teen problem drinkers than was expected.

In this study marital status and the alcoholism or non-alcoholism of the spouse are hypothesized to be important factors affecting the female alcoholic's personality and treatability.

Adolescent Alcohol Use (AAU) is widespread and potentially harmful to the health of youth. Substantial research and theoretical development suggest that both violence exposure and internalizing and externalizing problems of adolescents are associated with AAU. The primary purpose of this study was to examine the roles of internalizing and externalizing problems in adolescents to determine if the two types of symptoms are differential mediators of the link between violence exposure and AAU for females and males. Using Developmental Systems Theory as a framework, three primary hypotheses were examined: 1) Increased violence exposure at home and in the community are associated with increased AAU in both females and in males; 2) Internalizing problems mediate the relationship between home/community violence exposure and AAU for females; and 3) Externalizing problems mediate the relationship between home/community violence exposure and AAU for males. The secondary dataset that was utilized to test the hypotheses is a product of the 1995 National Survey of Adolescents in the United States. It includes a national probability sample of 3,161 adolescents and a probability oversample of 862 adolescents residing in urban areas for a total of 4,023 adolescents between the ages of 12 and 17. The data were collected by telephone interviews with the adolescents. The findings indicated that, for the most part, witnessing and experiencing physical and sexual violence across home and community contexts were associated with increased levels of AAU for both females and males. Internalizing problems mediated the relationship between sexual abuse and AAU for both females and males. Externalizing problems did not mediate the relationship between violence exposure and AAU for males or females. The findings suggest that internalizing and externalizing problems may play similar roles in females and males. The findings also indicated that home violence exposure accounts for unique variance in AAU beyond community violence exposure, but that community and home violence exposure do not interact to contribute to the highest level of AAU. Both number of different types of sexual victimization and number of different types of physical victimization at home were related to AAU. Implications for social work are discussed. The primary implication for Development Systems Theory is that differential pathways for females and males from environmental stress, in particular violence exposure, to increases in AAU may not be needed. Social work programs aimed at preventing and intervening in AAU should include components that address not only the use itself, but also the level of violence the adolescent has been exposed to, as well as any internalizing problems the adolescent may be experiencing. Future research should continue to examine how risk factors operate to influence AAU.

This study examined the effect of the experience of a loss on alcohol use and drinking motives in a college sample. Participants for this study were drawn from the “Spit for Science” project (Dick et al., 2014). The sample included 3,013 students (31.8% men, 68.2% women; 44.3% White, 21.1% Black, 19.6% Asian, 6.0% Latinx; mean age = 18.96; 16.2% bereaved) from Virginia Commonwealth University. Data were collected from participants’ freshman spring and sophomore spring time points on the Life Events Checklist, Alcohol Consumption items, and Drinking Motives Questionnaire-Revised. Participants who were bereaved between the freshman and sophomore timepoint did not significantly differ in their alcohol consumption, coping drinking motives, or conformity drinking motives compared to their non-bereaved counterparts. Limitations and future directions for research are reviewed.

Older women constitute a growing segment of Puerto Ricans and the U.S. population. A limited number of studies have examined the activity level in response to alcohol use in late life. Generally, older women present risks and benefits from alcohol use. Alcohol misuse may decrease health and in some cases, psychiatric symptoms may develop. However, some benefits are found in moderate alcohol consumption including improved physical function compared with nondrinkers (Blow & Barry, 2002). Since activity level may depend on factors such as health, functioning, emotional well-being, and perception of alcohol effects, these factors were then assessed in response to alcohol use in order to identify the degree of greater or lesser activity among elderly Puerto Rican females. This study examined the activity level in response to alcohol use in a sample of elderly Puerto Rican females (N = 419) and investigated factors that influence the practice of alcohol consumption. The independent variable was daily and weekly consumption of alcohol. Five dependent variables were examined, which included self-rating of physical health and emotional well-being, self-perception of activity level, function, and perception of alcohol effects. After conducting MANOVA analyses, no significant association between activity level and alcohol use was found. In addition, regarding the negative and positive effects of alcohol, the researcher found that elderly females who drank heavily reported having alcohol-related problems compared to those who drank moderately who described their drinking behavior as positive. The MANOVA and ANOVA analyses determined a significant relationship between higher self-perception of functionality and moderate alcohol use, but the relationship between moderate alcohol use and physical health and emotional well-being was not significant. Considering the increase of alcohol use in the older adult population, principally in the baby boomer generation, these findings are important not only to rehabilitation counseling professionals, but to many individuals in the helping professions, including educators and researchers. Rehabilitation counseling professionals should focus on initiatives to decrease and prevent alcohol misuse in the older adult population. Information revealed from this study will also contribute to knowledge of the cultural characteristics and psychosocial aspects of older Puerto Rican females regarding their alcohol use to promote better outcomes, as well as support literature in the area.

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