This study was designed to collect data that would provide evidence as to what students' expectations of the environment were along with whether these expectations were actually being experienced by students living in the substance-free environment. A systematic sample of 139 students were surveyed who lived in the Students Uniting to Remain Free (SURF) substance-free living environment at Ball State University during the Fall semester of 2001 academic year. Data collection consisted of a survey instrument that had eight three-part questions, 10 demographic characteristic questions, and six student involvement questions.The data revealed that new and returning students living in the SURF hall were very satisfied with their residential experience. The majority of their expectations matched the majority of their experiences. Statistically significant differences between the expectations of new and returning students existed with the following variables: drinking and using drugs outside of the SURF hall, expecting that they would not have to deal with noise and disruptions caused by alcohol usage, living with students who had similar religious ideals and values, expecting the SURF hall to be a quiet study area and expecting and experiencing wellness and healthy lifestyle programs.The growing interest in substance-free housing environments is an area that many Chief Housing Officers and Student Affairs Administrators may want to consider investing more time researching in addition to allocating additional institutional resources in the creation of increased levels of this living environment option. Current expansion of this lifestyle option on campuses across the nation may dictate that for institutions to stay competitive and to meet the needs of the various populations living on their campuses the offering of this lifestyle option may need to increase. Additional research into the academic benefits and long-term retention benefits may be necessary for the development of new programs. / Department of Educational Leadership

Bakgrund: Patienter med substansbruksyndrom ökar i vården och därmed sjukvårdspersonalens kontakt med denna patientgrupp. Sjukvårdpersonal har ansvar för att ge vård till patienter på lika villkor samt ha ett gott bemötande.  Sjukvårdpersonalens attityder inverkar på patientens upplevelse av bemötande och vårdkvaliteten vilket i sin tur påverkar deras tillit till sjukvården.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            Syfte: Syftet med studien var att undersöka vårdpersonals erfarenheter av att vårda samt attityder till patienter med substansbruksyndrom på avdelningar där inte endast missbruksvård bedrivs. Metod: En litteraturstudie genomfördes och inkluderade 10 artiklar med kvalitativ ansats. Dessa har granskats, analyserats och sammanställts med hjälp en integrativ litteraturöversikt. Sökningarna utfördes i databaserna Cinahl, PsychInfo och Pubmed. Resultat: Tre huvudkategorier och sju subkategorier identifierades. De tre huvudkategorierna innefattade: Synen på och erfarenheter av patienter med missbruksproblematik, Synen på att vårda patienter med missbruk, och Synen på uppkomst och ansvar över missbruk.  Slutsats: Vårdpersonals attityder till patienter med missbruk varierar, dock visar studien på att det förekommer negativa attityder till dessa patienter. Det resulterar i att vården ofta blir mer uppgiftsorienterad och mindre individorienterad. Litteraturstudien visar även att vårdpersonal med erfarenhet och utbildning inom missbruk generellt har en mer positiv attityd till patienter med missbruksproblematik. Det tyder på att det behövs mer utbildning av vårdpersonal för att negativa attityder gentemot patienter med missbruksproblematik ska undvikas. / Background:The number of patients with substance use disorder are increasing within the healthcare system, therefore is also the contact between this patient group and the healthcare personnel becoming more frequent. It is the healthcare personnel’s responsibility to give equal care to all patients, including a respectful treatment. The attitude of the healthcare personnel will influence the patient’s experiences of how they are approached and the quality of the care they receive, which in turn affects the patients trust in the healthcare system.  Aim:The Aim of this study was to explore healthcare personnel’s experience of caring for patients with substance use disorder and their attitudes towards this patient group, in non-specialist settings.  Method:A literature study was conducted including 10 articles with a qualitative approach. These articles have been reviewed, analysed and compiled with help of an integrative literature review. Database searches have been executed in Cinahl, PsychInfo and Pubmed. Result:Three major categories and seven subcategories were identified. The three major categories included: The view and experiences of patients with substance misuse, The view on care for patients with substance misuse, and The view on responsibility and origin of misuse. Conclusion:Attitude towards patients with substance use disorder varies among healthcare personnel, however this study indicates that the attitudes are predominantly negative. This results in a care that are often more task oriented, and less orientated toward the individual. Furthermore, the literature study also demonstrates that more educated and experienced healthcare personnel usually express a more positive attitude toward this group of patients. This indicates that there is a need to educate healthcare personnel to avoid negative attitudes towards patients with substance use disorder.

Bakgrund: I Sverige uppskattas att 29500 personer utvecklat ett problematiskt narkotikabruk. Droger påverkar hjärnans delar som är kopplade till känslor av lust och välbehag. Narkotika är beroendeframkallande, hälsofarligt och påverkar hela människan. I samhället förekommer fördomar mot personer som har substansmissbruk vilket kan leda till utanförskap, mindervärdeskänslor och minskad benägenhet att uppsöka sjukhusvård. Syfte: Syftet var att beskriva sjuksköterskors attityder och erfarenheter av att möta personer som har ett substansmissbruk samt att beskriva de valda artiklarnas datainsamlingsmetod. Metod: Litteraturstudie med deskriptiv design. Elva artiklar inkluderades i studien, 4 med enkäter, 1 enkät med öppen fråga och 6 intervjuer. Artikelsökning genomfördes i databaserna Cinahl och Pubmed. Huvudresultat: Sjuksköterskor hade olika uppfattningar om orsaken till missbruk, där det ansågs bero på antingen brist på eget ansvar eller livsomständigheter. Sjuksköterskor beskrev personer som har ett substansmissbruk som manipulativa, våldsamma och krävande vilket byggde på tidigare erfarenheter. Andra sjuksköterskor hade ett holistiskt synsätt och såg människan bakom missbruket. Viktiga faktorer för en god relation var att vara ärlig och rak. Vidare beskrevs också att utbildning och erfarenhet hade betydelse för sjuksköterskans attityder och erfarenhet av personer som har ett substansmissbruk. Slutsats: I mötet spelar erfarenhet av missbruk, människosyn och utbildning stor roll för interaktionen mellan sjuksköterskan och personen som har ett missbruk. Där det råder brist på utbildning och erfarenhet finns känslor av misstro och frustration som leder till avståndstagande. Positiva attityder sammankopplas med sjuksköterskans förmåga att ha en helhetssyn och öppenhet mot personer som har ett missbruk. / Background: In Sweden it´s estimated that 29,500 people have developed a problematic drug abuse. Drugs affect the parts of the brain that affect feelings of desire and pleasure. Drugs are addictive, harmful to health and affects the whole person. The society’s stigma against people who have substance abuse can lead to alienation, inferiority and reduced tendency to seek hospital treatment. Aim: The aim of this literature review were to describe nurses' attitudes and their experience of meeting people who have a substance use disorder and to describe the selected articles method of data collection. Method: A literature study with descriptive design. Eleven articles was included in the study, 4 questionnaire, 1 questionnaire with an open question and 6 interviews. The search of the articles were carried out in the databases Cinahl and Pubmed. Findings: Nurses have different attitudes about the cause of substance use, some considered it to be because of lack of responsibility and others because of life circumstances. Nurses described people who have a substance use disorder as manipulative, violent and demanding, which was based on previous experiences. Other nurses had a more holistic approach and saw the person behind the substance use. Honesty and straightforwardness were important factors in meeting people with substance use disorder. Education and previous experience were important to the nurse's attitudes and experience. Conclusion: Experience, humanity and education played a major part in the interaction between the nurse and the person who has a substance use disorder. Where there is lack of education and experience feelings of distrust and frustration lead to rejection. Positive attitudes were linked to the nurse's ability to have a holistic approach and openness toward people who have a substance use disorder.

The Substance Abuse Subtle Screening Inventory was constructed to screen for substance abuse patterns despite non-admittance of respondents. Predictive validity studies of the SASSI are limited, and are not available for probationers. Participants were 147 male and 54 female probationers mandated to treatment. Overall differences among SASSI scales were significant for treatment compliance and outcome. Higher SASSI scales were found among those probationers who were compliant/successful. Individual scales were not significantly different, however, a trend was revealed; those respondents who scored higher tended to comply/succeed in treatment. The SASSI alone accurately classified 59.7% of respondents. In summary, the SASSI's use in predicting treatment outcome is limited and should be employed with concomitant data.

The effectiveness of drug abuse treatment for clients coerced into care remains controversial. Some studies find clients with legal pressure do better than those without legal pressure, while others report the exact opposite. Opposing views are often fueled by the wide-ranging models that guide delivery of addiction treatment. The present study examined how participants with and without legal pressure to attend treatment responded to a motivational (MET) vs. traditional (TAU) form of addiction treatment. Additionally, the predictive value of the Readiness to Change (RTC) score, from the URICA, was assessed across days of substance use and treatment retention. Legal status was shown to have a significant effect on days of primary substance use per week and treatment retention, regardless of intervention condition. The RTC score was shown not to be predictive of days of primary substance use or treatment retention. Research and clinical implications and future directions are discussed.

To date, low rates of patient compliance have made it impractical to study whether regular exercise can contribute to positive outcomes in women with substance use disorders (SUD). One robust strategy for promoting and maintaining behavior change is contingency management (CM). CM has been used successfully to reinforce drug abstinence, treatment attendance, and other pro-social behaviors. CM delivers incentives (prizes) contingent upon target behaviors, though can be expensive. To reduce costs, CM is often delivered with an escalating variable-ratio schedule, first tested by Petry and colleagues (2005). As a Stage Ib behavioral therapies development project (Rounsaville et al., 2001), the primary aim of the present study was to test the use of behavioral incentives (BI) to promote regular physical activity in a residential SUD treatment setting with cocaine-dependent women. The target was physical activity, which was objectively defined at two levels: 30 minutes of treadmill walking at any pace and treadmill walking at moderate intensity. Specifically, a pilot RCT compared rates of physical activity over a six-week study period in a sample of N = 17 women with Cocaine Dependence. N = 10 were randomized to BI group and n = 7 were placed in the control (C) group. All participants completed baseline assessment, attended a 45-minute health and fitness education class, and were scheduled in exercise sessions three days/week. Those randomized to BI, however, were eligible three days/week, to receive incentives for meeting the target behavior(s). Follow-up assessment occurred at 3-weeks and 6-weeks post-randomization (midpoint and end of intervention), and 4-weeks post-discharge from the residential program. The primary outcome variables (percentage of sessions completed and total time spent in scheduled sessions) were used for effect size estimations, which were then used to perform power analyses so that sample size calculations could be estimated for the design of a Stage II RCT. A significant Group effect demonstrated that the BI group spent a significantly greater number of total minutes in scheduled exercise sessions than the C group. This dissertation provided benchmark data on the utility of BI for promoting physical activity for women with cocaine dependence. These promising findings support the use of BI procedures to promote exercise compliance, which will ultimately allow scientists to better develop SUD programs that directly utilize the mental and physical health benefits of physical activity.

Adolescent dating violence is commonly experienced by adolescents and is associated with a variety of negative outcomes. Stress and coping and social learning theories suggest that dating violence victimization may predict increased substance use and dating violence perpetration. However, few studies have assessed these relations over time, and existing studies have not assessed physical and psychological dating violence victimization separately nor focused on early adolescent populations. The current study addressed these gaps by examining longitudinal relations between physical and psychological dating violence victimization and substance use and physical and psychological dating violence perpetration among early adolescents. The extent to which gender and class norms for dating violence moderated these relations was also examined. Participants included two cohorts of sixth grade students who reported being involved in a dating relationship at Waves 1 and 2 (N = 2,022; 43% female; 52% African American, 21% Latino/a, 20% European American, and 7% other). Analyses utilized a multilevel approach whereby students were represented at Level 1 and classes (scores for students in the same cohort and school; n = 74) at Level 2. Models tested direct effects from Wave 1 psychological and physical victimization to Wave 2 outcomes and the extent to which gender moderated this effect. Models including psychological and physical perpetration also tested cross-level interactions between Level 1 dating violence victimization and Level 2 class norms for dating violence. Key findings indicated that gender moderated relations between physical and psychological victimization and psychological perpetration. High levels of psychological victimization predicted greater change in psychological perpetration for girls as compared to boys and high levels of physical victimization predicted greater change in psychological perpetration for boys as compared to girls. Additionally, physical and psychological victimization significantly predicted changes in substance use. High levels of physical victimization predicted greater change in substance use, whereas high levels of psychological victimization predicted less change in substance use. These findings highlight the need to address dating violence early in middle school, so as to prevent negative outcomes associated with victimization by a dating partner.

This study focuses on the social networks of probationers, who comprise the largest segment of the criminal justice population in the United States, but about whom there are few studies of network processes. It provides information on how elements of a probationer’s social network change over time and can affect drug use. This study employs longitudinal analysis of the social networks for 251 substance abusers on probation to examine how these networks are influenced by an intervention designed to increase pro-social behaviors and how network changes impact drug use. Baseline drug use of the probationers was examined according to the number of substances used in the last 6 months. Blacks were less likely to be polydrug users (aOR: 0.34, 95% CI: 0.14 to 0.84), while those using cocaine or heroin as their primary drug of choice were more likely to be polydrug users (aOR: 3.02, 95% CI: 1.32 to 6.94). Age at first illicit drug use was also significant, with those initiating drug use younger than 18 more likely to be polydrug users (aOR: 2.12, 95% CI: 1.01 to 4.46).The majority of probationers had drug user networks with the same number of persons in them over the 12-month follow-up period (82.5%), and perceived social support that also did not change (76.1%). Men were less likely to change their drug user networks over time and older persons were less likely to have decreasing social support over time. Those with low drug use that have increasing (aOR= 5.08, 95% CI: 1.09 to 23.75) and decreasing (aOR= 6.45, 95% CI: 1.35 to 30.85) drug user networks over time were more likely to be in the lowest drug using group compared to those with stable larger drug user networks. Older persons were less likely to be in the drug use trajectory (aOR=0.96, 95% CI: 0.92 to 0.99), whereas those with high criminal risk were more likely to be in a stable drug use class compared to an increasing drug use class (aOR=2.52, 95% CI: 1.03 to 2.64). The findings of this study indicate that changing the drug using networks of probationers may be difficult, given that most are stable over time and effective interventions to decrease substance use may need to target individual and structural factors, rather than social support and network composition. The finding that smaller networks that do change over time were associated with lower rates of drug use indicates that programs could also focus on mechanisms that determine how and why probationers choose drug using network members. Reducing drug using peers for corrections-involved populations may be difficult, but can lead to lower drug use rates which can also reduce recidivism.

A multidimensional model of associations between domestic violence exposure and risk of violence and prosocial behavior was tested in a sample of Colombian adolescents, with attention to impulsivity and substance use problems as mediators of these associations. A representative sample of 1,152 school youths and a convenience group of 148 juvenile offenders aged 11-19 years was recruited from Medellin, the second largest city in this South American country. Assessment was carried out in classrooms in the school sample and in correctional institutions for juvenile offenders. Structural Equation Modeling (SEM) was utilized to test the conceptually derived models. Similarly, multisample analyses and nested model comparisons were used to explore mediator effects. Results showed strong associations between domestic violence exposure and putative mediators and outcomes, especially among offenders. Though impulsivity and substance use problems mediated the relation between family violence (i.e., exposure to interparental violence) and adolescent maltreatment (i.e., harsh parenting) and violent and prosocial behavior in both groups, impulsivity exerted a greater effect on adjustment among juvenile offenders than their counterparts. Juveniles who reported less ability to inhibit their impulsive responses engaged in more problems related to illicit substance use, violent acts (e.g., carrying weapons at school and in the streets), and less prosocial activities with their peers. Nonetheless, the best model fit indexes were obtained when paths from impulsivity to substance use problems and violent behavior were added to model comparisons. Results are discussed within the framework of Information-Processing theory for understanding pathways to violent and prosocial behavior.

Substance use is a significant problem among middle school students in the United States. Research indicates that the early use of substances increases the likelihood of negative outcomes including long-term use and abuse. Both parenting and peer variables exert strong influences on children's decisions to use or abstain from substances. As children age, peers begin to exert a stronger influence, but parenting practices can significantly reduce peers' harmful influences. In this study, three waves of data (collected at the end of 6th grade, and the beginning and end of 7th grade) from a large multi-site study were used to examine the role of peer deviance as a mediator of the influence of parental monitoring on substance use among an ethnically diverse sample of over 2,500 middle school students. Structural equation modeling was used to examine the longitudinal interrelations among parental monitoring, peer deviance, and substance use among middle school students, and to investigate potential group differences by gender and family structure. The hypotheses that peer deviance and substance use would influence one another over time were upheld. The two variables were interrelated such that peer deviance produced increases in substance use over time, but so too did substance use produce peer deviance over time. The prospective relation between substance use and peer deviance was stronger than the converse relation, suggesting that substance using peers seek one another out. Parental monitoring was associated with decreases in substance use over time, but its influence was small. Parental monitoring was more strongly associated with decreases in peer deviance. However, parental monitoring's effect on substance use was not mediated by peer deviance over these 3 waves in that parental monitoring at Wave 1 did not predict substance use 1 year later. Contrary to hypothesis, substance use was not associated with changes in parental monitoring over time, although peer deviance was associated with less monitoring. In general, parental monitoring was more closely linked to peer deviance than it was to substance use. This study found no convincing evidence to suggest group differences in the overall pattern of findings according to gender or family structure.