A adolescência é uma fase de descobertas e auto-afirmação, normalmente conhecida pela preocupação dos pais, esta torna os jovens vulneráveis a vários problemas, dentre eles o consumo de drogas, o que requer atenção para que esses adolescentes não entrem neste mundo. O governo faz sua parte distribuindo informações, cartilhas e campanhas sobre a utilização das drogas, mas normalmente essas não embarcam êxito por tratar o jovem como problemático e sendo uma forma mais tradicional não consegue mais atrair a atenção, podendo ser considerada uma forma inadequada para este público. Por um outro lado, os jovens possuem fascínio por jogos. Acredita-se que uma abordagem utilizando jogos educacionais eletrônicos possam lograr maior sucesso, devido ao ambiente atrativo que oferecem. Em estudos realizados em jovens, com jogos comuns e jogos eletrônicos pôde-se notar a importância da utilização desse tipo de intervenção. Esta dissertação apresenta uma proposta de desenvolvimento por meio de um jogo com Realidade Aumentada como estratégia de auxiliar na informação e prevenção ao uso de drogas em jovens e adolescentes, um tipo de jogo onde foi utilizada uma tecnologia que mistura o mundo real com imagens em 3D. A pesquisa também realizou uma métrica para pesquisa dentro do universo escolar, que possui o público necessário para a aplicação do jogo. Analisando os resultados pode se concluir que a potencialidade do jogo caracterizado para esta comunidade pôde perfazer uma maior conscientização do que as demais abordagens apresentadas. / Adolescence is a stage of discovery and self-affirmation, commonly known by the concern of parents, this makes young people vulnerable to various problems, including drug use, which requires attention to these teenagers do not enter this world. The government is doing its part by distributing information leaflets and campaigns on the use of drugs, but usually these board not succeed by treating the youth as problematic and being a more traditional way can no longer attract attention and can be considered an inappropriate way for this public. On another side, young people have fascination for games. It is believed that an approach using electronic educational games can achieve greater success due to the attractive environment they offer. In studies conducted in young people, with common games and electronic games could be noted the importance of using this type of intervention. This work presents a proposal for development through a game with Augmented Reality as an aid strategy in information and prevention of drug use in young people and adolescents, a type of game where a technology was used to mix the real world with 3D images . The survey also conducted a metric for research within the school environment, which has the public necessary for the implementation of the game. Analyzing the results it can be concluded that the game featured potential for this community could make up a greater awareness than other approaches presented.

The way in which adolescents perceive themselves and interact with peers, teachers and caregivers could determine whether they would drink alcohol and smoke dagga or not. Without positive self-concept amongst adolescents and experiencing of positive communication with caregivers, it can be said, there is a likelihood of drinking alcohol and smoking of dagga by adolescents. A 52-item questionnaire was constructed on the basis of current international and South African research on the adolescents who drink alcohol and smoke dagga. The biographical data was used as independent variables in the questionnaire. These independent variables included questions on age, gender, grade and the person who takes care of adolescent. The questionnaire was completed by 443 adolescents in grade 9 and 11 from one secondary school in Soweto. Of this total, 48,1% were males (N=213) and 51,9% were females (N=230). A factor analysis of the questionnaire revealed two statistically significant constructs and they were termed “Experience of locus of control with respect to school” (Chronbach alpha of 0.900) and “Experience of communication with caregivers by adolescents (0.892). With respect to the bivariate analysis of the relationships between (1)the gender of adolescents (2)the age of adolescents and who is the caregiver to the adolescent and the (1)drinking of alcohol and the (2)smoking of dagga, the following was found: • adolescents who lived with stepparents are more inclined to drink alcohol than adolescents who lived with both mother and father, single parents and other. • a significantly higher proportion of males drink alcohol man females who drink alcohol. • a significantly higher proportion of older adolescents (17 years, 18 years and older) drink alcohol than younger adolescents (16 years, 15 years and younger). The impact of this research would indicate that adolescents with negative self-concept about themselves display a significantly greater inclination towards drinking alcohol and smoking of dagga. Also, adolescents who live with stepparents display a significantly more negative experience of drinking alcohol and smoking of dagga than adolescents who live with both mother and father, single parents and other. / Prof. C.P.H Myburgh

Substance abuse remains one of the critical challenges facing South Africa. Research studies conducted locally and internationally, reflect a sharp increase in the number of young people that are falling prey to substance abuse (with the age of onset decreasing rapidly). These rising statistics, as well as the guidelines for evidence based practice suggest that drug prevention interventions need to be tailored to the needs of specific recipients of the service. The aim of the present study was therefore to understand the needs of a specific group of adolescents from a designated community in the Northern Areas of Port Elizabeth. This community has been riddled by gang violence, high levels of unemployment, teenage pregnancies, school dropout and in particular, large numbers of adolescent drug users. The goal of the study was therefore to enhance an understanding of the risk and protective factors associated with substance abuse amongst adolescents from this specific neighbourhood in the Northern Areas of Port Elizabeth. The study was imbedded in a socio-cultural and systemic theoretical framework. A qualitative research approach was adopted, employing an exploratory, descriptive and contextual research design to address the primary research question. A purposive sampling method was used to recruit eight non users and a snowball sampling technique was used (with the assistance of two gatekeepers) to identify eight substance users from the identified neighbourhood in the Northern Areas. An in-depth, semi-structured individual interview was used as the method of data collection with each of the 16 research participants. The data was analysed according to the steps for qualitative data analysis, as proposed by Tesch (in Creswell, 1994:155). The trustworthiness was enhanced by employing the four criteria proposed by Guba (in Krefting, 1991:214-222). The findings of the study indicate that the dominant risk factors for substance use are located at a family and community level. These included the absence of family structure, poor parental discipline and supervision, the presence of parental substance abuse, neglect of children and family disharmony. At a community level the risk factors included: the prevalence of drug outlets, normalization of substance use in the community, prevalence of gangsterism as a way life and source of income and apathy of community members in protecting their community. Protective factors were mutually exclusive and additional protective factors were discussed at length in the report. The findings which point to the adoption of an integrated community based approach to effect meaningful drug prevention strategies for substance abuse amongst adolescents in the studied community, are disseminated here in the form of a written report and will be prepared for submission to a journal for publication.

Several studies showed adolescents living in temporary housing face multiple risks. The Floating Hospital (TFH), a non-profit organization serving homeless families in New York City, created the Camp Rise Up intervention as a six-day overnight camp to address these risks via a 14-lesson curriculum on the following topics: 1) communication; 2) self-esteem/body image; 3) anatomy; 4) alcohol and drugs; 5) puberty; 6) peer pressure; 7) pregnancy; 8) contraception; 9) gender and sexuality; 10) healthy relationships; 11) consent; 12) STIs/HIV; 13) media literacy; 14) managing emotions and conflict negotiation. Evaluation of Camp Rise Up compared pre-camp to post-camp mean scores for stage of change, self-efficacy, knowledge and social support for five behaviors of focus: saying “no” to sex, if pressured to have sex; talking about the need to use a condom every time, if you have sex; saying “no” to drugs, if pressured to use them; saying “no” to alcohol, if pressured to drink; and ending unhealthy relationships, if being abused. A secondary analysis of existing data collected by TFH on their August 2019 camp included a sample (n=24) that was 50.0% (n=11) Black, 36.4% (n= 8) Latinx, and 13.6% (n=3) mixed race with 13 girls (54.2%) and 11 boys (45.8%) with mean age of 13.26 (SD= 1.322, min=11, max=16). Results showed: a significant increase from pre-camp to post-camp for knowledge of how to say “no” to sex, if pressured (p=.002); self-rated knowledge for all 14 topics covered in the curriculum increased significantly from pre-lesson to post-lesson (p=.000); post-camp ratings for counselors, teachers, overall camp experience, and 14 lessons were all very good to excellent; and, majority of participants would recommend the camp to others, diffusing the innovation of Camp Rise Up. Emergent themes from qualitative data analysis were: camp was a fun positive experience, they made new friends, learned new things, and tried new things beyond their comfort zone, Findings may serve as preliminary studies data to justify grant funding to support a camp of longer duration with a larger sample size and long-term follow-up. The curriculum may find application in meeting needs of this vulnerable population for vital health education.

A research report submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the award of Masters of Arts in Demography and Population Studies, 2017 / Background: Risky behaviours among adolescents are notably the most important factors contributing to negative health outcomes of this population group. Adolescents in South Africa are at risk of the HIV infection, unintended pregnancies, unintentional injuries (motor vehicle accidents) and substance and drug abuse. South Africa is regarded as one of the countries with nearly half adolescents living with HIV, as a result of unprotected sex. It is also regarded as one of the countries with motor accidents cases and as a result of reckless driving and substance use. To understand this, there is substantial research on the demographic and socio-demographic determinants of risky behaviour amongst adolescents but little research on the household and community factors. The main aim of this study is to determine the contextual determinants of adolescent risky behaviours in South Africa. Method: This study used data from the South African Youth Life Style Survey of 2008. The study sample size is 3336 adolescents aged 12 to 19 across all nine provinces in South Africa. Risky behaviours are organized using an ecological framework into individual, household, and community levels. Binary- multilevel logistic regression was employed to analyze the data. Results: The results indicated that age, sex, education, race, living arrangements, number of income earners, were significant, however, the relationship between risky behaviours and community level variables were negatively significant. . 3336 adolescents participated in the study, 934 (28.0%) had sexual intercourse and 158 (4.74%) had two or more sexual partners, and 234 (7.01) did not use a condom during their last sex. In terms of substance use, 34.24 % ever used alcohol and about 24.45% ever been a passenger with a driver under the influence. Adolescents who were living with their grandparents (OR=1.07), living in a household with seven or more members (OR=1.06), while residing in had a higher likelihood of engaging in risky behaviours. Findings demonstrated that community level factors were not associated with reports of risky behaviour among adolescents but were influential in shaping the risky behaviour of adolescents. Conclusion: Firstly, results from this research will provide a better understanding of the contextual factors that relate to risky behaviours. Secondly, results from this research will help inform polices such as the National Youth Policy in reducing risky behaviours. Lastly, interventions aimed at reducing risky behaviours among adolescents in South Africa should not only focus on individual level but also on the household and community engagement. / XL2018

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-05-09T13:39:22Z No. of bitstreams: 1 Andreia Maria da Silva.pdf: 1564506 bytes, checksum: 862f31a0de04bfd10c07aa71fd46034a (MD5) / Made available in DSpace on 2018-05-09T13:39:23Z (GMT). No. of bitstreams: 1 Andreia Maria da Silva.pdf: 1564506 bytes, checksum: 862f31a0de04bfd10c07aa71fd46034a (MD5) Previous issue date: 2018-03-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The trajectory of mental health in the Brazilian society is marked by important transformations resulting from the strengthening of the Unified Health System, the anti-asylum Struggle and the Psychiatric Reform. However, the recognition of the demand of the adolescent public with questions related to the use and abuse of drugs is still necessary in order to construct actions based on a logic of care in the perspective of Harm Reduction and Integral Protection. Such demand is complex and suffers directly the impact of the National Drug Policy, where we observe a strengthening of the illegal commerce of these substances and the non-control of the consumption of the population in general. The objective of this research was to characterize the course of care of adolescents with a history of abusive use of alcohol and other drugs that are followed in a CAPS IJ II and a CAPS AD III in the city of São Paulo. The method consisted of a quantitative and qualitative analysis of the medical records of adolescents who used the service for the first time in 2016, a case study and information brought by the researcher, who is a worker in one of the CAPS. The discussions were built based on the theoretical-methodological reference of Socio-Historical Psychology, making possible a critical evaluation of the social reality in which these questions are immersed. Given this scenario, we show that the look at the complexity of actions, permeated by adolescents' uniqueness of life, their emotional care network, the characteristics of the territory and the service, should contribute to overcoming the logic centred on health services. The need to continue investing in creative care constructs, through Harm Reduction and other tools consistent with SUS principles, Psychiatric Reform and Integral Protection to Adolescents, emerges from the analysis as a possibility of psychosocial intervention. Such a perspective aims to extend the care beyond the practices centered in the CAPS, at the same time that bets on the possibilities of this service / A trajetória da saúde mental na sociedade brasileira é marcada por importantes transformações decorrentes do fortalecimento do Sistema Único de Saúde, da Luta Antimanicomial e da Reforma Psiquiátrica. Entretanto, o reconhecimento da demanda do público adolescente com questões relacionadas ao uso e abuso de drogas, ainda se faz necessário no sentido da construção de ações pautadas em uma lógica de cuidado na perspectiva da Redução de Danos e da Proteção Integral. Tal demanda é complexa e sofre diretamente o impacto da Política Nacional de Drogas, onde observamos um fortalecimento do comércio clandestino destas substâncias e o não controle do consumo da população em geral. Inserida neste cenário, esta pesquisa teve como objetivo caracterizar o percurso de atendimento de adolescentes com histórico de uso abusivo de álcool e outras drogas que são acompanhados em um CAPS IJ II e um CAPS AD III no município de São Paulo. O método foi constituído de uma análise quantitativa e qualitativa dos prontuários dos adolescentes que recorreram ao serviço pela primeira vez no ano de 2016, um estudo de caso e informações trazidas pela pesquisadora, que é trabalhadora em um dos CAPS. As discussões foram construídas a partir da referência teórico-metodológica da Psicologia Sócio-Histórica, possibilitando uma avaliação crítica sobre a realidade social na qual estão imersas estas questões. Diante deste cenário, evidenciamos que o olhar para a complexidade das ações, permeada pela singularidade de vida do adolescente, da sua rede afetiva de cuidado, das características do território e do serviço, deve contribuir para superar a lógica centrada nos serviços de saúde. Emerge da análise realizada a necessidade de continuar investindo em construções criativas de cuidado, por intermédio da Redução de Danos e outras ferramentas coerentes com os princípios do SUS, da Reforma Psiquiátrica e da Proteção Integral ao Adolescente, como possibilidade de intervenção psicossocial. Tal perspectiva visa ampliar o cuidado para além das práticas centradas no CAPS, ao mesmo tempo em que aposta nas possibilidades desse serviço

Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished

How adolescents spend their time is a crucial predictor of their engagement in delinquency. Activities with peers away from direct supervision of adults are of concern as more opportunities and motivation to use marijuana exist in such situations. However, adolescents may vary in their propensity to use marijuana when faced the opportunity. Especially adolescents living with a single parent may have a higher propensity compared to those from two-parent households to use marijuana due to reduced parental monitoring and increased peer attachment. This thesis investigates the moderating effects of family structure on the routine leisure activities and adolescent marijuana use relationship, using data from Monitoring the Future Study 2007, 12th Grade Survey. The results provide partial support for the moderating effects.

The current research analyzed the relationship between methamphetamine use, cocaine use and marijuana use within the last 12 months and crime committed within the last 12 months. Crime is defined as drug sales, property and violent crime. The research design is a quantitative approach which uses secondary data analysis of the National Longitudinal Survey of Adolescent Health (Add Health) to provide evidence toward the research question; does illegal drug use increase the risk of committing a crime?The public access, 2008 Wave III data results of this nationally representative sample of adolescents in grades 7 through 12 in the US in the 1994-95 school year was used for analysis. Methamphetamine use was associated with an increased risk of committing all crime, only until cocaine use was controlled for. Once cocaine use was controlled for, methamphetamine use became non-significant. Cocaine use and marijuana use were significant and associated with an increased use of committing a crime.

Adolescence is a sensitive developmental period encompassing neural maturation that is critical for an individual’s behavioral transition into adulthood. Due to widespread physiological changes attributed to this period, adolescents are also vulnerable to the initiation of risky behaviors, such as drug experimentation and use, as well as the emergence of various neuropsychiatric disorders. The mesocorticolimbic dopamine (DA) system in the brain undergoes a transient peak in activity and continues to mature during adolescence, potentially mediating adolescent hypersensitivity to social, appetitive, and drug-associated rewards. Simultaneously, the serotonin (5-HT) system exerts its influence on the dopamine system throughout adolescence, a process vital for proper impulse control and emotional regulation in adulthood. Substance use disorders (SUDs) are multifaceted and are comprised of diverse maladaptive behaviors that promote compulsive drug seeking, including loss of control and the propensity to engage in drug use irrespective of personal risks and/or consequences. Drug addiction and substance use have a large negative impact globally both economically and with regards to public health outcomes, representing approximately 1.3% of the global burden of disease. Furthermore, dopamine reward pathways are heavily impacted by drug use, particularly with respect to stimulants, and the level of drug-induced dopamine release in the ventral striatum can be correlated with a drug’s perceived “high.” Certain experiences and adverse behaviors linked to refinement of monoamine connectivity in the brain during adolescence, such as heightened stress and sensation seeking, may predispose individuals for developing SUDs in adulthood. However, how drug reward sensitivity and associated activity of the dopamine system is altered in adulthood as a consequence of interfering with monoamine neurodevelopment during adolescence has not been clarified. To this end, I aim to understand how imbalanced monoamine development during adolescence contributes to stimulant-mediated behaviors in adulthood, specifically contextual reward associations, in relation to in vivo activity of the dopamine reward system. I introduce a sensitive peri-adolescent (PA) period in mice, during which blockade of the serotonin transporter (SERT) via fluoxetine administration during postnatal (P) days 22-41 leads to inhibited adult aggression and locomotor response to stimulants. Conversely, I describe a more refined PA (P32-41) period during which systemic dopamine transporter (DAT) blockade via GBR12909 administration leads to enhanced aggression and stimulant-induced locomotor activity in adulthood. Utilizing these behaviorally opposing models characterized in our lab, I describe the diverging effects of systemic DAT and SERT blockade from P32-41 on cocaine-induced locomotor response as well as cocaine-mediated contextual preference. I administered cocaine intraperitoneally (i.p.) at doses of 5 and 10 mg/kg, applying the open field test and cocaine conditioned place preference (CPP) paradigm to assess stimulant-induced locomotor response and environmental reward associations, respectively. Potentiation of serotonergic tone during P32-41 via fluoxetine administration leads to decreased cocaine-induced locomotor response and a lack of preference for a cocaine-associated context in adulthood at a dose of 10 mg/kg, compared to controls and PA GBR treated subjects. Conversely, potentiation of dopaminergic tone by administering GBR12909 during P32-41 is associated with enhanced cocaine-induced locomotor reactivity at 10 mg/kg and greater contextual preference at lower doses of cocaine (5 mg/kg), in comparison to PA fluoxetine treated mice and controls. To understand how in vivo VTA dopamine population activity is altered in both PA models during cocaine-associated behaviors in adulthood, I performed cocaine CPP while recording calcium signals in VTA dopamine neurons using fiber photometry in freely behaving subjects. Importantly, I utilize these recordings as a proxy for measuring changes in VTA dopamine activity as the subjects engage with a cocaine-paired environment. I found that PA DAT blockade was associated with greater baseline VTA dopamine activity in adulthood compared to controls, as well as heightened VTA dopamine activity while the subjects were in a cocaine-paired context during selected portions of the behavioral task compared to control subjects. Additionally, we found a significant positive correlation between the magnitude of preference for a cocaine-associated context and the frequency of VTA dopamine calcium signals recorded while the subject is engaged with a cocaine-paired environment. Adult mice following PA DAT blockade displayed a greater frequency of recorded VTA dopamine calcium signals while in a cocaine-paired environment compared to PA fluoxetine treated mice. Supporting our correlational analysis, I detected a decreased preference for a cocaine-paired context in PA fluoxetine treated subjects compared to both controls and PA GBR12909 mice, when using a dose of cocaine in between the previous concentrations tested (7.5 mg/kg). Interestingly, PA fluoxetine treated subjects showed transition-dependent differences in VTA dopamine calcium activity during the final five-minute portion of our behavioral task, displaying less activity shortly post-entry into the cocaine-paired environment compared to pre-entry. In congruence, PA fluoxetine subjects showed enhanced VTA dopamine calcium activity on the saline-paired side shortly post-entry compared to pre-entry. In collaboration with the Sulzer Lab, we also probed the effects of both PA manipulations on electrically evoked dopamine release in the ventral striatum of adult anesthetized mice using fast-scan cyclic voltammetry. Electrical stimulation was targeted to the midbrain and evoked dopamine release was recorded in the ventral striatum both at baseline and in response to cocaine injection, using the same 7.5 mg/kg dose applied in the calcium imaging study. Overall, we found a significant increase in dopamine release at baseline in the ventral striatum of adult PA GBR12909 treated subjects compared to both PA fluoxetine subjects and controls. Moreover, we found significantly greater cocaine-induced dopamine release in our PA GBR12909 mice compared to controls in adulthood. These findings are consistent with the imaging and behavioral data, highlighting the persistence of an elevated dopaminergic phenotype due to systemic PA DAT blockade. Conversely, systemic PA SERT blockade leads to behaviorally opposing effects and generally lower VTA DA activity dynamics in comparison to PA GBR12909 treated subjects in adulthood. The unique, combinatorial approach applied in this dissertation work further our knowledge of how sensitive developmental periods influence the emergence of complex behaviors in adulthood, which is vital to improving treatment approaches for neuropsychiatric disorders.