Book Summary: Places school superintendents within the ongoing dialogue about the future of public education, from which they have been largely absent. Includes practical and theoretical assessments of how superintendents and administrators can move into the future.

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Alcohol dependence is a major public health concern. Despite the FDA’s approval of multiple anti-relapse drugs, relapse rates remain unacceptably high. Furthermore, cognitive deficits among chronic drinkers are evident and are suggested to contribute to relapse risk. Current evidence suggests that several critical features of alcoholism and alcohol-associated neurodegeneration are mechanistically linked to glutamatergic actions; specifically, they appear positively affected by glutamatergic inhibition, particularly inhibition via polyamine modulation of a subpopulation of n-methyl-d-aspartate receptors. The current project was designed to evaluate the performance of two putative polyamine modulators (JR-220 and CP-101,606) in a variety of screens designed to identify the potential to reduce withdrawal severity, neurotoxicity and relapse risk. Screens included a complex organotypic screen designed to assess neuroprotective potential (Experiment 1), a simple behavioral screen designed to assess withdrawal severity (Experiment 2) as well as several more complex behavioral screens designed to examine cue-conditioning during withdrawal (Experiment 3), relapse behavior (Experiment 4), stress-associated consumption (Experiment 5) and binge-like consumption (Experiment 6). An additional open field experiment (Experiment 7) was conducted in order to address interpretational issues concerning activity in Experiments 2-6. Finally, as a first step in moving beyond simple screening, we expanded our binge screen to adhere more closely to an established, validated model of binge consumption (Experiment 8). While some interpretational issues were noted, taken together, the results from these experiments provide strong evidence for both drugs as potential pharmacotherapies for alcoholism and further implicate polyamines and NR2B subunits as critical mechanisms in ETOH consumption and withdrawal.

Stress is associated with poor mental health, specifically anxiety and depression, and stress and mental health problems are predictors of substance dependence and relapse. Social characteristics, such as racial/ethnic minority status, female gender, and low socioeconomic status, are often associated with increased psychological distress and substance use disorders. Pearlin’s social stress theory postulates that this association is due to increased exposure to stress and subsequent experiences of distress related to social disadvantage and decreased access to resources for coping with stress. This project uses a social stress theoretical perspective to examine predictors of substance use after treatment entry and follow-up addiction severity in a large sample of Kentucky substance abuse treatment participants (N = 1123). A conceptual model is tested to determine if social characteristics along with psychological distress, perceived stress, and economic hardship are predictors of substance use and follow-up addiction severity. In addition, since recovery support, efficacy, and self-control have been previously identified as mediators in the stress and relapse processes these factors were included as mediators in the model tested. The conceptual model was tested with three outcome variables, substance use between baseline and 12-month follow-up, follow-up alcohol addiction severity, and follow-up drug addiction severity. Bivariate and multivariate analyses, including logistic regression and ordinary least squares regression, were used to test conceptual models with the full sample and also with a subsample with baseline substance use indicative of potential substance dependence. Findings indicated that significance of predictors varied depending on outcome variable, although recovery support, efficacy, and self-control were significant predictors of all three dependent variables. Findings for each outcome variable are discussed, as well as limitations of the present study, implications for social work practice, and implications for future research.

Selective attention towards alcohol-related cues (i.e., “attentional bias”) is thought to reflect increased incentive motivational value of alcohol and alcohol cues acquired through a history of heavy alcohol use, and as such attentional bias is considered to be a clinically relevant factor contributing to alcohol use disorders. This dissertation consists of two studies that investigated specific mechanisms through which attentional bias might serve to promote alcohol abuse. Study 1 compared magnitude of attentional bias in heavy (n = 20) and light (n = 20) drinkers following placebo and two doses of alcohol (0.45 g/kg and 0.65 g/kg). Heavy drinkers displayed significantly greater attentional bias than did moderate drinkers following placebo. However, heavy drinkers displayed a dose-dependent decrease in response to alcohol. Individual differences in attentional bias under placebo were associated with both self-reported and laboratory alcohol consumption, yet bias following alcohol administration did not predict either measure of consumption. These findings suggest that attentional bias is strongest before a drinking episode begins, and as such might be most influential in terms of initiation of alcohol consumption. Study 2 addressed theoretical accounts regarding potential reciprocal interactions between attentional bias and inhibitory control that might promote excessive alcohol consumption. Fifty drinkers performed a measure of attentional bias and a novel task that measures the degree to which alcohol-related stimuli can increase behavioral activation and reduce the ability to inhibit inappropriate responses. As hypothesized, inhibitory failures were significantly greater following alcohol images compared to neutral images. Further, heightened attentional bias was associated with greater response activation following alcohol images. These findings suggest that alcohol stimuli serve to disrupt mechanisms of behavioral control, and that heightened attentional bias is associated with greater disruption of control mechanisms following alcohol images. Taken together, these studies provide strong evidence of an association between attentional bias in sober individuals and alcohol consumption, suggesting a pronounced role of attentional bias in initiation of consumption. Further, findings show that attention to alcohol cues can serve to disrupt mechanisms of inhibitory control that might be necessary to regulate drinking behavior, suggesting a potential means through which attentional bias might promote consumption.